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· · Health benefits of water-drinking challenged

There is no clearcut scientific rationale for the average healthy individual to drink a lot of water -- and it may be downright harmful -- according to two kidney experts.

Drinking a lot of water is claimed to be helpful for everything from clearing toxins and keeping organs in tip-top shape to keeping weight off and improving skin tone. At best, however, the evidence to back up these claims is weak, according to a new scientific review published in the Journal of the American Society of Nephrology.

"There is what I call an urban myth that drinking a lot of water is a healthy thing to do and it leads to people toting around plastic water bottles all day drinking water," said Dr. Stanley Goldfarb, of the University of Pennsylvania, Philadelphia.

"The source of this is the complementary and alternative medicine worlds. If you go on the internet and look up water-drinking and its health implications, that's what you encounter," Goldfarb said. As a kidney specialist, Goldfarb is interested in how the kidney handles fluids, which prompted him and colleague Dr. Dan Negoianu to review the scientific literature on the benefits of drinking water. In doing so, the researchers debunked four myths.

One is that drinking a lot of water suppresses appetite. "Many people drink water before and during the meal to try to suppress their appetite," Goldfarb explained, yet there is "no consistent evidence" that water suppresses appetite. "Because you absorb water so quickly and it moves through the GI tract so quickly, it probably doesn't fill you up the way people have proposed, nor does it lead to the release of hormones which suppress appetite as far as we know," the researcher said.

The second myth is that filling up on water flushes toxins from the body. "In fact, that is not how the kidney works," Goldfarb said. "When you drink a lot of water you end up having a larger volume of urine but don't necessarily increase the excretion of various constituents of the urine."

The third myth is that it reduces headaches. It does not, according to the evidence. The fourth myth is that water drinking improves your skin. "There are no data to suggest that it actually improves the water content of the skin," Goldfarb said.

Goldfarb and Negoianu did find solid evidence that people living in hot, dry climates, as well as some athletes, have an increased need for water, and people with certain diseases like kidney stones may benefit from increased water intake -- but no such data exist for average, healthy individuals.

Furthermore, there are a couple of circumstances where drinking a lot of water may be actually unhealthy. "In long-distance runners, for example, more harm is done by long distance runners over-drinking during races than by long distance runners who under-drink," Goldfarb explained.

He also cited the case of a woman who developed swelling of the brain and died when she drank water continuously and very rapidly for several minutes as part of a contest. Goldfarb also said there is no rational basis for the widespread belief that people need to drink eight glasses of water a day, and it is unclear where this recommendation came from.

SOURCE: Journal of the American Society of Nephrology, online April 2, 2008

Dr. Cinque's comments: Unlike with cardiologists, gastroenterologists, and some other medical specialties, I don't have any major problem with kidney specialists. By the time you need them, there really isn't anyone else who can help you. And I certainly agree with these two kidney doctors that copious water drinking is a foolish practice. Your body is not like a set of pipes that you can wash out simply by running more water through it. Your body is alive, and it uses water, but the amount that it needs hangs in a very delicate balance that is affected by a myriad of things. The best and most practical way to make sure you obtain the right amount of water is to be guided by thirst. And note that your diet has a great impact on your water needs. For instance, when you eat a lot of fresh fruits and vegetables, you obtain a lot of water- so much so that you may be able to meet most of your water needs that way. But in contrast, if your diet is low in fruits and vegetables and high in salt and meat, you may have to drink a lot of water to meet your needs. In fact, if in the normal course of living-apart from unusual heat and sweating situations- you are inclined to drink 8 glasses of water a day, then something is wrong; something is out of whack. Either your diet is skewed, or you've got diabetes or some kind of glandular problem. The only time I ever drink copious amounts of water is when I have worked or exercised a lot in hot weather. But most of the time, I drink very little water: perhaps two glassfuls a day. There is no benefit in forcing down water. You're just giving your body more work to do to get rid of it.

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