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Hydration: How much do you need?

waterWe have been counseled to drink eight, 8-ounce glasses of water a day (8 x 8) for such a long time that the advice has become unwritten law…and slavishly followed at that. This chant started so long ago that most people have no idea of its origin. At the same time, we are cautioned not to count alcohol and coffee as hydration elements. The science behind the recommendation is so scant that little support can be given to the exhortation, yet the possession of a water bottle is ubiquitous. It is possible that this idea is the result of misinterpretation or misreading of a notion proposed by the Food and Nutrition Board of the National Research Council that recommended one milliliter of water for every calorie consumed. The neglected fact is that there is water in our food. That would surely separate liquid intake from total dietary intake.

Dr. Heinz Valtin, a medical professor at Dartmouth, examined this mantra earlier in this century, and learned, “No scientific studies were found in support of 8 x 8.”  After reviewing surveys of food and fluid intake on thousands of adults of both genders, Dr. Valtin stated that, “…such large amounts (of water) are not needed because the surveyed persons were presumably healthy and certainly not overtly ill.”  He added that most other kinds of beverages, including soft drinks and coffee, contribute to one’s daily need for hydration, continuing that a considerable body of evidence supports the premise that the human body is fully capable of maintaining proper water balance.  But all this must be tempered with the qualifier, “in healthy persons.”  He leaves us with, “…large intakes of fluid, equal to and greater than 8 x 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.”  In the spirit of open-mindedness, Dr. Valtin asks that readers submit their own findings to him.

Including the 20% supplied by foods, the Institute of Medicine recommends a fluid intake of about 91 ounces a day for women and 125 ounces for men.  Do you know how much water is in your food?  Few of us do. The puzzling thing about this recommendation is the lack of sufficient data available on water metabolism in adults, especially those who are sedentary and living in a temperate environment.  Most of us take in more than that suggested level, when we account for comestibles, although the geriatric populace is apt to take in less of both food and liquid water, partly because of insensitivity to a thirst stimulus and partly because of a waning ability to taste foods and beverages as well as they did in their early years.  It appears that older men drink less than their younger counterparts, but excrete more urine.  Differences in women have shown to be insignificant, but contribute to the notion that, “water turnover is highly variable among individuals…”  (Raman et al. 2004)

Admittedly, older adults are at greater risk for dehydration, but water balance in this population had not been faithfully studied until Purdue University picked up the reins in 2005, and compared/contrasted water intake/output and total balance of fluids in an older population (63-81 y.o.) and a younger one (23-46 y.o.), finding that, in fat-free mass, there is little difference.  The study noted, though, that fat-free mass was lower in the elderly and that fat-free hydration was significantly higher.  Considering that the elderly have less muscle to begin with, this is simple to follow.  (Bossingham. 2005)

Many people complain that, if they increase water intake, they will spend more time in the lavatory.  While this is the case with many of us, there is a limiting factor—time.  The period of time over which a specific amount of water is consumed makes a difference in when the urge to evacuate that water will arise.  The faster you drink that glass of water, the sooner you will need to excrete it.  The longer the glass lasts, the more time there will be prior to evacuation.  “A water diuresis occurs when a large volume of water is ingested rapidly.”  (Shafiee. 2005)   Also note that water mixed with a poorly absorbed sugar (not glucose) will retard absorption and delay excretion.

The kidneys can process almost four gallons of water a day.  Too much water will make you sick because sodium stores will become depleted and electrolyte activity will be sorely jeopardized.  Drinking over a period of time can thwart this threat.  You need not measure urine output to figure out how much fluid to replace.  That is something you can eyeball.  Thirst should not be the barometer by which fluid need is determined.  While there is no absolute proof that we all need 8 x 8, have a glass of water even when you are not thirsty, working in the heat, or running a marathon.  To prevent electrolyte displacement, we might consider electrolyte replacement in at least a couple of our glasses.

References

MAIN ABSTRACT
Am J Physiol Regul Integr Comp Physiol. November 2002; vol. 283 no. 5: R993-R1004
“Drink at least eight glasses of water a day.” Really? Is there scientific evidence for “8 × 8”? Heinz Valtin and (With the Technical Assistance of Sheila A. Gorman)

SUPPORTING ABSTRACTS
Am J Physiol Renal Physiol. 2004 Feb; 286(2):F394-401. Epub 2003 Nov 4.
Water turnover in 458 American adults 40-79 yr of age. Raman A, Schoeller DA, Subar AF, Troiano RP, Schatzkin A, Harris T, Bauer D, Bingham SA, Everhart JE, Newman AB, Tylavsky FA.
Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA.

Am J Clin Nutr. 2005 Jun; 81(6):1342-50.
Water balance, hydration status, and fat-free mass hydration in younger and older adults. Bossingham MJ, Carnell NS, Campbell WW.
Department of Foods and Nutrition, Purdue University, West Lafayette, IN 47907, USA.

Kidney Int. 2005 Feb;67(2):613-21.
Defining conditions that lead to the retention of water: the importance of the arterial sodium concentration. Shafiee MA, Charest AF, Cheema-Dhadli S, Glick DN, Napolova O, Roozbeh J, Semenova E, Sharman A, Halperin ML.

Renal Division, St. Michael’s Hospital, University of Toronto, Toronto, Ontario, Canada.

Am J Physiol Regul Integr Comp Physiol. 2000 Sep;279(3):R966-73.
Effects of time of day, gender, and menstrual cycle phase on the human response to a water load. Claybaugh JR, Sato AK, Crosswhite LK, Hassell LH.

Department of Clinical Investigation, Tripler Army Medical Center, Tripler Army Medical Center, Hawaii 96859 – 5000. [email protected]

Eur J Clin Nutr. 2010 Feb;64(2):115-23. Epub 2009 Sep 2.
Water as an essential nutrient: the physiological basis of hydration. Jéquier E, Constant F.
Department of Physiology, University of Lausanne, Pully, Switzerland. [email protected]

J Am Soc Nephrol 19: 1041-1043, 2008
Just Add Water
Dan Negoianu and Stanley Goldfarb

Renal, Electrolyte, and Hypertension Division, University of Pennsylvania, Philadelphia, Pennsylvania

*These statements have not been evaluated by the FDA.
These products are not intended to treat, diagnose, cure, or prevent any disease.

Who Needs Electrolytes and Why?

Many people talk about electrolytes but do you have any idea what electrolyte really is? Being among the smallest of chemicals important to a cell’s function, electrolytes are crucial to the manufacturing of energy, the maintenance of membrane stability, the movement of fluids in the body, and a few other jobs, such as contracting a muscle, like the heart.

No Sweat

You know that you’ll taste salt if you lick the back of your hand after jogging or cutting grass on a hot summer day. Sodium is one of sweat’s main ingredients, along with chloride and potassium. All three are carried to the surface of the skin by the water made in sweat glands and the salt stays after the liquid evaporates. The purpose of sweating is regulation of body temperature, which is achieved by the eccrine glands that cover much of the body. An adult can easily sweat two liters an hour (Godek, 2008), up to eight liters a day (Vukasinovic-Vesic, 2015). It’s the evaporation of the water that has the cooling effect. Some animals do not have efficient sweat glands, such as dogs that have to pant to cool down, or hogs that needs to wallow in mud or cool water.

After exercise — or other cause of heavy perspiration — it’s important to restore fluid balance, especially in hot weather when it is easy to get dehydrated. Rehydration occurs only if both water and electrolytes are replaced. The amount of electrolytes lost through sweat varies from person to person. Accurately matching beverage electrolyte intake with loss through sweat is practically impossible. If you are eating at the same time as drinking plain water, this may suffice for rehydration. Otherwise, inclusion of electrolytes is essential.

What Are They and What Do They Do?

In the body, the electrolytes include sodium, potassium, calcium, bicarbonate, magnesium, chloride, and phosphate. Not all are contained — or needed — in an electrolyte replacement beverage. Sodium, the main cation outside the cell, controls total amount of water in the body, regulates blood volume and maintains muscle and nerve function. You need at least 500 mg a day. The suggested upper level is 2300 mg, but most Americans ingest more than 3000. Chloride, also from table salt, is an anion. Found in extracellular fluids, chloride, in the company of sodium, helps to maintain proper fluid balance and pressure of the various fluid compartments.

Potassium is the major cation inside the cell, where its job is to regulate heart beat and blood pressure while balancing the other electrolytes. Because it aids in transmitting nerve impulses, potassium is necessary for muscle contractions, actually the relaxation half of the contraction. Deficiency of potassium is more common than overdose, and may arise from diarrhea or vomiting, with muscle weakness and cramping being symptoms. Intake of potassium is generally much lower than the recommended 4700 mg a day, which is not surprising in light of the deficits in food caused by insulting agricultural practices. Perhaps the most under-appreciated mineral in the nutrient armamentarium is magnesium, not only a constituent of more than three hundred biochemical reactions in the body, but also a role player in the synthesis of both DNA and RNA. As an electrolyte, magnesium supports nerve and muscle function, boosts immunity, monitors heart cadence, stabilizes blood glucose, and promotes healthy bones and teeth. With half the U.S. population deficient, Mg is the orphan nutrient that is able to prevent elevated markers of inflammation (such as CRP), hypertension (It’s called nature’s calcium channel blocker), atherosclerotic vascular disease, migraines, asthma, and colon cancer (Rosanoff, 2012). Supplementation with magnesium is uncertain because absorption is inverse to intake.

Like the others, calcium is involved in muscle contraction and the transmission of nerve messages, but also in blood clotting. Calcium tells sodium to initiate a contraction so that you can pick up a pencil or scratch your nose. In opposition, magnesium tells potassium to let the pencil go or to move your arm back down. Because the heart needs calcium for a strong beat, it will pull the mineral from bone if dietary sufficiency is missing. After calcium, phosphorus — phosphate — is the most abundant mineral in the body. This anion helps to produce energy inside the cell besides being a bone strengthener. It’s a major building block of DNA and the cell membrane. Bicarbonate keeps pH in balance and is important when muscles make lactic acid from work.

Where Can I Get the Electrolytes I Need?

