DO YOU DRINK ENOUGH WATER?

Water is a vital element of life and constitutes 55%–65% of a person's body weight, making it the most common element in the body. Water needs to be taken in throughout the day because the body cannot produce enough on its own. Adults lose between 1450 to 2800 ml (about 3 – 6 local water sachets) of fluids each day from insensible (immeasurable) and sensible (measurable) losses. Insensible water losses include evaporation from the skin and exhalation (breathing out). Sensible water losses include urine and stool excretions. Daily water intake must be balanced with losses in order to maintain total body water.

Health benefits of water
Water carries out several functions within the body. Adequate water intake is needed for optimal absorption of water-soluble vitamins, which include vitamin B and C. Water flushes toxins out of vital organs and aids digestion and the absorption of nutrients. It provides shape and structure to cells, regulates body temperature and is a major component of mucus and other lubricating fluids which provides a moist environment for ear, nose and throat tissues. Dehydration, a condition that occurs when you don't have enough water in your body to carry out normal functions like transport of nutrients and oxygen to cells, can drain your energy and make you tired.

Recommended Amount
Every day you lose water through your breath, perspiration, urine and bowel movements. For your body to function properly, you must replenish its water supply by consuming beverages and foods that contain water. It is difficult to determine a specific level of water intake that would ensure adequate hydration and optimal health under all environmental conditions; however an adequate intake levels have been set to prevent deleterious, primary acute, effects of dehydration, which include metabolic and functional abnormalities.

What you eat also provides a significant portion of your fluid needs. For example, most cooked breakfast cereals like maize porridge and rice water have 90% water while other semi solid foods like 'banku', 'kenkey' and 'fufu' have an average of 70% moisture. Most fresh vegetables such as cabbage, carrots and cucumber are made up of about 90% water. About 80% of the weight of fresh fruits (mango, orange and banana) is water. Our meat and fish are almost 70% rich in moisture. In Ghana, our common soups - palm nut, groundnut, okro and light soup – have about only 20% solids, with the rest being water. In addition, beverages such as Milo drink are composed mostly of water. Even caffeinated beverages — such as coffee or tea— can contribute, but these should not be a major portion of your daily total fluid intake.

Total water intake includes drinking water, water in beverages, and water that form part of food. A total water intake of 3.7L/day (about 7 to 8 local water sachets) and 2.7L/day (about 5 to 6 local water sachets) have been established for men and women respectively. Pregnant and lactating women require additional fluid intake and would therefore need a total water of about 7 local sachets a day. It is recommended that on average 80% of total water intake should come from drinking water and beverages while the remaining 20% should come from food.

On average, men can take about 2.8 L/day (about 5 to 6 local water sachets) of water while women can also drink about 1.8 L/day (about 3 to 4 local water sachets) of water besides their three regular meals. Pregnant and lactating women will require about 4 to 5 local sachets of water a day. The elderly may not be able to take the recommended levels of fluid because the elderly have an elevated risk of over hydration due to the weakened physiological movement of water through the system.

Factors that influence water needs
Many factors may impact our daily fluid requirements including physical activity levels, environmental exposure and health status. Over the course of a few hours, body water deficits can occur due to reduced intake or increased water losses from physical activity. Individuals who exercise or engage in any strenuous physical exertion that makes them sweat; will need to drink extra water to compensate for the fluid loss. The additional fluid need will depend on how much you sweat during exercise, and the duration and type of exercise. 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. It is advisable to continue to replace fluids after you have finished exercising.

Higher intakes of total water will be required for individuals who are exposed to hot and dry environments. Hot or humid weather can make you sweat and will require an additional intake of fluid. Heated indoor air also can cause your skin to lose moisture. Further, altitudes may trigger increased urination and more rapid breathing, which use up more of your fluid reserves. Fever, vomiting or diarrhea, can cause your body to lose additional fluids. In these cases, you should drink more water. On the other hand, some forms of heart diseases and some types of kidney and liver diseases may impair excretion of water and even require that you limit your fluid intake.

One frequent rationale for increasing water intake is to increase satiety as part of the self-management of obesity. And there is some evidence that water drunk along with a meal or water incorporated into food does promote satiety in adults. However, it is not yet clear to what extent this effect reduces food intake, how long the effect lasts, and how much fluid might be needed to influence satiety.

On a day-to-day basis, fluid intake, driven by the combination of thirst and the consumption of beverages at meals, allows maintenance of hydration status and total body water at normal levels. You can drink enough fluid so that you rarely feel thirsty. If you produce enough colourless or slightly yellow urine a day, your fluid intake is probably adequate. If you're concerned about your fluid intake, seek expert advice.

The writer is a dietician, asaredomfeh@yahoo.com