Water, hydration, and health.

This review examines the current knowledge of water intake as it pertains to human health, including overall patterns of intake and some factors linked with intake, the complex mechanisms behind water homeostasis, and the effects of variation in water intake on health and energy intake, weight, and human performance and functioning. Water represents a critical nutrient, the absence of which will be lethal within days. Water's importance for the prevention of nutrition-related noncommunicable diseases has received more attention recently because of the shift toward consumption of large proportions of fluids as caloric beverages. Despite this focus, there are major gaps in knowledge related to the measurement of total fluid intake and hydration status at the population level; there are also few longer-term systematic interventions and no published randomized, controlled longer-term trials. This review provides suggestions for ways to examine water requirements and encourages more dialogue on this important topic.

[1]  Nutrition Board,et al.  RECOMMENDED DIETARY ALLOWANCES. , 1964, Clinical pediatrics.

[2]  G. Mathé [Physiology of thirst]. , 1953, L' Alimentation et la vie.

[3]  Minimum urine total solute concentration in response to water loading in normal men. , 1957, Journal of applied physiology.

[4]  R. Lindeman,et al.  Osmolar renal concentrating ability in healthy young men and hospitalized patients without renal disease. , 1960, The New England journal of medicine.

[5]  P. L. Altman,et al.  Blood and Other Body Fluids , 1961, Pediatrics.

[6]  S. Papper,et al.  Differential diagnosis of oliguria in aged patients. , 1962, The New England journal of medicine.

[7]  G. Goldsmith,et al.  Diet Advice to the Healthy Patient: Interpretation of 1964 Recommended Dietary Allowances of the Food and Nutrition Board, National Academy of Sciences-National Research Council , 1964 .

[8]  W. Höfler [Heat acclimatization]. , 1968, Hippokrates.

[9]  L. Taitz,et al.  High Calorie/Osmolar Feeding and Hypertonic Dehydration , 1972, Archives of disease in childhood.

[10]  Brick Je,et al.  Cold water syncope. , 1978 .

[11]  International society for developmental psychobiology , 1979, Physiology & Behavior.

[12]  O. Bar-or,et al.  Voluntary hypohydration in 10- to 12-year-old boys. , 1980, Journal of applied physiology: respiratory, environmental and exercise physiology.

[13]  P. Miller,et al.  Hypodipsia in geriatric patients. , 1982, The American journal of medicine.

[14]  M D Curley,et al.  Cognitive performance during a heat acclimatization regimen. , 1983, Aviation, space, and environmental medicine.

[15]  L. Wollner,et al.  Reduced thirst after water deprivation in healthy elderly men. , 1984, The New England journal of medicine.

[16]  J. Delmont,et al.  Gallbladder emptying after drinking water and its possible role in prevention of gallstone formation. , 1986, Singapore medical journal.

[17]  P. Gopinathan,et al.  Role of dehydration in heat stress-induced variations in mental performance. , 1988, Archives of environmental health.

[18]  G. Beaton TOTAL WATER AND TAPWATER INTAKE IN THE UNITED STATES: POPULATION-BASED ESTIMATES OF QUANTITIES AND SOURCES , 1988 .

[19]  L. Brown,et al.  Intake of tapwater and total water by pregnant and lactating women. , 1991, American journal of public health.

[20]  C. Johnston,et al.  Reduced osmotic thirst in healthy elderly men. , 1991, The American journal of physiology.

[21]  E. Coyle,et al.  Influence of graded dehydration on hyperthermia and cardiovascular drift during exercise. , 1992, Journal of applied physiology.

[22]  J. Morley,et al.  Role of the Opioid System in the Hypodipsia Associated with Aging , 1992, Journal of the American Geriatrics Society.

[23]  C. Johnston,et al.  Disturbed fluid and electrolyte homoeostasis following dehydration in elderly people. , 1993, Age and ageing.