There are scores of electrolyte replacements on the market and entirely too many with sugar or additives. The issue with electrolytes is, in all honesty, that they taste bitter and salty. The fact that sugar is a carbohydrate hinders the processing of a hydration drink because absorption is slowed. That’s what carbohydrates do. Sugar concentrations in many sports drinks are higher than that of body fluid, so will not be readily absorbed. Plain water passes through too fast; carb-laden drinks pass too slowly. Therefore, an electrolyte balanced drink will do the job better and faster. Sodium and potassium, after all, encourage fluid retention and help to reduce urine output.

It is common knowledge that most of us gravitate to sweetness in times of dehydration; saltiness less so. But when you need rehydration, choose the real stuff, BodyBio’s E-lyte and E-lyte Sport, two electrolyte replacements that copy the mineral balance of the body. Elyte may be used as a daily addition to the diet, and is effective to restore homeostasis in times of virus-induced gastrointestinal distress for adults and children, in electrolyte deficit from uncontrolled diabetes and even for restless leg syndrome. When sodium loss is high from exercise, chose Elyte Sport.

References

Coyle EF.
Fluid and fuel intake during exercise.
J Sports Sci. 2004 Jan;22(1):39-55.

Robert W. Kenefick, PhD and Michael N. Sawka, PhD
Hydration at the Work Site
J Am Coll Nutr. October 2007; vol. 26 no. suppl 5: 597S-603S

Meurman JH, Härkönen M, Näveri H, Koskinen J, Torkko H, Rytömaa I, Järvinen V, Turunen R.
Experimental sports drinks with minimal dental erosion effect.
Scand J Dent Res. 1990 Apr;98(2):120-8.

Noble WH, Donovan TE, Geissberger M.
Sports drinks and dental erosion.
J Calif Dent Assoc. 2011 Apr;39(4):233-8.

Sports Med. 2002;32(15):959-71.
Hydration testing of athletes.
Oppliger RA, Bartok C.

Sawka MN, Montain SJ, Latzka WA.
Hydration effects on thermoregulation and performance in the heat.
Comp Biochem Physiol A Mol Integr Physiol. 2001 Apr;128(4):679-90.

Convertino VA, Armstrong LE, Coyle EF, Mack GW, Sawka MN, Senay LC Jr, Sherman WM.
American College of Sports Medicine position stand. Exercise and fluid replacement.
Med Sci Sports Exerc. 1996 Jan;28(1):i-vii.

Rehrer NJ.
Fluid and electrolyte balance in ultra-endurance sport.
Sports Med. 2001;31(10):701-15.

Maughan RJ, Shirreffs SM.
Dehydration and rehydration in competative sport.
Scand J Med Sci Sports. 2010 Oct;20 Suppl 3:40-7

Gal Dubnov-Raza, Yair Lahavb, and Naama W. Constantinic
Non-nutrients in sports nutrition: Fluids, electrolytes, and ergogenic aids
e-SPEN, the European e-Journal of Clinical Nutrition and Metabolism. 6(4); Aug 2011: pp. e217-e222

*These statements have not been evaluated by the FDA.
These products are not intended to treat, diagnose, cure, or prevent any disease.

Water Is Water. Period.

water-glassA topic of considerable debate in recent days is alkalized water.  From a chemical point of view this raises both eyebrows and evokes a grin.  A review of the meaning of pH might help to explain the absurdity of alkaline—or acidic, for that matter—water.   You remember that pH is a measure of acidity or alkalinity of a liquid using a scale that ranges from 0 to 14, with 7 being neutral.  Anything below 7 is an acid; above 7 an alkali (base).  The fact is that pure water is pH neutral, neither an acid nor a base.  Because the pH scale has no upper or lower limit, the range may go below zero or above 14.

If an acid is dissolved in water, the pH will drop.  The opposite applies to an alkali.  A strong acid, such as hydrochloric (HCL), has a pH of 1.0 or 0.0.  Stomach acid contains HCL, and has a pH of 1.0 to 2.0, which is quite strong.  Lye—sodium hydroxide—will bring the pH of water up to 14, a very strong base.  Because pH is a logarithmic scale, a difference of one pH unit is equivalent to a tenfold change in hydrogen concentration.  A low pH indicates a high concentration of hydrogen—or, rather hydronium, the form in which hydrogen exists in solution (a combination of H+ and H2O, making it H3O).  This is what determines pH.  Pure water has a pH of 7, having an equal number of hydronium and hydroxide (OH) ions.  By itself, hydronium is quite acidic at pH -1.7  Yes, negative.

Since pure water is pH neutral, something has to be added to it to change pH.  It isn’t the water that’s acidic or alkaline.  It’s what’s IN the water that alters the pH.  All water has both H+ and OH- ions.  More hydrogens yield acidic water; more hydroxides, alkaline.   Pure water has equal numbers of each.  Add an alkaline mineral, such as calcium or magnesium, and voila, alkaline water.  Municipal water generally contains one or both of these, therefore is alkaline.

Electrolysis of water, whereby the H’s and OH’s are separated, is an inefficient process if the water is pure.  It’s s-l-o-w, too.  But all that does is to separate the H’s from the OH’s near the electrodes, allowing very small excesses of both to build up.  Any changes in pH would be barely detectable because the H’s and the OH’s would recombine in a heartbeat.  True electrolysis requires the presence of additional ions—the minerals sold to the consumer by the alkaline water machine company.  Ordinary salt makes the water more conductive.  (Pure water is a very poor conductor.)  That salt solution will liberate hydrogen gas at the electrode (cathode) and produce alkaline water consisting essentially of sodium hydroxide (NaOH).  At the other electrode, the anode, chloride ions become chlorine, which, if allowed to mix with the hydroxides, will make a disinfectant oxidizing agent called hypochlorous acid, HOCl.

Buying a water ionizer is a costly way to get a product you could make yourself by diluting some laundry bleach.  You could adjust the pH with lemon juice.  Bleach, by the way, has a pH of about 12.6, quite alkaline.  Lemon juice is about 2.2, almost as acidic as stomach acid.  The pH of blood runs from 7.35 to 7.45.  Change that and you will likely die.  Whatever you drink will not affect blood pH because the body knows enough to grab calcium from your bones to neutralize an acidic insult, such as would come from eating too much sugar or too much protein.

If you swallow alkaline water, it will be upset by the acid in your stomach, and the effect you anticipate will not happen.  On its way to the large intestine, the place of absorption, your originally alkaline water will meet bicarbonates made by the pancreas and shot into the beginning of the small intestine.  Now, regardless of how it went in, the water is alkaline.  So, too, is all the food you swallow.

Urinary pH depends on a variety of factors, but is useful only in light of other diagnostic values, so daily pH testing is virtually futile unless you have kidney stones or gout and need to balance pH.  If you hold your breath long enough, carbon dioxide will accumulate in the blood and turn the blood acidic.  That’s uncomfortable and will force you to breathe, which will return pH to normal.  See how the body takes care of itself?  We are fearfully and wonderfully made, for sure.  But urine is the only body fluid that can have its pH changed by food or supplements, and since it’s stored in the bladder it has no effect on the pH of the rest of the body.  It’s true that excess protein, which cannot be stored, breaks down into amino acids that have the capacity to acidify the blood, but the body mobilizes calcium from bone to neutralize it immediately.  Lots of clinicians feel that too much protein may cause osteoporosis.  Calcium, magnesium, and alkaline water will not change the pH of your blood.

On the other side of this coin is acidic water…for people who don’t want to alkalize.  It’s awfully hard to keep some people happy.   This contraption is supposed to keep H3O+ in solution.  That can’t be done because it needs OH- to remain stable.  Want acid water?  Try lemon juice.  Want alkaline water?  Use baking soda, which will give you a pH of 8.3 and taste lousy.  Alka-seltzer would work, too.

No placebo-controlled, double-blinded, randomized studies have been found in the scientific literature to support the alkaline water sales pitch.  No credible evidence has been found to ascertain the benefits of alkaline water.  To be alkaline, water must contain metallic ions of some kind—sodium, calcium, or magnesium is most common.

References

University of Illinois, Dept. of Chemistry (2011-10-28).
Electrolysis of water using an electrical current.
http://www.chem.uiuc.edu/clcwebsite/elec.html.

Lower, S.
“Ionized” and alkaline water: Snake oil on tap.
http://www.chem1.com/CQ/ionbunk.html. Retrieved 2011-10-30.

Hricova D, Stephan R, Zweifel C.
Electrolyzed water and its application in the food industry.
J Food Prot. 2008 Sep;71(9):1934-47.

Greenwood NN and Earnshaw A (1997)
Chemistry of the Elements (2nd ed)

Oxford, England:  Butterworth-Heinemann

*These statements have not been evaluated by the FDA.
These products are not intended to treat, diagnose, cure, or prevent any disease.

Kidney Stones: The Basics

green-healthy-foodUreterolithiasis, renal calculi, nephrolithiasis and kidney stone all mean the same thing:  agony.  The nurse told us the pain is equivalent to passing a five-pound canned ham through the southern end of the digestive system, with the lid opened.  If you’ve never experienced the long road to relief, thank the Creator for being excused.

What causes kidney stones?

There is no single cause, but a combination of factors.  The wrong balance of fluids, minerals and acids can put you on your knees faster than being knighted.  If urine has more crystal-making elements than the fluid can dilute, bingo, you have the makings of a stone…or stones.  In looking for a definitive cause, science has left no stone unturned.  No pun intended.  Beneath one of those stones is fluoride, having been fingered as causative a decade ago, but only in those with symptoms of skeletal fluorosis and the propensity to form stones in the first place (Singh, 2001).  That rules lots of us out.  Whether or not high doses of vitamin C are implicated in the formation of stones is debatable and based on the status of other nutrients.  By itself, vitamin C, chemically known as ascorbic acid, is able to be converted by the body into oxalates, which increases the likelihood of making oxalate stones among stone formers who take more than the recommended upper limit of 2000 mg of vitamin C a day (Massey, 2005). But you gotta be a stone former.  Is that like a mason?   Earlier research found that high intake of vitamin B6, pyridoxine, reduces the risk of stone formation from unrestricted doses of ascorbic acid (Curhan, 1999).   Up to 500 mg of pyridoxine a day was found to be useful in the control of elevated urinary oxalates (Mitwali, 1988).  In a study reported in the New England Journal of Medicine in the dark ages of the last century, the degree of oxaluria dictates the dosage of vitamin B6.  But the degree of supplementation depends on how much B6 comes from food (Yendt, 1985).

