28 Responses to “Waterlogged?”

  1. Martin Budden July 13, 2011 at 6:58 am #

    “Hydration for Health, an initiative to promote drinking more water, held its annual scientific meeting in Evian, France, last week.” You have to laugh, don’t you? Next month “Ham for Health” has its meeting in Parma, and “Pasties for Health” will be meeting in Cornwall.

  2. Shona July 13, 2011 at 11:48 am #

    Page 13 of the Times today…

  3. George Paterson July 13, 2011 at 12:38 pm #

    There may well be doubts about the exact benefits of drinking water, and the exact quantities that one should drink, which presumably is what you are talking about. But surely remaining hydrated is generally agreed to be good for your all-round body functioning. And surely drinking water is one the best or easiest ways to do that. The debate about bottled water aside, if the (Glasgow) Herald starts publishing an article doubting the benefits in general of drinking water (that’s surely not what you are saying?), then that seems hardly a good message to be sending to the large irn bru / coke drinking population?

  4. Margaret McCartney
    margaretmccartney July 13, 2011 at 12:52 pm #

    there is no question : of course I would recommend water over sugary drinks, absolutely.
    the only thing I am trying to say is that we do not need to drink more than we would normally do. The bottled water industry is pushing the idea that we shoudl drink more than we normally would with the promise of health benefits, and I don’t think there are any.
    that’s all
    and I would recommend tap rather than bottled water; cheaper, and far better for enviroment.

  5. George Paterson July 13, 2011 at 1:33 pm #

    Agree with that, for sure. Then I think the article in the The Herald is a bit ambiguous / not very well written, that’s all. The Times article is clearer.

  6. A A Macbeth July 13, 2011 at 4:35 pm #

    Many years ago – not sure what age I was, maybe 6/7, my pals and I had a water drinking competition in the hayfield on a hot day. I won the competition but became seriously ill with a fever. Ever since I have thought that the effect of water on steel provided a warning; I didn’t want to rust my brain!
    Nice to see that the current craze for semi-continuous hydration has no scientific foundation.

  7. Graham Richings July 14, 2011 at 4:05 pm #

    Can not agree with Dr McCartney in Daily Telegraph 13th July 2011. Is she familiar with Dr. Batman’s book “Your Body’s Many Cries for Water? He spent over 20 years researching this subject and probably knows better than she does. For some 25 years I have consumed up to 5pts of filtered boiled tap water per day, (Thames Water) and before bed add a small quantity of Hymalyan Mountain salt. I am 69 years old. My blood pressure and heart rate are low and I am healthy. Just for digestive functions alone the body needs water. Probably 75% of the population is chronically dehydrated. Dr McCartney is doing them no favours. I will not purchased bottled water. It is probably a “Con”! At the time of writing I am living proof that water is good for you.

  8. Dr Aust July 14, 2011 at 4:33 pm #

    The “Dr Batman” Graham Richings refers to is the late Dr Fereydoon Batmanghelidj, whose, errm, far-fetched ideas about water, as his Wikipedia entry puts it with dry understatement:

    ‘have not been adopted by the medical community”.

    – the reason being, of course, that the ideas are based entirely on Batmanghelidj’s ‘personal experiences’, as recounted in his book, and thus not substantiated by any science. There is zero credible scientific or medical evidence I’ve heard of for Dr B’s contentions that we are all chronically dehydrated, and that this is the root cause of lots of illness.

    Apart from anything else, much of what Dr B cites as evidence (e.g. finding that giving water helped in settings where he had nothing to treat people with, like his fellow-prisoners in post-revolutionary Iranian jails) is fairly evidently ascribable to a combination of placebo/’treatment’ effects. By treatment effect I mean here the effect of a doctor giving you something and saying ‘here, take this, it may help you’, even if the treatment in and of itself has no biological action at all. This has been well described in all kinds of settings.

    Finally, for those wanting another – hopefully fairly plain language – discussion of:

    – how your body is actually rather good at sensing lack of fluid;
    – why all fluids (not just water) count; and
    – why the ‘eight glasses a day’ thing is a crock

    – you could try this blogpost of mine, which I’ve cited on here before.

