By BOB CONDOR
Special from the Chicago Tribune
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It's not hard to feel awash in nutritional advice. Rarely a week passes that you don't read about a new study that contradicts last month's study.
Although experts might debate the health value of, say, bacon-and-egg breakfasts, a fallback position for most any dietitian is urging people to consume adequate fluids to be fully hydrated.
Yet even the standard recommendation of eight glasses of water per day has been challenged in recent times.
"The research question has been raised whether there is actually scientific evidence for drinking eight to 10 glasses of water each day," said JoAnn Hattner, a clinical nutrition professor at Stanford University and spokeswoman for the American Dietetic Association.
The answer is a definitive "we don't know for sure." Not surprisingly, nutritionists are not about to play down the importance of daily fluids. You still consistently read or hear that you need eight to 10 cups of fluids each day for optimal health. Another common suggestion is to divide your body weight in pounds by two. That's the number of ounces you need each day.
What is surprising is the range of beverages that count toward your daily hydration total.
"What's really changed [among nutrition researchers in the last few years] is caffeine is not considered as severely dehydrating," said Monique Ryan, an Evanston, Ill.-based nutritionist and author of the new book "Sports Nutrition for Endurance Athletes" (Velo Press, $19.95). "Caffeinated drinks can count as about half water."
That means your 16-ounce morning coffee can count as one of the recommended eight to 10 cups of water. Or half of your soda can is equal to six ounces of water. It appears caffeine itself is not the diuretic agent once believed, though it does prompt most people to urinate more frequently. The result is the 50 percent fluid loss.
Ryan is quick to add that this reversal of thinking is "not a directive to drink caffeine." Coffee, for instance, stimulates both the bladder and central nervous system. Coffee drinkers need to be aware of how caffeine affects them.
What's more, regular soft drinks have excess sugar (10 teaspoons per 12-ounce serving) or additives (especially diet soda). Cutting your soda intake could be the healthiest change you make this year.
"My rule of thumb is no more than four sodas per week," said Jackie Berning, assistant professor of nutrition at the University of Colorado at Colorado Springs and nutritionist for several Denver-area professional sports teams.
Berning said some beverages, such as juice, milk, soy milk, and herbal teas, can match water ounce for hydrating ounce. She and other nutritionists mentioned provisos about juice (drink 100 percent varieties, consume only 6 to 8 ounces daily because of high caloric content, don't use it to quench thirst) and milks (require more work in the digestive tract than water).
Alcoholic drinks don't fare so well on the fluid-replacement index. Most nutritionists suggest not counting any of your favorite beers, wines, or cocktails toward the daily water mark. Researchers say alcohol blocks a hormone that otherwise helps the body stay hydrated.
In fact, a frequent suggestion is to consume a full glass of water for every alcoholic serving. Ryan said consuming alcohol after exercise may inhibit muscle recovery.
In any case, Hattner said each of us needs to get in the flow of our personal health and energy levels.
"You are the best judge of whether you are getting enough fluids in your day," she said. "It's more than monitoring your thirst. If you are feeling lethargic, it may well be from lack of hydration."
A quick biology lesson: Water flushes toxins out of the body and keeps your organs functioning at peak levels. One of water's primary duties is maintaining adequate blood supply to the skin.
It is indeed scientifically documented that a typical human can't survive more than a few days without water. One reason is that even the sedentary individual loses 1.5 to 2 liters of water daily. At rest, urine output represents our greatest losses, while sweating during physical activity can double fluid losses on any given workout day.
Thirst is not a reliable gauge for your fluid needs, especially as you grow older, because the body's thirst mechanism becomes less attuned. An adult can more easily confuse the sensations of hunger and thirst than children.
A better indicator of fluid intake is urine color.
"If it is pale lemonade or no color," Berning said, "then you are getting enough fluids. If it is darker, like apple juice, you are a 'hurtin' unit.'"
Many of Berning's clients, pro athletes included, regularly take multiple vitamin-mineral supplements. Their urine color can often be much darker or yellower, particularly if the product has high amounts of B vitamins.
