Do I really need eight glasses of water?

Podcast transcript

INTRO
Welcome to Docs in a Pod presented by WellMed. Over the next half hour, Docs in a Pod will educate you about the health and wellness of adults everywhere. Co-hosts Dr. Rajay Seudath and Carmenn Miles will share information to improve your health and well-being. And now here are Carmenn Miles and Dr. Rajay Seudath.

RON AARON
Well, thank you so much for joining us today on the award winning Docs in a Pod. I'm Ron Aaron. Dr. Rajay Seudath is our co-host and our special guest today. It's a great topic. Just think of the Ancient Mariner. Water, water all about and nary a drop to drink. Dr. Seudath is a board certified family medicine physician, a Tampa native and a current lead physician for Optum. He's at the University location. Dr. Seudath has a passion for primary care, and he talks about that passion whenever he gets a chance to do so. Working as an English teacher abroad, he was inspired by helping others. He's been in family medicine almost ever since. Dr. Seudath, thanks for joining us on Docs in a Pod.

DR. RAJAY SEUDATH
I'm so happy to be here again. It's great to be working with you again, Ron.

RON AARON
Thank you. I'll tell you what. This time of year with the heat, it is absolutely blistering America. In fact, at a football game yesterday on the Titans field, the players had to change their cleats several times because the temperature of the artificial grass was 157¡F. Unbelievable.

DR. RAJAY SEUDATH
Gosh, that is super, super hot.

RON AARON
We are told we need to hydrate. Hydrate, hydrate, hydrate. So that brings up the question Dr. Seudath, how much water do we need?

DR. RAJAY SEUDATH
How much water indeed. If you look online, you're going to see a lot of different numbers. The one I tend to go by is the CDC, Center for Disease Control a disease control. They tend to say, for women, it's going to be nine cups of water. For men, it's going to be 13 cups of water.

RON AARON
A cup being eight ounces?

DR. RAJAY SEUDATH
A cup being eight ounces. Now, the rule of thumb, because generally people say, I need eight cups of water, and that's a good general rule of thumb, because the CDC is also calculating in your fruits and vegetables. So, I like to go by the general rule. If you're getting eight cups of water a day, you're meeting the goal pretty good. You're doing pretty good. Eight cups of water is going to be 64oz, a half gallon, or four 16oz of the Zephyrhills bottles. For people who are not getting the water in their routine, usually those four 16oz bottles are usually the easiest way to get them in. Oftentimes people will say, well, doc, I think about drinking it, but I just don't ever get it. I try to get it, but I just never have the amount that I want. I know I should be drinking more. How can I get more in my diet? One of the easiest ways to do that is just to have the water available. You can put it in a reusable bottle. They have these 64 ounce bottles that have these motivational inscriptions on them. So, you can go from the top to the bottom, and it's something like Òstarting the dayÓ and then Ògetting betterÓ and then Òfeeling hydratedÓ and then like at the halfway point you're almost there. They have all these different things. Those can be very helpful because they allow you to take the bottle with you wherever you go. So, you get into this routine of drinking all the time, and that's one way to stay hydrated. I like when people are able to break it up into those four 16 ounce bottles. Now, again, someone can go out and buy a 48 pack or a 64 pack or whatever you catch on sale, that's great. I like using the reusable ones because it kind of fits into your routine. You wash your bottles, you fill them up, you wash your bottles, you fill them up. That that becomes part of your routine. Most people will eat three meals a day. Breakfast, lunch, dinner, that's three out of the way. Then you got one more to fill in the gaps, so to speak.

RON AARON
The question is, because marketers have turned water into something, is water water, or do you need fancy water?

DR. RAJAY SEUDATH
That's a good question. I will tell you, living in Florida all my life and visiting different parts of the state, water does taste different depending on where you are. So, hard water versus spring water versus municipal water. I believe when people do the head to head tasting, I think New York City had the best tasting tap water in the country, which is kind of hard to think about. Here in Tampa, we actually have a pizzeria, and their claim to fame is that they basically bring in New York tap water to make their New York style pizza. There are some people who eat their pizza who say they swear it makes a difference in how the pizza tastes. So, if it makes your pizza taste different than it can certainly taste different on your tongue.