What are they made from?

Most stones (~80%) are calcium oxalate calculi, which crystallizes in a hurry.  It’s the stuff that forms a needle-like crust on the inside of a brewery container.  If you swallowed this material, you’d get really sick, and maybe die.  Calcium oxalate crystal formation is one of the effects of ingesting antifreeze.  A small dose of calcium oxalate will make your tongue burn and swell your throat shut.  This is what happens when the cat chews on a Dieffenbachia leaf in the living room window, and then requires a trip to the vet.

Some plants, including spinach, contain calcium oxalate in their leaves. If you’re a stone former, you might choose to avoid, or at least limit, raw spinach salads, although some researchers say it doesn’t matter, as long as you’re amply hydrated and your diet is sufficiently balanced to provide calcium and vitamin B6, both of which are found in spinach (Curhan, 1999).  A little baffling, huh?  After a stone passes through the urine and gets collected in that little strainer that painters use to get the globs out of a gallon of linen white, you’ll be asked to take that stone to the doctor so he can determine its makeup.  Then he’ll know what course of action to give you.

How do I prevent kidney stones?

If ever the proverbial ounce of prevention is worth a lot, this is the place.  Most experts agree that drinking fluids is the key.  Believe us when we say that a stone former is more than willing to increase his water intake, despite its lack of flavor.  If you need flavor, try lemon juice.  Counseling in this area is simple:  if you don’t drink enough water, you’ll experience this again.  That means you have to drink even when you’re not thirsty (McCauley, 2012).  Swapping soft drinks for water is prudent (Fink, 2009).

Increasing dietary calcium intake is inversely related to stone formation.  Supplemental calcium, on the other hand, may increase risk.  Dietary calcium blocks the amount of oxalates absorbed by the body, while supplements, especially if taken between meals, spill too much of the mineral into the urine.  If calcium supplementation is needed, take it with a meal to improve absorption.  We’re cautioned not to take more than 500 mg at a time, anyway.  It’s all about the timing (Curhan, 1997).

It’s believed that most stones form in the summer, when people are more likely to get dehydrated, so we’re admonished to drink ten to twelve glasses of water a day.  Other beverages, though, fare well in the prevention category.  Caffeinated and decaffeinated coffee, tea, and wine accounted for a decreased risk of stone formation, according to the Brigham and Women’s Hospital study of the 1990’s (Curhan, 1998).

Obesity increases the risk of kidney stones, but drastic weight loss measures that rely on high protein intake can stymie the good intentions.  So, too, can laxative abuse, rapid loss of lean tissue and, naturally, poor hydration.  A diet high in fruits and vegetables can alkalize urine enough to offset oxalate and uric acid stone formation ( Frassetto, 2011).  Produce is known for its magnesium content.  Intake of magnesium is related to reduced stone manufacture, and has been a recommendation since the 17th century.  Even without overt deficiency, magnesium intake, at 500 mg a day in the form of magnesium hydroxide, was shown to decrease stone formation, and it has no adverse side effects as long as it’s not overzealously done (Johansson, 1980 and 1982).  Too much magnesium may induce laxation.  That’s an individual response.   Later study learned that magnesium combined with vitamin B6 offered a substantial decline in the risk for oxalate stones (Rattan, 1994)

Kale, turnip greens, radishes, chard and other leafy greens, broccoli, Brussels sprouts, and cabbage are good sources of dietary calcium.  Almonds and cashews, pumpkin seeds, barley, quinoa, leafy greens, white and black beans are a few good sources of magnesium.  Since calcium and magnesium compete for occupancy in the body, with calcium the winner, magnesium supplementation is a good idea.  An Epsom salts bath allows magnesium levels to increase transdermally…and it’ll help you fall asleep.  Drink water.  Prevent stones.

References

Conte A, Pizá P, García-Raja A.
Urinary lithogen risk test: usefulness in the evaluation of renal lithiasis treatment using crystallization inhibitors (citrate and phytate).
Arch Esp Urol. 1999 Jan-Feb;52(1):94-9.

Curhan GC, Willett WC, Speizer FE, Spiegelman D, Stampfer MJ.
Comparison of dietary calcium with supplemental calcium and other nutrients as factors affecting the risk for kidney stones in women.
Ann Intern Med. 1997 Apr 1;126(7):497-504.

Curhan GC, Willett WC, Speizer FE, Stampfer MJ.
Beverage use and risk for kidney stones in women.
Ann Intern Med. 1998 Apr 1;128(7):534-40

Curhan GC, Willett WC, Speizer FE, Stampfer MJ.
Intake of vitamins B6 and C and the risk of kidney stones in women.
J Am Soc Nephrol. 1999 Apr;10(4):840-5.

Curhan GC.
Epidemiologic evidence for the role of oxalate in idiopathic nephrolithiasis.
J Endourol. 1999 Nov;13(9):629-31.

Fink HA, Akornor JW, Garimella PS, MacDonald R, Cutting A, Rutks IR, Monga M, Wilt TJ.
Diet, fluid, or supplements for secondary prevention of nephrolithiasis: a systematic review and meta-analysis of randomized trials.
Eur Urol. 2009 Jul;56(1):72-80. Epub 2009 Mar 13.

Frassetto L, Kohlstadt I.
Treatment and prevention of kidney stones: an update.
Am Fam Physician. 2011 Dec 1;84(11):1234-42.

Gill HS, Rose GA.
Mild metabolic hyperoxaluria and its response to pyridoxine.
Urol Int. 1986;41(5):393-6.

Grases F, Costa-Bauzá A.
Phytate (IP6) is a powerful agent for preventing calcifications in biological fluids: usefulness in renal lithiasis treatment.
Anticancer Res. 1999 Sep-Oct;19(5A):3717-22.

Habbig S, Beck BB, Hoppe B.
Nephrocalcinosis and urolithiasis in children.
Kidney Int. 2011 Dec;80(12):1278-91. doi: 10.1038/ki.2011.336. Epub 2011 Sep 28.

Johansson G, Backman U, Danielson BG, Fellström B, Ljunghall S, Wikström B.
Biochemical and clinical effects of the prophylactic treatment of renal calcium stones with magnesium hydroxide.
J Urol. 1980 Dec;124(6):770-4.

Johansson G, Backman U, Danielson BG, Fellström B, Ljunghall S, Wikström B.
Effects of magnesium hydroxide in renal stone disease.
J Am Coll Nutr. 1982;1(2):179-85.

Massey LK, Liebman M, Kynast-Gales SA.
Ascorbate increases human oxaluria and kidney stone risk.
J Nutr. 2005 Jul;135(7):1673-7.

McCauley LR, Dyer AJ, Stern K, Hicks T, Nguyen MM.
Factors influencing fluid intake behavior among kidney stone formers.
J Urol. 2012 Apr;187(4):1282-6. Epub 2012 Feb 15.

Miggiano GA, Migneco MG.
[Diet and nutrition in nephrolitiasis].   [Article in Italian]
Clin Ter. 2007 Jan-Feb;158(1):49-54.

Mitwalli A, Ayiomamitis A, Grass L, Oreopoulos DG.
Control of hyperoxaluria with large doses of pyridoxine in patients with kidney stones.
Int Urol Nephrol. 1988;20(4):353-9.

Moyad MA.
Calcium oxalate kidney stones: another reason to encourage moderate calcium intakes and other dietary changes.
Urol Nurs. 2003 Aug;23(4):310-3.

Rattan V, Sidhu H, Vaidyanathan S, Thind SK, Nath R.
Effect of combined supplementation of magnesium oxide and pyridoxine in calcium-oxalate stone formers.
Urol Res. 1994;22(3):161-5.

Saxena A, Sharma RK.
Nutritional aspect of nephrolithiasis.
Indian J Urol. 2010 Oct;26(4):523-30.

Singh PP, Barjatiya MK, Dhing S, Bhatnagar R, Kothari S, Dhar V.
Evidence suggesting that high intake of fluoride provokes nephrolithiasis in tribal populations.
Urol Res. 2001 Aug;29(4):238-44.

Yendt ER, Cohanim M.
Response to a physiologic dose of pyridoxine in type I primary hyperoxaluria.
N Engl J Med. 1985 Apr 11;312(15):953-7.

*These statements have not been evaluated by the FDA.
These products are not intended to treat, diagnose, cure, or prevent any disease.

Coconut Water: Is It What It’s Cracked Up To Be?

fresh-coconutWhether or not Robinson Crusoe was sustained by it, coconut water—not coconut milk—has gathered a following among those fitness fans looking for an all-natural alternative to sports drinks. However, it just might not be good enough for all athletes.  The liquid endosperm of young coconuts, coconut water is considered one of the world’s most versatile natural products. To enhance that image, science has found evidence to support the role of coconut water in health and medicinal applications. One of the traditional uses of coconut water is as a growth supplement in plant tissue propagation and culture, but a wider application can be justified by its unique chemical composition of sugars, vitamins, minerals, amino acids and phytohormones. The last category holds a few welcome surprises, since soy genistein has hogged the spotlight for years.

What’s The Big Deal?
Coconut water is the liquid endosperm and is served directly as a beverage to quench thirst, while coconut milk is the product obtained by grating the solid endosperm with or without additional water to get a food ingredient useful in traditional recipes. Coconut water is more than 90% water; the milk about 50% water, but also containing fat and protein (Seow, 1997). Coconut water is a clear isotonic solution plentiful in young coconuts. (Isotonic means that the tonicity, or tension, of a solution is similar to that of a body fluid and exerts basically the same pressure on both sides of a membrane.) As the coconut matures, its chemical composition and liquid volume change. The liquid may exceed half a liter at nine month’s maturity (Jackson, 2004).