  9. Guy Chapman July 14, 2011 at 10:29 pm #

    You rarely see anyone at a power meeting these days without the obligatory bottle of mineral water. I have a sneaking suspicion that they’re getting more chemicals from the plastic bottle than the expensive water inside.

    I have a cure for all this nonsense: bring back the good old-fashioned British tea break.

  10. Francisco July 15, 2011 at 11:56 am #

    For years I suffered terrible headaches.
    Every week, I would have at least one that lasted for a day or two.

    Then, i started to drink more water… like 2 litres a day.
    Headaches a almost disapeared, GONE.

    I have more energy and no pain.
    HONESTLY i rather drink water than taking pain killers

    Are pain killer drugs (and any other drug for that matter) better than water?
    Do you what works for you and use your common sense.

    Surely the mineral water industry is promoting it. So does every other industry (including big pharma).

    The question is: is it good or bad for people?
    For me i know its good. Better than good.

  11. Margaret McCartney
    margaretmccartney July 15, 2011 at 2:01 pm #

    lovely Dr Aust, thankyou.
    I am not ‘against’ anyone drinking a bit more than they thirst for – the article is mainly about the claims made by bottled water manufacturers. that’s the focus.

  12. derek Tunnicliffe July 15, 2011 at 5:24 pm #

    A while ago we allowed someone calling himself a “Water Technician” into the house (here in France). He asked for a glass of tap water, then added some chemical. After a delay of some 30 seconds, we were astounded to see a separation of the water into different coloured zones; a thin film of dirty grey at the top, then various others below. Our “Technician” was non-plussed: he had expected a thicker grey zone, he said. It turned out our tap-water was of very good quality. The other colours represented appropriate nutrients, etc.

    He then saw we had a plastic bottle of a well-known brand of water on the work-surface and asked for a glass of that. Same chemical: but what a different result. There was a greasy, thick film at the top, plus other colours below. This greasy film was, he explained, an oil-related breakdown of the plastic bottle. Bottled water firms don’t say when their water was bottled. It stands in the sun for who knows how long until it is sold. And the sun causes the plastic of the bottles to break down – into the water.

    So, what you’re drinking when you raise that plastic bottle to your lips, is oil (OK mixed with water). We’ve been drinking tap-water ever since. And, No, we didn’t buy one of his reverse-osmosis water “cleansing” systems.

  13. Martin Foter July 16, 2011 at 9:26 am #

    As I am familiar with conducting comprehensive literature research (I am doing research in chemistry), I was quite shocked when reading your article in the BMJ. It suggested to me a very low level of research in the field of human water intake. Given that the total amount of water in an adult man and woman of average weight is about 60% and 70% of the total body weight, respectively, one might expect a high number of studies.

    Fortunately, as google scholar taught me very briefly, this apparent lack does not conform to reality. I found a high number of peer-reviewed articles and some of them are for instance summarized in the Scientific Opinion on Dietary Reference Values for Water by the EFSA (http://www.efsa.europa.eu/en/efsajournal/doc/1459.pdf). In there, evidence is given that a number of people drink less water than recommended by scientific reference values for total water intake. In particular in the elderly, water turnover can be compromised by a reduced thirst response to a fluid deficit (Leiper et al., 2005). Thirst alone is shown to be often not sufficient in order to govern an adequate water turnover. In fact, conscious drinking behaviour is required. Simple mass balance tells us how much we should drink in order to maintain our water balance and it is common sense to take care of this.

    I scientific respect, I hence cannot see your point to recommend people not too pay attention to their daily water intake. What’s more, I do not understand why you refer to personal believes from your Pennsylvanian friend, rather than to the mass of existing scientific reports.

    Furthermore, I wonder what your actually driving force of this rather political than scientific article was. The lobbyism of Danone et al., I grant, is both evident and influential. Even though, I find a advertisement for water preferable to the omnipresent promotion of softdrinks, beer and high percentage alcoholic drinks. If the advertising campaigns of Danone persuade people to grab a fresh sparkling water instead of a can of coke, I strongly appreciate this.