[24]  E. Nadel,et al.  Body fluid balance in dehydrated healthy older men: thirst and renal osmoregulation. , 1994, Journal of applied physiology.

[25]  G. Grossberg,et al.  Drinking Behavior and Vasopressin Responses to Hyperosmolality in Alzheimer's Disease , 1994, International Psychogeriatrics.

[26]  S. Gates,et al.  Atomic layer epitaxy of Si on Ge(100): Direct recoiling studies of film morphology , 1994 .

[27]  I. Davies,et al.  Age-associated alterations in thirst and arginine vasopressin in response to a water or sodium load. , 1995, Age and ageing.

[28]  Stanley J. Goldberg,et al.  Gender differences in dehydration-induced mitral valve prolapse. , 1995, American heart journal.

[29]  Nadine Bazilinski,et al.  Brenner and Rector's The Kidney , 1997 .

[30]  J. Vanderhoof,et al.  Increasing oral fluids in chronic constipation in children. , 1998, Gastroenterology nursing : the official journal of the Society of Gastroenterology Nurses and Associates.

[31]  M. Sawka,et al.  Hydration Effects on Temperature Regulation , 1998, International journal of sports medicine.

[32]  J. Leiper Intestinal Water Absorption - Implications for the Formulation of Rehydration Solutions , 1998, International journal of sports medicine.

[33]  A. Harris,et al.  Mechanism of exercise-induced ocular hypotension. , 1999, Investigative ophthalmology & visual science.

[34]  A. Harris,et al.  Regulation of intraocular pressure after water drinking. , 1999, Journal of glaucoma.

[35]  A. Farb,et al.  Swallow syncope. , 1999, Maryland medical journal.

[36]  M. Mpaka,et al.  Hematocrit and stroke in black Africans under tropical climate and meteorological influence. , 1999, Annales de medecine interne.

[37]  C. Wolfe,et al.  Influence of Raised Plasma Osmolality on Clinical Outcome After Acute Stroke , 2000, Stroke.

[38]  R. Baumgartner,et al.  Do elderly persons need to be encouraged to drink more fluids? , 2000, The journals of gerontology. Series A, Biological sciences and medical sciences.

[39]  Thomas W. Rowland,et al.  Climatic Heat Stress and the Exercising Child and Adolescent , 2000, Pediatrics.

[40]  S M Shirreffs,et al.  Markers of hydration status. , 2000, The Journal of sports medicine and physical fitness.

[41]  D. Kiely,et al.  Development of constipation in nursing home residents , 2000, Diseases of the colon and rectum.

[42]  B. Brenner Brenner and Rector's The Kidney , 2000 .

[43]  Christian Raphel,et al.  Influence of Variations in Body Hydration on Cognitive Function: Effect of Hyperhydration, Heat Stre , 2000 .

[44]  P. Rogers,et al.  A drink of water can improve or impair mental performance depending on small differences in thirst , 2001, Appetite.

[45]  D. Kennedy,et al.  Water ingestion improves subjective alertness, but has no effect on cognitive performance in dehydrated healthy young volunteers , 2001, Appetite.

[46]  C Cian,et al.  Effects of fluid ingestion on cognitive function after heat stress or exercise-induced dehydration. , 2001, International journal of psychophysiology : official journal of the International Organization of Psychophysiology.

[47]  R. F. Johnson,et al.  Blood and urinary measures of hydration status during progressive acute dehydration. , 2001, Medicine and science in sports and exercise.

[48]  P. Lawlor Delirium and dehydration: some fluid for thought? , 2002, Supportive Care in Cancer.

[49]  M. Burge,et al.  Differential effects of fasting and dehydration in the pathogenesis of diabetic ketoacidosis. , 2001, Metabolism: Clinical and Experimental.

[50]  A. Saba,et al.  Food consumption patterns in Italy: the INN-CA Study 1994–1996 , 2001, European Journal of Clinical Nutrition.