"The yellower color means you are not absorbing all of the multivitamin," she explained. "I strongly recommend you cut back on the supplement, such as taking it every other day or third day to avoid wasting the vitamins."
Another idea is splitting up your vitamin dose during the day, perhaps taking some with breakfast and the rest at dinner. The idea is to maintain a consistently pale urine color, except for the first thing in the morning, which tends to be darker.
There are no set "healthy number of times" for daily urination. Bladders differ as much as personalities. But if you go at 9 a.m., then not again until 2 p.m., you need to consume more fluids.
On the other hand, Berning said, if you are getting up twice a night or more, it is best to seek medical attention. The overnight frequency could be a sign of diabetes or other troubles.
Ryan suggested that the properly hydrated person will empty four full bladders each day.
Moreover, the best approach to hydration is drinking water throughout the day and not too much at any one time. A standard strategy is eight ounces every one to two hours (especially if you are constipated). Otherwise, drinking too much fluid at once, even a pint or two of spring water, simply overloads the kidneys without actually hydrating the body.
"It's always better to space it out," Ryan said.
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Winners and losers
Getting in the flow of good health starts with drinking enough fluids to fully hydrate the body. Water is the beverage of choice. Some popular alternative drinks can help you get enough fluids in your day, but others don't help the cause.
Water
Pros: Best choice for hydrating the body in a hurry. Easily digested. Highly accessible. Can help keep appetite in check.
Cons: Some people don't find it thirst-quenching (try it colder). Others say it's a bother to carry a water bottle. Excuses, excuses.
Quantity: Shoot for a minimum of 48 ounces every day or six 8-ounce cups. Better yet, fill up a 20-ounce water bottle at breakfast, lunch, and dinner times.
Coffee/tea
Pros: Surprise, even your daily coffee fix can help you get enough fluids. New thinking is a 12-ounce cup of coffee counts as roughly six ounces of water/proper fluids. Figure tea at about eight ounces.
Cons: Too much caffeine can disrupt your physical and emotional states. Rather than boost your energy, an afternoon cup is likely fatiguing your adrenal glands.
Quantity: We all know how much coffee is too much (your best move is keeping to 12 to 16 ounces tops). Try green tea or other herbal tea instead.
Fruit juices
Pros: Substitutes ounce for ounce with water in terms of fluid needs. Appealing taste. Change of pace from water.
Cons: Sugar content of juice can be hard on the digestive tract and can slow the hydration process. People watching weight might be inadvertently consuming too many calories with juice.
Quantity: Adults and kids alike shouldn't drink much more than eight ounces daily. Keep it to 100 percent juice. Stretch the juice with water or sparkling water.
Milk/soy milk
Pros: Matches water ounce for ounce. Cow's milk is a good source of calcium. Soy milk offers a nutritious, non-dairy option (buy a product fortified with calcium).
Cons: Sugar content of milk and soy milk (check labels for lower sugar content) is harder to digest than water, can slow the hydration effect. Be careful about saturated-fat content in milk.
Quantity: American Dairy Association suggests three cups of non-fat milk daily. Can match calcium with a combination of fortified soy milk, leafy greens, canned salmon, tofu, and yogurt.
Alcohol
Pros: Research shows wine in moderation can protect against heart disease and certain cancers.
Cons: Doesn't count a single ounce toward hydration. Experts suggest drinking one tall glass of water for every beer, glass of wine, or cocktail.
Quantity: You know the drill. One to two drinks daily maximum for women, two to three for men.
Soft drinks
Pros: Hard to talk up soda as part of a healthful diet. But it does count as 50 percent water. Works as the occasional treat.
Cons: Too much sugar in regular sodas (roughly 10 teaspoons per 12-ounce can) and too many additives in diet sodas.
Quantity: Drink sparingly. One a day is too much. Consider four per week as maximum. Try sparkling water with a splash of juice as your everyday substitute.
- Bob Condor
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