    Finally, you have disqualified yourself as the author of a serious article with your attempt to dissuade people from drinking bottled water by citing the personal opinion of Prof Goldfarb about this matter. I believe people are smart enough to decide by themselves what kind of water resource the like to utilize and I am very much surprised that this has been included into your article without any scientific context.

  14. Dr Aust July 16, 2011 at 10:22 am #

    @Martin Foter

    Negoianu & Goldfarb’s J Am Soc Nephrol editorial is some 1600-2000 closely argued words, and is essentially a concise scientific review of recent studies. By dismissing it as “opinion” you suggest that you do not know as much as you claim about scientific research. In addition, what the authors were doing in part was updating an earlier (2002) comprehensive review on the topic of water consumption by Heinz Valtin. So the main point is that Negoianu & Goldfarb’s was a ‘scientific and medical view based on close consideration of the evidence’. It thus has the same sort of status as the reports from other bodies, like the one you cited. Many of the ones favouring more drinking of plain water come from organisations with obvious ties to the bottled water industry, which Goldfarb and Valtin conspicuously do not have.

    Incidentally, the 2005 paper by Leiper et al that you refer to is a tiny (pilot?) study with less than 40 subjects in all, and does little more than raise some questions. It is awash with confounding factors, and certainly does not show anything like ‘a reduced thirst response to a fluid deficit’ in the elderly.

    Of course, if I was writing something with the object of promoting bottled water consumption, I might well cite a thin paper like this as evidence that people should drink more. Which is rather where we came in.


  15. Dr Aust July 16, 2011 at 10:32 am #

    Oops – sorry, left in duplicated URL linking to Leiper et al

  16. Heather Johnston July 16, 2011 at 5:24 pm #

    Although I have not done a literature review, I have worked with tens of thousands of patients. Although I did not want to believe the following to be true, as I did not drink water myself 20 years ago, and did not believe that it was needed to be consumed in large quantities, over the years this is what my patients have experienced.

    1. After increasing water intake for 7-8 weeks many of their symptoms such as headaches, digestive issues, colon issues, and general anxiety decreased or disappeared for reasons unknown as well as pain decreasing or disappearing.

    2. Most patients reported constantly they were not thirsty until they had increased their water intake for over a month. They found it quite confusing that they were not thirsty before, they increase their water intake, and now they are thirsty? It doesn’t make sense. The only explanation I have is a comparison to what happens when humans go on a hunger strike, or stop eating for other reasons. They report that after 3 days they aren’t hungry any more. It may be that when the body gives signals of thirst and hunger that are ignored they simply stop sending those signals. No one would argue that because someone isn’t hungry after 3 days of not eating they obviously do not need food any more. Why would the same argument be valid for water consumption? Because the person is not thirsty any more they must not need water. Many health care professionals that work in emergency rooms will tell you the patients that are admitted with acute failures that turn out to be due to dehydration all tell them “how could I be dehydrated? I wasn’t ever thirsty”. With food the person has to begin eating again normally for the body to be healthy enough to send the signals that they are hungry. Perhaps with water the same holds true: they need to be hydrated enough for the body to send signals of thirst. Health Care professions that work with those afflicted with anorexia understand that they lose the feeling of hunger long-term. The patients argue, “I must not need to eat any more than I am because I am not hungry”. No one would accept that those patients indeed did not need to consume more than 0 – 100 calories a day just because they are not hungry, why would we accept a person must not need to drink water if they are not thirsty. Of note, with some anorexia patients it may take months of them eating somewhat normally before they even start having any signals of hunger.

    3. When patients decreased their water consumption (not fluid consumption) after having become re hydrated again, many of the past symptoms returned and often then they have generalized edema starting as well.

    Water consumption may be one of those health areas that we need to go by what appears to be happening in humans and not what the literature, which is often researched/written with an agenda in mind, indicates. Remember, doctors for years recommended smoking and stated that it was healthful and that there was not “proof” in the literature that it was harmful. They ridiculed the element of the medical community, as well as the general public, who tried to encourage people to stop smoking. The “research” was on the side of the argument of those that stated that smoking was not harmful; however, the reality was actually on the side of those that did not have the “proof in the literature” but went by the actual affects on human beings. It took 75 years for the research to catch up to the reality. Of note is the 50 year recommendation of doctors to use margarine instead of butter based on the “medical proof”. It turns out in that case as well, that the “literature” was incorrect, and the health care professionals and general public that were more aware of the affect it was having on humans were correct all the way along.

