Nutrition and Water

Give your Body Water

The body is about two-thirds water. Just that fact alone tends to suggest that water is an important component in health and well-being. However, while water plays a multitude of roles in the body and is essential to life, it very rarely gets the attention it deserves. I am convinced that drinking more water is one of the simplest, cheapest and most effective ways of improving health and vitality. In this chapter, we’ll be exploring the benefits that water has to offer, how much water we need each day, and what types of water are the best for our health.

What, precisely, does water do in the body?

Every second of every day, the body partakes in countless reactions and processes that are integral to life. Nerve impulses from the brain stimulate movement in the body and control unconscious actions such as the speed at which the heart beats. Acid and digestive enzymes are secreted into the intestinal tract to break down food ready for absorption. Hormones are secreted in various organs around the body and travel in the blood stream to tissues where they have their effects. The circulation pumps blood around the system delivering oxygen and nutrients to the body’s cells as it does this. The blood is filtered in the kidneys, allowing impurities to be eliminated from the body. The one thing that these and all other processes in the body have in common is water.

Water is absolutely essential for the maintenance of optimum health and efficiency in all the body’s systems. Nerves simply do not transmit their messages efficiently if they are not properly hydrated. If the circulation is lacking in volume, it simply does not deliver oxygen, nutrients and other essential substances to the tissues as well as it might. Poor circulation to the kidneys means that toxins are less readily removed from the system.

Dehydration jeopardises all of the most basic processes and systems in the body.

The short-term effects of dehydration

It doesn’t take much fluid loss from the body for it to impact on our well-being. There is evidence that as little as 1% dehydration (700 mls of fluid for a 70 kg adult) can impair the body’s physiological and biochemical processes. In the short term, even mild dehydration can provoke problems with a diverse array of symptoms including headache, fatigue, loss of appetite, heat intolerance, light-headedness and dry mouth and eyes.

In the long term, however, dehydration can increase the risk of significant health problems including kidney stones and cancer.

Long term effects of dehydration

Dehydration generally causes the urine to be more concentrated. There is a theory that concentrated urine is more likely to lead to the development of kidney or bladder stones (urinary calculi). Research shows that kidney stones are more common in populations where urine volume is low (1-9). Not only this, but the research has also shown that increasing urine volume to about 2 – 2 ½ litres each day reduces the risk of kidney stones (1,4,5,7). Anyone wanting to protect themselves from kidney stones would therefore ensure a good fluid intake, and this is particularly important for individuals who have a history of this condition.

There is good evidence that a reduced intake of fluid can increase the risk of certain cancers. One study found an increased risk of cancers of the kidney, bladder, prostate and testes in individuals who consumed relatively low levels of fluid (10). Other research has found that increasing fluid intake seems to reduce the risk of cancer of the bladder (11). More research has found a link between water consumption and cancer of the colon. One study found that women consuming five or more glasses of water per day had about half the risk of developing cancer of the colon compared to women consuming two or fewer glasses of water per day (12). There is even evidence that water can protect against breast cancer. One study found that water consumption was associated with about an 80% reduction in risk of breast cancer in women after the time of menopause. Risk for pre-menopausal women was reduced by a third (13).
Cancer is a condition which is rapidly becoming more common in the Western world. It seems incredible that doing something as simple as drinking more water might help significantly reduce our risk of this condition. Good hydration is likely to dilute and speed the elimination of toxic, ‘cancer-inducing’ substances within the body. Dehydration may also impair the activity of key enzymes involved in the regulation of important detoxification and immune-system related processes. Quite how water reduces cancer risk is not known for sure, but the evidence that it does is there!

How much water do we need?

Water is clearly fundamental to health, the question is, how much do we need? Water in the body is in a state of constant renewal. Water is lost from the body via the urine, faeces, breath and sweat. Each day an adult loses the equivalent of about 4% of body weight in water. For a 70 kg person this equates to about 2,500 – 3,000 mls (2½ – 3 litres) of water. Clearly, to prevent dehydration, this quantity of fluid must be replenished in the body.

Water is essentially obtained by eating and drinking. Our diet will provide us about 1,000 mls of fluid per day. The rest has to come from drinks. This means, that as a minimum, we need to consume between 1,500 and 2,000 litres of water per day. This rough approximation can be fine-tuned according to weight. For average day-to-day needs, we should aim to consume about 30 mls of water for each kg of our body weight (this equates to abut ½ ounce of water for each pound of body weight). A 70 kg adult should drink just over litres (30 X 70 = 2100 mls = 2.1 litres). A 100 kg adult would need 3 litres per day as a minimum requirement.

How do we know if we are getting enough?

