I ask every patient I see how much and what fluids they drink. Why? Because I feel it’s such an important factor for the optimal functioning of their body and for the recovery and prevention of injuries.

I hear it all the time: “I don’t feel thirsty!”. Did you know that by the time one feels thirsty, they are already somewhat dehydrated?
Without water, a human likely can only live for a few days.

from ‘water and your health’ by health direct, 2019.

Why is hydration important?

Did you know that the human body is made up of about two thirds of water? It plays a big role in many functions:

Lubrication

Water oils your joints, muscles, skin and organs. Imbalance between fluids inside and outside the body can prevent it from working at optimal capacity.

Wound and injury healing

Its role in this is so often overlooked. Cells are not able to migrate and repair appropriately in a dehydrated environment. Correct hydration will improve the recovery rate.

Blood flow

Water helps maintaining ideal circulation, which provides the right amount nutrients and oxygen to areas healing from injuries.

Prevention

In the musculoskeletal world, dehydration can contribute to potential soft tissue, muscle and joint strains and sprains, tightness, cramps, and even bone fractures.

Thermostat

Water aids in temperature regulation of the body in response to external temperature changes.

Cleansing

Water flushes toxins and metabolic waste throughout the body, aiding inflammation processes (e.g. arthritis) and the ideal body’s metabolism, which can lead to pain relief.

What are the signs of dehydration?

Watch out for even mild signs of dehydration:

dry mouth and dry skin
sleepiness
headaches and migraines
dizziness
constipation
muscle cramps
decreased or dark coloured urination

In children and babies, beware of no wet nappies for longer than 3 hours, and a sunken spot on the top of the head. Generally, symptoms are reversible.

Signs of extreme severe dehydration include: irritability, confusion, low blood pressure, rapid breathing, little or no urination and even delirium/unconsciousness. At this stage, medical treatment is needed. Prolonged dehydration can cause urinary or kidney issues, seizures, and hypovolemic shock.

What causes dehydration?

It can be simply from insufficient fluid intake to replenish loss; so for example when we’re not drinking any fluids because particularly busy at work or not wanting to drink because of lack of toilet availability.
Other causes include gastro-intestinal illnesses (severe diarrhoea and/or vomiting), sweating (excess or prolonged), prolonged outdoor activities, fever, frequent urination (e.g. diabetes) or particular medications.

Who is at greater risk?

Every one is at risk, however people at higher risk include athletes (especially in extreme weather conditions), people working outdoors, infants/children (diarrhoea, vomiting), the elderly (up to 20-30% of the elder population) and the ill.

Tip to keep hydrated

Water is best! Perhaps try coconut water (aim for the pure form which contain the natural replenishing electrolytes).
Add some flavour to your water for taste (e.g. lemon or lime slices, watermelon, mint).
Keep a jug of water by your side or by your table when you’re working to remind you to drink often.
Listen to your body, watch even for mild signs between the ones described above.
Keep cool temperatures in your body, so avoid overheating.
Avoid exercising in high heat without regular replenishment of fluids.
Avoid excess alcohol consumption; ensure you drink water with it too, to avoid dehydration (and subsequent hangover!).
Wear light-coloured and loose-fitting clothes to decrease the effect of the harsh sun

Focus on prevention and early diagnosis; do seek medical care if you have the following symptoms:

Fever
Vomit for more than 1 day
Diarrhoea for more than 2 days
Unexplained weight loss
Decreased urination
Confusion
Weakness

How much should I be drinking?

SA Health recommends 8 cups (2 litres) for adult women, and 10 cups (about 2.5 litres) for adult men. Factors that may vary this include how much you weigh, if you are pregnant or breastfeeding and certain medications. The Australian environment (hot and humid) and how much we sweat are also factors that may influence these recommended amounts.

FAQ

I drink a lot of coffee, tea, coke, milk, soups, drinks, beer, alcohol… isn’t this enough?

Well yes, these are fluids, however water is usually the best option. Some drinks e.g. caffeine, soda, and particularly alcohol are actually diuretics and cause us to urinate more, so actually promote dehydration. Other drinks (e.g. fruit juices or sweetened drinks) are very high in sugar in which may inhibit the body’s ability to absorb the water it needs.

Can I drink too much?

You sure can! Overhydration is actually a problem in itself as well. If you are drinking excess of the above recommended amounts (for no other reasons than those mentioned above), you’ll put unwanted extra pressure on the kidneys to excrete the water. In extreme cases, this can lead to kidney dysfunction. Excess water in the body can also cause dilution of electrolytes in the blood, especially sodium (hyponatremia), and in turn cause symptoms such as nausea, headache, confusion and fatigue.

So, hopefully this blog has given you a bit of an insight into the importance of adequate water intake. Let us know if you have any favourite tip of how you like to keep on top of it; or if you’d like to get more guidance from our dietitian and nutritionist Karen M, feel free to contact us.

Healthy regards always, Karen.

Karen Chan is the chief physiotherapist, acupuncturist and director of Prospect Physiotherapy and Health Plus Clinic in Adelaide and has over 21 years of practice. She is also a lecturer at Endeavour College of Natural Health and has a keen interest in holistic health and well-being. For more of the team’s blogs read here.

Resources

Cheuvront, S. N., & Kenefick, R. W. (2014). Dehydration: physiology, assessment, and performance effects. Compr Physiol, 4(1), 257-285. doi: 10.1002/cphy.c130017

Health Direct. (2019). Drinking water and your health. Retrieved from https://www.healthdirect.gov.au/water-and-your-health

Magee, P. J., Gallagher, A. M., & McCormack, J. M. (2017). High Prevalence of Dehydration and Inadequate Nutritional Knowledge Among University and Club Level Athletes. Int J Sport Nutr Exerc Metab, 27(2), 158-168. doi: 10.1123/ijsnem.2016-0053

Miller, H. J. (2015). Dehydration in the Older Adult. J Gerontol Nurs, 41(9), 8-13. doi: 10.3928/00989134-20150814-02

Pross, N. (2017). Effects of Dehydration on Brain Functioning: A Life-Span Perspective. Ann Nutr Metab, 70 Suppl 1, 30-36. doi: 10.1159/000463060

SA Health 2020, Choose water as a drink, viewed 25th January 2020, <https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/healthy+living/healthy+eating/healthy+eating+tips/choose+water+as+a+drink>

Wittbrodt, M. T., & Millard-Stafford, M. (2018). Dehydration Impairs Cognitive Performance: A Meta-analysis. Med Sci Sports Exerc, 50(11), 2360-2368. doi: 10.1249/mss.0000000000001682

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