Drinking water

Be Safe, Drink More Water: Fact or Myth?

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Do you have bad conscience about drinking water? Do you think you’re not drinking enough?

I noticed that many of my patients always carry a bottle of water with them to the clinic, and that made me start thinking when I came across some articles about the problem with too much intake of water.

You probably heard that you should be drinking 8 glasses of water per day, or if you drink coffee you should drink extra water with it, or to stay beautiful you should drink plenty of water or most dehydration leads to cramps.

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Kevin Miller, an associate professor of athletic training at Central Michigan University, together with 15 leading experts, wrote a report about Exercise-Associated Hyponatremia (EAH) also known as water intoxication or water poisoning. EAH happens when a person drinks too much water while exercising and his/her body can’t rid itself of the excess through sweating or urination. As a result, water levels rise in the bloodstream (and cells begin to swell), and sodium level falls. Hyponatremia or abnormally low blood sodium level can cause many health problems, from mild to life-threatening.

Published in British Journal of Sports Medicine in July, Dr. Miller described a case in which a 17-year-old high school football player died from hyponatremia after drinking a combined 4 gallons (approximately15 liters) of water and sports drinks in order to avoid cramps during practice. The massive fluid intake resulted to a drop in sodium level – when this happens, fluids move from the blood vessels into the brains cells, brain cells start to swell and the brain is left with no room for expansion. The increase in the pressure in the skull (hyponatremic encephalopathy) led to his unfortunate death.

The problem with overconsumption of water was something we saw before with professional athletes, for instance people who run the marathon.

In the Boston Marathon 2002, they took blood samples from the runners and 13% suffered from lack of sodium in their body fluids. What is alarming is that it’s spreading to a lot of different sports and to people like you and me. There have been cases reported in yoga and spinning classes too.

What is a fact is that a mild dehydration can affect the ability to perform when you are a professional athlete but has no meaning for the public in general. People have a pathological fear of becoming dehydrated but the truth is that no one ever died in dehydration in athletic events. Having a mild dehydration is normal and not dangerous.

Listen to your body, if you get thirsty during exercise, by all means, drink. If you are not thirsty, don’t drink. This is the advice recommended for normal healthy people. We should know how much fluid intake we should have and not add extra “just to be on the safe side.” There are three situations when this is not applied: 1) healthy elderly persons do not have the same sense of thirst as younger people, 2) very small children have to be “persuaded” to drink extra, 3) very hot climate, like Dubai in summer – if you are outdoors, do not drink just water, add electrolytes. In a normal situation, it is recommended that we should have an intake of 1½ liter fluid per day. Remember that we also get half a liter more through our food.

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