Different needs for water at different life stages

Water requirements change at different life stages. So how much water should people drink at each stage of their lives?

1.Hydration for pregnant and breast feeding women.

Because of the particular importance and responsibility of the pregnancy and lactation phases, it is often a time when mothers modify their nutritional habits and lifestyles to ensure the best and healthiest start in life for their new child.

 Most pregnant and lactating women are likely to pay attention to living healthily and eating healthily– it is important that health care practitioners should ensure that hydration is not overlooked.

Indeed, weight increases about 12 kg during pregnancy, and most of this added weight, 6 to 9 L, is water¹, because:

• The plasma volume (which is mainly water) increases
• 85% of the placenta is water²
• The fetus itself is 70-90% of water

To ensure adequate water intakes during pregnancy, the EFSA recommends an increase of 300 mL per day compared to the normal intake for non-pregnant women, taking total adequate water intake (from food and fluids) to 2,300 mL, or approximately 1,850 mL/ day from fluids.³

During lactation, water intake needs to compensate for the loss of water through milk production. Milk is made of 88% water, and the EFSA therefore recommends that lactating women increase their water by about 700 mL/day, meaning an adequate intake of 2,700 mL/day (from food and drink), or approximately 2,200 mL/day from fluids.
 

References:

1. Institute of Medicine (IOM). Dietary Reference Intakes for Water, Potassium, Sodium, Chloride, and Sulfate. Washington, DC: National Academies Press,2004.
2. Beall MH, van den Wijngaard JPHM, van Gemert MJC, Ross MG. Amniotic Fluid Water Dynamics. Placenta 2007;28:816-23.
3. EFSA Panel on Dietetic Products, Nutrition, and Allergies (NDA); Scientific Opinion on Dietary reference values for water. EFSA Journal 2010; 8:1459-1507. doi:10.2903/j.efsa.2010.1459. Available online: www.efsa.europa.eu

Hydration in infancy and childhood

At birth, the total body water content is as high as
75%. It decreases during the first year of life in
childhood to reach 60% at adult age.

Compared to adults, infants not only have a higher
body water content, but also a higher surface area-
to-body mass ratio, a higher rate of water turnover,¹
a limited ability to excrete solutes, and a lower
ability to express thirst. For these reasons,
dehydration in infants is more quickly life
threatening than for children or for adults.

 However, because of the low potential renal solute
load of human milk, healthy ad libitum breast-fed
infants do not need additional water, even under
conditions of high environmental temperature.²

Water requirements increase with age. Adequate
Intakes for infants and children have been defined
by the EFSA in 20102 and are summarized in the
table below:

 

EFSA recommended adequate fluid intakes in children²

As part of their nutritional education, children should

be taught how to drink in a healthy way: attention

should be paid to allow children good access to water

throughout the day.

 

Encouraging children to favour non-caloric beverages

such as water should be a component of broader

advice on lifestyle and nutrition.

• A study recently conducted in Germany has
• shown that a simple intervention with the sole
• focus of promoting water consumption
• effectively prevented overweight among
• children in elementary schools.³

References:

1. Fusch C, Hungerland E, Scharrer B, Moeller H. Water turnover of healthy children measured by deuterated water elimination. Eur J Pediat. 1993;152:110-4.
2. EFSA Panel on Dietetic Products, Nutrition, and Allergies (NDA); Scientific Opinion on Dietary reference values for water. EFSA Journal 2010; 8:1459-1507. doi:10.2903/j.efsa.2010.1459. Available online: www.efsa.europa.eu
3. Muckelbauer R, Libuda L, Clausen K, Toschke AM, Reinehr T, Kersting M. Promotion and provision of drinking water in schools for overweight prevention: randomized, controlled cluster trial. Pediatrics. 2009;123:e661-7.

Hydration and the elderly

As we get older, body water content decreases, the

risk for dehydration increases, and the consequences

become more serious.

