Dehydration is a common cause of many of the conditions that bring patients to the emergency room on a daily basis. This includes headaches and dizziness, fatigue, nausea, abdominal cramps and constipation, muscle aches and kidney stones. From a biological point of view, this makes sense, as 60% of our body is made up of water.
The benefits of adequate hydration are beyond question.
So it’s no surprise that TikTok and social media abound with fads around adequate hydration and hacks to achieve it. One of the more famous is the #gallonofwateraday, which encourages participants to drink 4.5 liters of water a day. Meanwhile, #cirkul has racked up nearly 400 million views on TikTok for a seemingly normal-looking water bottle with an intensity-adjustable water-flavor mechanism to encourage drinking. And elsewhere on social media, Khloe Kardashian swears by her $23 motivational water bottle that has become a best-seller on Amazon.
But how much water should we actually drink every day?
The US National Academies of Sciences, Engineering and Medicine have determined that an adequate daily fluid intake is about 3.7 liters of fluid per day for men and 2.7 liters for women. This seems like a lot, but remember that about 20% of our daily fluid intake comes from food. There are multiple foods that are 85% water that are a great source of hydration and other important vitamins we need, including cucumbers, tomatoes, watermelon, apples, and kale.
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So, after taking into account liquids obtained from food, the adage to drink about six to eight glasses of water a day (1.2-1.5 liters) is generally accepted and seems practical. Higher daily amounts are needed for athletes, for those who live in hot or humid climates or at high altitudes, and for those who are ill with fever, vomiting or diarrhea.
The truth is, there is no magic formula to quantify adequate hydration. Either way, an idea of how much water you need on a daily basis may be more palatable to those who feel the daily grind of chasing a number too daunting. In addition, hydration is a better measure based on observable signs that your body is telling you it has had enough water.
In the emergency room, we determine adequate hydration by measuring hourly urine production and electrolyte concentration in complicated urinalysis tests. A practical hack at home and on the go is to watch your urine. Urine that is dark yellow and has a strong odor indicates insufficient hydration. If the urine is as clear as water and you find yourself going several times an hour, you are overhydrated. The target is a urine that is light yellow in color. Another easy way to check if you’re hydrated is to pinch the skin on the lower part of your arm; if the skin immediately snaps again, you are hydrated. If the skin slowly returns to its resting state, start drinking.
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It is also important to remember to spread your water intake throughout the day. If you drink too much in a short period of time, you will feel bloated and full. And don’t try to catch up in the evening unless you want to wake up several times during the night to use the bathroom when you should be sleeping.
Another pro tip: Drink water with your meals. Water aids digestion, especially during chewing and swallowing, and keeps stool soft and moving through the gut. A common misconception is that drinking water dilutes digestive juices and hinders nutrient absorption. But that’s a myth that needs to be debunked some other day.
Michael Daignault is a board-certified ER physician in Los Angeles. He studied global health at Georgetown University and received a medical degree from Ben-Gurion University. He completed his residency training in emergency medicine at Lincoln Medical Center in the South Bronx. He is also a former United States Peace Corps volunteer. Find him on Instagram @dr.daignault
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