Tuesday, October 18, 2011

TO DRINK OR NOT TO DRINK?



We often associate thirst to drinking water otherwise you will be dehydrated. From the Greek word hydor, which signifies water, to hydrate means the process of supplying water or liquid in order to maintain a healthy balance. Fluid intake does not necessary mean just plain water intake. This can only connote to fruit/vegetable juices, soups, gelatin, popsicles, sodas and even alcoholic beverages.
Water is the simplest and most important beverage. It is an essential nutrient and medium of life. Water constitutes about 60% of an adult’s weight and a higher percentage of a child’s.
Fluid requirements increase due to age, exercise, environmental factors, illness and pregnancy.
AGE
* Fluid requirements in children are based on body weight according to the Holliday-Segar method. Fluid requirements are better estimated by weight than age, to take into account the possibility of an underweight or overweight child.
Holliday-Segar Fluid Requirement Calculation
Weight Baseline Daily Fluid Requirement
1 to 10 kg (2.2 to 22 lbs) 100 ml/kg
11 to 20 kg (23 to 44 lbs) 1000 ml plus 50 ml/kg for each kg over 10 kg
over 20 kg (over 44 lbs) 1500 ml plus 20 ml/kg over 20 kg
The above figure shows how water affects the other organs.
Beverages like milk, some soy beverages and some fortified juices provide a convenient way for children to get nutrients like bone-building calcium and vitamin D. Having several beverage options for these nutrients, which tend to be lacking in many children's diets, helps give picky eaters choice and parents peace of mind.
Many fruit juices also provide vitamin C, an antioxidant nutrient found primarily in fruits and vegetables that helps keep gums healthy and boosts iron absorption. Some water sources contain fluoride, a mineral that can help maintain strong teeth in children.
* Total body fluid decreases with age. Consequently, even mild stress – such as fever or hot weather – can result in rapid dehydration of the elderly. The elderly are at increased risk for infections and other problems linked to dehydration. Such condition will trigger symptoms like altered mental status, delirium, dizziness from low blood pressure  Some elderly have lost their bladdercontrol and may be afraid to drink too much water . Fluid requirement  for the elderly is 30 cc per kg/body weight (if you’re grandma weighs 55 kg kg multiply by 30, requires 1650 cc or ml or almost 7 glasses of fluid a day). But if the elderly is diagnosed with Congestive Heart Failure (CHF) or with Chronic Obstructive Pulmonary Disease (COPD) then their fluid is at 25 cc per/kg body weight.  Encourage older adults to drink throughout the day even if they are not thirsty. Keep beverages that they enjoy nearby, possibly pre-poured in non-breakable cups and glasses that are easy to hold and hard to tip over. Also offer soups, popsicles, gelatins or other flavorful fluid-rich foods as often as possible.
Exercise - The more you exercise, the more fluid you'll need to keep your body hydrated. Athletes daily fluid needs can often exceed 3 to 4 liters per day, sometimes pushing 10 liters per day, depending on conditions. An extra 1 or 2 cups of water should suffice for short bouts of exercise, but intense exercise lasting more than an hour (for example, running a marathon) requires additional fluid. How much additional fluid is needed depends on how much you sweat during the exercise, but 2 to 3 cups an hour will generally be adequate, unless the weather is exceptionally warm.
During long bouts of intense exercise, it's best to use a sports drink that contains sodium, as this will help replace sodium lost in sweat and reduce the chances of developing hyponatremia (decreased sodium in the blood), which can be life-threatening. Fluid also should be replaced after exercise.
Climate and Altitude
Hot or humid weather can make you sweat and requires additional intake of fluid. In cold weather, we lose a great deal of water from our bodies due to respiratory fluid loss through breathing. Our bodies also are working harder under the weight of extra clothing, and sweat evaporates quickly in cold, dry air. So in the comfort of your airconditioned rooms do take a drink of water.
And research suggests that people tend to drink less at high altitudes, probably due to a decreased sensation of thirst. Being high above sea level can affect hydration, too. Have you ever noticed how hard and frequently you breathe when you are in higher elevation? With every breath you exhale, you are losing fluid.
High altitudes greater than 2,500 meters (8,200 feet) may trigger increased urination and more rapid breathing, which use up more of your fluid reserves.. So the next time you take the airplane, drink up!
Illnesses or health conditions. Signs of illnesses, such as fever, vomiting and diarrhea, cause your body to lose additional fluids. In these cases you should drink more water and may even need oral rehydration solutions, such as Gatorade or Powerade . Certain conditions, including bladder infections or urinary tract stones, also require increased water intake. On the other hand, certain conditions such as heart failure and some types of kidney, liver and adrenal diseases may impair excretion of water and even require that you limit your fluid intake.
Pregnancy or breast-feeding. Women who are expecting or breast-feeding need additional fluids to stay hydrated. Large amounts of fluid are lost especially when breast-feeding. The Institute of Medicine recommends that pregnant women drink 2.4 liters (about 10 cups) of fluids daily and women who breast-feed consume 3.0 liters (about 12.5 cups) of fluids a day.
Dietary Sources:
Your diet provides the water your body needs. In an average adult diet, food provides about 20 percent of total water intake. The remaining 80 percent comes from beverages you drink.
  • Beverage requirements are met best by consuming plain water. You can also choose herbal or green tea (hot or iced), diluted fruit juice, sparkling water, or add lemon/lime juice to plain water.
  • Fruits and vegetables contain lots of water and are also good sources of vitamins, minerals and fiber.  However, your daily water requirement of 8 glasses for women and 12 for men should be consumed above and beyond the water that is consumed as food.
  • While alcoholic beverages (like beer or wine) and caffeinated beverages (like coffee and colas) can contribute to your total fluid intake, they also have diuretic properties which can cause you to urinate more often and dehydrate more easily.
BEVERAGES FOR DIABETICS
COFFEE/TEA - Caffeine usually works within 20 minutes and the effects last 6 hours with the greatest effect within the first 3 hours. Researchers are cautious about making public health claims. But it certainly appears safe to keep drinking that delicious, aromatic, pick-me-up cup or two of coffee each day.
Just be sure to keep your intake moderate, to be on the safe side. If you experience palpitations, a rapid heartbeat or any symptoms associated with caffeine overload, talk to your doctor about your coffee intake.
DIET SOFTDRINKS – an alternative to your regular softdrinks. Per can of diet softdrinks yields virtually zero calorie but sugar conscious tend to substitute this artificial-sweetened beverage as their sole fluid for the day. As a precautionary recommendation, 1 to 2 cans a day on top of your water intake will do.
100% PURE FRUIT JUICE – for every 1 cup of fresh orange juice, you  have to squeeze out 3 oranges. Most diabetics need only 2 or 3 fruits a day.  While 100 percent fruit juice can be a healthful beverage, too much fruit juice can add excess calories and sugar to the diet. Whole fruit is often a better choice for their added fiber.
How much water should you drink each day?  In truth, your water needs depend on many factors, including your health, how active you are and where you live.
Though no single formula fits everyone, knowing more about your body's need for fluids will help you estimate how much water to drink each day.



By: Ma. Bernadette Platon, RND
Nutritionist-Dietitians' Association of the Philippines

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