 

Dehydration has been associated with increased

mortality rates among hospitalized older adults¹ and

can precipitate emergency hospitalization and

increase the risk of repeated stays in hospital.^2,3

 

Dehydration is a frequent cause of hospitalization of

older adults and one of the ten most frequent diagno

-ses responsible for hospitalization in the United-

States.³ Evidence suggests high dehydration rates of

elderly patients within hospitals and other health care

 institutions.²

Dehydration has also been associated with various

morbidities, such as impaired cognition or acute

confusion, falling or constipation.

 

The cost associated with dehydration may be very

high: a study conducted in 1999 in the United

States evaluated the avoidable costs of

hospitalizations due to dehydration at $1.14 billion.⁴

 

Why are the elderly more susceptible to dehydration?

The amount of body water decreases by

approximately 15% (about 6 L) between the ages of

20 and 80.⁵ With this decrease, the body becomes

more susceptible to dehydration from the loss of a

small amount of body water.⁶ Moreover, the elderly

often experience diminished thirst sensation which

leads to a reduced fluid consumption.^7,8 Also as a

consequence of ageing, the kidneys have a reduced

ability to concentrate urine and retain water during

water deprivation.⁹ In addition, ageing kidneys are

less able to conserve or excrete sodium.¹⁰

Insufficient fluid intakes can also be the result of
limitations such as reduced swallowing capacity,
decreased mobility, or comprehension and
communication disorders. Disease-related factors,
such as incontinence can increase water losses.
Dehydration may also be caused by warm
temperature, inadequate staffing in institutions, or
use of laxatives or diuretics.¹

What steps can be taken to prevent

dehydration in the elderly?

Prevention is primarily based on ensuring adequate

fluid intake. Raising awareness of the elderly, their

families and caregivers on the risks of dehydration

and its consequences is fundamental for dehydration

prevention,^1,11and can lead to cost-savings in geriatric

institutions.^12,13

SOME STRATEGIES FOR ENCOURAGING

FLUIDS CONSUMPTION^9,11

• Offer fluids regularly during the day
• Make liquids readily available all day (at bedside

or chairside in geriatric institutions) by placing

containers such as small bottle of water or sippy cups

• Encourage consumption of fluids with medication
• Provide preferred beverages
• Prescribe and safeguard a minimum intake of

1.5 L in periods of increased risk for dehydration

References:

1. Mentes J. Oral hydration in older adults: greater.

awareness is needed in preventing, recognizing, and
treating dehydration. Am J Nurs. 2006;106:40-9;
quiz 50.

2.Begum MN, Johnson CS. A review of the literature
on dehydration in the institutionalized elderly.

E SpenEur E J ClinNutrMetab. 2010; 5:e47-e53.

 

3.Sheehy, CM, Perry PA, Cromwell SL. Dehydration

: biological considerations, age-related changes, and

 risk factors in older adults. Biol Res Nurs. 1999;

1:30-7.

 

4.Xiao H, Barber J, Campbell ES. Economic burden

of dehydration among hospitalized elderly patients.

Am J Health Syst Pharm. 2004;61:2534-40.

 

5.Gille D. Overview of the physiological changes

and optimal diet in the golden age generation over 50.

European Review of Aging and Physical Activity

2010;7:27-36.

 

6.Rikkert MG, MelisRJ, ClaassenJA. Heat waves

and dehydration in the elderly. BMJ. 2009:339:b2663.

 

7.Schols JM, De Groot CP, van der Cammen TJ,

Olde Rikkert MG.Preventing and treating dehydration

in the elderly during periods of illness and warm

weather. J Nutr Health Aging 2009;13:150-7.

 

8.Kenney WL, Chiu P. Influence of age on thirst and

fluid intake. Med Sci Sports Exerc. 2001; 33:1524-32.

 

9.Bennett JA. Dehydration: Hazards and Benefits.

Geriatric Nursing 2000;21:84-8.