[51]  M. Kersting,et al.  Fifteen year trends in water intake in German children and adolescents: Results of the DONALD Study , 2001, Acta paediatrica.

[52]  Siep Thomas,et al.  Normal values and determinants of circadian urine production in older men: a population based study. , 2002, The Journal of urology.

[53]  Gary E Fraser,et al.  Water, other fluids, and fatal coronary heart disease: the Adventist Health Study. , 2002, American journal of epidemiology.

[54]  Heinz Valtin,et al.  “ Drink at least eight glasses of water a day . ” Really ? Is there scientific evidence for “ 8 8 ” ? , 2002 .

[55]  [Impaired urinary flow rate during the day: a new factor possibly involved in hypertension and in the lack of nocturnal dipping]. , 2002, Archives des maladies du coeur et des vaisseaux.

[56]  B. Popkin,et al.  The nutrition transition in Spain: a European Mediterranean country , 2002, European Journal of Clinical Nutrition.

[57]  Jens Jordan,et al.  Water Drinking Acutely Improves Orthostatic Tolerance in Healthy Subjects , 2002, Circulation.

[58]  R. Cuomo,et al.  Effects of carbonated water on functional dyspepsia and constipation , 2002, European journal of gastroenterology & hepatology.

[59]  B. Popkin,et al.  The unique aspects of the nutrition transition in South Korea: the retention of healthful elements in their traditional diet , 2002, Public Health Nutrition.

[60]  A. Diedrich,et al.  Water Ingestion as Prophylaxis Against Syncope , 2003, Circulation.

[61]  M. Arnaud Mild dehydration: a risk factor of constipation? , 2003, European Journal of Clinical Nutrition.

[62]  A. Levey,et al.  High urine volume and low urine osmolality are risk factors for faster progression of renal disease. , 2003, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[63]  P. Diamond,et al.  Relationship of initial hematocrit level to discharge destination and resource utilization after ischemic stroke: a pilot study. , 2003, Archives of physical medicine and rehabilitation.

[64]  K. Madison,et al.  Barrier function of the skin: "la raison d'être" of the epidermis. , 2003, The Journal of investigative dermatology.

[65]  M. Tönz,et al.  Behavioral and functional abnormalities linked with recurrent urinary tract infections in girls. , 2003, Journal of nephrology.

[66]  M. Lóden Role of Topical Emollients and Moisturizers in the Treatment of Dry Skin Barrier Disorders , 2003, American journal of clinical dermatology.

[67]  J. Marinković,et al.  Fluid intake and bladder cancer. A case control study. , 2003, Neoplasma (Bratislava).

[68]  H. Kalhoff Mild dehydration: a risk factor of broncho-pulmonary disorders? , 2003, European Journal of Clinical Nutrition.

[69]  J. Bytomski,et al.  Heat illness in children. , 2003, Current sports medicine reports.

[70]  B. Popkin,et al.  Estimating body fat from anthropometry and isotopic dilution: a four-country comparison. , 2003, Obesity research.

[71]  M. Berwick,et al.  Fluid intake and the risk of tumor recurrence in patients with superficial bladder cancer. , 2003, The Journal of urology.

[72]  M. Sawka,et al.  Fluid balance and endurance exercise performance. , 2003, Current sports medicine reports.

[73]  M. Wilde,et al.  A chart audit of factors related to urine flow and urinary tract infection. , 2003, Journal of advanced nursing.

[74]  Caryn Bern,et al.  The global burden of diarrhoeal disease, as estimated from studies published between 1992 and 2000. , 2003, Bulletin of the World Health Organization.

[75]  R. Warner,et al.  Hydration disrupts human stratum corneum ultrastructure. , 2003, The Journal of investigative dermatology.

[76]  E. Negri,et al.  Fluid intake and risk of bladder and other cancers , 2003, European Journal of Clinical Nutrition.

[77]  D. Schoeller,et al.  Water turnover in 458 American adults 40-79 yr of age. , 2004, American journal of physiology. Renal physiology.

[78]  Robert W. Kenefick,et al.  Hypohydration effects on thermoregulation during moderate exercise in the cold , 2004, European Journal of Applied Physiology.

[79]  J. Suhr,et al.  The relation of hydration status to cognitive performance in healthy older adults. , 2004, International journal of psychophysiology : official journal of the International Organization of Psychophysiology.

[80]  M. Jayashree,et al.  Diabetic ketoacidosis Predictors of outcome in a pediatric intensive care unit of a developing country* , 2004, Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.

[81]  S. Shirreffs,et al.  The effects of fluid restriction on hydration status and subjective feelings in man. , 2004, The British journal of nutrition.

[82]  B. Wakefield,et al.  Bioelectrical impedance analysis and other hydration parameters as risk factors for delirium in rural nursing home residents. , 2004, The journals of gerontology. Series A, Biological sciences and medical sciences.

[83]  K. Michaelsen,et al.  Energy and nutrient dietary reference values for children in Europe: methodological approaches and current nutritional recommendations. , 2004, The British journal of nutrition.

[84]  A. Rudd,et al.  Dehydration and venous thromboembolism after acute stroke. , 2004, QJM : monthly journal of the Association of Physicians.

[85]  C. Kell,et al.  Water‐Deprivation Headache: A New Headache With Two Variants—A Response , 2004, Headache.

[86]  Gerald S. Berenson,et al.  The Relation of Childhood BMI to Adult Adiposity: The Bogalusa Heart Study , 2005, Pediatrics.

[87]  P. Vogelaere,et al.  Thermoregulation and aging. , 2005, Revista portuguesa de cardiologia : orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official journal of the Portuguese Society of Cardiology.

[88]  W. Roberts,et al.  Youth football: heat stress and injury risk. , 2005, Medicine and science in sports and exercise.

[89]  L. Armstrong Hydration assessment techniques. , 2005, Nutrition reviews.

[90]  Robert Carter,et al.  Human water needs. , 2005, Nutrition reviews.

[91]  F. Manz,et al.  The importance of good hydration for the prevention of chronic diseases. , 2005, Nutrition reviews.

[92]  H. Cohen,et al.  Is the prevalence of dehydration among community-dwelling older adults really low? Informing current debate over the fluid recommendation for adults aged 70+years , 2005, Public Health Nutrition.

[93]  J. Stookey High prevalence of plasma hypertonicity among community-dwelling older adults: results from NHANES III. , 2005, Journal of the American Dietetic Association.

[94]  Gabor Szinnai,et al.  Effect of water deprivation on cognitive-motor performance in healthy men and women. , 2005, American journal of physiology. Regulatory, integrative and comparative physiology.

[95]  Patrick Ritz,et al.  The importance of good hydration for day-to-day health. , 2005, Nutrition reviews.

[96]  E. Kozminsky,et al.  The effect of voluntary dehydration on cognitive functions of elementary school children , 2005, Acta paediatrica.

[97]  A. Bartolozzi,et al.  Hydration Status in College Football Players during Consecutive Days of Twice-a-Day Preseason Practices , 2005, The American journal of sports medicine.

[98]  P. Knipschild,et al.  Increasing the daily water intake for the prophylactic treatment of headache: a pilot trial * , 2005, European journal of neurology.

[99]  F. Manz,et al.  Hydration status in the United States and Germany. , 2005, Nutrition reviews.

[100]  J. N. Blau Water Deprivation: A New Migraine Precipitant , 2005, Headache.

[101]  Robert Carter,et al.  Hypohydration impairs endurance exercise performance in temperate but not cold air. , 2005, Journal of applied physiology.

[102]  W. Willett,et al.  A new proposed guidance system for beverage consumption in the United States. , 2006, The American journal of clinical nutrition.