  17. Jessie McDaniel July 17, 2011 at 3:03 am #

    I agree water is needed for your body but I have probably drank 8 glasses in 2 years vs what the doctors say about 6-8 a day. I think it is all about how your activities are.Water does not set well with me, I belch it back up alot with stomach acids so I dont drink it much. Sip here or there and that’s it. My only medical condition is I have hypoglycemia. Which means my sugar has to be regulated through 6 small meals a day. So my conclusion is we don’t need as much water as they say for most people.

  18. Ian Bright July 17, 2011 at 1:02 pm #

    The relative merits of sugar based drinks and water raised by @George Paterson, July 13, 12:18 is covered in the original article, easily reached through Margaret’s link.

    The article state “Professor Goldfarb told me: “The current evidence is that there really is no evidence [for drinking extra water]. I agree, if children drank more water rather than getting extra calories from soda, that’s good for weight loss, and self evident…”

    The author of an article in any specialist publlication (such as the BMJ) cannot control what is written in the mainstream press (such as the Glasgow Herald). If the mainstream press article is a poor summary of the orignal well argued piece there is little the original author can do to correct this.

    Keep up the good work, Margaret.

  19. Margaret McCartney
    margaretmccartney July 17, 2011 at 8:54 pm #

    thank you
    repeat: the article was not a systematic review and it certainly didn’t pretend to be. It was an assessment of the claims made by Hydration for Health. Despite the very good rationale that drinking more water may help with various problems, the RCT evidence is lacking. People have looked for this on many times and failed to find convincing evidence for drinking more than you naturally would. I am well aware of the problems with overprescribing and polypharmacy and it’s something I’ve written about a lot. If there was an easy solution to the complex problems of deprivation, addiction, obesity, cancer, vascular disease or diabetes, I’d like to know it. I don’t think it comes in bottles.

  20. Jonathan Hall July 17, 2011 at 9:04 pm #

    The following information from the website of the MAYO CLINIC in the states was discussed on the Around the Water Cooler radio show [Water Nutrition A Vital Link archive podcast: http://bit.ly/p5Mjse%5D with Jennifer Nelson, Director of Clinical Dietetics and Nutrition at the Mayo Clinic and Assoc. Professor of Nutrition at Mayo Clinic College of Medicine. She spoke to us about the importance of drinking water in maintaining good health.

    So how much water does the average, healthy adult living in a temperate climate need? In general, doctors recommend 8 or 9 cups. Here are the most common ways of calculating that amount:
    • Replacement approach. The average urine output for adults is about 1.5 liters (6.3 cups) a day. You lose close to an additional liter (about 4 cups) of water a day through breathing, sweating and bowel movements. Food usually accounts for 20 percent of your total fluid intake, so if you consume 2 liters of water or other beverages a day (a little more than 8 cups) along with your normal diet, you will typically replace your lost fluids.
    • Eight 8-ounce glasses of water a day. Another approach to water intake is the “8 x 8 rule” — drink eight 8-ounce glasses of water a day (about 1.9 liters). The rule could also be stated, “Drink eight 8-ounce glasses of fluid a day,” as all fluids count toward the daily total. Although the approach really isn’t supported by scientific evidence, many people use this easy-to-remember rule as a guideline for how much water and other fluids to drink.
    • Dietary recommendations. The Institute of Medicine advises that men consume roughly 3 liters (about 13 cups) of total beverages a day and women consume 2.2 liters (about 9 cups) of total beverages a day.
    Even apart from the above approaches, if you drink enough fluid so that you rarely feel thirsty and produce 1.5 liters (6.3 cups) or more of colorless or slightly yellow urine a day, your fluid intake is probably adequate.