Coconut water is touted as being high in potassium, one of the electrolytes essential to muscle function as the body’s predominant intracellular cation. One cup of coconut water (240 gm) carries about 600 mg of potassium, which is a fraction of the Institute of Medicine’s recommended 4700 mg (http://www.iom.edu/Reports/2004/Dietary-Reference-Intakes-Water-Potassium-Sodium-Chloride-and-Sulfate.aspx). Of course, 8 glasses will put you over the top. The concern is that potassium needs to be balanced with sodium, the electrolyte first lost to heavy sweating. This is where coconut water falls short as a sports beverage. Sodium content of one cup of coconut water is about 250 mg, not enough to aid recovery after a hard workout that spent eighteen times that by sweating more than a day’s worth of suggested intake. There’s more sodium in a glass of vegetable juice. If you have an interest in electrolytes’ role in human health — and you should, really — check out this site for a cogent explanation:  http://crampnomore.com/sportshealth/electrolytes-101.html.

What Good Is It, Then?
In an era of anti-aging curiosity, coconut water seems to be able to hold its own.  The vitamin content of coconut water is insignificant, although considerably better than the zero of plain water, but its phytonutrients, cytokinin and its analog kinetin, have demonstrated appreciable impact as anti-senescent agents. Isolated more than half a century ago, cytokinin has a potent biological effect on plant cells and tissues that influence gene expression, cell cycle, chloroplast development and biosynthesis, stimulation of vascular architecture, and delay of senescence. This characteristic was extrapolated to humans and cell membrane lipid peroxidation (Mik, 2011). Against placebo, in a randomized, double-blind, controlled study, a combination of topical cosmetic ingredients that featured kinetin and niacinamide was found to induce a reduction in spots, pores, and wrinkles and to re-establish evenness after eight weeks (Chiu, 2007). Additionally, age-related changes attributed to lipofuscin, an indicator of damage represented as brown pigmentations from oxidized fats, were delayed (Rattan, 1994).

Cytokinin and its analogs were found to induce cell death and to inhibit cell proliferation in diverse cancer cell lines (Vermeulen, 2002), where researchers were surprised to find anti-cancer effects that extended beyond the original discoveries (Voller, 2010). An item of interest is that these studies were conducted outside the United States, but not necessarily where coconuts are native. There is a modicum of protein in a cup of coconut water (less than 2.0 grams), but when part of a more voluminous coconut protein product, it is sufficiently influential to contribute to an increase and a strengthening of the immune cells that are born in bone marrow (Vigila, 2008). All the while, non-malignant cells are left alone, as cytokinin and kinetin are selective in their inhibition of cell proliferation (Dudzik, 2011).

To Use Or Not To Use?
Though not quite as balanced as serious electrolyte replacement beverages, coconut water has a place in health promotion and disease prevention. To some, it is the darling of India’s Ayurvedic medical practice, where the coconut palm is labeled “Kalpavriksha,” the all-giving tree that provides antibacterial, antifungal, antiparasitic, hypoglycemic, immunostimulant and hepatoprotective properties (DebMandal, 2011) (Preetha, 2012).   To overcome coconut water’s sodium shortfall, some formulators add salt and other enhancements to their drink and then market it as a complete sports beverage. There’s a lot more to learn about what’s in the marketplace, since adulteration is common and can ramp up calories from the basic 46 per cup.

Oral rehydration using coconut water following bouts of diarrhea, especially in children, can forestall the need for intravenous therapy in those who are amply nourished prior to the onset of the infirmity. It is contraindicated in cases of dehydration for lack of electrolyte balance (Adams, 1992). The absorption of coconut water is far superior to that of soft drinks, too, which are often used as fluid replacements by those who are unaware of the options (Chavalittamrong, 1982). The problem with this application, however, is the variability of sodium and glucose content of the coconut fluid at various stages in its development (Fagundes, 1993). A legitimate coconut water purveyor will have analyzed his product before packaging, and will put that data on the label.  Coconut water costs about fifteen cents an ounce. A quality electrolyte replacement concentrate, making four gallons of sports beverage, costs about four cents an ounce…and has the right balance of potassium and sodium, the two important players in muscle contraction and relaxation.

References

Adams W, Bratt DE.
Young coconut water for home rehydration in children with mild gastroenteritis.
Trop Geogr Med. 1992 Jan;44(1-2):149-53.


Adolf K Awua, Edna D Doe and Rebecca Agyare
Exploring the influence of sterilisation and storage on some physicochemical properties of coconut (Cocos nucifera L.) water
BMC Research Notes 2011, 4:451


Casati S, Ottria R, Baldoli E, Lopez E, Maier JA, Ciuffreda P.
Effects of cytokinins, cytokinin ribosides and their analogs on the viability of normal and neoplastic human cells.
Anticancer Res. 2011 Oct;31(10):3401-6.


Chavalittamrong B, Pidatcha P, Thavisri U.
Electrolytes, sugar, calories, osmolarity and pH of beverages and coconut water.
Southeast Asian J Trop Med Public Health. 1982 Sep;13(3):427-31.


Chee C. Seow, Choon N. Gwee
Coconut milk: chemistry and technology
International Journal of Food Science & Technology. May 1997; 32(3):  189-201


Chiu PC, Chan CC, Lin HM, Chiu HC.
The clinical anti-aging effects of topical kinetin and niacinamide in Asians: a randomized, double-blind, placebo-controlled, split-face comparative trial.
J Cosmet Dermatol. 2007 Dec;6(4):243-9.


DebMandal M, Mandal S.
Coconut (Cocos nucifera L.: Arecaceae): in health promotion and disease prevention.
Asian Pac J Trop Med. 2011 Mar;4(3):241-7. Epub 2011 Apr 12.


Dudzik P, Dulińska-Litewka J, Wyszko E, Jędrychowska P, Opałka M, Barciszewski J, Laidler P
Effects of kinetin riboside on proliferation and proapoptotic activities in human normal and cancer cell lines.
J Cell Biochem. 2011 Aug;112(8):2115-24.


Fagundes Neto U, Franco L, Tabacow K, Machado NL.
Negative findings for use of coconut water as an oral rehydration solution in childhood diarrhea.
J Am Coll Nutr. 1993 Apr;12(2):190-3.


Institute of Medicine of the National Academies
Dietary Reference Intakes: Water, Potassium, Sodium, Chloride, and Sulfate
Released:February 11, 2004


Jose C. Jackson, Andre Gordon, Gavin Wizzard, Kayanne McCook and Rosa Rolle
Changes in chemical composition of coconut (Cocos nucifera) water during maturation of the fruit
Journal of the Science of Food and Agriculture. Jul 2004; 84(9): 1049-1052


Kende H, Zeevaart J.
The Five “Classical” Plant Hormones.
Plant Cell. 1997 Jul;9(7):1197-1210.


Mik V, Szüčová L, Smehilová M, Zatloukal M, Doležal K, Nisler J, Grúz J, Galuszka P, Strnad M, Spíchal L.
N9-substituted derivatives of kinetin: effective anti-senescence agents.
Phytochemistry. 2011 Jun;72(8):821-31. Epub 2011 Feb 25.


Eze K. Nwangwa and Chukwuemeka P. Aloamaka
Regenerative Effects of Coconut Water and Coconut Milk on the Pancreatic β–Cells and
Cyto Architecture in Alloxan Induced Diabetic Wistar Albino Rats

American Journal of Tropical Medicine & Public Health. 2011; 1(3): 137-146


Preetha PP, Devi VG, Rajamohan T.
Hypoglycemic and antioxidant potential of coconut water in experimental diabetes.
Food Funct. 2012 Jul;3(7):753-7. Epub 2012 Jun 27.


Rattan SI, Clark BF.
Kinetin delays the onset of ageing characteristics in human fibroblasts.
Biochem Biophys Res Commun. 1994 Jun 15;201(2):665-72.


Sandhya VG, Rajamohan T.
Beneficial effects of coconut water feeding on lipid metabolism in cholesterol-fed rats.
J Med Food. 2006 Fall;9(3):400-7.


Vermeulen K, Strnad M, Krystof V, Havlícek L, Van der Aa A, Lenjou M, Nijs G, Rodrigus I, Stockman B, van Onckelen H, Van Bockstaele DR, Berneman ZN.
Antiproliferative effect of plant cytokinin analogues with an inhibitory activity on cyclin-dependent kinases.
Leukemia. 2002 Mar;16(3):299-305.


A. Geo Vigila and X. Baskaran
Immunomodulatory Effect of Coconut Protein on Cyclophosphamide Induced Immune Suppressed Swiss Albino Mice
Ethnobotanical Leaflets 12: 1206-12. 2008.


Vigliar R, Sdepanian VL, Fagundes-Neto U.
Biochemical profile of coconut water from coconut palms planted in an inland region.
J Pediatr (Rio J). 2006 Jul-Aug;82(4):308-12.


Voller J, Zatloukal M, Lenobel R, Dolezal K, Béres T, Krystof V, Spíchal L, Niemann P, Dzubák P, Hajdúch M, Strnad M.
Anticancer activity of natural cytokinins: a structure-activity relationship study.
Phytochemistry. 2010 Aug;71(11-12):1350-9. Epub 2010 Jun 1.


tJean W. H. Yong, Liya Ge, Yan Fei Ng and Swee Ngin Tan
The Chemical Composition and Biological Properties of Coconut (Cocos nucifera L.) Water
Molecules. 2009, 14, 5144-5164

*These statements have not been evaluated by the FDA.
These products are not intended to treat, diagnose, cure, or prevent any disease.

The Secret About Cellulite Is No Secret At All

cellulite-cross-sectionThat dimpled skin on the thighs, hips and buttocks that looks like bubble wrap is the result of uneven distribution of body fat. It’s not serious, but it does little for self-image.  That can be debilitating… mentally, at least. One can always refrain from wearing shorts or a bathing suit, but that would change quality of life for many of us. What happens is that the collagen that holds us together, that connects fat to the skin, may break down, stretch, or pull tight, allowing the fat cells to bulge outward. From that come the ripples.

It’s In The Genes
Genes can play a part in having cellulite or not. Lousy diet, s-l-o-w metabolism, fad dieting, hormones and insufficient hydration play a role, too. Lots of money goes down the drain to get rid of cellulite, mostly an exercise in futility. Sorry. Liposuction, about as drastic a measure as any, doesn’t work, and will probably make things worse. With a little luck, all those creams, wraps, exercise and massages may offer temporary relief at best (Khan, 2010, Parts 1 & 2).

