Scientific Opinion on Water Intake

Water in the body is derived from different sources; drinking water, from beverages, the moisture content in foods and oxidative processes in the body. Water is an essential component for virtually all body functions. However, thermoregulation is the outstanding function of water in the body. There ought to be a balance between water intake and water loss; one needs to replenish the water lost so as to achieve optimal body functions.

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Distribution of water within the body and water needs for different intercellular and extracellular activities are largely regulated by homeostatic function though this changes with age. Loss of body weight as a result of 1% water loss is usually compensated within a period of 24 hours. Continued water loss without replenishment could lead to a shutdown of vital body functions which could be fatal. Body water loss exceeding 10% could lead to fatalities. Life-threatening water intoxication is rare but can occur in near-drowning in fresh water, rapid rehydration and overconsumption of water beyond the kidneys' maximum excretion rate.

Water requirements vary depending on environment and individuals. For infants exclusively under breast milk, adequate water for the first six months is 100-190m/kg per day. For kids aged between 6-12 months, adequate water intake of 800-1000ml per day is adequate. For adult males, adequate water intake is 2.5l per day whereas for females it is 2l per day. Lactating women should consume 700ml more water than the non-lactating woman.

A G Ershow, K. (1991). Intake of tapwater and total water by pregnant and lactating women. American Journal Of Public Health, 81(3), 328. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1405003/

Intake of tap water and total water

Weight gain during pregnancy and breastfeeding in lactating women can cause an increased water intake in women. The amount of water cannot, however, be precisely determined. A survey was conducted to estimate the amount of water consumed by lactating and pregnant women in the US. A total of 30,770 subjects participated in the survey. It involved a study of women who were nursing babies aged two years or less (87%) and those who were 4 or more months pregnant. The age range for these women was 15-49 years. The control group was taken to be those women of the same age range who were neither pregnant nor lactating.

Drinking water was used to refer to plain water taken directly as a beverage but not including water used for cooking and other beverages. Tap water refers to drinking water as well as water used in cooking and tap water-based beverages. Total water is tap water and non-tap water sources, including water from food.

All calculations and statistical procedures for the survey were conducted using SAS software package.

The results of the study showed that lactating women were generally older than pregnant women and tended to live in households with higher education levels. The heights and weights of the subjects measured favorably with available data from NHANES. A close association between reproductive status and water intake was observed. Lactating women consumed higher quantities than pregnant women.

(2016). Retrieved 15 February 2016, from http://www.cdc.gov/nchs/data/nvsr/nvsr61/nvsr61_04.pdfThis is a report summary relating to deaths, infant mortality, life expectancy, trends selected by characteristics such as age, sex and state of residence in the US for the year 2010.

Data for the study are obtained from state registration offices.

From the analysis of the study, a total of 2,468,435 deaths occurred in the US. The death rate was 747 per a population of 100,000 people, a record low. In the previous year, the rate was 749.6. Life expectancy rose from 78.5 in 2009 to a record high of 78.7 in the year under consideration. Leading causes of death were same as those of the year 2009 except for one of the leading 15 causes. Homicide was replaced by pneumonitis due to solids and liquids as the leading cause of death in 2010. Infant mortality decreased by 3.8% to a record low of 6.15 deaths per 1,000 live births. Death rates per specific age brackets decreased for each group less than 85 years.

In conclusion, decrease in death rates per age-specific groups and increased life expectancy show consistency with long-term trends in mortality.

Coresh J, e. (2016). Prevalence of chronic kidney disease in the United States. - PubMed - NCBI. Ncbi.nlm.nih.gov. Retrieved 15 February 2016, from http://www.ncbi.nlm.nih.gov/pubmed/17986697There has been a rise in incidences of kidney failure treated by dialysis and transplants in the US from 1988-2004. It is however not certain whether this prevalence can be attributed to failure to arrest the situation at its early stages.

Prevalence of chronic kidney disease was gauged based on constant albuminuria and a decrease in glomerular filtration rate.

The results showed that decreased GFR and albuminuria prevalence increased in the periods under consideration. Prevalence of chronic kidney disease stages 1-4 increased from 10% witnessed in 1988-1994 to 13.1% in the years 1999-2004. High diabetes and hypertension prevalence, as well as increased body mass index, could explain the increased albuminuria. They could however only partially explain the prevalence in decreased GFR.

In conclusion, CKD prevalence in the US was higher in 1999-2004 compared to 1988-1994. This could partly be explained by increased hypertension and diabetes, and further raises future concerns of CKD and its complications.

Thomas, R., Kanso, A., & Sedor, J. (2008). Chronic Kidney Disease and Its Complications. Primary Care: Clinics In Office Practice, 35(2), 329-344. http://dx.doi.org/10.1016/j.pop.2008.01.008Chronic kidney disease affects more than 20 million people in the US. Individuals suffering from CKD should be assessed for these complications to arrest its severity and mortality.

CDK can be defined as the existence of kidney damage, manifested by excessive albumin excretion and slow kidney function that persists for more than three months. To assess the severity of chronic kidney disease (CKD), four stages of the disease have been developed. Each stage has its own level of severity and treatment.

CKD can be caused by different other related ailments that affect the body. The major related causes of CKD include anemia, mineral and bone disorders and cardiovascular risks. Each of these complications exposes an individual to a higher risk of CKD.

Levey, A. (2003). National Kidney Foundation Practice Guidelines for Chronic Kidney Disease: Evaluation, Classification, and Stratification. Annals Of Internal Medicine, 139(2), 137. http://dx.doi.org/10.7326/0003-4819-139-2-200307150-00013CKD can be prevented and treated if an early diagnosis is done. This can only be achieved if one undertakes regular check-ups to determine his health status.

Glomerular filtration rate is the best measure to determine the functionality of a kidney. Normal GFR varies depending on age, sex and body size. Abnormalities in urine sediments, abnormal blood and urine measurements, persistent proteinuria and abnormal findings on imaging studies are other indicators of kidney damage that can predispose an individual to CKD.

Wenzel, U. (2006). My Doctor Said I Should Drink a Lot! Recommendations for Fluid Intake in Patients with Chronic Kidney Disease. Clinical Journal Of The American Society Of Nephrology, 1(2), 344-346. http://dx.doi.org/10.2215/cjn.01140905Patients suffering from chronic kidney disease are often advised to take plenty of water. But is this the correct prescription? No scientific basis has been advanced for such recommendation, however. A physician who recommends a high fluid intake to CKD patient may be driven by the following misconceptions:

An increased plasma volume leads to increased perfusion which in turn leads to increased urine production which helps in excretion of urea and other wastes. This assumption only holds water in case of perennial kidney failure as a result of dehydration.

The second misconception is that the kidney needs a moist environment to work well and that a high urine production is an indication that the kidney is working well...