Sunday, 2 August 2009

Being Thirsty is OK !!

Why waiting until you are thirsty is NOT too late

We really hope everyone is enjoying this series so far. It is proving fun and challenging to write, and we hope that is coming across in the posts. So far we investigated the history of fluid ingestion in Part I, demonstrated why it is the metabolic rate that predicts temperature in Part II, and weighed up the strengths and weaknesses of the lab-based and field studies in Part III. For Part IV we will look at the thirst mechanism and why waiting until you are thirsty is not "too late."

Myth busting: If you wait until you are thirsty, it is too late

How often have you heard this? This is an oft stated mantra of athletes, coaches, and arm-chair quarterbacks everywhere. But where did this concept originate? In 1965 John Greenleaf did a study on four well-trained men to examine how much water they would ingest during exercise in the heat. The title was "Voluntary dehydration in man," and is the first reference to the finding that when given ad libitum access to fluids---that is, when we drink to thirst---humans do not replace 100% of their weight losses. For those of you who have read Part II and Part III, this should be no surprise, since in those posts we introduced the concept that weight is not the regulated variable, and therefore your body does not care how much weight you lose during exercise. This "thirst is bad" guide stuck, however, and some time later you were introduced to the mantra above: "If you wait until you are thirsty, it is too late."

What is it too late for?

The argument is that by waiting until you are thirsty, you are already dehydrated. This argument has been perpetuated because you have been led to believe that weight losses equal body water losses. However, even in a class lab we performed recently, our volunteer cycled for just over two hours. During that time he burned nearly 300 g of carbohydrate and fat while ingesting water ad libitum. His weight losses, or "dehydration," were 1 kg. Yet a whole 30% of that "dehydration" was not water at all and instead represented fuel that he burned. Let us say that again---the weight loss method overestimated his "dehydration" by 30%. So the take home message here is that the body weight losses grossly overestimate the fluid losses, and when someone is said to have lost 4% of his or her body weight, at least 10% of that or more will be fuel that has been burned during the exercise.

The thirst mechanism - a well-oiled physiological machine

The reality of the situation is that humans (and mammals) have very well-developed and successful mechanisms in place to help conserve and maintain their fluid balance, although the sports drinks companies have informed you otherwise. As we have said, the body is not concerned about body weight, but rather the concentration of the body fluids---otherwise known as the osmolality, and here is how it works.

Incredibly small increases (1%) above the resting value (280-300) first will trigger the release of anti-diuretic hormone, or ADH. Its job is to keep you from losing any more water in the urine. It has a profound effect so that even small amounts of ADH produce a maximal effect---that is, it is not possible for you to produce any less urine. Next, if ADH does not do the trick, as is the case when you are exercising and sweating, your thirst kicks in. Again, this occurs at a very marginal (4% or less) elevation of the osmolality. The effect is that we seek fluid, drink, and some time later the fluid gets in to the blood and dilutes it back down below the thirst threshold. This cycle continues indefinitely until you stop excreting fluid (i.e., sweating) and restore your osmolality once and for all.

So in fact humans have a very acute sense of when it is important to drink fluid, and it does not take much to stimulate us to seek water. Thirst is a very deep-seated, physiological desire for water, and it has been shown again and again in lab studies to effectively defend the osmolality.

Why is the osmolality so important?

The reason the body does not care about weight losses and instead "defends" the osmolality is that this concentration of the body fluids is what keeps the fluid balance between the cells. We have fluid both inside and outside the cells, and under normal conditions, the osmolality maintains this balance. The following two changes are possible:

  • The osmolality can increase outside the cells. This will cause the fluid to leave the cells. Because this is undesirable, the ADH and thirst mechanisms explained above kick in and we correct the change to restore balance (homeostasis, in physiology-speak!)
  • The osmolality can decrease outside the cells. If this happens, then fluid will move into the cells. Similarly, the body will initiate a sequence of responses, including the release of other hormones (aldosterone, for example) that we won't go into here.
As our bodies are mostly water, you can imagine why keeping these fluid volumes balanced is so important, and that is precisely why the body defends the osmolality and not the body weight.

"My sweat tastes salty"

Yes, it certainly does, and that is because it does contain some sodium. However it contains profoundly less than the fluids in your body, and is still mostly water---body fluids have a sodium concentration of 140mM while sweat has a value of 20-60mM. Therefore when you remove a liter of sweat from your blood, it has much more of an effect on the volume compared to the solutes (sodium), and what happens is that the osmolality rises in response to sweat losses. This is absolutely crucial to realise - you cannot lose sodium, even if you are a "salty sweater", as Gatorade are now claiming. If the sodium content of the blood is dropping, it's because you're drinking too much water, not because you're sweating sodium!

In fact, a very interesting study was published in 1992 by Robert Cade, the man who invented Gatorade. His experiment took place during a marathon, and the groups of runners were given Gatorade, 1/2 Gatorade (half water, half Gatorade), or water. The really interesting finding was that the water group maintained their sodium concentration (a surrogate for the total osmolality) just fine, while the Gatorade group actually increaesed its concentration. In fact this explains why people drink more of a sports drink compared to water---the sports drinks keep your osmolality higher and therefore makes you thirstier. So instead of lowering osmolality, which is what your body wants you to do, the sports drinks raise it. Seems kind of counter-intuitive, doesn't it?

The final word - Drinking to thirst optimizes your fluid intake

We hope it has become clear that, for a number of reasons, it is not necessary to drink so much during exercise, and in furthermore no one needs to tell you how much to drink. As we have shown you here, the thirst mechanism is highly sensitive and very successful at what it is meant to do: maintain your osmolality, not your weight. But the final message here is that when you drink to thirst, you optimize your fluid intake, and by that we mean your thirst will always keep you from drinking too much or too little. There is such a thing as both of those, but drinking to thirst will always prevent you from straying too far in one direction or the other.

In addition, who wants to carry around three Liters of fluid in a backpack when half that volume will be just plenty? And when there is no scientific evidence to support the claims that dehydration increases your core temperature or elevates your risk for heat stroke, it seems quite unnecessary. In fact, the concept that people are "dehydrated" while losing a few kg's is now debatable.

One last thing, is that as humans, we are regarded (by most, anyway) as the smartest animals, right? Yet for some reason, companies making fluids deem it necessary to inform you how much you should drink. Have you ever had to force your pet cat or dog to the water bowl? Have you ever seens signs in the wild pointing animals to the watering hole with instructions to drink before they're thirsty? Yet somehow, the Gatorades of the world have "discovered" the NEED to educate us all about fluid. It does strike one as patently ridiculous - thirst is good enough for every animal in the world, it's good enough for us...!

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