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David Baxter PhD

Late Founder
Why 'Drink More Water'?
By James Hamblin, The Atlantic
September 12, 2013

Watertown has twice been voted as having the best water in Wisconsin. That?s why First Lady Michelle Obama is speaking there later today, as she launches a campaign ?calling on every city to be a water town.?

That is, yes, a play on words. It is not a dystopian Kevin Costner Waterworld scenario; Mrs. Obama just wants every town in the U.S. to drink more water. The campaign is known as ?Drink Up? and it encourages people to drink ?even just one more glass a day.?

Obama's appearance today is just part of the campaign's ?bi-lingual day of water messages on a dozen TV shows ? which will involve hosts drinking water and encouraging viewers to drink water." The shows include Today, Good Morning America, The View, Live With Kelly and Michael, Late Night, The Tonight Show, The Late Show, The Doctors, and Rachael Ray. All will feature ?Drink up? messages.

Why? That is the question.

?40 percent of Americans drink less than half of the recommended amount of water daily,? said Sam Kass, White House senior policy advisor for nutrition policy [sic?], yesterday. Kass and Mrs. Obama?s press secretary Hannah August attributed that statistic to a CDC study.

The problem is, though, that there is no recommended daily amount of water. If we knew how much we should be drinking, and it turned out we weren?t drinking enough, then yes, tell us to drink more. If they were telling us to replace soda in our diets with water, that would also be reasonable and potentially productive. They're explicitly not doing that, though.

***​

The CDC study called 4 cups a moderate amount; not a recommendation. The average American drinks about 2.5 cups. The U.S. government?s official dietary recommendation document reads:

Screen Shot 2013-09-11 at 3.08.23 PM.png
(USDA)

Here is that "adequate intake" :acrobat: recommendation from the Institute of Medicine. The Mayo Clinic's recommendation is "If you drink enough fluid so that you rarely feel thirsty and produce 1.5 liters (6.3 cups) or more of colorless or light yellow urine a day, your fluid intake is probably adequate." Not that you have to measure your urine every day, but you get it. The Institute of Medicine likewise sidesteps quantified intake guidelines and takes an Al Jones-esque approach: "Let thirst be your guide." That?s what most doctors will tell you, too.

Today?s launch of the pro-water initiative is a part of Mrs. Obama?s pro-movement movement, Let?s Move! (Mission: ?to ensure all our children grow up healthy? via providing American families with? simple, actionable information to make healthy choices.?)

What could be simpler and actionable-r than a call to drink more water?

Mrs. Obama, we love you. We also love kids and believe they should be healthy. But let?s actually not move on this for a minute, because it?s missing all the points.

***​

Sam Kass joined the White House via the kitchen staff in 2009, when he took job as Assistant Chef. He is now Senior Policy Advisor for Nutrition Policy [again, possibly sic; seems redundant]. He is also Executive Director of ?Let?s Move!? Kass briefed members of the press yesterday, including me, about the launch of Drink Up.

As Kass put it, ?Water is our original energy drink. It's a really exciting, fun, and positive campaign that will inspire people to drink more water.?

Agh! Why?

He said that the campaign will bring together ?leaders from industry, entertainment, media and government around the simple message that water is one of the best and easiest choices every one of us can make every day.?

As August put it, ?This new effort will remind people that more water helps you have more energy and stamina so you can do more, longer and with better focus.? I?d love that to be true.

Plus, PLUS, the average United States person is already drinking 38 percent more water than 15 years ago. It is true that a quarter of kids are drinking no water at all, that doesn't make it prudent to tell everyone to drink more. Too much water can be as bad as too little.

Americans reporting drinking water in a given day
Screen Shot 2013-09-11 at 3.38.31 PM.jpg
(USDA)

One of my colleagues asked the question that was on my tongue: What are the health benefits you refer to?

