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Abstract
Purpose
An increasing body of evidence suggests that excreting a generous volume of diluted urine is associated with short- and long-term beneficial health effects, especially for kidney and metabolic function. However, water intake and hydration remain under-investigated and optimal hydration is poorly and inconsistently defined. This review tests the hypothesis that optimal chronic water intake positively impacts various aspects of health and proposes an evidence-based definition of optimal hydration.
Methods
Search strategy included PubMed and Google Scholar using relevant keywords for each health outcome, complemented by manual search of article reference lists and the expertise of relevant practitioners for each area studied.
Results
The available literature suggest the effects of increased water intake on health may be direct, due to increased urine flow or urine dilution, or indirect, mediated by a reduction in osmotically -stimulated vasopressin (AVP). Urine flow affects the formation of kidney stones and recurrence of urinary tract infection, while increased circulating AVP is implicated in metabolic disease, chronic kidney disease, and autosomal dominant polycystic kidney disease.
Conclusion
In order to ensure optimal hydration, it is proposed that optimal total water intake should approach 2.5 to 3.5 L day−1 to allow for the daily excretion of 2 to 3 L of dilute (< 500 mOsm kg−1) urine. Simple urinary markers of hydration such as urine color or void frequency may be used to monitor and adjust intake.
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Details
1 Danone Research, Health, Hydration & Nutrition Science, Palaiseau cedex, France (GRID:grid.433367.6) (ISNI:0000 0001 2308 1825)
2 University of Connecticut, Department of Kinesiology, Storrs, USA (GRID:grid.63054.34) (ISNI:0000 0001 0860 4915); Hydration & Nutrition, LLC, Newport News, USA (GRID:grid.63054.34)
3 London Health Sciences Centre and Western University, London, Canada (GRID:grid.412745.1) (ISNI:0000 0000 9132 1600)
4 Arizona State University, College of Health Solutions and Hydration Science Lab, Phoenix, USA (GRID:grid.215654.1) (ISNI:0000 0001 2151 2636)
5 Eberhard Karls University, Department of Physiology, Tübingen, Germany (GRID:grid.10392.39) (ISNI:0000 0001 2190 1447)
6 Westwood, USA (GRID:grid.10392.39)
7 Lund University, Department of Clinical Sciences Malmö, Malmö, Sweden (GRID:grid.4514.4) (ISNI:0000 0001 0930 2361)
8 Children’s Hospital Oakland Research Institute, Oakland, USA (GRID:grid.414016.6) (ISNI:0000 0004 0433 7727)
9 Hôpital Rangueil, Explorations Fonctionnelles Physiologiques, Toulouse, France (GRID:grid.414295.f) (ISNI:0000 0004 0638 3479)
10 Université de Montréal, École de Kinésiologie et des Sciences de l’activité Physique, Faculté de Médecine, Montréal, Canada (GRID:grid.14848.31) (ISNI:0000 0001 2292 3357)