Some people use thirst as a sign that they need to drink more. However, it does seem that by the time we’re thirsty, the body is about 1 – 2% dehydrated (14, 15). Bearing in mind that at 1% dehydration we may already be feeling the effects, it seems as though thirst is not to be relied upon to tell us when it’s time to drink.
The degree of the body’s hydration can be gauged by measuring the concentration of the blood or urine in the laboratory. Clearly, this is not practical for day-to-day use. Fortunately, a simple and cost-free method for gauging hydrations does exist; it appears that we can assess our state of hydration quite simply and accurately from the colour of our urine (16). Essentially, the paler in colour our urine, the better our state of hydration. Our aim is to keep our urine colour very pale yellow or pale yellow throughout the day. If our urine colour strays into darker tones, particularly if this is accompanied by a pungent smell, then we know it’s time to step up our water intake.

Does it have to be water?

Now we know why we need water, and have a pretty good idea of how much we need too. Does it really need to be water, though, or will other types of fluid do?
Let’s have a look at some alternative drinks and their effects on hydration and health. Coffee and tea and some soft drinks contain caffeine. Caffeine is what is known as a ‘diuretic’. This means it stimulates the production of urine, dehydrating the body in the process. Another substance which has a diuretic effect is alcohol. Both caffeine and alcohol containing beverages tend to induce toxicity in the body (more about this in chapter 3). So, in summary, caffeine and alcohol contribute to the body’s toxicity, but also reduce the body’s capacity to eliminate those toxins. Not ideal.
Clearly, caffeinated and alcohol containing drinks cannot be substituted for water. In fact, for each caffeinated or alcoholic drink, it makes sense to consume a glass of water on top of the normal recommended amount. This helps to dilute and eliminate toxicity in from the body, and obviously also helps to keep the body hydrated. The other thing about balancing caffeinated or alcoholic drinks with water is that it generally leads to a reduction in the consumption of these drinks anyway (there’s only so much we can drink, after all!).
Perhaps decaffeinated drinks are better? Because decaffeinated drinks have little or no caffeine, they tend not to be diuretic in nature, and therefore are better than their caffeinated versions in terms of body hydration. However, it is interesting to note that in some studies, water, and only water, seems to be associated with health giving properties. For instance, in the study mentioned above which found increased fluid consumption reduced the risk of colon cancer in women, this association was only true for water: not even fruit juice appeared to have a protective effect.

Sugar-laden soft drinks should generally be avoided. Not only can they upset blood sugar control, but they may also suppress the immune system, reduce levels of ‘healthy’ HDL cholesterol, and increase levels of uric acid levels in the body (which may increase the risk of gout). Sugared soft drinks have also been found to be linked to childhood obesity (15). One study found that for each additional can or glass of sugar sweetened soft drink consumed each day, risk of obesity rose 60%. Perhaps ‘diet’ drinks are a viable alternative. It turns out that artificial sweeteners are not without hazards of their own. These are discussed in chapter 4.
There really is no getting away from the fact that there is no better fluid than water. Don’t forget, for pretty much all of our evolution, we drank nothing but water. While these days there is a bewildering array of beverages which are readily available and sometimes very enticing. Unfortunately, from a health perspective it’s difficult to make a case for any of them.

What form of water?

There are three main forms of water – tap, distilled and mineral. Let’s look at each of these and discuss their pros and cons in turn.

Tap water

A common theme in nutrition is that processed foods should be generally avoided. What about processed water? After all, that’s what tap water is. Not only that, but water in some countries is not processed just once, but again and again. Many of us are basically drinking sanitized water that comes from dishwashers, washing machines, baths and showers!

For water to be made ‘fit to drink’ it is first allowed to sit so that some of the impurities can sediment out. After this, the water is treated chemically to encourage the sedimentation of some of the lighter impurities in the water. Next, the water is filtered, after which it is disinfected. Disinfection generally involves chlorine, although ozone and ultraviolet light radiation are other more expensive options.
There is concern about the presence of chlorine in tap water and its role in cancer. Chlorine is what is known as an ‘oxidising’ agent, and can induce chemical changes which, at least in theory, should increase cancer risk. Water may also contain related compounds which are by-products of the chlorination process known as ‘trihalomethanes’. These are also thought to have cancer-inducing potential. A review of 10 studies which examined the link between chlorine and its by-products and found that exposure to these harmful chemicals increased the risk of bladder cancer by 21% and rectal cancer by 38% (16). Another study found that exposure to chlorine or trihalomethanes was associated with an increased risk of brain tumour (19).
Another substance which is used in the purification of water is aluminium sulphate. There is some concern that aluminium may have some role to play in Alzheimer’s Disease (see Alzheimer’s Disease in e-book ‘Natural Solutions of Common Ailments’). While the evidence here is far from clear-cut, it is known that aluminium is a potentially toxic substance, and there does seem to be at least enough research which suggests it should be viewed with suspicion.
And what of fluoride? This substance is added to the water in some countries because it is believed to protect teeth from decay. The most recent study to look at this association – often referred to as the ‘York study’ – did indeed confirm this to be the case (20). However, the York study also found that the protection offered by fluoride is much lower than previously thought. In fact, just one in six people drinking fluoridated water benefits from this practice. However, drinking fluoridated water was also found to cause ‘dental fluorosis’ (a condition in which the teeth become mottled due to excess fluoride) in half of individuals drinking fluoridated water. One might question the wisdom in preventing dental disease in one in six while at the same time causing dental disease in one in two!
Also, because dental fluorosis is a sign of fluoride toxicity, could it be that fluoride might also lead to more sinister health effects. There is at least some evidence which suggests, for instance, that fluoride exposure may increase the risk of bone fracture. Not only all this, but there is a wealth of scientific evidence that fluoride may have toxic effects in many parts of the body including the brain, pineal gland and thyroid. More information about the potential hazards of fluoride can be found on the website www.fluoridealert.org.

