We are all roughly two-thirds water. It makes up about three-quarters of our lean body mass, about 10% of our fat, and in terms of the amount of time we could live without consuming it, water is the most essential of our nutrients. But exactly how much water should we be taking in each day? You might expect science to have provided a reliable answer to such a question – water is a fundamental constituent of life, after all. But with the highly evolved ability of the human body to regulate water so exquisitely – and with lots of individual…

We are all roughly two-thirds water. It makes up about three-quarters of our lean body mass, about 10% of our fat, and in terms of the amount of time we could live without consuming it, water is the most essential of our nutrients. But exactly how much water should we be taking in each day?

You might expect science to have provided a reliable answer to such a question – water is a fundamental constituent of life, after all.

But with the highly evolved ability of the human body to regulate water so exquisitely – and with lots of individual variability in the optimum intake – there is no definitive answer for the amount of water one person or another should get each day.

In fact, the best guidance is simply to follow the natural call of the body when more fluid is needed: just follow your thirst.

Yet the question of amount persists, and there is misinformation in abundance. Vested interests come up with highly questionable ideas about how we should all be drinking more water. Even well-respected sources cite daily intake amounts that lack good scientific evidence to support them.1,2

Fast facts on water intake

Here are some key points about daily water consumption. More detail and supporting information is in the article.

  • We must consume foods and fluids as the source of almost all of the water in our bodies
  • Humans cannot live without fluid intake for more than a few days
  • Lots of myths about optimal daily water intake are widely circulated, and even get repeated by official sources
  • Some guidance about water intake, such as to counter dehydration during endurance exercise, can be dangerous if it leads to overconsumption and hyponatremia
  • The intuitively plausible claim that 2% dehydration from exercise adversely affects performance has been debunked
  • Concerning normal daily consumption, the often-cited recommendation that we should drink 8 glasses containing 8 ounces of water a day is not based on evidence
  • No set volume can be provided reliably because a recommended amount cannot match the wide variety of individual fluid needs and differences in water loss
  • There are times when we need to be more wary of the risk of dehydration, such as during illness
  • The body is masterful at maintaining an exquisitely well-tuned water balance against the amount we consume – and it lets us know through thirst when we need more or this need has been quenched.

How much water is in the human body?6,7

[woman looking at a glass of water]A large proportion of the human body consists of water, with the exact proportion depending on factors such as age and fitness.

The principal chemical making up the human body is water (H2O), roughly comprising two-thirds of the body because humans show considerable variability in body composition.

The average young man has a percentage water composition anywhere between 50-70% of their body weight.

A similar range is seen between early and later years – infants have 75% of their body weight accounted for by water, whereas the proportion in older people is just 55%.

Variability in the overall water composition of the body is mostly due to differences explained by age, sex and aerobic fitness. These affect the ratio between:

  • Lean body mass, which is about 73% water, and
  • Fat body mass, which is about 10% water.

How is water regulated by the body?6-8

Without water, there can be no life at all, let alone human life. From the earliest origins of life on earth to continued survival today, organisms have adapted to avoid dehydration.

Healthy humans can survive only a matter of days without water intake, and water loss through illness that does not get replaced can quickly prove dangerous in vulnerable people such as the very young or old.

We have evolved fantastically effective physiological mechanisms for maintaining our bodies’ fluid homeostasis (water balance). The two main mechanisms for maintaining water balance are:

  • Thirst – this tells us when we need to take in more fluid
  • Urine output – the kidneys regulate the surplus, or deficit, of the water we consume by either emptying it into the urinary bladder or holding onto it in the blood plasma.

The kidneys also regulate the balance of electrolytes such as sodium and potassium in the body fluids. The kidneys receive hormonal signals to conserve or release water into the urine following the brain’s detection of alterations in the concentration of the solutes in the blood (changes in the plasma osmolality), via tiny changes in cell size according to the amount of water inside versus outside cells.

The brain’s response to plasma osmolality is also partly responsible for the sensation of thirst that drives us to replace lost water.

Water is lost by other means aside from the action of the kidneys. Total water loss from the body is accounted for by the following means, each of which shows a range of variability:

  • Urinary – water regulation by the kidneys, with excess fluid excreted into the urine being estimated at 500-1,000 mL per day
  • Respiratory – water lost from the lungs as we breathe out, about 250-350 mL per day
  • Fecal – excreted in our solid waste, estimated at 100-200 mL per day
  • Other “insensible water loss” – other unnoticed water loss is via evaporation from the skin, which increases with greater sweating. Sedentary loss is somewhere between 1,300-3,450 mL per day but can range from 1,550-6,730 mL per day with sweating due to physical activity.

