Making hydration a priority

Drinking water seems obvious, doesn’t it? Like breathing or sleeping, it’s just something we do when we’re thirsty, and we know we need it to survive. However, the research shows that it’s not that simple. This week is Nutrition and Hydration Week 2019, and after our recent focus on healthy eating, let’s tackle hydration.

What is hydration?

Hydration is the body’s ability to absorb water, the vital liquid it needs, and is based on how much is available to it. Every cell, tissue, and organ requires fluid, performing functions such as maintaining temperature, disposing of waste products and lubricating joints.

This absorption of water is primarily done through drinking liquids, preferably water, but around 20% of our intake comes from food as well. The general recommendation is 6–8 glasses of water on top of what we eat, but it’s important to note that this isn’t a ‘one size fits all’ situation.

Factors which will affect hydration, and so how much water we need, include age, climate, and level of physical activity. We lose water through a range of normal bodily functions such as breathing and urinating, and this needs to be replaced. Additionally, drinks such as coffee actually dehydrate, despite containing water, so should not be considered a source of fluid.

Complications of dehydration

Dehydration can occur for a number of reasons, from simple lack of adequate water intake to losing it through illnesses such as sustained vomiting and diarrhoea. With water’s essential role in our bodies, the consequences of not getting enough are understandably wide-ranging in both nature and severity.

At one end of the scale, not taking in enough water during the day will cause thirst, lethargy, dizziness, and headaches, but prolonged dehydration begins to cause the body to shut down. Heart rate will increase as the body compensates for the lack of liquid in the blood, and fluids will be diverted from vital organs such as the brain and lungs.

A major condition associated with dehydration is kidney disease or acute kidney injury (AKI). The kidneys may stop working temporarily or fail entirely. It’s caused by reduced blood flow and so can be associated with dehydration.

Monitoring hydration in the pharmacy

As with many conditions with multiple and common causes, pharmacists are well-placed to identify the signs. While medications such as some antibiotics can cause dehydration and so come with advice from the pharmacy, customers will also seek over the counter remedies for conditions such as urinary tract infections (UTIs).

With 2 out of 3 cases of AKI starting in the community, the Department of Health commissioned an audit in 2015. The NHS surveyed nearly 1,000 pharmacies and almost 15,000 patients, looking into how many came to pick up prescriptions for certain antibiotics, as well as those looking for oral rehydration solutions and UTI relief. The report helped to produce and review the 10 key characteristics of ‘good nutrition and hydration care’.

Helpful resources

Nutrition and Hydration Week:

     Website: www.nutritionandhydrationweek.co.uk

     Email: info@nutritionandhydrationweek.co.uk

The Association of UK Dietitians

Specialist Pharmacy Service AKI audit data collection form

NHS Eat well