By Stephen T. Sinatra, M.D., F.A.C.C., F.A.C.N., C.N.S., C.B.T.

To me, water is a gift from above, a living, nourishing substance important not just for life but for quality of life as well. Yet water is so taken for granted that people don’t tend to think of it in health or anti-aging terms. They should.

Just look at a house plant when you forget to water it, and look again after you do. We are no different.

In this article, I cover a wide range of topics as they relate to water, including some surprising relationships with common health conditions. Let’s get started:

• Water and Heart Disease
• Joint Pain, Ulcers, and Dr. “Batman”
• Water Facts
• Water and Weight Loss
• Ideal Water Intake

You’d never imagine it, but plain old water is probably one of the most overlooked tools against heart disease. Researchers from Loma Linda University in California confirmed this some years ago by checking the water intake of about twenty thousand well-educated men and women (ages 38 to 100) as a possible risk factor for fatal coronary artery disease (heart attacks). In a 2002 study (Chan), they concluded that water indeed had a strong protective association for both sexes.

To be sure, statistical studies can only provide an indication, and are not outright proof of cause and effect. What was interesting to me is that the researchers here found elevated viscosity (blood thickness), volume of red blood cells (hematocrit), and fibrinogen (a protein involved in the clotting process) among individuals who drank less than two glasses of water daily compared to those who drank five or more. When elevated, and even at high normal range, these factors are associated with coronary heart disease. They make blood thicker, something I have consistently found among heart and diabetic patients. Elevated values, in fact, are found years before acute cardiovascular problems show up, in early stages of atherosclerosis (arterial disease) and high blood pressure. Such elevations can result from chronic dehydration.

Viscosity is a big deal – an important, but overlooked risk factor for cardiovascular disease. The thicker your blood, the slower it flows through the thousands of miles of your circulatory system and the greater the risk of nasty things happening, like inflammation, clots, plaque, and cardiac and vascular trouble. Your heart works harder. Thicker blood is often full of toxins, bacteria, excess glucose and insulin, and other substances that stoke inflammation and damage to the fragile endothelial lining of blood vessels. Healthy blood is more like the consistency of wine, and not sludgy like ketchup.

Many of my patients were dehydrated and that status likely contributed to their thicker blood. However, the research (see Sugaya) doesn’t show that flooding your body with water will necessarily decrease viscosity, or prevent heart attacks and stroke. It will, for sure, increase urinary frequency. The key thing is not to become dehydrated.

One of the best, and simplest, ways to reduce blood viscosity is to “Earth” or “ground.” To ground is to provide your body with the natural, gentle electric energy omnipresent on the surface of the Earth by regularly walking barefoot outside or sleeping, working, relaxing indoors in direct skin contact with conductive sheets, mats, bands, or patches. In my experience, such contact, whether outside or inside, has a blood-thinning effect and improves circulation. I conducted a study on this amazing effect, which I believe has significant implications for both prevention and treatment of cardiovascular disease. You can learn more about Earthing here, and read the blood viscosity study here.

You may never have heard of Fereydoon Batmanghelidj, M.D., who became a celebrity in the health world during the 1980s and 1990s for his unusual story and work with water. Batmanghelidj (pronounced Batman-gey-lij) studied the effects of water (or lack of it) in the human body for more than twenty-five years before his death in 2004.

Often referred to as “Dr. Batman” because Americans couldn’t pronounce his name, he championed the healing benefits of water in lectures and books. He believed that chronic dehydration contributes to many of today’s serious illnesses, such as heart disease, asthma, hypertension, lupus, and multiple sclerosis. He often said that a chronic lack of water caused the body to cry out in pain, and pointed to arthritis and joint pain as an example.

“If you have chronic pain in the spine, hands, or legs, that means those joints are thirsting for water,” he said. “You are not drinking enough water. The pain is due to dehydrated joints, plus wear and tear, and the inability of the cartilage to repair the damage.”

His interest in water went back to his native Iran where the London-trained physician was jailed as a political prisoner from 1979 to 1982. When fellow prisoners asked him to help another man suffering from an acute peptic ulcer attack, all he had to offer was water. He gave the man two glasses of water. To his surprise, the prisoner’s pain vanished in minutes. During the next two years as one of the prison’s doctors, he researched and applied the use of water for treating people under stress. A clinical report describing his treatment of more than three thousand peptic ulcer cases with water appeared in a 1983 issue of the Journal of Clinical Gastroenterology.

After his release from prison, he found his way to the United States and devoted his full-time attention to researching, writing, and lecturing about dehydration-related health problems. Part of his lasting legacy is a wonderful book I highly recommend reading: Your Body’s Many Cries for Water.

