Healing Foods Pyramid™
Water is included in the Healing Foods Pyramid™ as part of a balanced, whole foods, plant-based diet. This Food Pyramid emphasizes foods that nourish the body, sustain energy over time, contain healing qualities and essential nutrients, and support a sustainable environment.
What are the recommended servings of water per day?
In 2004 the Institute of Medicine published the following recommendations for average daily total water intake in healthy individuals:
- Women: Drink 9 cups (72 oz) per day
- Men: Drink 12 cups (100 oz) per day
While many individuals allow thirst to guide their daily water intake, this may lead to inadequate consumption. By the time you experience thirst, your body fluids are already depleted. Furthermore, in individuals who are ill, infants, athletes and those living in hot environments, sense of thirst is not an adequate reflection of water needs.
Why should you drink water?
- It is an essential nutrient and makes up > 60% of adult body weight
- It is needed for all body functions, such as nutrient digestion, absorption, transport, and metabolism
- It aids in body-temperature maintenance
- It is vital to electrolyte balance
- It helps lubricate and cushion joints
- Water contains no calories or fat
- May help with weight loss by acting as a natural appetite suppressant
- Prevents complications from dehydration, such as headache or fatigue
- May benefit people with respiratory diseases by thinning mucous secretions that worsen asthma
- May help people who experience recurrent urinary tract infections by increasing their urine flow
- May help reduce cancer risk of the colon, kidneys, bladder
When is it important to increase your water consumption?
Fluid requirements increase due to exercise, environmental factors, fever, diarrhea, certain illnesses, pregnancy, and other conditions
Exercise |
Pregnancy |
Short bouts of exercise: Intense exercise lasting >1 hour: |
Pregnant women should drink 2.3 liters (about 10 cups) per day Women who breastfeed should drink 3.1 liters (about 13 cups) per day. |
Environment |
Diarrhea |
Increase fluid intake under these conditions: |
Increase fluid intake when tolerable. Avoid milk, instead consume clear fluids such as: water, tea, juice, or carbonated water when possible. |
Cold/Flu |
|
Increase fluid intake when tolerable. Consume at least the daily recommendation of water and electrolytes throughout the day. |
Solution for Rehydration after Sustained Exercise
Research shows that individuals who consume food and water within the two hours after exercise rehydrate better that those who drink water or sports drinks. So enjoy a balanced meal or snack that includes fresh fruit and/or vegetables with a large glass of water for optimal recovery after sustained exercise.
Dietary Sources
- Your diet provides the water your body needs. In an average adult diet, food provides about 20 % of total water intake. The remaining 80 % comes from beverages you drink.
- Fruits and vegetables contain lots of water and are also good sources of vitamins, minerals and fiber. However, your daily water requirement of 9-12 glasses for women and 12 for men should be consumed above and beyond the water that is consumed as food.
- Beverage requirements are met best by consuming plain water. You can also choose unsweetened herbal or green tea (hot or iced), diluted fruit juice, sparkling water, or add lemon/lime juice to plain water.
Specific Considerations
Dehydration
Too little water can lead to dehydration, a condition that occurs when you do not have enough water in your body to carry out normal functions. Even mild dehydration can make you tired. Signs and symptoms of dehydration include:
Signs |
Symptoms |
|
Poor skin turgor |
Excessive thirst |
Dizziness |
Drinking Too Much Water
- Drinking too much water is uncommon but may lead to hyponatremia, a condition in which excess water intake dilutes the normal amount of sodium in the blood
- Those most at risk of drinking too much water are high-endurance athletes, such as marathon runners
- Symptoms of water intoxication include nausea, vomiting, fatigue, and confusion
- Check with your health care provider or a registered dietitian if you're concerned about drinking too much or too little water
Chlorine and Lead
Chlorine and lead are the two most common contaminants in tap and some bottled water. Although it may serve an important role in a public water supply, chlorine is a strong oxidizing agent and may increase the risk of heart disease and certain cancers. Small amounts of lead may be toxic, especially in infants, children, and pregnant women. The following are some ideas to increase the likelihood that your drinking water is safe:
- Check your local water report for data on impurities and/or bacterial contamination
(visit http://www.epa.gov/safewater/dwinfo/index.html for more information on the safety of drinking water in your area) - Install a home purification/filtration system
- Install a home water distillation system
- Use a Brita or other comparable water filtration pitcher
- Use a quality bottled water if it is the only available safe water source; however, we encourage you to avoid plastic when possible
Bisphenol-A
- Bisphenol-A (BPA) is a chemical used in the production of polycarbonate plastics and epoxy resins which line aluminum cans.
