WATER CONSUMPTION AND

HEALTH
When examining the classical medical literature for
recommendations on drinking fluids, one encounters a few
references to the advantage of drinking warm fluids, and to the
potential adverse effects of drinking cold ones, and there are
references to the advantage of drinking tea, but there is no
mention of drinking fluids in large quantity. In a review of
numerous works that include a discussion of rules for keeping
healthy, food is extensively described and almost always
mentioned in relation to its quantity, consuming beverages is
rarely discussed other than in passing. In the English-Chinese
Encyclopedia of Practical Traditional Chinese Medicine volume titled Maintaining Your Health
(1) some advice collected from traditional works is passed on. Regarding drinking, two ancient books
are quoted:
As the book Qianjin Yaofang [Prescriptions Worth a Thousand Gold by Sun Simiao; Tang
Dynasty] puts it: those good at health care dine when they feel hungry and drink when thirsty. The
book Zunsheng Bajian [Eight Commentaries Honoring Life by Gao Lian; Ming Dynasty] holds
the same view that one should not eat until he feels hungry and not drink until very thirsty….

The Encyclopedia points out that in China the traditional beverages were tea and wine, and advice is
given regarding how to make the best use of these, indicating their benefits but cautioning about
drinking too much of either.

A modernized interpretation of an Ayurvedic recommendation, is this from the Maharishi Institute

(2):
Drinking hot water regularly is a classical Ayurvedic recommendation for balancing vata and kapha
dosha, strengthening digestive power, and reducing metabolic waste (ama) that may have
accumulated. Boil a sufficient amount of unchlorinated tap water or (better still) mineral water in an
open saucepan, for at least ten minutes. Keep this water in a thermos flask and take a few sips (or
more, if you are thirsty) every half-hour throughout the day. It is the frequency rather than the
quantity that is important here. To increase the positive effect you can add 1-2 slices of fresh ginger
(or a pinch of ginger powder) to the water when boiling it.

A typical thermos is 1 liter, and there is no suggestion here that the full amount needs to be consumed
in the day. In both the Chinese and Ayurvedic cases, the amount of water to consume is not specified,
but consumption of fluids appears to be limited, regulated to some extent by actually being thirsty. In
China, a practice similar to that of the Ayurvedic recommendation is followed: a thermos of hot
water, used to pour over tea leaves, is relied upon to have small amounts of tea throughout the day.
According to the Chinese view, it is considered best to have the tea between meals, not while very
hungry, and not immediately after the meal (though it can be taken shortly after eating in cases where
the meal was too heavy, in an effort to relieve the discomfort and aid the digestion of the food).

In the Quintessence Tantras of Tibetan Medicine (3) it is noted that there are three main beverages:
milk, which opposes wind and increases phlegm; water which opposes bile and increases wind; and
alcohol which opposes phlegm and increases bile. This description follows the Ayurvedic tridosha
system (wind = vata or vayu; phlegm = kapha; bile = pitta). In Tibet, where there are vast areas
without easy access to water, different natural water sources are recognized as having different
benefits (or harm) for drinking:
The different types of water include rainwater, melted snow, river water, spring water, well water,
lake water, and forest water. Rainwater is of supreme quality and the rest are successively inferior.
Rain water is of indeterminate but pleasant taste, is invigorating and satisfying, has cool, light power,
and is like nectar. Melted snow water comes in rushing torrents. It is very fine, cool water which is
hard for the digestive power to withstand. Still calm areas of water [such as
the lake and forest water] produce germs, elephantiasis, and heart diseases.
Good water is that which comes from a clean area and which has felt the
touch of the sun and wind….Cool water cures fainting, fatigue, hangovers,
vertigo, vomiting, thirst, obesity, blood and bile disorders, and poisoning.
Freshly boiled water increases digestive heat, facilitates digestion, cures
hiccoughs, promptly cures distention of the abdomen, caused by phlegm, and
cures asthmatic conditions, fresh colds, and infectious fevers. Cool boiled
water does not increase phlegm and cures bile conditions, but if it is left
standing for one day or more it acquires toxic properties and increases all
three humors.

Consistent with certain ancient Ayurvedic suggestions, which differ from the
modern one, the drinking of beverages is usually associated with meals and its quantity related to the
amount of food consumed. The description in the Tibet tantras is: "One should fill two parts of the
stomach with food, one with drink, and in the fourth part leave room for the fire-like equalizing wind,
the decomposing phlegm, and the digestive bile." Of course, it is difficult to know what would
constitute one-fourth part of the stomach, but the idea expressed here is to not eat until full, indeed,
only half full, and then consume far less beverage than food, still not filling the stomach. Depending
on the kind of food consumed and the type of humoral imbalance a person might have, different
beverages would be recommended, which might best be taken at different times after completing the
meal. At any rate, the quantity of the beverage to be consumed is not as critical as the type of
beverage, and it is limited.