According to University of North Carolina experts (see Popkin), thirst plays little day-to-day role in the control of water intake in healthy people. Here are some other facts about water and your health from their review:

• Total fluid intake increased from 79 fluid ounces daily in 1989 to 100 in 2001 among U.S. adults, all from caloric beverages like sodas.
• The elderly have low water reserves compared to younger people. Because of this, it is prudent for seniors to learn to get into the water drinking habit more.
• Body water loss through sweat is an inherent cooling mechanism in hot weather and during physical activity. Sweat loss needs to be compensated for with fluid intake.
• Dehydration can influence cognition and even a mild level can disrupt mood, concentration, alertness, and short-term memory in children, young adults, and the elderly.
• Constipation has a number of causes, including medications, inadequate fiber, poor diet, and illness. An increase in fluid intake is popularly recommended as a remedy, but the evidence suggests that more liquid is only effective for individuals who are dehydrated. In the elderly, however, those who consume the least amount of fluid have over twice the frequency of constipation compared to those consuming the most.
• Your kidneys have a primary role in regulating water balance and blood pressure as well as removing waste from the blood stream and excreting it through the urine. Water is necessary for the filtration of waste.
• Dehydration can lead to headaches, including migraine, and in the case of water-induced headache, drinking water often provides relief within 30 minutes to 3 hours. The role of water, however, as a form of prevention in the general population of headache sufferers, is not known.
• The skin contains about 30 percent water, but there is little evidence indicating that drinking more water every day (such as 8 to 10 glasses) will flush toxins from the skin and generate a “glowing complexion,” as is widely touted in beauty magazines and via the Internet. Adequate skin hydration won’t prevent wrinkles or other signs of aging that are typically connected to genetics, the sun, and environmental damage. Skin dryness is usually linked to exposure to dry air, prolonged contact with hot water, and scrubbing with soap, as well as certain medical conditions and medications.
• Good water intake reduces the risk of developing stones in the urinary tract (kidneys, bladder, and urethra)
  

Yes, according to a 2010 study (Dennis), and all it takes is just two 8-ounce glasses of water just before you eat.

In the study, researchers from Virginia Tech found that over a 12 week period, dieters who drank water before meals, three times a week, lost about 5 pounds more than dieters who did not increase their water intake.

Previous studies have hinted that drinking water before meals reduces calorie intake. But this was the first study that compared weight loss among two groups of dieters randomly selected to either drink water before low-calorie meals or not to. Forty-eight adults (55-75 years) participated in the study. After 12 weeks, the water group lost on average 15.5 pounds, the non-drinkers, about 11.

Brenda Davy, Ph.D., the lead author, indicated that water’s effectiveness may simply be due to the fact it supplies no calories and fills up the stomach. People feel fuller and eat less.

If you are overweight and stumped about how to lose weight, try a double shot of water before meals the next time you go on a diet. You will likely not find anything simpler or less expensive. And, in the process, you will contribute to your hydration status.

Obviously, in hot weather or when you sweat a lot, you need to compensate for the fluid loss from your body. One 2012 study (Armstrong) conducted with a group of 25 young women found that even mild dehydration, a result of not drinking enough fluids to replace fluids lost through exercise, can generate adverse changes in mood, vigor, and fatigue, as well as increased headaches and difficulty concentrating among young women.

The overall issue of how-much-to-drink is somewhat complex, because physical activity and energy expenditures affect the need for water, as does body size. Other considerations are the water content of food, such as milk, fruits, and vegetables, and the growing increase in consumption of sweetened beverages. Researchers (Popkin) admit that there is little understanding globally of measuring total fluid intake or even of measuring the hydration status of individuals.



According to the U.S. Institute of Medicine, the generally recommended amounts for daily water consumption, including from beverages and food, are 2.7 liters (91 ounces) for women and 3.7 liters (125 ounces) for men. About 80 percent of total intake comes from drinking water and beverages, and the other 20 percent from food.

• Drink water when you are thirsty.
• Drink more when the weather is hot and you sweat a lot from exercise.
• If you work at a desk, sip water throughout the day.
• Drink water out of glass containers. Try to avoid the plastic water bottles as they are made from many different chemicals that have the potential to leach into the water.
• Sip warm or hot water during a meal (not ice drinks) to help with digestion.
• Eat fruits and vegetables high in water content. This habit provides not just fluid but vitamins, minerals, and other healthy nutrients. Soups are another good source of fluid plus nutrients.
• Try to avoid beverages like sodas that are sweetened with sugar, high fructose corn syrup, and other ingredients that your body doesn’t need. They provide little, if anything, in the way of nutrients, and if consumed regularly, can contribute to metabolic syndrome and diabetes, and a host of problems.
  

• Popkin BM, et al. Water, hydration and health. Nutrition Rev. 2010; 68(8):439-58.
• Chan J, et al. Water, Other Fluids, and Fatal Coronary Heart Disease The Adventist Health Study. Am J Epidemiology. 2002;155(9):827-833.
• Sugaya K. Change of blood viscosity and urinary frequency by high water intake. Online at Int J Urol. 2007;14(5):470-2.
• Sinatra ST, et al. Earthing (Grounding) the Human Body Reduces Blood Viscosity—a Major Factor in Cardiovascular Disease. J Alt Comp Med. 2013;19(2):102-10.
• Batmanghelidj F. A New and Natural Method of Treatment of Peptic Ulcer Disease. J Clinical Gastroenterology. 1983;5(3):203-6.
• Batmanghelidj F. Your Body’s Many Cries for Water. Global Health Solutions, Inc. Third Edition edition (November 1, 2008).
• Armstrong LE, et al. Mild dehydration affects mood in healthy young women. J Nutrition. 2012:142(2):382-88.
• Dennis EA, et al. Water consumption increases weight loss during a hypocaloric diet intervention in middle-aged and older adults. Obesity (Silver Springs). 2010;18(2):300-7.
• American Chemical Society. Clinical trial confirms effectiveness of simple appetite control method. 2010.
• U.S. Institute of Medicine. Dietary Reference Intakes: Water, Potassium, Sodium, Chloride, and Sulfate. 2005.