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Doctor’s Tip: What should we drink every day and how much

Greg Feinsinger

Last week’s column was about the pros and cons of Lifeline Screening, which was offered locally the end of June. Prior to that there were 10 columns on Dr. Michael Greger’s daily dozen — things we should eat every day. The 11th item on the daily dozen list is what we should drink every day and how much.

Depending on age and sex, at least 50% of the human body is composed of water, which is present in cells, between cells and in our bloodstream. Adequate fluid intake is important for optimal health. Among other things, dehydration leads to concentrated urine and thicker blood, which is more apt to clot. If severe enough, dehydration can lead to death. Studies have shown a 50% decrease in bladder cancer and heart disease in people who drink an adequate amount of water every day.

What’s adequate depends on several factors. For example, plant-based food has a high water content, whereas animal products don’t, so people who are plant-based meet a lot of their daily water requirements through the food they eat. Another example is that water requirements for a couch potato are much lower than for someone exercising or doing hard physical work outside on a hot day.



A good rule of thumb is that people should drink enough water so that they are urinating every hour or so throughout the day, and so that their urine is clear to light yellow. Dark urine means dehydration, although a caveat is that B-vitamins cause dark urine for a few hours after intake. In their recently released book “Healthy Heart, Healthy Brain,” Brad Bale, M.D., and Amy Doneen, PhD, point to research that supports using weight to determine how much to drink every day — roughly half of body weight in ounces of water per day. So if you weigh 100 pounds you should drink 50 ounces of water a day (8 ounces is a cup).

When to drink? If you are getting up to urinate once or more during the night, it’s best to avoid fluids after 6 p.m. or so. If you’re going to engage in vigorous exercise, drink before, during (at least every hour) and after.



What to drink? Dr. Greger recommends tap water because in contrast to bottled water it is less expensive, has less environmental impact and often has less chemical and microbial contamination. However, Nutrition Action Health Letter printed an article titled “America’s drinking water is in trouble,” which pointed out that while most Americans no longer have to worry about getting parasitic, bacterial or viral illnesses from water, we now have to worry about industrial, pharmaceutical, agricultural and other chemical contaminants; as well as naturally occurring ones such as arsenic and lead (think Flint, Michigan). If you have any concerns, such as living in an old house that could have lead pipes, get your water tested.

Water can be boring, so consider spicing it up with things like lemon, lime, mint, cucumber slices, ginger shavings, a cinnamon stick, lavender or carbonation. Here’s what you need to know about other fluids:

• Tea has many health-promoting micronutrients, according to Dr. Greger, and hibiscus tea has the most (buy looseleaf from a specialty tea shop or online). Green tea is a close second best. Hibiscus tea has been shown to lower blood pressure, and green tea to decrease risk of several cancers. You can make hot tea or cold-steep it.

• Coffee has some health benefits but not as many as tea. The downside of coffee is that it can contribute to gastric-esophageal reflux, sleep problems (some caffeine is still present at bedtime from your morning coffee) and in some people a rise in pulse rate and blood pressure.

• Alcohol is not recommended as a source of fluids, because other than beer, it is dehydrating. And any alcohol other than small amounts of red wine increases risk of breast cancer in women.

• The Beverage Guidance Panel ranked cow’s milk far down the list of recommended beverages due to links to prostate, breast and ovarian cancer. (Unsweetened soy and almond milk are fine).

• Soda is not recommended in any form or quantity. Sugar is an issue with regular soda (10 teaspoons in a can), and there are other health issues with artificial sweeteners in sugar-free soda.

• Sports drinks such as Gatorade are not healthy unless you are exercising vigorously, such as running more than a 10K, because of their high sugar, salt and calorie content.

• Avoid fruit juices, which are basically flavored sugar water.

Dr. Feinsinger is a retired family physician with special interest in disease prevention and reversal through nutrition. Free services through Center For Prevention and The People’s Clinic include: one-hour consultations, shop-with-a-doc at Carbondale City Market and cooking classes. Call 970-379-5718 for appointment or email gfeinsinger@comcast.net.


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