Kat Lay
The Times
Gerry Gajadharsingh writes:
“There are many patients who do not drink enough water. Having a low eGFR (estimated glomerular filtration rate) on blood tests is common, especially as a patient gets older, eGFR helps us understand how well the kidneys are working, with 90% being a good level. The calculation we use in Metabolic Balance is 35ml per kg of body weight, to assess how much water a patient should be drinking. This needs to be increased in hot climates and or if the patient is doing a lot of sport or exercise. Some patients drink too much water and the problem with that, is it can dilute electrolytes which can affect health and how we feel.
What’s interesting about the research article below is the fact that they focused on sodium and in particular those patients who were at the other end of normal, but still in the medical reference range. It’s quite a big study, based on more than 11,000 American adults over a 30-year period, and the conclusion was there that was a significant association with higher end of reference values of sodium, indicating dehydration, with patients more likely to develop chronic conditions than those with lower readings. In March, the same group published a study which found links between higher ranges of normal serum sodium levels and increased risk of heart failure. The paradox of this is that patients suffering from heart failure are often put on diuretic drugs and are instructed to limit their fluid intake.
The other takeaway is the perennial problem of deciding when blood tests are normal or not normal. Most labs provide a standard medical range and most clinicians assume that as long as the patient’s blood results are within the normal standard medical range, then the patient is fine. This is a great example of how this is often not true. I think it’s important to interpret blood test from both pathological/medical perspective, and also a more functional perspective.
If you’re interested, please have a look at one of our new online courses which focuses on the interpretation of blood test results.”
https://www.thehealthequation.co.uk/thehealthequationcourses/
Staying well hydrated can keep you healthy well into old age and reduce the chances of dying early, a new study suggests.
Research published yesterday based on more than 11,000 American adults found that people with lower concentrations of sodium in their blood — indicating higher fluid intake — were less likely to develop chronic conditions.
They were also less likely to have a “biological age” greater than their actual age, while adults with higher levels tended to die younger.
“The results suggest that proper hydration may slow down ageing and prolong a disease-free life,” said Dr Natalia Dmitrieva, a study author and researcher in the Laboratory of Cardiovascular Regenerative Medicine at the National Heart, Lung, and Blood Institute, part of the US National Institutes of Health.
The study, published in eBioMedicine, uses health data taken from 11,255 adults over a 30-year period.
They gave blood samples at five medical visits – the first two when they were in their 50s, and the last when they were between ages 70-90.
The researchers looked at the concentration of sodium in their blood to judge their hydration levels.
Biological ageing was assessed by looking at 15 health markers including blood pressure, cholesterol and blood sugar, to judge how various systems in the body were functioning.
Normal sodium ranges fell between 135-146 milliequivalents per litre (mEq/L).
The research team found that adults with serum sodium levels at the higher end of a normal range were more likely to develop chronic conditions than those with lower readings.
Levels above 142 mEq/L were linked to up to a 64 per cent higher chance of developing chronic diseases like heart failure, stroke, atrial fibrillation and peripheral artery disease, as well as chronic lung disease, diabetes and dementia.
People with higher levels were also more likely to show signs of advanced biological ageing than those with serum sodium levels in the medium ranges.
Adults with serum sodium levels above 142 mEq/L were between 10 and 15 per cent more likely to be biologically older than their chronological age compared with ranges between 137-142 mEq/L. Levels above 144 mEq/L were linked with a 50 per cent increase.
Those higher levels of 144.5-146 mEq/L were linked with a 21 per cent increased risk of premature death compared with ranges between 137-142 mEq/L.
The research is observational and so cannot prove a causal link between the sodium levels and health problems. However, the researchers said many people could benefit from thinking about their fluid intake.
The UK’s Eatwell Guide says we should drink six to eight cups or glasses of fluid a day, which can include water, lower-fat milk and sugar-free drinks, including tea and coffee. But research has found many people do not drink enough.
“On the global level, this can have a big impact,” Dmitrieva said. “Decreased body water content is the most common factor that increases serum sodium, which is why the results suggest that staying well hydrated may slow down the ageing process and prevent or delay chronic disease.”
In March, the same group published a study which found links between higher ranges of normal serum sodium levels and increased risk of heart failure.
The new study excluded adults who had high levels of serum sodium at baseline check-ins or with underlying conditions, like obesity, which could affect serum sodium levels. They also adjusted for factors like age, race, biological sex, smoking status and hypertension.
Dmitrieva said most people could safely increase their fluid intake, although fellow author Dr Manfred Boehm said certain people with underlying health conditions might need medical guidance.
“The goal is to ensure patients are taking in enough fluids, while assessing factors, like medications, that may lead to fluid loss,” he said. “Doctors may also need to defer to a patient’s current treatment plan, such as limiting fluid intake for heart failure.”