Dear Doctors: My doctor wants me to hydrate more, but I find it difficult to drink the 64 ounces of water per day he recommends. I have a protein shake with 8 ounces of milk each morning -- does that count toward my total consumption? What other strategies would you suggest?
Dear Reader: The conversation with your doctor about drinking enough water mirrors one we have with many of our own patients. It’s an important topic because water plays a key role in so many bodily functions. We need it to regulate body temperature; break down, transport and absorb nutrients; maintain blood volume; eliminate metabolic byproducts; regulate electrolyte balance; support immune response; maintain healthy blood pressure; moisten the mucus membranes; keep skin moisturized; and keep the connective tissues pliant and lubricated.
In theory, thirst will prompt people to drink the water they need. In reality, that’s not always the case. When you’re busy, stressed or absorbed in a task, the signals of thirst can be easy to ignore. There’s also the fact that the sensation of thirst diminishes as we age. The amount someone needs to drink each day also varies. It depends on age, body size, fitness and activity level. But climate, environment and even altitude also play important roles.
The 64 ounces your doctor recommends is based on the guideline of eight glasses of water per day. Another common rule of thumb is to drink half your body weight in ounces of water each day. With our own patients, we simplify things and recommend drinking to quench thirst and -- this is the important part -- enough to ensure that the urine runs clear.
You’re not alone in struggling to stay hydrated. The good news is that, yes, the milk in your morning smoothie, as well as the tea, coffee and other beverages you may drink throughout the day, count toward your hydration total. Depending on your diet, up to 20% of daily water can come from fruits, vegetables and liquid dairy products. But the balance has to be made up with beverages. Some people find adding a squeeze of citrus or a few slices of cucumber to plain water makes it more palatable. Sparkling water is also a great alternative. But limit sweetened beverages, which contribute added sugars. Ditto for artificially sweetened beverages, which add chemicals to your diet.
If you find you’re still falling short, consider water-based strategies. Starting the day with a glass of water can awaken your thirst awareness. Water before a meal not only contributes to daily totals, but it can also help manage appetite. Track water intake by filling a reusable bottle with your daily amount, and empty it gradually throughout the day. And, if all else fails, try tough love. Remind yourself that being chronically dehydrated increases your risk of developing gallstones, kidney stones, heart arrhythmias, pancreatitis, blood clots, high or low blood pressure, headache and fatigue. Bottom line: Getting enough water each day is crucial to staying healthy.
(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)
