This is what the vitamin industry doesn't want you do know, and one thing you can do to improve your health today.
In medical school, one of my professors used to joke that American's have the most expensive urine in the world. Not a day goes by in clinic without a patient asking me if there is a vitamin that can help with heart attacks, atrial fibrillation, or strokes. I don't know who keeps marketing vitamins as a cure-all but they've done a better job than physicians marketing actual, rigorously studied medicines.
Vitamins are great and they have their role but a lot of them end up being filtered out by the kidneys and out through our urine.
"But vitamins are all natural", the patients say... and yet they don't realize that there is little "all-natural" about this ingredient list:
Cellulose Gel
Maltodextrin
Croscarmellose Sodium
Stearic Acid
Gelatin
Magnesium Stearate
Recognize any of these? I sure don't and I took a year long course in organic chemistry to learn words like this. But that class was good for one thing and one thing only: getting into medical school.
What actually is natural and has almost zero marketing dollars behind it: Water. Ingredient list: water.
It's funny how real, honest to goodness food has a very, very short ingredient list. Usually 2-3 ingredients.
It's not super sexy. Water definitely doesn't have as much clout as crystals, which is a thing, I guess.
Many patients complain that water doesn't taste good, but there are fewer beverages with as many health benefits.
Unlike crystals, water's benefits don't rely on the placebo effect, the barnum effect, or confirmation bias. Water is cheaper too.
~ 15.5 cups (3.7 liters) of fluids daily for men
~ 11.5 cups (2.7 liters) of fluids daily for women
That's a lot of water and definitely more than the 8 cups that we've all been told before. These recommendations include fluids from water, coffee, tea, other drinks, and foods high in water like fruits or vegetables. You may need more or less depending on your activity level or if you spend a lot of time outside in hot weather. Obviously don't drink this much if you have congestive heart failure (not that that ever stopped anyone) or kidney disease as you'll swell up like a balloon.
But to be honest, in most situations and studies (like this one), drinking to satisfy your thirst seems to be enough. I'm sure it's controversial in some circles (because everything seems to get someone riled up) but I don't think it's going to hurt you to drink this much water. We don't think about it or talk about it because no one is getting paid to tell you to drink your water. Yes, it can be annoying to have to go to the bathroom. Yes, it's annoying to drink plain old water. But it's good for you! And once you stop eating trash and eating real food, water gets to be refreshing.
For variety, I like to drink my fancy bubbly flavored water, but I do not guzzle a twelve pack of mountain dew every day.
I started aiming to drink a daily gallon of water about a year ago. I'm trying to make sure I'm in tip top shape because I want to live forever. It feels weird to say and it kind of goes against the ethos of medicine, but... I can't care for other people if I'm not taking care of myself. I didn't take care of myself for a full year while in fellowship, clocking in >80 work weeks, with 36-hour shifts. I regret it.
Medical school didn't teach me about how much water to drink; we regurgitated the old adage of 8 cups of water, but we didn't find evidence or data behind this saying.
To be honest though, you don't feel much at first as your body gets acclimatized to the extra hydration. Be careful because it is possible to drink too much water - that's called hyponatremia (sorry for the big word). The acclimatization is kind of the point, because prevention, like good technology is meant to fit in seamlessly, almost without notice, into your life. A well functioning car or computer does what you need it to do without issues. Likewise, you know good preventive measures are working if you don't have issues, not for a few weeks or months, but for years and decades. Personally, my goal is to be on like at most 3-4 medicines when I'm 80 years old. Any more than that and I know that I've been wasting my medical training and not properly taking care of myself.
I definitely feel it when I don't drink as much water. I feel sluggish and I don't think I think as clearly. It's probably all placebo, but the advantages outweigh the minimal risks, it's water after all.
Potential benefits of water:
Helps physical performance - this is mostly important if you're doing sports or anything involves a lot of water that is lost in sweat.
Affects energy and brain function - some small studies, poorly powered studies have shown some data that 1.4-1.6% of fluid loss can impair brain function.
May prevent and/or treat headaches
Can prevent hangovers
Relieves constipation
More steps for those of us trying to get our 10K steps daily
This dutch article claims that any more than 3L daily of water consumption does not have any convincing health benefits. The article might be right but the article investigates more than 3L of daily water. Most people are not drinking this much. I'd say that this is the minimum amount of water to drink though. Appropriate hydration helps a lot, even if you don't believe in everything in the above list.
Despite everything above, I'm gonna keep aiming for a gallon of water daily. Here's my current hydration routine.
1 liter within 5 minutes of waking up.
0.75 liters during my workouts
shaker bottle for pre-workout is 12 ounces = 1.5 cups of water.
I drink two of these during my workout, so roughly 24 ounces = 0.75 liters
1.5 liters during the workday, with 24 ounces with lunch to prevent overeating
My work water bottle is a 24-ounce Camelbak.
Keeping this bottle at my work desk provides a reliable cue that I should drink water.
1 liter after work until bedtime. By the time I get home, I know I just need 1 full bottle of water (which is 1 liter) to last me until bedtime, so I sip on that during my after-school (work) snack and with dinner.
Tips:
Drinking this much water becomes a habit over time.
Being healthy and improving your health is all a matter of developing the most advantageous habits.
Cues that help ingrain the habit:
Waking up - I immediately fill up my water bottle and drink this with waking up as I start my morning
Working out - I have a shaker cup that accompanies me to the gym. Drinking this twice is pretty easy over the course of an hour as I get thirsty while exercising.
The work water bottle - this is a bottle that is what it sounds like. It's a water bottle that stays at work. When I see it at work, it reminds me to hit my daily target.
The home water bottle - Again, the cue-reward mechanism is simple. I see my sad, lonely, empty water and I'm reminding to fill it up and keep it next to me while I tackle my tasks for the evening which usually include doing flashcards and looking at a fuzzy, black and white picture of hearts (echocardiography boards are coming up soon).
