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The New Fluid Guidelines

In February 2004, the Institute of Medicine (IOM) issued new recommendations. The new guidelines remove the eight-glasses-a-day recommendation, and say healthy adults may use thirst to determine their fluid needs. Exceptions to this rule include anyone with a medical condition requiring fluid control; athletes; and people taking part in prolonged physical activities or whose living conditions are extreme.

How Much Is Enough?

The IOM report made general fluid intake recommendations of 91 ounces (that’s 11-plus cups a day) for women and 125 ounces (15-plus cups a day) for men. These guidelines are for total fluid intake, including fluid from all food and beverages.

Approximately 80% of our water intake comes from drinking water and other beverages, and the other 20% comes from food. The recommended amount of beverages, including water, would be approximately 9 cups for women and 12.5 cups for men.

When You Need More

Physical activity, heat, and humidity can increase our fluid needs. In these situations, keep water bottles close at hand and drink frequently to avoid dehydration. If you’re going to be physically active for long periods, consider sports drinks that hydrate and provide easily usable sugar and electrolytes.

Water and Weight Control

The weight loss benefits of water stem from several facts:

• Foods that incorporate water tend to look larger.
• The higher volume of these foods provides greater oral stimulation.
• Most important, when water is bound to food, it slows down absorption and lasts longer in the belly.

Bottom Line

The experts agree: Drinking water - either sparkling or flat and perhaps with a twist of citrus - is a great, noncaloric way to satisfy your thirst. But if you struggle with drinking water, you’re off the hook as long as you:

• Enjoy plenty of high-volume foods, including fruits and vegetables.
• Satisfy your thirst with a variety of healthy, low-calorie beverages such as 100% fruit juice, skim or low-fat milk, tea, and, of course, water.

Pay attention to signs of dehydration, such as dry mouth and concentrated urine, which indicate a need for more liquids.

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A new study suggests that swapping out a small amount of carbohydrates in an already heart-healthy diet for either protein-rich foods or unsaturated fats may provide additional benefits in lowering heart disease risk.

Reducing Heart Risk

The protein-rich diet reduced heart disease risk by 21%, and the monounsaturated-fat-rich diet reduced it by almost 20%, compared with the 16% reduction found with the carbohydrate-rich diet.

“Our study provides strong evidence that replacing some carbohydrate with either protein or monounsaturated fat has important health benefits,” says Appel. “There is already agreement that reducing saturated fat lowers risk for heart disease, but the question of which macronutrient [fat, protein, or carbohydrate] to emphasize has been controversial.”

Trade in a Few Carbs for Heart Benefits

In the high-protein diet, researchers replaced approximately 10% of the total daily calories from carbohydrates with protein. About 50% of the protein came from plant sources, such as beans, nuts, seeds, and some grains. The unsaturated fat diet was enriched with monounsaturated fats and included olive and canola oils, as well as some nuts and seeds.

In the study, which appears in The Journal of the American Medical Association, researchers compared the effects of the three diets in 164 adults who either had high blood pressure or were on the verge of having it.

Blood Pressure and Cholesterol Changes

Researchers found that blood pressure and cholesterol levels improved after each diet phase compared with the start of the study. But the benefits achieved with the protein-rich and monounsaturated-fat-rich diets were greater than with the DASH-based diet alone.

In an editorial that accompanies the study, Myron H. Weinberger, MD, of Indiana University Medical Center, says the results of this study may be difficult to apply to the public. He says the people in this study were highly motivated to follow the diets because of their blood pressure status and the fact that all of the foods were provided to them.
“Although the benefit of blood pressure reduction in those in the prehypertensive group is clear,” Weinberger says the ability to control high blood pressure adequately in the people with existing hypertension is not clear. “It is likely that more than diet will be required to reach goal blood pressures for the majority of these individuals.”

By Jennifer Warner, WebMD Medical News

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New research shows how a fat found in fish such as salmon, mackerel, and herring might help fight Alzheimer’s disease. The fat is called DHA. That’s short for docosahexaenoic acid. Technically, it’s an omega-3 fatty acid.

Fat to the Rescue
Scientists don’t know exactly what triggers Alzheimer’s disease to develop. However, they’ve noticed clumps of amyloidal protein and bundles of tangles (twisted fibers) in brains of people who suffer with the condition.

It’s unclear whether plaques or tangles cause Alzheimer’s disease or whether these are a byproduct of some other process that causes the condition.

DHA may help put the brakes on beta-amyloid proteins and rev up NPD1, write Bazan and colleagues. NPD1 acts like a bodyguard for brain cells, blocking the disease’s attempts to make brain cells die, the study shows.

Fish as Brain Food
Bazan’s study was done in a lab. They didn’t serve anyone fish for supper every night or dole out fish oil capsules. The researchers also don’t recommend any particular dose of DHA for Alzheimer’s disease. But they note that DHA is essential for the brain.

Past studies have shown that people who eat a lot of fish tend to be less likely to develop Alzheimer’s disease than those who hardly ever eat fish. For instance, a study published in 2003 showed that elderly Chicagoans who reported eating fish once a week for four years developed Alzheimer’s less often than those who rarely or never ate fish.never ate fish.

That doesn’t prove that fish prevents Alzheimer’s, but the pattern is getting lots of attention. DHA has also been found to be important for babies’ brain development. Fish oil capsules are another option.

In December 2004, consumerlab.com reported that its tests found no mercury or other toxins called PCBs in 41 fish oil supplements. Discuss any supplements you take with your doctor.

By Miranda Hitti, WebMD Medical News, September 2005

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