Looking for clues to cellulite treatment is not a top priority for medical researchers because cellulite is considered a fact of life and not a condition. One of the first of those clues, as pointed out by Spanish dermatologists, is that cellulite is a physiological phenomenon characteristic of women more than men (Do we need scientists to make that observation?) and is multi-causal (same comment) (de la Casa, 2012).

To make it seem more like a condition worthy of attention, we have devised names for cellulite—adiposis edematosa, status protrusis cutis, gynoid lipodystrophy, and dermopanniculosis deformans. Such elevated semantic achievement aroused the interest of a group of Brazilian doctors who looked at cellulite from a new angle and decided to expose their patients to four hours a day of manual and mechanical lymph drainage and cervical stimulation using the “Godoy and Godoy technique.” This modality was originally used in the treatment of lymphedema, a swelling that results from obstruction of lymph nodes and consequent accumulation of lymphatic fluids (Godoy, 2004, 2012). These researchers found the technique efficacious in cellulite treatment, with a reduction in gluteal perimeter measurements by as much as ten centimeters and an average of nearly 5.0 cm (Ibid). Practically antipodal to this finding was the comparative failure of long-pulsed laser treatment using a Nd:YAG solid state laser. This employs neodymium and yttrium aluminum garnet in the projecting beam, sounding like a tool in a Bond movie, apparently intended to create heat and to evaporate the water that inhabits fat cells, thereby shrinking them. The rate of improvement was minor in less than half the population (Truitt, 2012). Since fat cells don’t go away but merely shrink, what happens when they become re-hydrated? If blessed by the good fortune fairy, you might experience positive effects for a few months. If you have the money, you can do it again (Peterson, 2011). Mechanical massage, somewhat akin to the Godoy system, might save a few bucks (Bayrakci, 2010).

Prevention Before Intervention
The tips postulated to avoid cellulite in the first place parallel the adage about an ounce of prevention being more valuable than a pound of cure. The National Institute of Health suggests a diet rich in fruits, vegetables and fiber, including substantial hydration.  Regular exercise and the avoidance of yo-yo dieting are encouraged. Oh, yeah… no smoking. (NIH, 2012) http://www.nlm.nih.gov/medlineplus/ency/article/002033.htm

Mesotherapy is a cosmetic procedure used for several purposes, cellulite elimination among them. This entails multiple injections of pharmaceutical or homeopathic medicines or extracts into subcutaneous fat. Although fat cells are the target, with lipolysis the goal, surrounding cells also are affected, often leading to unwanted complications. The list of substances that can be used in these injections is surprisingly long, accompanied by a list of successes that is not surprisingly short, most of which resulting in inflamed granulated nodules associated with lipid deposits, called eleoma (Ramos-e-Silva, 2012). Because the disruption of neighboring tissue is a real issue, mesotherapy, though medically benign, might not be your cup of tea (Rotunda, 2005).

Topical treatments for cellulite work on the assumption that microcirculation can be improved, that lipogenesis can be interrupted, and that lipolysis can be promoted.  All this is supposed to happen while the normal architecture of the skin and underlying tissue is restructured during free radical removal. To the dismay of the consumer more than the researchers, none of this occurs with predictability or regular efficacy (Hexsel, 2011). However, one avenue of study sought to find a way to thicken the skin by stimulating production of keratinocytes, the cells that make more than ninety percent of the skin you see when you look at a person. In this French study supported by Johnson & Johnson, a combination product made of caffeine, carnitine, forskolin (from the coleus plant), and a chelating chemical called tetrahydroxypropyl ethylenediamine was found to reduce circumferential measurements after only four weeks of a twice-a-day application.  “Orange peel” and cellulite were significantly decreased (Bertin, 2011). If this stuff is available, it’s got to be $$$$.

Extracorporeal shockwave therapy is advertised on the radio to treat plantar fasciitis and tennis elbow.  What used to take a half hour under local anesthetic is now complete in less than ten minutes without it. This procedure introduces inflammation to the targeted tissue, producing re-routed blood flow to the area that intends to promote healing. Skin remains undamaged while collagen and elastin formation is enhanced, thereby improving the scaffolding within subcutaneous fat (Kuhn, 2008) (Knobloch, 2010) (Angehm, 2007).  It seems to work.

The bottom line (no pun intended) is that a woman has more fat cells than a man. That is to address nourishing a fetus from her own energy reserves. Since lots of fat is contained in the gluteal fold to begin with, it makes sense that is where it’ll end up.  Exercise is the best way to keep it where it started. Keep the fat cells small through a righteous diet. Drink plenty of fluids. Start with the most conservative measures if money is burning a hole.

References

Angehrn F, Kuhn C, Voss A.
Can cellulite be treated with low-energy extracorporeal shock wave therapy?
Clin Interv Aging. 2007;2(4):623-30.

Bayrakci Tunay V, Akbayrak T, Bakar Y, Kayihan H, Ergun N.
Effects of mechanical massage, manual lymphatic drainage and connective tissue manipulation techniques on fat mass in women with cellulite.
J Eur Acad Dermatol Venereol. 2010 Feb;24(2):138-42. Epub 2009 Jul 13.

Bertin C, Nkengne A, Da Cunha A, Issachar N, Rossi A.
Clinical evidence for the activity of tetrahydroxypropyl ethylenediamine (THPE), a new anti-aging active cosmetic.
J Drugs Dermatol. 2011 Oct;10(10):1102-5.

José Maria Pereira de Godoy, Maria de Fátima Guerreiro Godoy
Manual lymph drainage: a new concept
J Vasc Br 2004;3(1):77-80

de Godoy JM, Groggia MY, Ferro Laks L, Guerreiro de Godoy Mde F.
Intensive treatment of cellulite based on physiopathological principles.
Dermatol Res Pract. 2012;2012:834280. Epub 2012 May 14.

de la Casa Almeida M, Suarez Serrano C, Rebollo Roldán J, Jiménez Rejano JJ.
Cellulite’s aetiology: a review.
J Eur Acad Dermatol Venereol. 2012 Jul 3.

Hexsel D, Soirefmann M.
Cosmeceuticals for cellulite.
Semin Cutan Med Surg. 2011 Sep;30(3):167-70

Khan MH, Victor F, Rao B, Sadick NS.
Treatment of cellulite: Part I. Pathophysiology.
J Am Acad Dermatol. 2010 Mar;62(3):361-70; quiz 371-2.

Knobloch K, Joest B, Vogt PM.
Cellulite and extracorporeal Shockwave therapy (CelluShock-2009)–a randomized trial.
BMC Womens Health. 2010 Oct 26;10:29.

Kuhn C, Angehrn F, Sonnabend O, Voss A.
Impact of extracorporeal shock waves on the human skin with cellulite: a case study of an unique instance.
Clin Interv Aging. 2008;3(1):201-10.

National Institutes of Health–Department of Health and Human Services
MedlinePlus:  Cellulite.  27 September 2012
http://www.nlm.nih.gov/medlineplus/ency/article/002033.htm

Ono S, Hyakusoku H.
Complications after self-injection of hyaluronic acid and phosphatidylcholine for aesthetic purposes.
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Peterson JD, Goldman MP.
Laser, light, and energy devices for cellulite and lipodystrophy.
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Proebstle TM.
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Ramos-e-Silva M, Pereira AL, Ramos-e-Silva S, Piñeiro-Maceira J.
Oleoma: rare complication of mesotherapy for cellulite.
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Rotunda AM, Avram MM, Avram AS.
Cellulite: Is there a role for injectables?
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Roure R, Oddos T, Rossi A, Vial F, Bertin C.
Evaluation of the efficacy of a topical cosmetic slimming product combining tetrahydroxypropyl ethylenediamine, caffeine, carnitine, forskolin and retinol, In vitro, ex vivo and in vivo studies.
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Sadick NS, Mulholland RS.
A prospective clinical study to evaluate the efficacy and safety of cellulite treatment using the combination of optical and RF energies for subcutaneous tissue heating.
J Cosmet Laser Ther. 2004 Dec;6(4):187-90.

Sasaki GH, Oberg K, Tucker B, Gaston M.
The effectiveness and safety of topical PhotoActif phosphatidylcholine-based anti-cellulite gel and LED (red and near-infrared) light on Grade II-III thigh cellulite: a randomized, double-blinded study.
J Cosmet Laser Ther. 2007 Jun;9(2):87-96.

Truitt A, Elkeeb L, Ortiz A, Saedi N, Echague A, Kelly KM.
Evaluation of a long pulsed 1064-nm Nd:YAG laser for improvement in appearance of cellulite.
J Cosmet Laser Ther. 2012 Jun;14(3):139-44.

Wassef C, Rao BK.
The science of cellulite treatment and its long-term effectiveness.

J Cosmet Laser Ther. 2012 Apr;14(2):50-8.

*These statements have not been evaluated by the FDA.
These products are not intended to treat, diagnose, cure, or prevent any disease.

Wellness In The New Year (or any year for that matter)

wellness-roadThere are some things in life we just can’t control. The weather is a good example, but other people’s behavior runs a close second. In fact, sometimes we have a hard time controlling our own behaviors. Take a look at the last éclair in the box. Isn’t it calling your name? Although we can’t direct weather patterns, we can prepare for their uncertainties. Humans do have the wherewithal to live through a hurricane unscathed, but it takes conscious effort and self-direction. We can’t rely on other people to take care of us while they’re trying to tend to their own needs. When it comes to our personal health behaviors, only we are responsible. This we can control. Making a resolution to do it is fruitless, almost inane. Doing it is noble.

Wellness is not the same thing as health. It’s possible to suffer a chronic condition and still be well. A person who lives with a limitation may be more well than a person whose faculties are fully operational. While health may be defined as being physically, mentally and spiritually sound—maybe even financially, occupationally and socially— wellness describes a desire to enhance successful existence, one’s quality of life. Yet the definition of wellness is elusive and subjective. New models of wellness emerge regularly, existing on a continuum and being peculiar to each of us.