Kass replied, "I think the science and evidence about hydration abounds. Starting with headaches, it leads to many more conditions. But this isn't a public health campaign. We think that being positive is most important, not getting into all the details about what a glass of water can do for you, is the message."

To be fair, Kass is a chef, not a scientist, and that was off the cuff. But if you?re a national policy advisor on nutrition, and launching a campaign whose singular objective is to tell 314 million people to drink more water, your cuff should have some data that says more water is better.

We even gave them an easy out. Another reporter: ?Why aren't we talking about obesity??

Kass: "We think a positive, forward-leaning campaign is the most effective way to insure that people are getting the water they need. Water is the simplest, most accessible healthy choice people can make, We're going to keep it positive from start to finish."

Another reporter: Are we talking about replacing sugary drinks and sodas with water??

Lawrence Soler, president and CEO of Partnership for a Healthier America, fielded that one. ?It's less a public health campaign than a campaign to encourage drinking more water. To that end, we're being completely positive. Only encouraging people to drink water; not being negative about other drinks. "

This is a public health campaign. How could this be anything but a public health campaign?

It will involve PSAs from first lady that will run nationwide, banner ads on prominent sites, the ?Drink Up? logo on 500 million bottles of water and more than 10,000 outdoor public taps, and a website called You Are What You Drink. Like everyone, they have social media strategies. These involve the Twitter hashtag "#drinkH20" and ?celebrities with combined followings of over 100 million.?

How is this not a public health campaign? What is it?

?[Today?s] launch in Watertown will involve having fun. It will emphasize emotional appeal, like a product launch more than a public health campaign,? Kass said.

No, I still don?t get it.

***​

Just, don?t think about it. Repeat the slogan you?re going to hear: "When you drink water, you Drink Up."

"When you drink water, you Drink Up."

"When you drink water, you Drink Up!"

Also, this could be of interest. Because, as Soler put it, ?We want to include very aspect of the water community ? Many water brands are lending their assets.?

That includes American Beverage Association, Aquafina, Arrowhead, Beverly Hills 90H20 (no joke), Britta, Dasani, Evian, Global Tap, Ice Mountain, International Bottled Water Association, Nestle Purelife, Poland Springs, Smart Tap, Swell, Voss, and Zephyr Hills.

Is that, I mean I don?t want to accuse anyone of anything, but is that relevant?

As Kass put it, the campaign must involve ?leveraging the power of the private sector to make a creative choice for consumers in new, fun, positive ways that will resonate with people trying to make a healthier choice to put this country on a healthier track.?

Municipalities are also signing on. ?The breadth and scope of this is truly extraordinary," Kass said. "Cities will also be partners: Chicago and Houston, as well as Watertown. It's not just bottled water, either. ... Cities will promote this positive message.?

I?m still not sure why Chicago would be telling me to drink more water. Or if I should. So I inquired further with the First Lady?s press office.

Me: Hi, one follow-up question from today's call. Do you know where the CDC daily water intake recommendations (mentioned in the call) are available?

August: Here are two relevant sources. (This is the one that says 43 percent of Americans drink less than four cups of water a day, including 7 percent who don?t drink any water daily.) And here?s an attachment, which says that a quarter of American children aren?t drinking any water on any, given day.

Me: Thanks! So, I don't find a recommended amount of water per day anywhere. Unless I'm missing something, which I totally could be. I know this is an area of debate in medicine ...

August: For your background, the new campaign isn?t going to go into how many glasses, ounces, etc. people should drink every day. The campaign and the First Lady will be asking people to just drink more water ? starting with just one more glass a day.

***​

Bordering on begging for some sort of rationale or standard, one reporter did at one point ask, ?How much water does Mrs. Obama drink on a daily basis??

Kass said, "She is a water drinker from morning until night."