Some traditional health specialists caution about drinking too much water (or other beverages) with a
meal, concerned both that digestive juices will be overly diluted and that the stomach will be overly
filled, causing one to feel uncomfortable and tired. In his book Ayurveda: Life, Health, and
Longevity (4), Robert Svoboda comments:
Water is essential for life, but too much water ruins health. The substances found in a humid climate
tend to be full of humidity themselves, and so are "heavy" for digestion; they contribute too much
water to the system, making it difficult for the digestive fire to remain hot enough to function
efficiently.

Large parts of India have a humid climate, which is a basis for this wording. However, the concern is
for foods that have a moist nature, wherever they might be grown, as well as pointing to the problem
of consuming too much moisture through beverages. A similar concern is raised by Chinese
physicians, who note that the "spleen" system is easily harmed by too much moisture, and then
digestion is adversely affected, so eating too many foods that are full of moisture, or drinking a lot of
fluids, would be considered potentially harmful.

By contrast, within the past few years, especially in America, millions of people have adopted the
practice of carrying water bottles (often with expensive pre-bottled water) wherever they go. While
these are often taken along when exercising (even if not vigorous or prolonged), water is also
consumed copiously during sedentary periods. At modern offices, many workers go to the water
coolers, not just to take a break but to fill up on the publicized daily water quotient, sometimes
carting large mugs back to their desks. The bottled water industry reaps the benefits, with 4 billion
dollars a year annual sales (in the U.S. alone) and growing. Where does this intensive drinking
behavior come from?

Most people today can cite the 8 x 8 rule: drink at least eight ounces of water, 8 times a day: that is
two quarts. Two quarts of total fluid isn't very much in a day, but sometimes another rule is imposed:
caffeinated and alcoholic beverages don't count; some say nothing but water counts in reaching this
total. Is this quantity of water really necessary? Is it advantageous? Is it really true that coffee and tea
don't count? Did the Chinese, many of whom only drank tea but not water, shrivel up and die because
the caffeine drained out all their fluids?
A few years ago, Heinz Valtin looked into the origin of the 8 x 8 rule
and searched for evidence for it (4). He noted that (emphasis has been
added):
No scientific studies were found in support of 8 × 8. Rather, surveys
of food and fluid intake on thousands of adults of both genders, analyses
of which have been published in peer-reviewed journals, strongly
suggest that such large amounts are not needed because the surveyed
persons were presumably healthy and certainly not overtly ill. This
conclusion is supported by published studies showing that caffeinated
drinks (and, to a lesser extent, mild alcoholic beverages like beer in
moderation) may indeed be counted toward the daily total, as well as
by the large body of published experiments that attest to the precision
and effectiveness of the osmoregulatory system for maintaining
water balance. It is to be emphasized that the conclusion is limited to
healthy adults in a temperate climate leading a largely sedentary existence, precisely the population
and conditions that the "at least" in 8 × 8 refers to. Equally to be emphasized, lest the message of this
review be misconstrued, is the fact (based on published evidence) that large intakes of fluid, equal
to and greater than 8 × 8, are advisable for the treatment or prevention of some diseases and
certainly are called for under special circumstances, such as vigorous work and exercise,
especially in hot climates.

His search for the origin of the 8 x 8 rule turned up nothing concrete, possibly an off-hand statement
from a nutritionist (who had commented on drinking at least 6 glasses a day), and no scientific basis
or detailed analysis seems to be at its source. One possible origin point was this comment from a
1945 report by the Food and Nutrition Board of the National Research Council:
A suitable allowance of water for adults is 2.5 liters daily in most instances. An ordinary standard for
diverse persons is 1 milliliter for each calorie of food. Most of this quantity is contained in prepared
foods.

DIURETIC DRINK MYTHS

The idea that drinking beverages containing natural diuretic substances, such as caffeine, actually
drain fluid out of the body (i.e., creates a net loss in body water content) is simply a misunderstanding
of the diuretic action. Mild diuretics found in ordinary foods and beverages may slightly hasten the
removal of water from the body, but the mechanisms (osmogregulatory system) that maintain proper
body balance of water, electrolytes, and other components prevent excreting more water than is taken
in from all sources. The exception would be where there has been an unhealthy water build-up
(edema): one could lose some of the excess without coming up against the natural barriers to
dehydration. But for most people, drinking naturally caffeinated tea all day is not different than
drinking water all day in terms of water balance, and this is the historical experience in China where
drinking plain water was not a routine practice. People who avoid natural diuretic substances (such as
caffeine) over an extended period of time may experience a water loss upon encountering these
diuretics for the first day. The water balance will be restored again almost immediately with
continued ingestion of the mild diuretics or with return to avoidance of them. While the original
concerns about drinking beverages other than water were not based on actual data, more recent
studies following up on this issue have been conducted to evaluate the potential role of natural
diuretics, and, as Valtin relays, they show no significant effects (5). In a recent study, AC Grandjean
and his colleagues observed the effects of different beverages on body hydration (6), in the
discussion, they noted: