The Exchange

Commentary and Observations from
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What’s the Best Way to Stay Hydrated?

What’s the Best Way to Stay Hydrated?

I see patients with acute illnesses in urgent care every week, and many have fever and anorexia, and are a bit dehydrated. As part of the management plan, I always talk to them about hydration. The visual cue I give them is that if they urinate and it is dark yellow, they need to drink more water or other fluids.

I came across an article on Time's website that talks about drinking water all day long. Isn't it interesting how common it has become to see people everywhere carrying a trendy, environmentally friendly, and washable, reusable water bottle? I'll admit to being one of those people who always has their water bottle with them— a new habit of sorts. There could be worse habits to develop.

But in any case, what is the best way to actually stay hydrated, whether for patients suffering from a time-limited illness or those who simply lead active and busy lives? Sipping small amounts of water throughout the day provides better hydration than gulping large volumes periodically. Consuming large volumes just ends up in the toilet rather than being utilized for total body hydration. This is especially true if large volumes of water are consumed on an empty stomach. According to David Nieman, a professor of public health at Appalachian State University and director of the Human Performance Lab at the North Carolina Research Campus, plain water tends to slip right through the human digestive system when not accompanied by food or nutrients.

Drinking water before or during a meal is a better way to stay hydrated. "Drinking water with amino acids or fats or vitamins or minerals helps the body take up more of the water, which is why beverages like milk and fruit juice tend to look pretty good in these hydration studies," Nieman says. Other research by Nieman and his colleagues explored hydration in athletes, and found that eating a banana is better than drinking a sports beverage when it comes to post-exercise recovery. Nieman says eating almost any piece of fruit along with some water is going to aid the body's ability to take up that water and rehydrate.

What's the bottom line for patients recovering from an acute illness who need hydration? I am going to shift my discussion from color of urine to encouraging small sips of water or other beverages with calories, electrolytes, or amino acids (think sports drinks) through the day and urge them to avoid large volume consumption. I typically ask patients what fluids they actually like, and suggest ginger ale or chicken soup, as well. It appears that these time-honored remedies may still have value today. And, don’t forget to remind patients to sanitize those expensive water containers!

References
  • Nieman D GN, Sha W, Esposito D, Ramamoorthy S. Metabolic recovery from heavy exertion following banana compared to sugar beverage or water only ingestion: A randomized, crossover trial. Plos One. 2018;13:e0194843.
  • Heid M. Why drinking water all day long is not the best way to stay hydrated. time.com/5646632/how-much-water-to-drink/. Accessed September 12, 2019.
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    Filed under: Miscellaneous, Public Health

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