How Much Water Should You Drink?

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An increased intake of pure water will enhance virtually every aspect of better health.

For years we have been told that we should drink a "minimum" of 8 eight ounce glasses of water each day. If the goal is to maintain a minimum level of health this eight glass rule is correct. If the goal is to achieve an enhanced level of health, we must consume some level of water above our minimum daily needs.

The world we live in today is much different than it was 70 years ago when this rule was first published in medical journals. Each day we are exposed to a multitude of toxic chemicals and environmental pollutants that didn't exist 70 years ago. We live more hectic and stressful lifestyles. We consume processed and preserved foods. All these factors require an increased intake of healthy water to offset the damage.

Water is the body's only way to flush out toxins and wastes.

So, How Much?

How much water should you drink each day? — a simple question with no easy answers. Studies have produced varying recommendations over the years, but in truth, your water needs depend on many factors, including your health, how active you are and where you live.

Though no single formula fits everyone, knowing more about your body's need for fluids will help you estimate how much water to drink each day

How much water do you need?

Every day you lose water through your breath, perspiration, urine and bowel movements. For your body to function properly, you must replenish its water supply by consuming beverages and foods that contain water.

A couple of approaches attempt to approximate water needs for the average, healthy adult living in a temperate climate.

• Replacement approach. The average urine output for adults is 1.5 liters a day. You lose close to an additional liter of water a day through breathing, sweating and bowel movements. Food usually accounts for 20 percent of your total fluid intake, so if you consume 2 liters of water or other beverages a day (a little more than 8 cups) along with your normal diet, you will typically replace the lost fluids.
• Dietary recommendations. The Institute of Medicine advises that men consume roughly 3.0 liters (about 13 cups) of total beverages a day and women consume 2.2 liters (about 9 cups) of total beverages a day.

Even apart from the above approaches, it is generally the case that if you drink enough fluid so that you rarely feel thirsty and produce between one and two liters of colorless or slightly yellow urine a day, your fluid intake is probably adequate.

Factors that influence water needs

You may need to modify your total fluid intake depending on how active you are, the climate you live in, your health status, and if you're pregnant or breast-feeding.

• Exercise. The more you exercise, the more fluid you'll need to keep your body hydrated. An extra 1 or 2 cups of water should suffice for short bouts of exercise, but intense exercise lasting more than an hour (for example, running a marathon) requires additional fluid. How much additional fluid is needed depends on how much you sweat during the exercise, but 13 to26 ounces (or about 2 to 3 cups) an hour will generally be adequate, unless the weather is exceptionally warm.
• During long bouts of intense exercise, it's best to use a sports drink that contains sodium, as this will help replace sodium lost in sweat and reduce the chances of developing hyponatremia, which can be life-threatening. Fluid also should be replaced after exercise. Drinking 16 ounces of fluid per pound of body weight lost during exercise is recommended.
• Environment. Hot or humid weather can make you sweat and requires additional intake of fluid. Heated indoor air also can cause your skin to lose moisture during wintertime. Further, altitudes greater than 2,500 meters (8,200 feet) may trigger increased urination and more rapid breathing, which use up more of your fluid reserves.
  
• Illnesses or health conditions. Signs of illnesses, such as fever, vomiting and diarrhea, cause your body to lose additional fluids. In these cases you should drink more water and may even need oral rehydration solutions, such as Gatorade, Powerade or Ceralyte. Certain conditions, including bladder infections or urinary tract stones, also require increased water intake. On the other hand, certain conditions such as heart failure and some types of kidney, liver and adrenal diseases may impair excretion of water and even require that you limit your fluid intake.
  
• Pregnancy or breast-feeding. Women who are expecting or breast-feeding need additional fluids to stay hydrated. Large amounts of fluid are lost especially when nursing. The Institute of Medicine recommends that pregnant women drink 2.4 liters (about 10 cups) of fluids daily and women who breast-feed consume 3.0 liters (about 12.5 cups) of fluids a day.

 

Beyond the tap: Other sources of water

Although it's a great idea to keep water within reach at all times, you don't need to rely only on what you drink to satisfy your fluid needs. What you eat also provides a significant portion of your fluid needs. On average, food provides about 20 percent of total water intake, while the remaining 80 percent comes from water and beverages of all kinds.