- BPA enters the human body through food and beverages and is potentially harmful to children, infants, and fetal development
- To avoid exposure to BPA, buy BPA-free plastics and avoid exposing plastic containers to high heat
Signs of appropriate water consumption
- You rarely get thirsty
- You produce a colorless or slightly yellow urine several times throughout the day
- You feel well
- Healthy skin and hair is a good indicator of hydration
Ideas to Increase Water Consumption
- Keep a pitcher of herbal iced tea in the fridge.
- Add fresh lemon or lime to juice or water.
- Drink hot herbal tea.
- We do not recommend drinking sodas because they are void of essential nutrients.
- We do not recommend drinking juices because they are high in calories and usually lack the fiber of whole fruit.
- Drink a glass of water with each meal and between each meal.
- Take water breaks instead of coffee breaks.
- Substitute sparkling water for alcoholic drinks at social gatherings.
- Carry water in your car. Be sure to use a glass bottle, as plastic kept in a hot car may leech chemicals into your water.
- Keep a water bottle with you and drink throughout the day. To keep a reusable bottle clean, wash it in hot, soapy water or run it through the dishwasher before refilling it.
Resources
Bisphenol-A
National Toxicology Program
National Institute of Environmental Health Sciences
http://www.niehs.nih.gov
Accessed November 15, 2009
Dietary Intake for Water, Salt, and Potassium
National Academies
www.nas.edu
Accessed July 28, 2009
Hyponatremia
Mayo Clinic
www.mayoclinic.com/health/hyponatremia/DS00974
Accessed July 28, 2009
Nutrition Fact Sheet: Water
Northwestern University
www.feinberg.northwestern.edu/nutrition/factsheets/water.html
Accessed July 28, 2009
Soda: Does it Increase the Risk of Osteoporosis?
Mayo Clinic
www.mayoclinic.com
Accessed July 28, 2009
The Wonders of Water
WebMD
www.webmd.com
Accessed July 28, 2009
Water: How much should you drink every day?
Mayo Clinic
www.mayoclinic.com
Accessed July 28, 2009
Water, Water Everywhere. How Much Should You Drink?
American Dietetics Association
www.eatright.org
Accessed July 28, 2009
Why You Should Drink More Water
University of Iowa Health Care
www.uihealthcare.com
Accessed July 28, 2009
The Wildcat Way to Wellness: Water is the Liquid of Life
University of Kentucky Cooperative Extension Service
www.ca.uky.edu
Accessed July 28, 2009
Water and Hydration
University of Arizona
http://www.health.arizona.edu
Accessed July 29, 2009
Original Research and Review Articles
Almond C, et al. Hyponatremia among Runners in the Boston Marathon. The New England Journal of Medicine. 2005; 352:1550-1556.
Altieri A, et al. Fluid intake and risk of bladder and other cancers. European Journal of Clinical Nutrition. 2003;57(Suppl 2):S59 -S68.
Armstrong L, Caffeine, Body Fluid-Electrolyte Balance, and Exercise Performance. International Journal of Sport Nutrition and Exercise Metabolism. 2002; 12: 189-206.
Backer, H. Wilderness First Aid: Emergency Care for Remote Locations, Sudbury, 2005, Jones & Bartlett Publishers.
Campbell SM. Hydration Needs Throughout the Lifespan. Journal of the American College of Nutrition. 2007;26(5):585S-587S.
Chalupka S. Tainted Water on Tap: What to tell patients about preventing illness from drinking water. The American Journal of Nursing. 2005;105(11):40 -52.
Gray M, et al. Does fluid intake influence the risk for urinary incontinence, urinary tract infection and bladder cancer? Journal of Wound, Ostomy, and Continence Nursing. 2003;30(3):126 -131.
Lin M, et al. Disorders of water imbalance. Emergency Medicine Clinics of North America. 2005; 23(3):749-70.
Manz F, et al. The importance of good hydration for the prevention of chronic diseases. Nutrition Reviews. 2005;63(6):S2 -S5.
Von Duvillard S, et al. Fluids and Hydration in Prolonged Endurance Performance. Nutrition. 2004; 20: 651-656.
The Healing Foods Pyramid™ was created by the Nutrition Education Team at the University of Michigan Integrative Medicine, Department of Family Medicine in 2005 and updated in 2009.
© copyright 2010 Regents of the University of Michigan - University of Michigan Integrative Medicine
Monica Myklebust, M.D. and Jenna Wunder, M.P.H., R.D. For questions and licensing information please call 734-998-7874 or email umim-hfp@umich.edu.
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