Preventive Medicine: Water and Hydration

 

#Preventive Medicine

Pani re pani….

Going hand in hand with food is water. And next to that is exercise. In the next two posts let’s look at these two basic yet important factors that are connected to our health. 

I have a confession to make. Everything I am about to write on the topic of water (and in the next post about exercise) is what I know and understand is true, and yet, shamefully, don’t practice. In Marathi you call it kaltay pun valat nahi! My family constantly reminds me and I kick myself frequently in acknowledgment, but honestly I don’t do it as much and as well as I should. It is work in progress. 

Water and Hydration:

80% of our body is made up of water.  All body fluids, blood, saliva, sweat, nasal and other secretions, urine, feces, menstruation, cerebrospinal fluid, neuro transmitters contain water. 

Not only does water serve as a transport medium it plays a big role in regulating our body temperature. It conserves warmth in cooler environments and dissipates heat in hot weather. 

If we don’t consciously replenish our daily water losses, our body is struggling with a short supply of essential material to carry its vital functions. Before serious symptoms and illness become apparent minor nuisances like irritability, inability to concentrate, getting tired with small tasks and such things will begin to surface. If we don’t take a clue from these early symptoms skin will begin to look dry, throat will be parched, urine starts looking darker and produced in smaller quantities, constipation may occur. We may feel dizzy, especially if we get up or turn too fast. Or we may even pass out briefly. 

If dehydration goes on longer then we risk more serious illnesses like kidney failure and heart failure. Heat stroke, seizures, acute altitude sickness are some other disorders that can be compounded as a result from being dehydrated.

Drink clean water. Contaminated water can bring parasites, bacteria and viruses causing serious illnesses like giardiasis,cholera, typhoid, hepatitis etc. Often mountain streams and well water contains parasites. One needs to be aware in endemic areas to avoid water borne illnesses. Here rely on boiled water or filtered water. Or,if that’s not available, then bottled water.

Most people don’t realize that serious illnesses can be prevented by cultivating a simple habit of always drinking plenty of water and clean water on a daily basis. 

Drink water at every opportunity you find. 

How much water should one drink?

An average person is recommended to drink 4 liters of water daily. 

If someone has an illness with fluid overload ( heart failure or such things) follow your doctor’s instructions. These conditions often require limiting fluid intake to much lower quantities.

In summer months water requirements are higher than in winters.

Athletes and laborers may need more water than others. 

Under conditions like vomiting and diarrhea or urinary infections the requirements for water would be increased to compensate for the excess fluid losses.

What is the best time to drink water? 

Drink first thing in the morning, on an empty stomach.

Avoid drinking water just before a meal. Reserve it to drink after your stomach is half full (as I have mentioned while discussing dietary habits) . At that time drink enough to leave some space for air. That is the level of fullness you need to feel. 

Drink more water in the earlier part of the day when water losses are more. If you minimize water intake later in the evening you will not have to wake up at night to use the bathroom.

I am often asked whether drinking tea, coffee, sodas, juices, lemonade etc count towards the daily fluid intake. 

Answer is yes and no. 

Yes because these are fluids. 

No because they are not equal to water in their merits and end results. 

If you drink a cup of water vs a cup of tea, at the end of the day your body will hold less water after the tea than it would after water. Why ? Because tea( or coffee) have diuretic properties. More of it will be lost in the urine than if you drink equivalent amount of plain water. 

There is excess consumption of coffee in the USA. High concentrations of caffeine can create anxiety, palpitations, hyper alertness, irritability, sleep disturbances, stomach ailments and even heart disease. I have seen caffeine causing dangerous slowing of the heart. 

Energy drinks are popular in the USA. Every now and then I see patients coming in for high blood pressure or fast heart rates or feeling palpitations or chest pains. When you ask about their dietary habits you discover they have been taking such high energy booster drinks. Often simply stopping these drinks gets rid of their symptoms.

When you drink fruit juices you get valuable minerals and vitamins from the juice but you also get a lot of sugar. And you lose valuable fiber in the process of juicing. Instead if you eat the whole fruit without juicing, you will get the fiber in good quantity, you will get the minerals and vitamins and only limited sugar. For hydration, rely on water, not juice.