For example, many fruits and vegetables — such as watermelon and cucumbers — are nearly 100 percent water by weight. Beverages such as milk and juice are also comprised mostly of water. Even beer, wine and caffeinated beverages such as coffee, tea or soda can contribute, but these should not be a major portion of your daily total fluid intake. Water is one of your best bets because it's calorie-free, inexpensive and readily available.

Dehydration and complications

Failing to take in more water than your body uses can lead to dehydration. Even mild dehydration — as little as a 1 percent to 2 percent loss of your body weight — can sap your energy and make you tired. Common causes of dehydration include strenuous activity, excessive sweating, vomiting and diarrhea.

Signs and symptoms of dehydration include:

• Mild to excessive thirst
• Fatigue
• Headache
• Dry mouth
• Little or no urination
• Muscle weakness
• Dizziness
• Lightheadedness

Mild dehydration rarely results in complications — as long as the fluid is replaced quickly — but more-severe cases can be life-threatening, especially in the very young and the elderly. In extreme situations, fluids or electrolytes may need to be delivered intravenously.

Staying safely hydrated

It's generally not a good idea to use thirst alone as a guide for when to drink. By the time one becomes thirsty, it is possible to already be slightly dehydrated. Further, be aware that as you get older your body is less able to sense dehydration and send your brain signals of thirst. Excessive thirst and increased urination can be signs of a more serious medical condition. Talk to your doctor if you experience either.

To ward off dehydration and make sure your body has the fluids it needs, make water your beverage of choice. Nearly every healthy adult can consider the following:

• Drink a glass of water with each meal and between each meal.
• Hydrate before, during and after exercise.
• Substitute sparkling water for alcoholic drinks at social gatherings.

If you drink water from a bottle, thoroughly clean or replace the bottle often. Refill only bottles that are designed for reuse.

Though uncommon, it is possible to drink too much water. When your kidneys are unable to excrete the excess water, the electrolyte (mineral) content of the blood is diluted, resulting in a condition called hyponatremia (low sodium levels in the blood). Endurance athletes — such as marathon runners — who drink large amounts of water are at higher risk of hyponatremia. In general, though, drinking too much water is rare in healthy adults who consume an average American diet.

If you're concerned about your fluid intake, check with your doctor or a registered dietitian. He or she can help you determine the amount of water that's best for you.

May 23, 2006

From MayoClinic.com
Special to CNN.com

Additional Articles

The Wonders of Water

By Kathleen M. Zelman, MPH

WebMD FeatureReviewed by Michael W. Smith, MDWater is one of the most basic elements of life but figuring out how much we ought to drink hasn't always been so simple.

Most of us grew up thinking we needed to drink eight glasses of water each day, in addition to any other drinks we might choose. But the latest recommendations say that we no longer need to worry about drinking specific amounts of water. Instead, we can simply satisfy our thirst with any beverage. As it turns out, there really was no scientific evidence for the 64-ounce daily recommendation that was based on survey data of usual consumption.

Of course, water -- clean, refreshing, and calorie-free -- is an ideal beverage of choice but studies have shown that you can be just as hydrated with coffee, soft drinks, or even beer. And some folks swear by its weight loss powers, including Mireille Guiliano, author of the best-selling book French Women Don't Get Fat.

To help make the facts about water crystal clear, WebMD asked experts for the skinny on just how much water we need, and whether drinking water can really help keep those extra calories at bay.

The New Fluid Guidelines

A 2002 study published in the American Journal of Physiology questioned the old recommendation of 8 ounces of water, eight times a day. After a thorough review, researcher Heinz Valtin concluded there was inadequate evidence that healthy adults -- living in temperate climates and not engaged in rigorous activities -- need large amounts of water.

For normal, healthy adults, Valtin recommended simply drinking when thirsty. And he reported that even caffeinated drinks can count toward satisfying our fluid requirements.