What can be done to improve tap water quality?

My advice is to avoid tap water. At the very least, I recommend that it is treated to reduce some of its potentially harmful qualities. A simple and relatively inexpensive way to do this is to us a jug which has an integrated carbon filter. These filters help to get rid of much of the chlorine and other chemicals that may be in your tap water, but will allow most of the healthy minerals in water (see below) to get through. Bacteria are not removed either. It is important to remember to change the filter frequently (most are good for 50 – 200 litres of water).
A step up from jug filters are filters which are plumbed into the water supply. These generally contain carbon filters, though some also include fine clay particles to help filter out bacteria. These are more expensive than the jug filters (expect to pay about £200) and cartridges do need replacing from time to time (usually annually). However, they are very convenient and generally do a good job.
Another form of ‘in-house’ water purifications is known as the ‘reverse osmosis system’. This is good for removing impurities including bacteria, but also puts pay to many of the healthy mineral water may contain. The systems are on the expensive side, quite costly to run, slow and discard about 80% of the water they treat. Overall, I prefer the plumbed-in carbon and ceramic filters.

Distilled water

Distilled water is ‘pure’ water. One of the major advantages that distilled water has over other forms of water is that it is free from impurities and potentially hazardous elements such as lead, fluoride, chlorine and pesticides. Personally, I’m not convinced that distilled water is actually the best water for the human body. For a start, I always thing it is a good idea to stick quite closely to the sort of diet we evolved on, because it stands to reason that this is the diet we are best adapted to. We did not drink distilled water during evolution, and this does cast some doubt about its suitability for us as human beings. Another factor against distilled water is that there is some evidence to suggest that the minerals dissolved in other forms of water may actually have some health giving properties.

Water hardness and health

Tap and mineral waters contain elements such as calcium and magnesium. The ‘hardness’ of a water basically refers to the concentration of calcium carbonate in the water. ‘Hard’ waters are classified as having 75 mg or more of calcium carbonate per litre, while ‘soft’ waters have less than this. The forms of nutrients such as calcium and magnesium found in water are known as ‘inorganic’ salts. These compounds are not thought to be easily used by the body in its physiological and biochemical processes, and have traditionally been believed to have little in the way of health-giving properties. However, there is some evidence that hard water may protect against certain conditions, particularly heart disease and stroke.

Dozens of studies in several countries (particularly the UK, the United States and Canada) have examined the link between water hardness and health. Not all the results of these studies have been consistent, but there has certainly been a strong trend to suggest that hard water can protect against cardiovascular conditions such as heart disease, stroke, high blood pressure, and other conditions. Studies in the United States and Canada have reported that cardiovascular mortality rates are about 15 – 20% higher in populations using very soft water compared to those consuming hard water.
There are two main theories which have been put forward to explain why hard water might protect against cardiovascular disease. One is that it might contain nutrients that are beneficial to health. The other is that soft water may contain relatively high levels of harmful elements.

Hard water and its beneficial properties

The two main nutrients in water are calcium and magnesium. There has been some research which has suggested that these minerals have a beneficial effect on health. In one study, calcium and magnesium in drinking water was found to protect women from heart attack (21). Another study found that low levels of magnesium in drinking water appeared to increase the risk of death due to stroke (22). Other research has found that individuals consuming water containing 13.5 mg or more of magnesium per litre, had a 40% reduction in risk of stroke (23).
Magnesium in drinking water has also been found to be associated with a reduced risk of diabetes (24) and prostate cancer (25).

The harmful effects of soft water

Soft water tends to be more corrosive that hard water. As a result, certain potentially harmful metals in plumbing materials are more likely to leach into soft water and contaminate. Two of the metals that have been linked to an increase risk of disease include cadmium and lead. Cadmium has been shown to produce high blood pressure in rates. Other studies show that cadmium can damage the human kidney, which may lead to an increase in blood pressure. While research here is lacking, it is likely that cadmium has an adverse effect on human health. The same is true of lead, high levels of which have been found in individuals living in homes served by lead pipes.

