The Institute of Medicine recommend that men achieve a daily fluid intake of around 3 liters and that women take in 2.2 liters.
Around of 70% of the body is comprised of water, and around of 71% of
the planet's surface is covered by water. Perhaps it is the ubiquitous
nature of water that means that drinking enough of it each day is not at
the top of many people's lists of healthy priorities?
One part of the body that relies on adequate water intake is the
kidneys. The kidneys are organs that might not get as much attention as
the heart or lungs, but they are responsible for many functions that
help keep the body as healthy as possible.
But what happens to the kidneys when we do not drink enough water? And
what can be done to improve our levels of hydration? On World Kidney
Day, we take a look at the role of drinking enough water for two of the
most important organs in the body.
Why do we need to drink water?
Water is needed by all the cells and organs in the body in order for
them to function properly. It is also used to lubricate the joints,
protect the spinal cord and other sensitive tissues, regulate body
temperature and assist the passage of food through the intestines.
Although some of the water required by the body is obtained through
foods with a high water content - soups, tomatoes, oranges - the
majority is gained through drinking water and other beverages.
During normal everyday functioning, water is lost by the body, and this
needs to be replaced. It is noticeable that we lose water through
activities such as sweating and urination, but water is even lost when
breathing.
Drinking water, be it from the tap or a bottle, is the best source of
fluid for the body. Beverages such as milk and juices are also decent
sources of water, but beverages containing alcohol and caffeine, such as
soft drinks, coffee and beer, are less than ideal due to having diuretic properties, meaning that they cause the body to release water.
The recommended amount of water that should be drunk per day varies from
person to person depending on factors such as how active they are and
how much they sweat. There is no universally agreed upon threshold of
water consumption that must be reached, but there is a general level of
consensus as to what a healthy amount is.
According to the Institute of Medicine (IOM), an adequate intake
for men is approximately 13 cups (3 liters) a day. For women, an
adequate intake is around 9 cups (2.2 liters).
Many people may have heard the phrase, "Drink eight 8-ounce glasses of
water a day," which works out at around 1.9 liters and is close to the
IOM's recommendation for women. Drinking "8 by 8" is an easy-to-remember
amount that can put people on the right track in terms of water
consumption.
Water also helps dissolve minerals and nutrients so that they are more
accessible to the body, as well as helping transport waste products out
of the body. It is these two functions that make water so vital to the
kidneys.
What do the kidneys do?
The kidneys are two small fist-sized organs that are shaped like beans.
They are located in the middle of the back, on either side of the spine
and situated just below the rib cage.
Despite their importance, the kidneys can sometimes receive less
attention than other organs in the body. "The role of the kidneys is
often underrated when we think about our health," state Kidney Health
Australia.
The role of the kidneys in keeping the body healthy may be underrated in relation to the heart and the lungs.
"In fact, the kidneys play an important role in the daily workings of
our body. They are so important to health that nature gave us two
kidneys to cover the possibility that one might be lost to an injury.
They are so important that with no kidney function, death occurs within a
few days."
A crucial function of the kidneys is to remove waste products and excess
fluid from the body via urine. The kidneys also regulate the levels of
salt, potassium and acid in the body and produce hormones that influence
the performance of other organs.
When we eat and drink, nutrients and minerals enter the bloodstream in
order to be transported around the body and used for energy, growth,
maintenance or repair. The blood also passes through the kidneys where
it is filtered, and any waste products and excess nutrients and water
are removed and sent to the bladder for expulsion.
Every day, the kidneys filter around 200 quarts of fluid. Of these,
approximately 2 quarts are removed from the body in the form of urine,
and 198 are recovered by the bloodstream.
If the kidneys do not function properly through kidney disease, waste
products and excess fluid can build up inside the body. Untreated, chronic kidney disease can lead to kidney failure, whereby the organs stop working, and either dialysis or kidney transplantation is required.
Water is important for the workings of the kidneys, not only for helping
to initially dissolve the nutrients, but for ensuring that waste
products, bacteria and proteins do not build up in the kidneys and the
bladder. These can lead to dangerous infections and painful kidney stones.
How does not drinking enough affect the kidneys?
