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ARTICLES

Water: A Refreshing School of Thought

Somya Sahay

Water is a highly undervalued nutrient. In a world of powerful pharmaceutical drugs, workout-enhancing supplements, miracle herbs, and super foods, water gets the cold shoulder. After all, there aren’t many who would financially benefit from you spending a few cents on a glass of water—it just isn’t that profitable. Unfortunately, this is why it isn’t marketed very well or studied for that matter. 

So, why is water THAT important? What happens when you don’t drink enough? To start off, our bodies are made up of ~75% water! Even more impressive, our brain tissues are estimated to be ~85% water!1 It is a major life-giving and sustaining molecule and should never be under-looked. 

Primary Roles of Water:

-Aids in the regulation of body temperature

-Lubricates joints (i.e. synovial fluid, articular cartilage)

-Provides structural support (Cells, intervertebral discs, etc.)

-Water is a transport medium to send chemical messages.

-Acts as a shock absorber (i.e. Intervertebral discs, synovial fluid)

-Creates hydroelectric energy through energy-generating pumps

-Plays an essential role in metabolism

Water plays a role in every system of our body, whether directly or indirectly. A lack of water, therefore, can lead to anything from weight gain, to alzheimer’s, to arthritis, to hypertension, to hormone imbalances, etc.

While discussing all the possible diseases in detail is equally important, I will only mention the most common ones that need to be addressed, with a fresher school of thought. The three I will be discussing are: Rheumatoid Arthritis, Dyspepsia, and Hypertension. 

**Note: All examples are discussed from a dehydration standpoint only—conditions can be caused from a combination of other health & lifestyle factors.** 

RHEUMATOID ARTHRITIS/JOINT PAIN

According to Dr. Batmanghelidj, in his book, Your Body’s Many Cries for Water, “50 million Americans suffer from some form of arthritis, 30 million people suffer from low back pain,…and 200,000 children are affected by the juvenile form of arthritis.”

Rheumatoid Arthritis is a chronic inflammatory disease of the joints. In order to understand the role of water in joint health, we must have a basic understanding of joint structure first. 

All Synovial (highly moveable) Joints have the following components:

  • Articular capsule
  • Articular cartilage
  • Synovial membrane
  • Joint cavity (which contains Synovial Fluid)
  • Sensory nerves and blood vessels
  • Accessory structures

Articular (Joint) Capsule-Made up of dense fibrous connective tissue, the articular capsule surrounds the joint cavity, providing a protective seal. It also functions as an active/passive stability mechanism.

Articular Cartilage-Articular cartilage is a matrix of cartilage cells that covers the bony surfaces of joints, protecting it from damage.

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Synovial Membrane-Lining the inside of the joint (except for the articular cartilage), the synovial membrane produces synovial fluid, which fills the joint cavity.

Synovial Fluid-Synovial fluid provides lubrication for joint movement, acts as a shock absorber, and is a medium for both nourishing the cartilage cells (Chondrocytes) and disposing of waste. The circulation of synovial fluid in and out of the articular cartilage is driven by joint movement. 

Accessory Structures-Structures that support the integrity and function of the joint. These include, but are not limited to, ligaments, tendons, and bursae. (Will not be discussed in this article)

When in a dehydrated state, your body triggers a rationing system because it cannot keep all systems functioning optimally. To compensate for a reduction in fluids, the body closes capillaries that supply blood/nutrients to various tissues based on a priority system. This redirects water to the more vital organs (i.e. brain, heart, liver, etc.). Unfortunately for joints, the rationing system puts them low on the priority list. People can survive with a frozen shoulder or an inflamed knee, but good luck trying to survive without your brain!

Without adequate nutrition and hydration, the articular cartilage deteriorates to the point where the bony surfaces of the joint are exposed. The grinding of these surfaces are too much for the body to handle. The rate at which bone cells are being sandpapered away is much greater than the body’s ability to replace them. As a result, the joint becomes chronically inflamed, also known as Rheumatoid Arthritis. 

DYSPEPSIA (Abdominal Pain)

Dyspeptic pain is all too common these days—to the point where antacids have become a common household item. Dyspeptic pain is related to the upper abdominal area, typically occurring after eating. It is generally known to be caused by gastritis or other similar diagnoses. It can be extremely painful and last for hours. It may come about once in a while, or every time you eat a meal. How many of you currently have, have had, or know people who have had dyspeptic pain (stomach pain)? Before you run off to the doctor’s office and come back with a prescription of antacids, let’s take a look at this from a dehydration standpoint. 