RON AARON
WeÕll talk more about water in just a minute. Stay with us. We're talking with Dr. Rajay Seudath. I'm Ron Aaron. If you just joined us, you're listening to the award winning Docs in a Pod. Our podcasts are widely available. Plus, the good news, we've added a number of sites where you can find us. Amazon Music, audible, YouTube, iHeartRadio, and coming soon to a radio near you or a computer near you, Spotify. We're there for you. Dr. Seudath we're talking about water and how much you need. The fact is, the more you drink, the more you pee. Doesn't just run right through you?

DR. RAJAY SEUDATH
That is correct. When I tell people you have to drink eight cups of water, theyÕre like, doc, IÕm going to be peeing all the time. I pee maybe 2 or 3 times a day. I'm going to be going once an hour. That's true. If you drink more water, you will absolutely be peeing more, which brings me to one of my points. Water is good for your kidneys. Your kidneys need water to keep themselves healthy. Your kidneys are like big living filters. When your blood is filled with water, their job becomes much easier. This is kind of simplifying things, but when you're dehydrated, your blood is much thicker and less fluid. You can think of it as gumming up the filter. So, that's one reason why drinking water is so important. Before the break, we were talking about, is water water? Do you need the bells and whistles? You'll see people who are drinking this PH water. PH 9 water. 6.7 water. Having a higher PH in your water may have a beneficial effect, but once that water hits your stomach, your body is automatically going to neutralize it. There's not that much of a benefit when it comes to that. So, you don't need to be paying 20 bucks for a liter of water. That's kind of outrageous. If you don't like the taste of your tap water, you can get a pure water filter where you pour it into the pitcher, or you put it on the faucet. That's more than enough to make the water palatable, I think. But more importantly than the types of water or how much of the water is why hydration is important. I always feel that humans do better to do better when they know why. If I tell you to drink eight glasses of water a day, why? People do so much better when you lead with the why. So, I want to spend some time and talk about the why, if that's okay, Ron.

RON AARON
I'd love to hear the why.

DR. RAJAY SEUDATH
Good. One of the things that we need in our body is oxygen, right? When we think about water, what does water have to do with oxygen? Oxygen is in your blood cells. So, you take a deep breath in, you let it out. That air goes into your lungs and into your bloodstream. Now that blood has to travel to where it needs to go, whether it's your heart, whether it's your muscles, anywhere. Having more water in your body allows that blood to travel faster.

RON AARON
Because it's thinner?

DR. RAJAY SEUDATH
Because it's thinner, but also there's just more blood. Blood is made up of your red blood cells, and it's made up of the plasma. The plasma is mostly water. So, the more water you have in your body now, all of a sudden, the more blood you have in your body. Even people who are anemic, I'll often tell them, well, I want to I want to make sure that you're drinking enough water. I want to make sure that you're staying well hydrated, because even though your blood count is low, if your blood volume is high enough, we can get the small amount of blood you got to where it needs to go. So, that's one reason. Another one is your metabolism. Let's take for, for instance, diabetes. A lot of our listeners have diabetes. When your blood sugars are high, if you are well hydrated, that dilutes the amount of sugar in your bloodstream. So, just by staying hydrated can help to bring down your blood sugars. Same thing if we have a very high, sodium filled diet. So, it's a person, theyÕve got high blood pressure and they're eating salty foods all the time. That means that the concentration of salt in their blood is high. If you're drinking enough water and staying hydrated, that can help to stabilize your salt levels and your blood pressure levels. So, that's two metabolic reasons why water is important to your body. I like those ones. There's two more I've got. One is inflammation. Everybody's got aches and pains, especially a lot of our patients who are over 65. We can't get away from that.

RON AARON
So much swelling.

DR. RAJAY SEUDATH
Well, not so much of the swelling. The swelling is part of that inflammation, but just the wear and tear on our body's, just making it to 65 itself is a battle. Your body starts to feel the toll of that battle. I want you to think about that wear and tear in your back, or that wear and tear in your knees of bones grinding against each other. That makes inflammation every single day. How does our body get rid of inflammation? Our body's travel system is the same thing for oxygenation. It's the same thing for inflammation. So, blood has to flow to that area, pick up the inflammation and bring it back to be inactivated, to be metabolized, to get rid of that from your system. So, if there's inflammation stuck in your back, if there's inflammation stuck in your hips or in your knees and you're not hydrated, you're not getting rid of that inflammation as fast as you could be.

RON AARON
I'm confused. When you say, and we'll pick this up in just a minute, think about it while we go away. Inflammation is that stuff that's there. We'll talk more about that on the award winning Docs in a Pod. I'm Ron Aaron. Dr. Rajay Seudath is our guest and co-host, and we're talking about water.

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RON AARON
I've been thinking a lot about the Ancient Mariner water and water, all about nary a drop to drink because it was salt water. I'm Ron Aaron. Thanks for joining us on the award winning Docs in a Pod. Dr. Seudath is with us, and we are talking water. You were mentioning, and this is when I got confused, the stuff that causes inflammation is real stuff. What is it?

DR. RAJAY SEUDATH
Absolutely. When we think of pain, just pain in general, pain is what you feel in your brain when you're experiencing something that's unpleasant. But the inflammation is an actual substance, actually several substances. I was talking about how hydration, when there's more hydration in your body or when you are properly hydrated, your body is better equipped to get those substances out of joints that are inflamed or muscles that are inflamed. Oftentimes you might see bodybuilders who are walking around with a gallon of water, and you're thinking, gosh, how old are they drinking that much? Well, one, they're trying to help with the inflammation of repairing their muscles. And two, when you're properly hydrated, your muscles kind of plump up and you look a little better. So, that's another reason. But that's absolutely what it's about is getting that inflammation from the source, whether it's your knees or your back or your hips, and bringing it to where it needs to go to get taken out of your body. Which leads me to my fourth why, which is excretion. Getting the pee and the wastes out of your body. Let's say there's inflammation in your body. Your body is nice and hydrated. It's picking it up and taking it to your liver and taking it to your kidneys to basically metabolize all the waste in your body. When you are excreting through the urine, your body needs water to do that. I'm sure anybody who's gone on a long fishing trip and has been dehydrated, when they pee, it's like, oh, my God, this is amber colored. I really need to drink some water. Most of those guys are having dark colored urine. So, that's one of the things. Another type of excretion, another type of elimination that we have is constipation. If you're having bowel movements and as we get to our age of over 65, you might notice your muscles become a little bit weaker in your arms and your legs and your back. That also happens in our intestines. The muscles in your arms become shorter and weaker. Well, we can do some exercise to try and strengthen those, but the muscles in your intestines become weaker and there's no real exercise to strengthen up your intestines. That's why hydration becomes so important when we are over 65, because we need that moisture to help move our stool through our intestines. That becomes a real issue of our bowel regiment. Oftentimes people will tell me, yeah, doc, I don't have bowel movements like I used to when I was in my 30s or my 40s. That's because you're 70. Almost everybody, when they get to that point, start to have some slowdown in their digestion and in their metabolism. So, that's one of the things that we have to try and take into account. Why is hydration important in that? Well, it has to do with the stool in your intestines. Your intestines absorb the water. So, the more water you drink, the less that's actually absorbed, the softer the stools. That's why it's good. What's a good stool? Well, I always say it's soft, smooth and long like a snake. That's a healthy stool. If you're having that, that's great. That means you're probably drinking enough water. If you're not staying hydrated, you may need to have a bowel regiment, which is stool softeners or laxatives. Those are two different things. People will say, I take a stool software or I take a laxative, but they're not the same thing. There are two specifically different things. In the bowel regiment game, we call it mush and push. The laxative is what needs water for most laxatives. For the gentle laxatives, for the laxatives you can use every single day. Most people have heard of MiraLAX. That's the jug you usually get when you're taking a colonoscopy. That medicine needs hydration. It takes moisture from your body and puts it in your intestine in order for you to have a bowel movement more frequently. A stool softener actually softens the stool. Mush and push. So, those are some of the reasons why your hydration is important for elimination. Those are kind of the whys. That's why we should drink enough water. But what if you're drinking enough water but you're still technically dehydrated? It seems that your doctor's telling you to drink more water, or you're finding that you're still having a lot of those other issues. Yes, we need eight cups of water, but there are things that dehydrate you. So, you might have eight cups of water, but if you have a martini, you need to take one of those cups away because it takes a 1 to 1 for alcohol. So, you need one cup of water to metabolize a unit of alcohol and unit alcohol. One bottle of beer, one glass of wine, one shot of the hard stuff. Again, it's approximately 1 to 1. It's a good rule of thumb. If you're drinking eight cups of water but you have two beers at the game, your net's only six cups. You're in a dehydration setting, even though you feel like I just drank two bottles of beer. How could I be dehydrated? The overall effect of the alcohol is you start to pee it out. It's a diuretic. It starts to make you lose fluid. The same thing with caffeine. Someone might say, well, doc, you're talking to me about constipation. I have my six cups of coffee, and I go to the bathroom with no problems. Well, those six cups of coffee are going to take six cups of water to metabolize. So, those are the kind of things that sometimes people don't necessarily factor in because they feel like they're getting a lot of fluids in. But we're not just talking about fluids, we're talking specifically about water. Free water is one way of saying it or just your amount of hydration. That's a little bit different from caffeine. It's a little bit different from alcohol. What's the other way we get dehydrated here in Florida? Heat. Sometimes it feels like you step outside in Florida, you step outside Texas and you've only been out five minutes, and you're soaked. Your clothes are soaked. It's like you're sweating buckets. So, that's another dehydrating factor. If you're going to be going to the beach, you're going to be doing yard work outside. It's the dead of summer and you're sweating bullets, you might need more than eight cups, and you might even need some electrolytes. One of those kinds of electrolytes sports drinks, coconut water, those kinds of things can replace electrolytes as well as the fluid that you might be losing. So, those are some of some of the whys. Those are some of the howÕs. Now, there are instances when we have to fluid restrict. Somebody had a heart attack, and now they can't have more than 40oz of water. I can't have salt. I can't have fat. I can't have this. I canÕt have that. A heart attack is a major, life changing thing. So, there are certain times when we tell people they actually have to drink less water. One of those issues is heart failure. I want you to think about water and blood and fluid in your body. It goes to the heart, and it goes out to the heart. Goes to the heart, goes out of the heart. If the blood is not flowing through the heart correctly, it starts to back up. When that fluid starts to back up, it's not going to cycle, so we get leg swelling first. It usually pulls in the legs, then it can start to pool in the lungs. So, people can become what's called fluid overloaded. Those people cannot cycle the amount of fluid in their body. We give them medicines to pee it out, and those medicines work on the kidneys so you can get that extra fluid off. So, that's one instance where we will cut a person's fluid intake. Another one is liver cirrhosis. Instead of blood going into the heart and out of the heart, it's into the liver, out of the liver. If it's not flowing through the liver, it backs up. Again, backs up into the legs of the ankles. Then it can back up into your liver, into your lungs, and it can make it difficult to breathe again. That person is fluid overloaded. So, those are two instances where we may want to cut back on the amount of fluid restriction. Not if you pee too much or not if you're not emptying your bladder. People say, oh gosh, doc, I'm up peeing 4 or 5 times a night. I just have to I have to stop peeing. Or doc, I pee every 20 minutes. I just stop drinking water. Nope, that's not the answer. The answer is to fix that problem. You see your provider, you get to a urine specialist, a bladder specialist, and we fix that problem. Having urine output issues or bladder issues is not a reason not to be hydrated. It is a good reason to fix the problem though.

RON AARON
All right. WeÕve got a minute left. Quick question. What are the signs that you may be dehydrated?

DR. RAJAY SEUDATH
That's a very good one. If you look at your tongue and your tongue is papery sandy. If you pinch your skin and it doesn't come back to normal. If you're looking at your eyes and your eyes are very, very dry and gummy. If you're looking at you and you don't look as beautifully hydrated as you normally do in the mirror, those are some of the signs. Also, if you're not having enough urine output. If you're used to peeing 4 or 5 times a day and you went one once yesterday and you went twice today, those could all be signs that you are dehydrated.

RON AARON
We're flat out of time. This is absolutely fascinating, Dr. Seudath. I'm glad you came up with the idea. Thanks for joining us on the award winning Docs in a Pod.

OUTRO
Executive producer for Docs in a Pod is Dan Calderon. The producer is Cherese Pendleton. Thank you for listening to Docs in a Pod presented by WellMed. Be sure and listen next week to Docs in a Pod presented by WellMed.

DISCLAIMER
This transcript is generated using a podcast editing tool; there may be small differences between this transcript and the recorded audio content.

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