How To Drink To Your Health

health, hydration, fluids, summer, hot weather tips

by B. Imei Hsu

Unless you’ve been hiding in a cool basement underground, you have probably noticed that parts of the U.S. are experiencing a heatwave. In the Puget Sound region where Seattle Direct Counseling is located, we’ve been hitting temperatures in the high 80’s and low 90’s. My fitness club has been filled with people running indoors in order to get their miles in without wilting, as many of us are not accustomed to exercising in weather that starts in the 70’s in the early morning and keeps climbing. We’re more used of jumping on a plane to Maui and laying in a hammock with a good book while a cool breeze passes by!

Yet every year, I see people taking actions in contradiction to the increased need to hydrate properly in warm weather. Sure, they might move from a latte to an iced latte, but there is a lack of connection with exactly what goes on when the mercury rises and you feel hot. I thought I’d give our readers a quick reminder on drinking for your health the smart way.*

1. Know what is lost. People often misunderstand what exactly is lost when it’s hot outside and you’re walking around in that heat. You lose water through sweat, which is your body’s built-in cooling system. When you sweat, evaporation helps to regulate your temperature. You also lose water through urination, and through breathing. Even if you are not a “heavy sweat-er”, you are still losing water.

2. Know What To Avoid. Some time ago, I spent time in the dessert with friends. One of the things we talked about was avoiding alcohol in the heat of the day. You want to avoid drinking alcoholic drinks, even if they are served chilled and on ice, when it’s very hot outside because:     1) alcohol is a diuretic (translation: things that make you pee), and therefore you can become dehydrated more easily, and 2) alcohol signals the suppression of vasopressin, which usually tells the kidneys to reabsorb water (translation: you’ll feel your bladder feeling quite full and you’ll be peeing shortly, which also means you can get dehydrated while drinking alcohol.

You’ll see this phenomenon in the summer time when folks spend a day in the sun on a sailboat, drinking beers and getting really warm. If they don’t slow down on the alcohol and start hydrating with water, they become nauseated, dehydrated, and are vulnerable to heatstroke.

3. Know What To Drink. Do you need to drink fruit juice, plain water, a sports drink, or specialty waters? The answer to that is: it depends on what you’re replacing. If you haven’t had much to eat for awhile, a fruit juice followed by a snack that contains protein and fat can be very helpful in both addressing the need for fluids while preventing any hypoglycemia. 

In general, plain water works for most people, and it works better than sugary sodas while being cheaper than specialty waters. Keeping a clear, hard plastic bottle of water nearby at all times encourages you to take sips throughout the day when you’re at work or on the go.

In hot weather, you may need to understand more about your sweat rate. If you sweat profusely and need to be outside for work or play, you need to replace more than just water to prevent dehydration. You need to replace the lost electrolytes.

When you’re exercising, you lose electrolytes that help your blood hold water inside of the bloodstream. Electrolytes are also very important for function of all your major organs. When the temperatures rise in the 80-90’s range, we tend to experience a higher lose of electrolytes and need to replace them. If you have ever tasted your own sweat, you’ll notice how salty it is; sodium is just one of the electrolytes you need to replace.

There is a plethora of commercially-made electrolyte tablets (i.e Metatab), effervescent discs (i.e Nuun, a Seattle-based product), and powders (i.e Osmo) made for athletes who need electrolyte replacement as they move through hours of high performance. There are also ready-made sports drinks, such as Gatorade. If you sweat heavily and notice that you have a headache on hot days, chances are you are becoming dehydrated and should look into ways to keep your sweat rate down by keeping cool, or try electrolyte replacement if ducking into shade isn’t a possibility.

I personally have not had much luck with Gatorade, and that is probably because I have an uber finicky gut that doesn’t do well with this product. Perhaps you may have more luck. Also, you should be aware that if you become dehydrated and need oral fluid replacement, some Pedialyte products contain whey, which is a milk-based protein. Those with milk allergies and sensitivity should avoid it.

4. Know the Signs of Dehydration. For athletes, knowing the signs of dehydration * are critical to avoiding illness and in extreme heat, death. During hot weather, you should be on the look out for the following (I’ve listed next to each a few notes so you can detect it in others, particularly seniors and children):

• Little or no urine, or urine that is darker than usual
• Dry mouth (hard to swallow, pasty)
• Sleepiness or fatigue (even after a long night of rest)
• Extreme thirst (in others, listen for the complaint)
• Headache (often pounding and persistant)
• Confusion (does not respond quickly, makes mistakes, acts “off” or silly)
• Dizziness or lightheaded feeling (low blood pressure, feels faint, often noted when moving from sitting to standing)
• No tears when crying (an important clue in babies)

You want to prevent yourself and others from getting to the point of dehydration. If you already find yourself there, you should seek medical care immediately.

Normal, healthy, and fit individuals can find themselves in the same situation as children and seniors when hot temperatures increase their sweat rate and fluids haven’t been properly replaced. Having experienced hyponatremia, a type of dehydration involving a shift of fluids out of the bloodstream, I know the horrible feeling of feeling healthy as a horse one moment, and then creeping along like a slug hours later. During the recent Ironman C’oeur D’Lene race, there was a noticeable DNF (Did Not Finish) rate compared to previous years, most likely due to dehydration in the 103 Fahrenheit temperature. I’m sure there will be race reports in the following weeks that can better describe what happened to the 22% of these athletes who have spent the better part of eight months or more preparing to complete an already difficult race further complicated by the heat wave.

So, the next time you say, “Wow, it’s hot today!” don’t forget to raise a glass — or a large cup! — of water, and take some sips. Keep it up, and pay attention to the color of your pee. Stay hydrated, and keep drinking to your health!

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* This blog post is not a substitute for medical advice from your doctor. It is meant to be an informative guideline and public service announcement to remind people to stay hydrated in hot weather conditions.

** The article this list is taken from is a family doctor’s blog, which states at the bottom of the article that it was partially underwritten by the Coca-Cola company. I know of no other medical articles that state that hydration using a caffeinated product such as coffee or a sugary soft drink are appropriate in the case of dehydration. The standard approach is to avoid these, or to pay close attention to replacing fluids after the diuretic effect of caffeine wears off. Clear sodas are, however, often suggested in the case of vomiting and diarrhea to help with hypoglycemia and dehydration. Those who don’t drink sodas can make a home brew of water and pure maple syrup if they need a quick sugar fluid replacement.