 Let’s start off with a simplified overview of the stomach. The inner lining of the stomach is covered with what are called mucous cells. This is known as the mucosal layer. These cells secrete a protective mucus to guard the deeper layers of the stomach from gastric juices. This cover of mucus is made up of ~98% water.1

In a well hydrated state, the mucus protects the stomach lining by neutralizing gastric juices with the help of sodium bicarbonate (which is released from the cells below). In order to prevent a build up of too much salt (the reaction of stomach acid—HCL—and sodium bicarbonate creates salt), the stomach relies on a constant supply of water to wash out the salt. A buildup of salt compromises the structural integrity of the mucus.

You can imagine that with a lack of hydration, the production of mucus is reduced, thinning the stomach’s primary and strongest defense mechanism. Without water to drive out excess salt, the mucous composition becomes less sticky, allowing stomach acid to tear through the protective layer and come into direct contact with the mucosal layer (cell lining). This is why pain occurs. The corrosive quality of HCL damages the stomach lining, causing pain, inflammation, and potentially ulcers. 

While antacids also neutralize HCL, it merely acts as a bandaid. It does not heal the stomach lining. The best solution is giving the body what it needs, WATER!

HYPERTENSION

I feel pretty bad for salt these days. Salt has gotten a bad reputation—especially from those with high blood pressure (not their fault though). Of course, it doesn’t help that most of the population buys cheap, bleached, and highly processed salt (white table salt) rather than naturally occurring and minimally processed salt (i.e. Celtic Sea Salt or Himalayan Pink Salt), but that’s an article for a different day. We’ll look at sodium’s role in hypertension shortly.

The question is: how does water (or rather a lack thereof) affect high blood pressure? 

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When talking about Rheumatoid Arthritis, I mentioned a rationing system your body activates when it does not have enough water supply. This is essentially you body saying “What systems  do I NEED to survive, and what can I live without?” Much like you would question if you were financially broke. “Well, I have to pay rent and I have to eat food, but I can skip the movies for the week and not go out to the bars to save some money.” Your body has a very intricate version of this.

When you are dehydrated, the blood volume will decrease and gas pockets will start to open up in the blood vessels, unless the volume of blood is adjusted. This is extremely dangerous! In order to prevent that from happening, the lumen (inner gap of blood vessel) shrinks. This feature adjusts the blood vessel for the available amount of fluid. Your body also starts to close capillaries to areas of less importance (i.e. joints, muscle, etc.) in order to adequately supply the more vital organs (i.e. brain, heart, liver, lungs, etc.). In areas of low circulation due to closing of the lumen/capillaries, increased blood pressure is needed to push the blood into the capillaries, causing high blood pressure. 

Now, the body has a shortage of water and therefore needs to get it from somewhere. If not the diet, where can it get if from? “In water shortage and body drought, 66 percent is taken from the water volume normally held inside the cells, 26 percent is taken from the volume held outside the cells, and 8 percent is taken from blood volume”1. It is for this reason our bodies retain sodium and hold on to it for dear life. Sodium is the main mechanism to attract water, indirectly supplying it to cells. Therefore, if you are dehydrated and have high blood pressure—trying to rid yourself of salt is a poor idea, because it is your body’s last resort for trying to retain water. 

HOW MUCH WATER SHOULD I DRINK?

We generally recommend 1/2 your bodyweight in oz of water, consumed gradually throughout the day. For those that live in hot conditions and/or are very active, 60% is more ideal. Juices and other drinks like tea and coffee do NOT count! 

It is easy to get lost in all the advertisements and ‘miracle supplements’ out there. However, sometimes the simplest solution is the most effective, no matter how complicated the problem. While water is not the most exciting beverage to drink, the depth at which it affects us is nothing short of marveling. 

References

1. Batmanghelidj, Fereydoon. Your Body’s Many Cries for Water: You’re Not Sick; You’re Thirsty Don’t Treat Thirst With Medication. 3rd ed. United States of America: Global Health Solutions, 2008

2. Martini, Frederic H., et al. Human Anatomy. 5th ed. San Francisco: Benjamin Cummings—Pearson Education, 2006