Mineral Water

As their name suggests, mineral waters can supply the body with minerals such as calcium and magnesium. According to European law, mineral waters much emerge from the ground in a state fit to drink, and must be bottled at source. The water must also be protected from pollution to ensure it purity. Natural mineral waters have nothing added, and nothing taken away. I’m a fan!

Are all bottled waters good to drink?

In a word – no. Bottled waters may be labelled in a variety of ways. Commonly used terms are ‘natural mineral water’, ‘mineral water’, ‘spring water’ and ‘table water’. In Europe, only one of these terms (natural mineral water) refers to proper mineral water which has not been processed other than perhaps the addition of some carbon dioxide bubbles. The other terms are used to label waters from other sources, including rivers, lakes and municipal water supplies. The quality of these bottled waters is not assured in the same way as natural mineral waters and I would therefore avoid them.
In the USA, as in Europe, proper mineral water can be found labelled as natural mineral water. However, in the USA, natural spring water is also used to describe this premium water. Natural spring water is generally used to describe waters of lower mineral content, while higher mineral content water is usually labelled natural mineral water. However, just to confuse matters there is some overlap. My advice is to opt for waters labelled ‘natural mineral water’, or to study the label for mineral content if you are looking for specific mineral quantities.

What about mineral content then?

Bearing in mind the potential benefit of ‘hard’ water over ‘soft’, I like waters with a high mineral content. While a lot has been made of the benefits of calcium, there is good evidence to suggest that magnesium is very important for health. Some of the evidence supporting magnesium’s role in disease protection was discussed above. In general, I think calcium is a somewhat overrated mineral, while magnesium appears to be quite underrated. When I look at mineral waters, I look at the magnesium content first. After this, I check the calcium (I’m less concerned about this), and then I look at the sodium content. Because of concerns about sodium raising blood pressure in some people, and the fact that we appear to get far too much sodium in our diets than we need, I tend to avoid it wherever possible. My all-time favourite mineral water in the UK is called Ashbourne. It has a very high level of magnesium, a good level of calcium, and very little sodium.

Sparkling or still?

I generally advise people to drink still rather than sparkling mineral waters. Why? Well, first of all, carbon dioxide is acidic. There is a concept in natural medicine that many of us are prone to acidity in the body, and this can predispose us to disease including inflammatory conditions such as arthritis. Does putting carbon dioxide into the body into the body via water add to this acidity? I don’t think anybody knows for sure but it stands to reason that it might. Remember also that carbon dioxide is a gas which the body is generally trying to rid itself of.
Another qualm I have over fizzy water concerns digestion. The bubbles in carbonated water can coat food in the stomach, which may impair acid and other digestive secretions from penetrating the food.
Overall, I feel the relative merits of still over sparkling water, are pretty marginal. My general advice is to drink the one that you prefer and is most convenient too – this should help to keep up a good intake of water, whatever precise form it takes.

Keep water around!

For many people, the idea of drinking 2 plus litres of water a day seems quite a feat. However, if we assume we are awake for 16 hours a day, then 2 litres a day equates to 125 mls per hour. Put that way, 2 litres a day doesn’t seem quite so daunting.
The one big piece of advice I have about getting 2 litres of water into the body each day is this – keep water by you. Water is something that we don’t tend to seek out. For this reason, I suggest it is kept readily to hand. If you’re doing the gardening, keep a bottle of water with you. Put a bottle of water on your desk at work. Make sure there is water available in meetings. Put a ½ litre bottle of water in the car and carry one in your handbag or briefcase when you are out and about. My experience with clients has led me to conclude that if we keep water by us we generally get through decent quantities of the stuff, but if we don’t – we won’t.

Summary

• Water is essential to all the body’s most basic physiological and biochemical processes
• Even mild dehydration can provoke symptoms such as fatigue, headache and loss of appetite
• Long term dehydration can increase the risk of important conditions such as kidney stones and certain forms of cancer
• We should aim to consume about 30 mls of water for each kg of body (about ½ ounce of water per lb of body weight)
• Thirst is a relatively late indicator of the need to drink
• We can tell how well hydrated we are from the colour of our urine –aim to ensure your urine is very pale yellow or pale yellow throughout the day
• Tap water should be avoided as there is concern over some of its common constituents including aluminium, chlorine and fluoride
• If tap water is drunk, it is best to filter it first
• Distilled water lack minerals which have proven value for health including calcium and magnesium
• Natural mineral water is probably the best form of water for regular consumption
• To ensure you get through your water quota each day – keep it by you!

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