Between the lines of statements like that, I hope what's really meant by "Drink up!" is this: Replace soda with water, yes. Remember that too much water can still be bad, though, and for most people we have no reason to believe that an extra glass of water will result in health benefits. Drinking a glass of water certainly shouldn't replace otherwise healthy behavior or give anyone a sense of confidence in their health that justifies subsequent unhealthy behavior. When you?re thirsty, yes, choose water over something with empty calories. If you?re thirsty from morning until night, figuratively or otherwise, see a doctor. Don?t let anyone who doesn?t know how much water you drink tell you to drink more water.

If you?re wont to insist on chanting about defunding a national health initiative, consider this one. I know we're just trying to "keep things positive," but missing the opportunity to use this campaign's massive platform to clearly talk down soda or do something otherwise more productive is lamentable. Public health campaigns of this magnitude don't come around every day. This one squanders both money and precious celebrity Twitter endorsements. Keeping things positive and making an important point are not mutually exclusive, you fools.
 

David Baxter PhD

Late Founder
Water: How much should you drink every day?

Water: How much should you drink every day?
MayoClinic.com
Oct. 12, 2011

Factors that influence water needs
You may need to modify your total fluid intake depending on how active you are, the climate you live in, your health status, and if you're pregnant or breast-feeding.

Exercise. If you exercise or engage in any activity that makes you sweat, you need to drink extra water to compensate for the fluid loss. An extra 400 to 600 milliliters (about 1.5 to 2.5 cups) of water should suffice for short bouts of exercise, but intense exercise lasting more than an hour (for example, running a marathon) requires more fluid intake. How much additional fluid you need depends 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 and reduce the chances of developing hyponatremia, which can be life-threatening. Also, continue to replace fluids after you're finished exercising.

Environment. Hot or humid weather can make you sweat and requires additional intake of fluid. Heated indoor air also can cause your skin to lose moisture during wintertime. Further, altitudes greater than 8,200 feet (2,500 meters) may trigger increased urination and more rapid breathing, which use up more of your fluid reserves.

Illnesses or health conditions. When you have fever, vomiting or diarrhea, your body loses additional fluids. In these cases, you should drink more water. In some cases, your doctor may recommend oral rehydration solutions, such as Gatorade, Powerade or CeraLyte. Also, you may need increased fluid intake if you develop certain conditions, including bladder infections or urinary tract stones. On the other hand, some 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 used especially when nursing. The Institute of Medicine recommends that pregnant women drink 2.3 liters (about 10 cups) of fluids daily and women who breast-feed consume 3.1 liters (about 13 cups) of fluids a day.

Beyond the tap: Other sources of water
Although it's a great idea to keep water within reach at all times, you don't need to rely only on what you drink to meet your fluid needs. What you eat also provides a significant portion of your fluid needs. On average, food provides about 20 percent of total water intake. For example, many fruits and vegetables, such as watermelon and tomatoes, are 90 percent or more water by weight.

In addition, beverages such as milk and juice are composed mostly of water. Even beer, wine and caffeinated beverages ? such as coffee, tea or soda ? can contribute, but these should not be a major portion of your daily total fluid intake. Water is still your best bet because it's calorie-free, inexpensive and readily available.

Staying safely hydrated
Generally if you drink enough fluid so that you rarely feel thirsty and produce 1.5 liters (6.3 cups) or more of colorless or light yellow urine a day, your fluid intake is probably adequate. If you're concerned about your fluid intake or have health issues, check with your doctor or a registered dietitian. He or she can help you determine the amount of water that's right for you.

To ward off dehydration and make sure your body has the fluids it needs, make water your beverage of choice. It's also a good idea to:

  • Drink a glass of water or other calorie-free or low-calorie beverage with each meal and between each meal.
  • Drink water before, during and after exercise.

Although uncommon, it is possible to drink too much water. When your kidneys are unable to excrete the excess water, the electrolyte (mineral) content of the blood is diluted, resulting in low sodium levels in the blood, a condition called hyponatremia. Endurance athletes, such as marathon runners, who drink large amounts of water, are at higher risk of hyponatremia. In general, though, drinking too much water is rare in healthy adults who eat an average American diet.