[103]  P. Humbert,et al.  Assessment of effects of an additional dietary natural mineral water uptake on skin hydration in healthy subjects by dynamic barrier function measurements and clinic scoring , 2006, Skin research and technology : official journal of International Society for Bioengineering and the Skin (ISBS) [and] International Society for Digital Imaging of Skin (ISDIS) [and] International Society for Skin Imaging.

[104]  M. Sawka,et al.  No effect of moderate hypohydration or hyperthermia on anaerobic exercise performance. , 2006, Medicine and science in sports and exercise.

[105]  B. Murray,et al.  Hydration and Physical Performance , 2007, Journal of the American College of Nutrition.

[106]  B. Popkin,et al.  Shifts in Patterns and Consumption of Beverages Between 1965 and 2002 , 2007, Obesity.

[107]  S. Shirreffs,et al.  Exercise, Heat, Hydration and the Brain , 2007, Journal of the American College of Nutrition.

[108]  S. Sasaki,et al.  Association between dietary fiber, water and magnesium intake and functional constipation among young Japanese women , 2007, European Journal of Clinical Nutrition.

[109]  N. Krueger,et al.  Effect of fluid intake on skin physiology: distinct differences between drinking mineral water and tap water , 2007, International journal of cosmetic science.

[110]  R. S. Moraes,et al.  Acute water ingestion increases arterial blood pressure in hypertensive and normotensive subjects , 2007, Journal of Human Hypertension.

[111]  M. Sawka,et al.  Does dehydration impair exercise performance? , 2007, Medicine and science in sports and exercise.

[112]  M. Sawka,et al.  Fluid Replacement and Performance During the Marathon , 2007, Sports medicine.

[113]  B. Popkin,et al.  Replacing Sweetened Caloric Beverages with Drinking Water Is Associated with Lower Energy Intake , 2007, Obesity.

[114]  N. Keim,et al.  Twenty-four-hour endocrine and metabolic profiles following consumption of high-fructose corn syrup-, sucrose-, fructose-, and glucose-sweetened beverages with meals. , 2008, The American journal of clinical nutrition.

[115]  S. Goldfarb,et al.  Just add water. , 2008, Journal of the American Society of Nephrology : JASN.

[116]  P. Havel,et al.  Endocrine and metabolic effects of consuming beverages sweetened with fructose, glucose, sucrose, or high-fructose corn syrup. , 2008, The American journal of clinical nutrition.

[117]  B. Popkin,et al.  Drinking Water Is Associated With Weight Loss in Overweight Dieting Women Independent of Diet and Activity , 2008, Obesity.

[118]  Susan Ash,et al.  Clinical assessment of dehydration in older people admitted to hospital: what are the strongest indicators? , 2008, Archives of gerontology and geriatrics.

[119]  Lacy A. Holowatz,et al.  Altered Mechanisms of Thermoregulatory Vasoconstriction in Aged Human Skin , 2008, Exercise and sport sciences reviews.

[120]  G. Bell,et al.  Effect of hydration status on high-intensity rowing performance and immune function. , 2008, International journal of sports physiology and performance.

[121]  B. Falk,et al.  Children's thermoregulation during exercise in the heat: a revisit. , 2008, Applied physiology, nutrition, and metabolism = Physiologie appliquee, nutrition et metabolisme.

[122]  M. Kovacs,et al.  A review of fluid and hydration in competitive tennis. , 2008, International Journal of Sports Physiology and Performance.

[123]  Wei Zhang,et al.  Consuming fructose-sweetened, not glucose-sweetened, beverages increases visceral adiposity and lipids and decreases insulin sensitivity in overweight/obese humans. , 2009, The Journal of clinical investigation.

[124]  C. Edmonds,et al.  Should children drink more water? The effects of drinking water on cognition in children , 2009, Appetite.

[125]  C. Edmonds,et al.  Does having a drink help you think? 6–7-Year-old children show improvements in cognitive performance from baseline to test after having a drink of water , 2009, Appetite.