Urinary tract infections
(UTIs) are the second most common type of infection in the body and
account for around 8.1 million visits to health care providers in the US
every year. If infections spread to the upper urinary tract, including
the kidneys, permanent damage can be caused. Sudden kidney infections
(acute) can be life-threatening, particularly if septicemia occurs.
Drinking plenty of water is one of the simplest ways to reduce the risk
of developing a UTI and is also advised for people that have developed
an infection.
The presence of kidney stones can complicate UTIs as they can compromise
how the kidneys work. Complicated UTIs tend to require longer periods
of antibiotics to treat them, typically lasting between 7 and 14 days.
The leading cause of kidney stones is a lack of water, and they are
commonly reported in people that have been found not drinking the
recommended daily amount of water. As well as complicating UTIs,
research has suggested that kidney stones also increase the risk of chronic kidney disease developing.
In November 2014, the American College of Physicians issued new guidelines
for people who have previously developed kidney stones, stating that
increasing fluid intake to enable 2 liters of urination a day could
decrease the risk of stone recurrence by at least half with no side
effects.
Dehydration
- using and losing more water than the body takes in - can also lead to
an imbalance in the body's electrolytes. Electrolytes, such as
potassium, phosphate and sodium, help carry electrical signals between
cells. The levels of electrolytes in the body are kept stable by
properly functioning kidneys.
When the kidneys are unable to maintain a balance in the levels of
electrolytes, these electrical signals become mixed up, which can lead
to seizures, involving involuntary muscle movements and loss of
consciousness.
In severe cases, dehydration can also lead to kidney failure, a potentially life-threatening outcome. Possible complications of chronic kidney failure include anemia, damage to the central nervous system, heart failure and a compromised immune system.
There are a considerable number of health problems that can occur simply
through not drinking enough water, and yet researchers have found that a
significant number of Americans may be failing to obtain the
recommended levels of fluid intake every day.
Does the US not drink enough water?
A study carried out
by the Centers for Disease Control and Prevention (CDC) in 2013
analyzed data from the National Cancer Institute's 2007 Food Attitudes
and Behaviors Survey, in order to assess the characteristics of people
who have a low intake of drinking water.
Out of a sample of 3,397 adults, the researchers found the following:
- 7% of adults reported no daily consumption of drinking water
- 36% of adults reported drinking 1-3 cups of drinking water a day
- 35% of adults reported drinking 4-7 cups of drinking water a day
- 22% of adults reported drinking 8 cups or more a day.
People were more likely to drink less than 4 cups of drinking water
daily if they consumed 1 cup or less of fruits or vegetables a day. The
study indicates that among this sample, a large number of people may
well have not been drinking the suggested 8 cups of fluid a day.
Although the study only measured the intake of drinking water and fluid
can be gained from other beverages, water is the ideal source of fluid
due to it being readily available, calorie-free, caffeine-free and
alcohol-free.
The fact that 7% of respondents reported drinking no water at
all daily, and that respondents who drank low volumes of water were
associated with low levels of fruit and vegetable consumption, would
suggest there is a certain number of people who are risking their health
by not getting enough fluid.
Even if the respondents reporting low levels of water intake were
obtaining enough fluid, it is likely that they would be obtaining it
from sources that could potentially compromise their health in other
ways.
"The biologic requirement for water may be met with plain water or via
foods and other beverages," write the study authors. "Results from
previous epidemiologic studies indicate that water intake may be
inversely related to volume of calorically sweetened beverages and other
fluid intake."
Thirst-quenching tips
The CDC make a number of suggestions that could help people increase the amount of water they normally drink:
- Carrying a water bottle with you means that fluid can be accessed when out and about, at work or running errands
- This water can be frozen in freezer-safe water bottles to provide a supply of ice-cold water all day long, which can be more satisfying than other beverages in certain situations
- Adding a wedge of lime or lemon to water can give it a different edge that may improve its taste without affecting its nutritional value.
Drinking enough should be an easily achievable health goal. "Under
normal conditions, most people can drink enough fluids to meet their
water needs," state the CDC. Although it is a relatively simple step to
take, it can easily get overlooked as part of increasingly hectic
lifestyles.
On National Kidney Day, it is worth remembering the risks that can come
from not getting enough fluids, and to raise a glass - ideally filled
with water - to those underrated organs that do so much for the health
of the body.
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