A sage cleric once said that ideas determine consequences, a concept based on absolute truth. Simply put, if you do this, that will happen. You can deny that black is black, and even call it dark white, but that changes nothing. The decisions you make today determine the outcome down the road. Because wellness is a process, it can always be improved, even by borrowing ideas and habits from others. Take a gander at some of these wellness ideas.  A few might make sense to you.

Indoor plants purify the air, albeit some are better at it than others. One of the best ways to improve indoor air is to quit smoking, and, if you have children, you’ll save money on doctor visits, too. Clean air also will help you in your newly-designed exercise program, even though it starts at only five minutes a day. We won’t beleaguer you with admonitions. We promise. This you can begin upon arising, while still in bed. What does the dog do when he first wakes up?  He stretches. Your blood vessels have been scrunched up all night. Stretch and open ’em up. Try to do a few sit-ups while you’re at it. Believe it or not, it’ll make a difference. Yes, it’ll take time, but some things are worth the wait. After your feet hit the floor, drink a full glass of water. A drop of lemon juice won’t hurt. You’ve been dehydrated all night—no fluids for eight hours. Your cells probably resemble dried peas or a half-inflated basketball. It’ll take about 20 minutes for the water to hit home, but when it does you’ll feel refreshed and improve the viscosity of your blood to keep it flowing the way it should.

Replacing that soda with plain or acidulated water or tea will swap hazard for benefit. The sugar in soda provides empty calories that get stored as fat if you don’t burn ‘em off. Even artificial sweeteners fool the body into thinking you ate something sweet. When the body learns it’s been fooled, it makes you hungry so you can use up all the insulin that’s now floating around, looking for something to do. Weight may increase. http://www.medicinenet.com/artificial_sweeteners/page11.htm

Have you looked into supplements?  Despite some negative press by opposing industries and their minions, they work. Fish oil does provide cardiac and anti-inflammatory profit, and high quality multi-vitamins do what they declare (Fletcher, 2002) (Gaziano, 2012). Besides, the nutrients once promised by fruits and vegetables now are in short supply because of modern farming practices, careless shipping and storage, and poor kitchen habits.

The cost of sleep deprivation—both financial and salubrious—is enormous. During this suspension of will power and consciousness the body and mind put things that have been disassembled by the day’s toils back together. Some of the factors that interfere with sleep can be controlled. Though not the simplest thing to do, interfering stress can be modified or even eliminated. Getting eight hours of sleep at least three or four times a week is a boon to health (Romeijn, 2012) (Ribeiro, 2012) (Chamorro, 2011) (Donga, 2010).

Taking care of yourself is necessary before you can be expected to take care of others. Some proactive measures, albeit controversial in particular circles, ask for more than moderate energy expenditure.

Reading labels is one. Learn what toxins are added to the kids’ vaccines and do something to avoid them, like asking the doctor to take the liquid from the middle of the vial—if vaccinations are a must. What’s the rub with vaccines?  Formaldehyde, mercury and MSG as preservatives. Getting more than one shot at a time places a heavy burden on a little body, so request dosing at intervals. Learn what additives are in your toothpaste. Got canker sores?  Look for sodium lauryl sulfate on the label (Chahine, 1997). Other personal and house care items might contribute to personal woes because of unneeded synthetic additives like perfumes, foaming agents, softeners and petroleum distillates.

Among the many steps to wellness, one of the most effective is realizing that food is nourishment, not entertainment. Eat what your body needs, not what your senses of smell and taste otherwise dictate. Unburned carbs get stored as fat. Sugars—think cookies and cakes—create acids that support disease, including cancer (Liu, 2000) (Burley, 1998) (Tuyns, 1988). The wrong fats encourage vascular problems—get the essential fats instead, like omega-3 and omega-6 fatty acids. Under hydration frustrates cell activity and will cause mental fog. The more you talk about health, the more likely you are to cater to it. Who better to direct person-centered health care than the person inside?

References

Mauro Alivia, Paola Guadagni, and Paolo Roberti di Sarsina
Towards salutogenesis in the development of personalised and preventive healthcare
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Burley VJ.
Sugar consumption and human cancer in sites other than the digestive tract.
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Chahine L, Sempson N, Wagoner C.
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Chamorro RA, Durán SA, Reyes SC, Ponce R, Algarín CR, Peirano PD.
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Donga E, van Dijk M, van Dijk JG, Biermasz NR, Lammers GJ, van Kralingen KW, Corssmit EP, Romijn JA.
A single night of partial sleep deprivation induces insulin resistance in multiple metabolic pathways in healthy subjects.
J Clin Endocrinol Metab. 2010 Jun;95(6):2963-8. Epub 2010 Apr 6.

Fletcher RH, Fairfield KM.
Vitamins for chronic disease prevention in adults: clinical applications.
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Gaziano JM, Sesso HD, Christen WG, Bubes V, Smith JP, MacFadyen J, Schvartz M, Manson JE, Glynn RJ, Buring JE.
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Albert Lee, Andrew Kiyu, Helia Molina Milman, and Jorge Jimenez
Improving Health and Building Human Capital Through an Effective Primary Care System
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Simin Liu, Walter C Willett, Meir J Stampfer, Frank B Hu, Mary Franz, Laura Sampson, Charles H Hennekens, and JoAnn E Manson
A prospective study of dietary glycemic load, carbohydrate intake, and risk of coronary heart disease in US women1,2,3
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Ronald W. Manderscheid, PhD, Director, Carol D. Ryff, PhD, Elsie J. Freeman, MD, MPH, Lela R. McKnight-Eily, PhD, Satvinder Dhingra, MPH, and Tara W. Strine, MPH
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McMahon S, Fleury J.
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Ribeiro S.
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Romeijn N, Verweij IM, Koeleman A, Mooij A, Steimke R, Virkkala J, van der Werf Y, Van Someren EJ.
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Tuyns AJ, Kaaks R, Haelterman M.
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*These statements have not been evaluated by the FDA.
These products are not intended to treat, diagnose, cure, or prevent any disease.

Arthritis and Common Chemicals

arthritisMerely because something is hereditary doesn’t mean it has to be inherited unless it’s a defined, overt physical characteristic, such as eye color or hairline. Disease or propensity for disease does not have to telegraph itself through gene expression. In the belief that genetic activity can be turned on and off, more than a handful of scientists are convinced that arthritis, in this case, does not have to pass from seed to seed along the family tree. Arthritis, the osteo- kind, can be spawned from unseen environmental assaults, namely perfluorinated chemicals, which are fluorocarbon derivatives. You remember fluorocarbons. They’re part of the chlorofluorocarbons (CFC’s) once used as propellants in spray cans and in refrigerant fluids. Although they aren’t used for aerosol sprays any more, they’re still in the marketplace. When released into the atmosphere, CFC’s affect stratospheric ozone, the depletion of which is implicated in the rise of skin diseases and climate change, not to mention depressed growth in plants and interrupted photosynthesis. Photosynthesis is important only to those of us who need to eat. Fluorocarbons are bioaccumulative—they are stored in the body.

Of special concern are perfluorooctanoic acid (PFOA) and perfluorooctanesulfonic acid (PFOS). (Aren’t abbreviations great?) What in the world are these things used for? If what you own resists stains and water, it probably contains one of these. Ever hear of Scotchgard? How about stone or tile sealers? Got your new sofa treated against kids’ spillage? Fast food wrappers don’t leak grease, do they? Gunk doesn’t stick to dental floss, does it? Ever do any plumbing and use Teflon tape to help seal a joint? Oh, yeah, got Teflon? The oxygen atoms on these chemicals help them to bind proteins to fatty acids or hormone substrates such as albumin, and to nuclear receptors that regulate genes, such as PPAR’s (Anitole, 2007) (Cheng, 2008). Their half-life is about three years. Production of these nifty chemicals has declined for safety reasons, ahem, but exposure remains widespread.

PFOA, especially, is associated with infertility (Fei, 2009) (Joensen, 2009) and ADD/ADHD in young adolescents (Hoffman, 2010). But its association with osteoarthritis concerns us at this time. Fluorine (chemical symbol F) is a corrosive gas that reacts with practically everything else in the periodic table except the noble gases, which happen to be so noble that they don’t mix with anything. If fluorine mixes with something else, it’s now a fluoride. On teeth, from the outside, fluoride is O.K. From inside the body, it’s not. That’s why the toothpaste label says not to swallow it. Fluoride usually enters the body either by inhalation or ingestion. (Did you know that tea contains fluoride? We’ll get to that in a minute.)

F reacts with hydrochloric acid in the stomach to form hydrofluoric acid (HF), which just so happens to be the precursor to Prozac. This acid passes to the liver, but evades phase 1 detoxification, where the liver uses O2 and enzymes to oxidize toxins to make them water-soluble. This short circuit occurs because fluorine is the strongest oxidizer currently known. At this point, hydrofluoric acid passes into the bloodstream and is distributed to all body parts, including bones. Now, bones are made from calcium compounds, particularly carbonated hydroxyapatite. When an acid and a base combine, they form a salt. Hydrofluoric acid mixes with the calcium (alkaline) to form CaF2, an insoluble salt. That increases density of bone, but lowers strength. The bone is less elastic and more prone to fractures. As bone thickens, it restricts mobility. To compound matters, factors that acidify the urine increase the retention of fluoride. However, happily, the opposite is also true. Absorption of fluoride is reduced by calcium (Whitford, 1994).

Tea may pose problems for heavy tea drinkers. Being labeled a heavy tea drinker is not common in the United States unless you earn membership in the gallon-a-day club. Tea plants readily absorb fluoride—and aluminum—from soil. Therefore, the beverage will contain various levels of fluoride, depending on soil levels. Brewed black tea in the States contains about 3 to 4 parts per million (which is practically identical to milligrams per liter); commercial iced tea has between 1 and 4 (Whyte, 2006) (Whitford, 1994) (Izuora, 2011). The number of skeletal fluorosis reports has grown in recent years, but that has been seen mostly in people who consumed 20 milligrams of fluoride a day for decades. In the mean time, 5 milligrams a day (That would be about a quart a day.) can present preclinical stages of fluorosis, so what has been diagnosed as arthritis may actually be skeletal fluorosis. Though this problem is more extensive in the tea cultures of Asia, it’s still a good idea to drink tea in moderation.

Getting back to PFOA and PFOS, levels in humans vary widely. Certain occupations can increase exposure thousands of times, especially for those working in chemical, metal refining and power plants. Drinking water contaminated with these chemicals contributes to human misery as much as direct exposure. Some American states have ground water that contains either naturally occurring fluoride compounds or the wastes from industrial sources. Ohio and West Virginia are two. In areas such as these, osteoarthritis prevalence exceeds that in other regions. Though a terrible affliction for anyone, women seem to be affected more than men. Cartilage damage and inflammatory responses are part of the spectrum (Uhl, 2013).

If you start to feel aches and pains that are new to you, take a look at what you’re been wearing, where you’ve been, and what you ate and drank. Stain resistant trousers and shirts, high intake of black and green teas, and the wrappers from the fast-food joint might be the cause. (See http://www.bodybio.com/content.aspx?page=Enhancing-the-worst)  Global production of these substances has been on the wane, but leftovers still occupy the environment. Substitute compounds are no doubt in the future, but now we have to be concerned about their long-term effects. Although research is sketchy, iodine, calcium, magnesium and boron are being studied as antidotes to fluoride toxicity (Kao, 2004) (Heard, 2001).

References

Cao J, Bai X, Zhao Y, Liu J, Zhou D, Fang S, Jia M, Wu J.
The relationship of fluorosis and brick tea drinking in Chinese Tibetans.
Environ Health Perspect. 1996 Dec;104(12):1340-3.

Cao J, Zhao Y, Liu J, Xirao R.
[Brick-tea type adult bone fluorosis].
Wei Sheng Yan Jiu. 2003 Mar;32(2):141-3.

Cao J, Zhao Y, Liu J, Xirao R, Danzeng S, Daji D, Yan Y.
Brick tea fluoride as a main source of adult fluorosis.
Food Chem Toxicol. 2003 Apr;41(4):535-42.

Cheng X, Klaassen CD.
Perfluorocarboxylic acids induce cytochrome P450 enzymes in mouse liver through activation of PPAR-alpha and CAR transcription factors.
Toxicol Sci. 2008 Nov;106(1):29-36.

Czerwinski E, Nowak J, Dabrowska D, Skolarczyk A, Kita B, Ksiezyk M.
Bone and joint pathology in fluoride-exposed workers.
Arch Environ Health. 1988 Sep-Oct;43(5):340-3.

Fei C, McLaughlin JK, Lipworth L, Olsen J.
Maternal levels of perfluorinated chemicals and subfecundity
Hum Reprod. 2009 May;24(5):1200-5.

Grandjean P, Thomsen G.
Reversibility of skeletal fluorosis.
Br J Ind Med. 1983 Nov;40(4):456-61.

Hayacibara MF, Queiroz CS, Tabchoury CP, Cury JA.
Fluoride and aluminum in teas and tea-based beverages.
Rev Saude Publica. 2004 Feb;38(1):100-5.

Heard K, Hill RE, Cairns CB, Dart RC.
Calcium neutralizes fluoride bioavailability in a lethal model of fluoride poisoning.
J Toxicol Clin Toxicol. 2001;39(4):349-53.

Hoffman K, Webster TF, Weisskopf MG, Weinberg J, Vieira VM.
Exposure to polyfluoroalkyl chemicals and attention deficit/hyperactivity disorder in U.S. children 12-15 years of age
Environ Health Perspect. 2010 Dec;118(12):1762-7.

Izuora K, Twombly JG, Whitford GM, Demertzis J, Pacifici R, Whyte MP.
Skeletal fluorosis from brewed tea.
J Clin Endocrinol Metab. 2011 Aug;96(8):2318-24.

Joensen UN, Bossi R, Leffers H, Jensen AA, Skakkebaek NE, Jørgensen N.
Do perfluoroalkyl compounds impair human semen quality?
Environ Health Perspect. 2009 Jun;117(6):923-7.

Kao WF, Deng JF, Chiang SC, Heard K, Yen DH, Lu MC, Kuo BI, Kuo CC, Liu TY, Lee CH.
A simple, safe, and efficient way to treat severe fluoride poisoning–oral calcium or magnesium.
J Toxicol Clin Toxicol. 2004;42(1):33-40.

Kavanagh D, Renehan J.
Fluoride in tea–its dental significance: a review.
J Ir Dent Assoc. 1998;44(4):100-5.

Kurland ES, Schulman RC, Zerwekh JE, Reinus WR, Dempster DW, Whyte MP.
Recovery from skeletal fluorosis (an enigmatic, American case).
J Bone Miner Res. 2007 Jan;22(1):163-70.

Lau C, Anitole K, Hodes C, Lai D, Pfahles-Hutchens A, Seed J.
Perfluoroalkyl acids: a review of monitoring and toxicological findings.
Toxicol Sci. 2007 Oct;99(2):366-94.

Luo Rui, Liu Ri-guang1, Ye Chuan, Yu Yan-ni, Guan Zhi-zhong
Total knee arthroplasty for the treatment of knee osteoarthritis caused by endemic skeletal fluorosis
Chinese Journal of Tissue Engineering Research. Feb 26, 2012; 16 (9): 1555-1558

Petrone P, Giordano M, Giustino S, Guarino FM.
Enduring fluoride health hazard for the Vesuvius area population: the case of AD 79 Herculaneum.
PLoS One. 2011;6(6):e21085.

Savas S, Cetin M, Akdoğan M, Heybeli N.
Endemic fluorosis in Turkish patients: relationship with knee osteoarthritis.
Rheumatol Int. 2001 Sep;21(1):30-5.

Howard Thomas
Some Non-essential Aerosol Propellant Uses Finally Banned
Federal Regulations:  43 F. R. 11301 (1978)
http://lawlibrary.unm.edu/nrj/19/1/16_thomas_some.pdf

Sarah A. Uhl, Tamarra James-Todd, and Michelle L. Bell
Association of Osteoarthritis with Perfluorooctanoate and Perfluorooctane Sulfonate in NHANES 2003–2008
Environ Health Perspect. February 14, 2013

Whitford GM.
Intake and metabolism of fluoride.
Adv Dent Res. 1994 Jun;8(1):5-14.

Whitford GM.
Fluoride metabolism and excretion in children.
J Public Health Dent. 1999 Fall;59(4):224-8.

Whyte MP.
Fluoride levels in bottled teas.
Am J Med. 2006 Feb;119(2):189-90.

Wong MH, Fung KF, Carr HP.
Aluminium and fluoride contents of tea, with emphasis on brick tea and their health implications.
Toxicol Lett. 2003 Jan 31;137(1-2):111-20.

Xiangjin Ge, Yuting Jiang, Guohua Tang, Meilie Zhang, Yurong Zhao
Investigations on the Occurrence of Osteoarthritis in Middle-aged and Elderly Persons in Fluorosis Afflicted Regions of Gaomi City with High Fluoride Concentration in Drinking Water
Preventive Medicine Tribune. Volume 12, No. 1;  January 2006:  pp. 57-58 ·57·

*These statements have not been evaluated by the FDA.
These products are not intended to treat, diagnose, cure, or prevent any disease.

Fill In The G__P.

proalkaline-foodThere might be one between your teeth. There could be some among wage earners. There definitely are those between generations, and there’s one at your local mall. But there’s one gap that you never think about and probably never heard of—the anion gap (AG). This is a laboratory assessment of the concentration of plasma anions and cations not routinely measured in some screenings. The AG accounts for the difference between anions of chloride and bicarbonate (negatively charged) and cations of sodium (positively charged) found in your blood, and is used to check for acidosis. A value of 8 –14 mEq/L is normal, and represents the negative charges that may be contributed by other ions, including phosphate, sulfate, organic acids and plasma proteins. If your last blood test doesn’t have AG listed as such, you can calculate yours by adding the chloride to the bicarbonate, then subtracting that value from the sodium level. As with anything else on earth, there are discrepancies in acceptable values because of advances in measurement techniques and laboratory hardware (Lolekha, 2001, pp. 33-36 and pp. 87-93). Listen to your health care provider’s interpretation.

Besides detecting acid-base disorders, the AG might point to disturbances related to multiple myeloma (bone marrow-related) (Jurado, 1998), or bromide and lithium intoxication. But that’s not so common. Low values, even within the range, probably indicate laboratory error, but might depict a low albumin level (which could arise from malnutrition, overhydration, increased capillary permeability or some kind of inflammation). High levels point to acidosis, but also could be erroneous based on laboratory operator technique, cleanliness of equipment or other impediment to accuracy (Kraut, 2007).

The matter of acid-base balance is not one to be dismissed. If it strays from the pH limits of 7.35-7.45, you could pass to the great hunting ground. Notice that this is slightly alkaline (basic). The closer to 7.0, the better it is. Acidity increases when acid compounds in the blood rise. This might happen from increased consumption, increased production or decreased elimination. Acidity drops under the opposite circumstances. That means that alkalinity increases. If pH deviates too far in either direction, cells die from their own toxic wastes. The management of the pH factor is so important to the body that it regulates the balance tightly through breathing, circulation and elimination. Even obesity may be blamed on increased acidity. Acid accumulation need not be addressed in terms of protein limitation though, but in terms of increasing the consumption of fruits and vegetables. Currently, this is under deeper investigation (Berkemeyer, 2009).

It has been accepted that the regulation of pH inside and outside cells is necessary for enzyme-controlled metabolic processes. The concentration of hydrogen ions, which determines the pH of aqueous solutions, can determine the structure and function of proteins, the permeability of the cell membrane, the distribution of electrolytes, and the structure of connective tissue. Unfavorable diet composition, a controllable factor in body pH, can have long-term consequences for the occurrence and progression of a number of diseases, including cancer (Robey, 2012). Among the most studied is the impairment of bone that results from chronic low-grade metabolic acidosis (Vormann, 2008). An aggravating element of bone degradation is sodium chloride, high intake of which, combined with low potassium intake, contributes to acid-base imbalance (Frassetto, 2008) (Morris, 1006).