Alcohol is a whole subject by itself. But while talking about fluids, alcohol is definitely not a means for hydration. It actually compounds dehydration and malnutrition.

We’ll talk more about  alcohol in context of preventive medicine another time.

When you drink sodas like coke or Pepsi it is multi pronged damage. The caramel coloring used in these is a known carcinogen( cancer causing ingredient). The phosphoric acid that gives the bubbles to any soda causes valuable minerals from bones to be lost, thus weakening the bones. Sugar is a pro-inflammation ingredient and not good for health. Even sugar free sodas are unhealthy because the sugar substitutes in them create a sweet tooth. You unknowingly crave for sweets once you get accustomed to it.

At one time I was drinking a Diet Coke almost on a daily basis thinking it is harmless, I am not getting any calories from it. One day I was seeing a new patient in my office. He was a diabetic and told me that prior to his diagnosis he was drinking 6 or more sodas each day. His wife taunted him that he can never change. But when he was told he has diabetes he quit drinking sodas since that day and never went back. He followed the recommended diet meticulously and had kept the diabetes under good control. Such patients are hard to come by. He was a poster patient who i wished I could introduce to my other patients to learn from.

 I myself learned from him. That day I told myself, if this man who was drinking 6 or more sodas a day could quit drinking, why can’t I ? Since that day I haven’t touched a single soda. I don’t crave for those and I don’t miss them. Even if I am in the company of others who are having them I decline sodas.

Once you know something is harmful it is stupid to continue that habit. A common human defense in such situations is to go into denial. Mind adopts an alternate narrative. Of course sodas can’t be so harmful as they are saying! And same thing with alcohol. Denial becomes an ally for propagation of self harm.

 It needs honesty to confront the mindset. And until a truth ascends from level of one’s mind to the level of the intellect, change will not happen. It’s like some corrupt subordinate staff holding off an important file from reaching the desk of an honest boss. They sabotage it because they are deriving personal benefits through illegal means and these benefits will cease once the truth comes to light. 

Sodas, energy drinks, coffee, high fructose drinks and many such things are heavily marketed by companies. It is their business and they don’t care if science advises against consumption of those products. It becomes the consumer’s responsibility to know and choose between shreyas and preyas ( beneficial vs attractive).

The truth is that no man-made liquid in this universe can beat the creation of God. Water is divine and also free (usually). It remains the best choice. Why choose a lesser option ? And worse, spend your hard earned money on those? 

Next post we will discuss benefits of exercise on prevention of illness. 

Yesterday was a long day. Earlier in the morning a classmate from medical school visited me. We were meeting after over 15 years and chatted for nearly 3 hours. Didn’t even realize that we didn’t reach out for a photo together until she had left my place. 

For lunch I was invited for a homemade jowar bhaakri, fresh garlic coconut chili chutney and vangi bhaaji at my sister in law’s home. Having cleaned up from our plates we sat at the table chatting and didn’t realize we had been in that one spot for 3 hours not counting the time when we were eating ! 

From there I proceeded to check out a couple of showrooms for a new refrigerator. I did a brisk walk of over a kilometer from one showroom to next, and at each place after noting down a few models and prices hurried for a dinner appointment with four friends. There too 3+ hours just flew by as we shared everything under the sun. 

The saree  is at least 2 decades old. Having draped it around 8 am in the morning it lasted until almost midnight with ease. It survived cooking and cleaning at home, walking in the rain when I went fridge shopping, a ride on a two wheeler sitting behind a friend under a drizzle and a few rickshaw rides in the rain as well. Despite everything it made me feel comfortable and good all the time. And at the end of the day or rather this morning when I ironed to put it away, it appeared like nothing had happened. My spirit can take a few lessons from this saree. 

So here is this 20 year old Bengal beauty, a jute silk mix with muslin pallu that has jamdani design using ghicha and silk yarn. The body in a unique shade of yellow has alternating stripes all over.

Watch for the selfie of back pose😃