 

10.Silver AJ. Aging and risks for dehydration. Cleve

Clin J Med. 1990:574:341-4.

 

11.Faes MC, Spigt MG, Olde MGM, Rikkert MD.

Dehydration in Geriatrics. Geriatrics and Aging

2007;10:590-6.

 

12.Simmons SF, Alessi C, Schnelle JF. An

intervention to increase fluid intake in nursing home

residents: prompting and preference compliance.

J Am GeriatrSoc 2001;49:926-33.

 

13.Robinson SB,Rosher RB. Can a beverage cart

help improve hydration? GeriatrNurs.

2002;23:208-11.

THE NEW PARADIGM

THE NEW PARADIGM

"A new scientific truth is not usually presented in a way to convince its opponents. Rather, they die off, and a rising generation is familiarized with the truth from the start."-Max Planck

The new scientific truth and level of thinking about the human body that will empower people to become practitioners of preventive medicine for themselves is as follows: It is the solvent— the water content—that regulates all functions of the body, including the activity of all the solutes (the solids) that are dissolved in it. The disturbances in water metabolism of the body (the solvent metabolism) produces a variety of signals, 
indicating a "system" disturbance in the particular functions associated with the water supply and its rationed regulation.

Let me repeat: every function of the body is monitored and pegged to the efficient flow of water. 'Water distribution"is the only way of making sure that not only an adequate amount of water, but its transported elements (hormones,chemical messengers and nutrients) first reach the more vital organs. In turn, every organ that produces a substance to be made available to the rest of the body will only monitor its own rate and standards of production and release into the "flowing water," according to constantly changing quotas set by the brain. Once the water itself reaches the "drier" areas, it also exercises its many other most vital and missing physical and chemical regulatory actions.

Within this view, water intake and its priority distribution achieve paramount importance. The regulating neurotransmitter systems (histamine and its subordinate agents) become increasingly active during the regulation of water requirements of the body. Their action should not be continuously blocked by the use of medication. Their purpose should be understood and satisfied by drinking more water. I have made exactly the same statements to a body of scientists that had gathered from all over the world in Monte Carlo in 1989 for a conference on the topic of inflammation, analgesics, and immune modulators.


The new paradigm permits an incorporation of the "fourth dimension of time" into scientific research. It will facilitate an understanding of the damaging effect of an establishing dehydration that persists and continues to increase during any duration of time. It will make it possible to forecast the physiological events that will lead to disease states at some later years, including what at present appears as genetic disorders. It will transform the present"shot-in-the-dark, symptoms-treating" approach to the practice of medicine into a scientifically accurate medical art;it will make preventive forecasting possible. It will establish excellent health and reduce health care costs to individuals and to any society that fosters its spread. Since water shortage in different areas of the body will manifest varying symptoms, signals, and complications now labeled as diseases, people may think water could not be offered as a natural solution. Water cures so many diseases? No way! Speaking thus, they shut their minds to the new possibility of preventing and possibly even curing so many different "diseases" that are dehydration produced. It does not occur to them that the only remedy for conditions that come about when the body begins to get dehydrated is water and nothing else. A number of sample testimonials are published in different sections of this book to open the eyes of skeptics to the fact that the greatest health discovery of all times is that water is a natural medication for a variety of health conditions.

Water Regulation at Different Stages of Life

There are basically three stages to water regulation of the body in the different phases of life. One, the stage of life of a fetus in the uterus of the mother (left of B in Figure 1). Two, the phase of growth until full height and width is achieved (approximately between the ages of 18 to 25). Three, the phase of life from fully grown to the demise of the person. During the intrauterine stage of cell expansion, water for cell growth of the child has to be provided by the mother. However, the transmitter system for water intake seems to be produced by the fetal tissue, but registers its effect on the mother. The very first indicator for water needs of the fetus and the mother seems to be morning sickness during ' the early phase of pregnancy. Morning sickness of the pregnant mother-to-be is a thirst signal of both the fetus and the mother.