If we are what we eat, then many of us are walking masses of low-grade chronic, acid-induced inflammation, caused largely by eating too many simple, refined carbohydrates from grains and cereals (Rachel, 2010) (de Punder, 2013), and not so much by protein ingestion. Decade-old findings agree that the contemporary diet provides what we want instead of what we are genetically determined to need, thereby upsetting the acid-base scales (Sebastian, 2002). This is especially pertinent in the age of osteoporosis. Our skeletons hold a reservoir of alkaline mineral in the form of hydroxyapatite, the calcium-phosphorus complex that is the primary mineral component of bone. The resorption of bone is driven by acid; the replacement of bone is impeded by it (Arnett, 2008) (Brandao-Burch, 2005).

Even drinking water gets into the act. Hard water, that which contains measurable levels of magnesium and calcium especially, has biologic benefits that are probably lacking in water that is chemically softened before it reaches the spigot. Though water itself cannot be either acid or alkaline, the stuff in it can change the pH up or down. That with a higher pH is beneficial in the maintenance of calcium sufficiency (Rylander, 2008) (Burckhardt, 2008). The opposite will increase the urinary excretion of minerals.

Alkaline supplements will improve mineral balance in those who overindulge on proteinaceous comestibles and refined grains, as evidenced by studies that administered oral potassium bicarbonate (Sebastian, 1994) or potassium citrate (Jehle, 2006), where parameters of bone resorption-formation were equalized. A diet of pro-alkaline foods will do the same thing. Believe it or not, ingesting some acidic foods, such as citrus, causes the pancreas to secrete bicarbonates that neutralize the net effect of the food. But the body has limited resources, so it’s the overloads that cause problems. If a person chooses to follow an alkaline diet, he will still allow about a fourth of his plate to be acidic. Roots, crucifers, leaves, cayenne and garlic are alkaline, as are pomegranates, coconuts and citrus fruits. Meats, dairy, grains except quinoa and amaranth, and fake sweeteners are not. You can find a list on the internet. A simple habit to initiate is the 1-2-3 technique of filling the plate. One part starch, two parts protein and three parts vegetables, the latter now covering half the plate, is easy. Meatless Mondays are better if they don’t feature a pile of pasta.

References

Arnett TR.
Extracellular pH regulates bone cell function.
J Nutr. 2008 Feb;138(2):415S-418S.

Berkemeyer S.
Acid-base balance and weight gain: are there crucial links via protein and organic acids in understanding obesity?
Med Hypotheses. 2009 Sep;73(3):347-56.

Brandao-Burch A, Utting JC, Orriss IR, Arnett TR.
Acidosis inhibits bone formation by osteoblasts in vitro by preventing mineralization.
Calcif Tissue Int. 2005 Sep;77(3):167-74.

Burckhardt P.
The effect of the alkali load of mineral water on bone metabolism: interventional studies.
J Nutr. 2008 Feb;138(2):435S-437S.

de Punder K, Pruimboom L.
The dietary intake of wheat and other cereal grains and their role in inflammation.
Nutrients. 2013 Mar 12;5(3):771-87. doi: 10.3390/nu5030771.

Frassetto LA, Morris RC Jr, Sellmeyer DE, Sebastian A.
Adverse effects of sodium chloride on bone in the aging human population resulting from habitual consumption of typical American diets.
J Nutr. 2008 Feb;138(2):419S-422S.

Hatherill M, Waggie Z, Purves L, Reynolds L, Argent A.
Correction of the anion gap for albumin in order to detect occult tissue anions in shock.
Arch Dis Child. 2002 Dec;87(6):526-9.

Sigrid Jehle, Antonella Zanetti, Jürgen Muser, Henry N. Hulter and Reto Krapf
Partial Neutralization of the Acidogenic Western Diet with Potassium Citrate Increases Bone Mass in Postmenopausal Women with Osteopenia
JASN. November 2006; vol. 17 no. 11: 3213-3222

Jurado RL, del Rio C, Nassar G, Navarette J, Pimentel JL Jr.
Low anion gap.
South Med J. 1998 Jul;91(7):624-9.

Kiwull-Schöne H, Kiwull P, Manz F, Kalhoff H.
Food composition and acid-base balance: alimentary alkali depletion and acid load in herbivores.
J Nutr. 2008 Feb;138(2):431S-434S.

Kraut JA, Madias NE.
Serum anion gap: its uses and limitations in clinical medicine.
Clin J Am Soc Nephrol. 2007 Jan;2(1):162-74.

Lolekha PH, Vanavanan S, Lolekha S.
Update on value of the anion gap in clinical diagnosis and laboratory evaluation.
Clin Chim Acta. 2001 May;307(1-2):33-6.

Lolekha PH, Vanavanan S, Teerakarnjana N, Chaichanajarernkul U.
Reference ranges of electrolyte and anion gap on the Beckman E4A, Beckman Synchron CX5, Nova CRT, and Nova Stat Profile Ultra.
Clin Chim Acta. 2001 May;307(1-2):87-93.

Rachel C. Masters, Angela D. Liese, Steven M. Haffner, Lynne E. Wagenknecht, and Anthony J. Hanley
Whole and Refined Grain Intakes Are Related to Inflammatory Protein Concentrations in Human Plasma
J Nutr. 2010 March; 140(3): 587–594.

Morris RC Jr, Schmidlin O, Frassetto LA, Sebastian A.
Relationship and interaction between sodium and potassium.
J Am Coll Nutr. 2006 Jun;25(3 Suppl):262S-270S.

Roberts WL, Johnson RD
The serum anion gap. Has the reference interval really fallen?
Arch Pathol Lab Med. 1997 Jun;121(6):568-72.

Robey IF.
Examining the relationship between diet-induced acidosis and cancer.
Nutr Metab (Lond). 2012 Aug 1;9(1):72.

Rylander R.
Drinking water constituents and disease.
J Nutr. 2008 Feb;138(2):423S-425S.

Sebastian A, Harris ST, Ottaway JH, Todd KM, Morris RC Jr.
Improved mineral balance and skeletal metabolism in postmenopausal women treated with potassium bicarbonate.
N Engl J Med. 1994 Jun 23;330(25):1776-81.

Anthony Sebastian, Lynda A Frassetto, Deborah E Sellmeyer, Renée L Merriam, and R Curtis Morris Jr
Estimation of the net acid load of the diet of ancestral preagricultural Homo sapiens and their hominid ancestors
Am J Clin Nutr December 2002 vol. 76 no. 6: 1308-1316

Juergen Vormann and Thomas Remer
Dietary, Metabolic, Physiologic, and Disease-Related Aspects of Acid-Base Balance: Foreword to the Contributions of the Second International Acid-Base Symposium1,2
J. Nutr. February 2008 vol. 138 no. 2 413S-414S

*These statements have not been evaluated by the FDA.
These products are not intended to treat, diagnose, cure, or prevent any disease.

Dehydration: Elderly to Children

nervous-systemElectrolytes are fundamental to good health. They transmit millions of messages per second through the nervous system. Electrolytes aid in brain, heart and nerve function as well as muscle control and coordination. They are crucial for cellular function. The body’s ability to absorb fluids depends on a healthy balance of electrolytes. Without a proper balance between fluids and electrolytes our health will decline. Severe imbalances can even be fatal. Conditions that disrupt electrolyte balance include illnesses that cause fevers, vomiting, or diarrhea. Other causes are prescription drugs such as diuretics, caffeine (including coffee and caffeinated soft drinks), excessive perspiration, extreme exercise, and inadequate fluid consumption.

As we age the water level in our bodies decrease making us more prone to dehydration. You can suffer from dehydration without realizing it. The elderly are particularly susceptible to dehydration without being aware of what is happening. Older people have 60% water content in their bodies as opposed to 70% water content in younger people. Elderly people also have a lower thirst response, which, when combined with other aging factors, such as swallowing difficulties, poor food intake, laxative use, and even resisting fluids due to anxiety associated with incontinence, can contribute to a state of dehydration without the individual being aware of it. As we age our kidneys allow glucose and sodium to escape along with necessary fluids to stay healthy. This also causes an increased chance of dehydration. Dehydration may also contribute to some conditions that are associated with aging, such as confusion, lethargy, low urine input, to name a few. Infants and young children are also at risk of electrolyte imbalance whenever they lose fluids through vomiting or diarrhea because of illness. The body’s ability to absorb fluids all depends on a healthy balance of electrolytes. Balance is the ultimate goal.

Symptoms of early or mild dehydration include:

• flushed face
• extreme thirst, more than normal or unable to drink
• dry, warm skin
• cannot pass urine or reduced amounts, dark, yellow
• dizziness made worse when you are standing
• weakness
• cramping in the arms and legs
• crying with few or no tears
• sleepy or irritable
• unwell
• headaches
• dry mouth, dry tongue; with thick saliva.
• in severe dehydration, these effects become more pronounced

Symptoms of moderate to severe dehydration include:

• low blood pressure
• fainting
• severe muscle contractions in the arms, legs, stomach, and back
• convulsions
• a bloated stomach
• heart failure
• sunken fontanelle – soft spot on a infants head
• sunken dry eyes, with few or no tears
• skin loses its firmness and looks wrinkled
• lack of elasticity of the skin (when a bit of skin lifted up stays folded and takes a
long time to go back to its normal position)
• rapid and deep breathing – faster than normal
• fast, weak pulse

Mild to moderate dehydration in adults can be corrected by drinking liquids, especially those that effectively restore electrolytes.

More:
The E-Lyte Story: Why You Need Electrolytes!
Sugar Free Electrolytes
Compare E-Lyte Sport with other “Sports” drinks
Pickle Juice
Taking A Peek Inside a Muscle Cramp
Night Cramps
ElyteSport Preloading

Other References:
References depicting the difficulty within the Medical Community to Resolve “Cramping”


The information contained in this web site is for educational purposes only and is not intended or implied to be a substitute for professional medical advice. Inclusion here does not imply any endorsement or recommendation. Always seek the advice of your physician or other qualified medical provider for all medical problems prior to starting any new regiment.

These statements have not been evaluated by the FDA.
These products are not intended to treat, diagnose, cure, or prevent any disease.

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