The ‘8 by 8’ water mantra: 8 times 8oz glasses a day1-5

[woman drinking from a water bottle]
How much water is enough? How much is too much?

The start of the millennium saw the widespread repetition of the idea that we needed to drink at least eight glasses of water a day. However, the origins of this mantra, and scientific support for it, remain elusive, even though it is still widely cited.

Even the UK’s National Health Service (NHS), through its NHS Choices website, once gave the recommendation to drink up to eight glasses of water a day – although it has since changed its recommendation to “plenty of water” for “quenching your thirst at any time.”

The one-size-fits-all mantras of daily water intake do seem to be retreating a little, however, or are at least including the idea that other fluids aside from water can contribute to the “8 by 8” recommendation.

Other questions are currently refocusing the ideas about optimum hydration, too. Are marathon runners drinking way too much water, for example? And is there any real role in the fight against obesity to be played by drinking more plain water?

How much is too much? Water intake and hyponatremia1,2,9-13

One of the major questions about water intake concerns exercise, and this is the area saturated by marketing messages from manufacturers of bottled beverages.

All shapes and sizes take part in marathons, and drinking too much water over the course of a race can lead to blood plasma becoming dangerously dilute.

Within the guidelines issued for normal daily intake in healthy adults, there is also guidance on how much to drink during exercise, but it is controversial.

Messages about water intake during exercise could even be proving dangerous in the case of high-endurance exercise. A study of runners taking part in the 2002 Boston Marathon, for example, estimated that almost 2,000 of the participants would have had some degree of hyponatremia (abnormally levels of sodium in the blood).

The study also found that some 90 finishers in that event might have had critical hyponatremia. These abnormally and potentially dangerously low sodium levels in the blood plasma at the end of the race were put down to excessive fluid consumption, as evidenced by weight gain while running.

Hyponatremia is a real danger whether too much fluid is taken in during exercise, or even as a result of the “eight glasses a day” guidance for regular intake.

A critique of evidence behind such messages – written by Dr. Heinz Valtin, emeritus professor of physiology and neurobiology at Dartmouth Medical School in Hanover, NH, and published in the American Journal of Physiology in 2002 – concluded:

“Not only is there no scientific evidence that we need to drink that much, but the [8 by 8] recommendation could be harmful, both in precipitating potentially dangerous hyponatremia and exposure to pollutants, and also in making many people feel guilty for not drinking enough.”

Exercise-induced dehydration

In the field of sports science, there is a well-established belief that dehydration during exercise is bad for sports performance, but even that message has been called into question by recent research.

Guidance from the American College of Sports Medicine, published in 2007, recommends an individual estimation of the fluid replacement needed by people taking part in exercise, to avoid dehydration that it says is detrimental to performance.

[woman running on treadmill]
It may be a myth that 2% dehydration during exercise has any adverse effect on performance.

The ACSM is following advice that bodyweight should not drop by more than 2% as a result of dehydration during exercise. Other respected bodies following this recommendation have included the International Olympic Committee and two North American associations of dietitians.

The idea is based on a belief that exercise performance is affected by this level of dehydration. But one carefully controlled study published in the British Journal of Sports Medicine in 2013 dismisses the premise of this guidance.

The study concludes that hypohydration of up 3% has “no effect” on real-world sports performance (a cycling time-trial over 25 kilometers in hot conditions of 33 °C and 40% relative humidity).

The research involved well-trained participants being blinded as to their hydration status. This was so that there could be no influence on their performance measures due to a placebo effect from drinking more fluid. Instead, they were hydrated, or not hydrated, via an intravenous drip.

Performance, physiological and perceptual variables were the same between the groups tested.

This was, the authors remind us, because of “the body’s rapid defense of its plasma and blood volume following dehydration” – in other words, that highly evolved, exquisite capacity for the body to tightly regulate water balance.

Developments on water as a weight-loss aid from MNT news

‘Replace soda with water, tea or coffee to fight diabetes’

This study, published in Diabetologia in March 2015, concluded that “reducing consumption of sweet beverages…and promoting drinking water and unsweetened tea or coffee as alternatives may help curb the escalating diabetes epidemic.”

A bottle of water before mealtimes could aid weight loss

“Water preloading before main meals” was tested as a strategy for weight loss in a small study of people with obesity, published in August 2015.

Water dispensers in schools: do they lower obesity in students?

A study in JAMA Pediatrics in January 2016 concluded that providing access to drinking water in schools could be a low-cost way of delivering a small reduction in children’s bodyweight.

On the next page, we look at how water needs are estimated and provide guidance for adequate daily amounts.

Source: How much water should I drink each day? : Medical News Today