References

  1. Sawka M, et al. Human water needs. Nutrition Reviews 2005;63:S30.
  2. Valtzin H. "Drink at least eight glasses of water a day." Really? Is there scientific evidence for 8 x 8? American Journal of Physiology - Regulatory, Integrative and Comparative Physiology. 2002;283:R993.
  3. Rose BD, et al. Maintenance and replacement fluid therapy in adults. Evidence-Based Clinical Decision Support at the Point of Care | UpToDate. Accessed March 2, 2010.
  4. Dietary reference intakes for water, potassium, sodium, chloride and sulfate. Institute of Medicine. http://www.nal.usda.gov/fnic/DRI//DRI_Water/73-185.pdf. Accessed March 2, 2010.
  5. Exercise and fluid replacement. Medicine & Science in Sports & Exercise. 2007;39:377.
  6. Campbell SM. Hydration needs throughout the lifespan. American Journal of Clinical Nutrition. 2007;26:5858.
  7. Nutrition and athletic performance: Position of the American Dietetic Association, Dietitians of Canada, and the American College of Sports Medicine. Journal of the American Dietetic Association. 2009;109:509.
  8. Park S, et al. Pathophysiology and management of calcium stones. Urology Clinics of North America. 2007;34:323.
  9. Manz F. Hydration and disease. Journal of the American College of Nutritionists. 2007;26(suppl):535S.
  10. Zeratsky KA (expert opinion). Mayo Clinic, Rochester, Minn. Oct. 3, 2011.
 

heatherly

Member
I didn't have to read this, but I hope that people will listen to you or rather the article. Many years ago I ran into a man who instantly said, "What you need is water." He told me to buy the book, "Your body's Many Cries for Water." I did, but I didn't listen. Recently my urologist told me to drink 7 glasses a day and it would cure my problem. It cured it. Now I am listening. All my life drs. said that I was dehydrated, and I didn't listen back then.
 
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GDPR

GDPR
Member
Obama's appearance today is just part of the campaign's “bi-lingual day of water messages on a dozen TV shows … which will involve hosts drinking water and encouraging viewers to drink water." The shows include Today, Good Morning America, The View, Live With Kelly and Michael, Late Night, The Tonight Show, The Late Show, The Doctors, and Rachael Ray. All will feature “Drink up” messages.


My initial thought when reading this was "what are they putting in the water?"

My second thought was "how very clever, they have put something in our water supply and now they are encouraging us to drink it".

I could go on a rant about this,but I will spare you all my conspiracy theories.
 

heatherly

Member
Michele Obama is actually a very good woman who is working on health issues. No one is trying to poison our water. If you fear city water, and some city water is polluted due to toxins from chemical spills, etc. get bottled water or resverse osmosis. But never buy into this conspiracy theories about the President and his wife.
 

GDPR

GDPR
Member
Michele Obama is actually a very good woman who is working on health issues. No one is trying to poison our water.

You don't know that for a fact.You are only hoping what you believe is true.I think it's a little naive to not even consider there might be a hidden agenda behind this campaign.
 

heatherly

Member
I think that there are been too many conspiracy theories these last years in politics. do you ever drink water? I have drank city water for years and I am still alive. I drink our city water when I am out of the house. I even cook with it. I only got reverse osmosis to get rid of fluoride in the water, that is, if it works. what do you drink to keep from being dehydrated?
 

GDPR

GDPR
Member
I didn't say I don't drink water,of course I do.All I was saying was what my first thoughts were when I read this article.

It's probably not a good idea for us to debate the conspiracy theories. It's fine that we disagree,and pointless to try to sway each other into thinking differently.
 

heatherly

Member
I am glad that you drink water. We can't help have those thoughts since the media has been coming up with all kinds of things.
 
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