In February 2004, the Institute of Medicine (IOM) issued new recommendations that agree with Valtin's findings. The new guidelines remove the eight-glasses-a-day recommendation, and say healthy adults may use thirst to determine their fluid needs. Exceptions to this rule include anyone with a medical condition requiring fluid control; athletes; and people taking part in prolonged physical activities or whose living conditions are extreme.

How Much Is Enough?

The IOM report did not specify requirements for water but made general fluid intake recommendations based on survey data of 91 ounces (that's 11-plus cups a day) for women and 125 ounces (15-plus cups a day) for men. Remember, these guidelines are for total fluid intake, including fluid from all food and beverages.

Approximately 80% of our water intake comes from drinking water and other beverages, and the other 20% comes from food. Assuming these percentages are accurate for most of us, the recommended amount of beverages, including water, would be approximately 9 cups for women and 12.5 cups for men.

http://www.webmd.com/diet/guide/wonders-of-water

Water is vital, but how much should you drink?

By Linda Saether

CNN

ATLANTA, Georgia (CNN) -- Very few people question the importance of water in a healthy diet, but lately the needed quantity has been called into question.

The conventional wisdom of eight, 8-ounce glasses a day has been tossed aside, leaving one to wonder what food group myths might topple next.

The apple-a-day thing? The medicinal aspects of Mom's chicken soup?

"There has been research out there for a while that the eight, 8-ounce glasses a day has no research to back up it at all," Food Network dietitian Ellie Krieger told CNN.

"People just latched onto this number because it was really easy to remember. And I think people feel that if they're not drinking eight glasses of water, then they are not doing well for their bodies, and that is not necessarily true. "

But what is true is that our bodies are made up of a good deal of water. It makes up on average 60 percent of our body weight. And it seems to enable our basic functions.

Not only does it moisten tissues -- such as those around the mouth, eyes and nose -- it also cushions our joints, regulates our body temperature, helps our bodies get nutrients, and flushes out waste products.

Whew, talk about multitasking!

But if the rule of eight is out, how do we know we're getting enough to keep us flowing?

"The general guideline is to pay attention to your thirst," Krieger said. "Your thirst is actually a good guide of how well hydrated you are and if you drink according to your thirst, you will stay hydrated."

She also had more good news: Liquids other than water count.

"So if you drink coffee or tea, even if it's caffeinated, it counts towards hydration," she said. "So do fruit juices and milk and soups and things like that."

Less caffeine -- which can dehydrate -- is better than more, in the fluid count.

Krieger says a good rule of thumb for moderately active women in temperate climates is that they need about nine 8-ounce glasses of fluids a day.

"Ideally," she adds, "you want at least half of that to be water."

Some conditions ramp up our water needs.

Obviously temperature is one thing, whether from a seasonal shift or a thermostat redial. The hotter your surroundings, the more you will sweat out your inner water supply and the more fluids you will need to consume. Turning up your own inner temperature through exercise will also increase the need to refuel the fluids.

Experts at the Mayo Clinic suggest that water is fine after short exercise sessions but recommend drinking a sports drink during longer, more intense workouts. Those drinks contain sodium and will reduce your risk of developing hyponatremia, a rare yet possibly life-threatening condition that occurs when you drink too much water.

It happens when the kidneys can't flush out the excess water, making the electrolyte content in the blood diluted. That leads to low sodium levels in the blood. This is very uncommon and mainly seen in endurance athletes, such as marathon runners.

Illness, pregnancy and breast feeding are also factors that will increase our bodies' need for fluids.

And don't forget, those fluids can also be found in food.

"It is a very good idea to eat water-rich food like fruits and vegetables and dairy and lean protein even," says Krieger. "Those are foods that are great for your body that are going to keep lean and healthy and keep hydrated."

So the quest for hydration is pretty easy to pursue, and Krieger gives hope to those of us who don't beat a constant path to the water cooler.

"The people who are walking around with huge bottles of water all day long probably don't need to be doing that," she said. "They are probably not hurting themselves, but it's probably not helping them as much as they think it is, and it's a psychological crutch."

Of course as psychological crutches go, how bad can a hefty bottle of water really be? Probably no couch time needed for that!

http://www.cnn.com/2008/HEALTH/05/16/hfh.water.guidelines/index.html