[126]  S. Suh,et al.  Fluid replacement following dehydration reduces oxidative stress during recovery. , 2009, Biochemical and biophysical research communications.

[127]  R. Townsend,et al.  Endocrine and metabolic effects of consuming fructose- and glucose-sweetened beverages with meals in obese men and women: influence of insulin resistance on plasma triglyceride responses. , 2009, The Journal of clinical endocrinology and metabolism.

[128]  Pierre-Hugues Carmichael,et al.  Predisposing Factors Associated With Delirium Among Demented Long-Term Care Residents , 2009, Clinical nursing research.

[129]  Chaoyang Li,et al.  Prevalence of Pre-Diabetes and Its Association With Clustering of Cardiometabolic Risk Factors and Hyperinsulinemia Among U.S. Adolescents , 2009, Diabetes Care.

[130]  A. Buchman,et al.  Oral Rehydration Solutions in Non-Cholera Diarrhea: A Review , 2009, The American Journal of Gastroenterology.

[131]  Caroline R. Mahoney,et al.  Voluntary Dehydration and Cognitive Performance in Trained College Athletes , 2009, Perceptual and motor skills.

[132]  B. Popkin,et al.  Snacking Increased among United States Adults between 1977 and 2006 1-3 , 2009 .

[133]  N. Montano,et al.  When Water Hurts , 2009, Pacing and clinical electrophysiology : PACE.

[134]  A. Takeshita,et al.  Simple standing test predicts and water ingestion prevents vasovagal reaction in the high‐risk blood donors , 2009, Transfusion.

[135]  D. Benton,et al.  The effect of the consumption of water on the memory and attention of children , 2009, Appetite.

[136]  M. Kersting,et al.  Promotion and Provision of Drinking Water in Schools for Overweight Prevention: Randomized, Controlled Cluster Trial , 2009, Pediatrics.

[137]  B. Popkin,et al.  Impact of water intake on energy intake and weight status: a systematic review. , 2010, Nutrition reviews.

[138]  D. Mozaffarian,et al.  Defining and Setting National Goals for Cardiovascular Health Promotion and Disease Reduction: The American Heart Association's Strategic Impact Goal Through 2020 and Beyond , 2010, Circulation.

[139]  I. Barata,et al.  The management of children with gastroenteritis and dehydration in the emergency department. , 2010, The Journal of emergency medicine.

[140]  E. Jéquier,et al.  Water as an essential nutrient: the physiological basis of hydration , 2010, European Journal of Clinical Nutrition.

[141]  F. Hu,et al.  Contemporary Reviews in Cardiovascular Medicine Sugar-Sweetened Beverages, Obesity, Type 2 Diabetes Mellitus, and Cardiovascular Disease Risk , 2010 .

[142]  Carmen Piernas,et al.  Snacking increased among U.S. adults between 1977 and 2006. , 2010, The Journal of nutrition.

[143]  F. Hu,et al.  Sugar Sweetened Beverages , Obesity , Type 2 Diabetes and Cardiovascular Disease risk , 2010 .

[144]  B. Popkin,et al.  Does hunger and satiety drive eating anymore? Increasing eating occasions and decreasing time between eating occasions in the United States. , 2010, The American journal of clinical nutrition.

[145]  K. Davy,et al.  Water Consumption Increases Weight Loss During a Hypocaloric Diet Intervention in Middle‐aged and Older Adults , 2010, Obesity.

[146]  B. Popkin,et al.  Trends in snacking among U.S. children. , 2010, Health affairs.

[147]  T. Marshall,et al.  Dietary Guidelines for Americans, 2010: an update. , 2011, Journal of the American Dental Association.

[148]  Sohyun Park,et al.  Consumption of sugar drinks in the United States, 2005-2008. , 2011, NCHS data brief.

[149]  R. Fanari,et al.  Effects of drinking supplementary water at school on cognitive performance in children , 2012, Appetite.