  21. Drink Up !! July 18, 2011 at 6:13 am #

    Wow…now I’ve seen it all…I’m assuming you are being paid by the distilleries of Scotland to promote drinking Scotch instead of water?? Just kidding but why on earth would you make such a ridiculous and obviously false statement. OF COURSE we need to drink water – maybe you missed the day in Med school where they talked about dehydration and its consequences. “Don’t need to drink more than you naturally would” – well guess what Doc – evidence shows that as adults age and drink less water their “thirst” drive reduces or it is mistaken as hunger so they eat and get fat. So what is “naturally would” . You are so off the mark I don’t know where to begin really. But bottom line I’m glad you’re not my Doctor.

  22. Alison July 23, 2011 at 12:44 am #

    “If you get your five portions of fruit and veg a day that makes a significant contribution”

    Read more: http://www.metro.co.uk/news/869165-nhs-water-drinking-guidelines-nonsense-says-glasgow-gp#ixzz1SsssC6GY

    IF – is a very little word, but very mighty. Most people here in Canada are lucky to claim one serving of fresh fruit or vegetable/day. We need to be a wee bit more careful in how we say things. Already I have 2 clients who tell me that they read an article(yours) telling them they didn’t have to drink ‘any’ water. The most they were taking up to now was about 1 cup per day. I would suggest that we need more than 8 oz of water a day. I do agree that some people tend to push water way too much, BUT, we do also need more than 8 oz /day. How about making a more balanced article and define a little better what “Too much” really means. Some have suggested 1 oz per 2 pounds of body weight for example. Would this be considered too much? No, especially if combined in the fruits and vegetables that we are suppose to be ingesting.

  23. Mufit Zeki August 27, 2011 at 8:41 pm #

    margaretmccartney repeats: “Despite the very good rationale that drinking more water may help with various problems, the RCT evidence is lacking.”
    If an RCT is lacking how can you end up with “If there was an easy solution to the complex problems of deprivation, addiction, obesity, cancer, vascular disease or diabetes, … I don’t think it comes in bottles.” Belief or science?
    Okay,? Okay,margaretmccartney repeats: “It was an assessment of the claims made by Hydration for Health.” and repeats
    What type or kind of assessment was that? Not a systematic review or meta-analysis, not an RCT.
    She is trying to say is that we do not need to drink more than we would normally do. of course Of course she would recommend water over sugary drinks, absolutely.
    And the final word; “I would recommend tap rather than bottled water; cheaper, and far better for environment.”
    Okay, better for environment sounds good, but why cheaper for human is better?
    Okay, she declared already “The article is mainly about the claims made by bottled water manufacturers.” But, cheaper for what? For health or wealth?
    She is somehow biased since she is commissioned to write against the claims of the bottled water industry without external peer-review. That is fine, people will drink less bottled water, more canned liquid, and otherwise the daily physiological water metabolism could not be maintained. Result; bottled water manufacturers will enjoy this trend since they all have sugared and bottled drinks in their product menus where they use water from the tap.
    Ah, H2O will always do its job in every form, thanks God. And, drinking it more will help with various problems, margaretmccartney belives or not, an RCT is lacking or not. Water is life!

  24. Doug September 13, 2011 at 4:36 pm #

    It’s taken me a while to catch up with this comment and doesn’t follow many of the others – IE, I’m not making a case for right or wrong here… I would like, however, to add the “5-a-day” (fruit/veg) to the “8-a-day” (glasses of water), as another example of how commerce seems to have a canny nack of creating conventioanl wisdom. After very successfully following some key principles from Zoe Harcombe on my diet – I shed more than 2 stones, and it’s not gone back on after nearly 18 months – I feel more inclined to challenge convention (as Zoe H does big time) and hence appreciate the challenge from the Margaret MaCartney article.

  25. Jon November 2, 2011 at 1:45 pm #

    It is funny isn’t it? Have we all totally lost touch with our natural desires? Drinking water has to be the most natural thing possible, a simple response to thirst. But nowadays people mistake thirst for hunger and eat instead and then wonder why they are overweight and always having headaches. Where did we go wrong?

  26. Orlando Barcellos May 22, 2012 at 8:17 pm #

    Very nice website, thanks for share this article with us

  27. Matt June 7, 2012 at 5:28 pm #

    Margaret, great article! I was turned on to your article through Valtin’s paper and was excited to find a link to full-text here. Thanks and keep up the good work!