How to Quench Your Thirst

Being adequately hydrated is essential to optimum health.  Curiously, in a country that offers so many convenient sources of water, I still encounter many patients that are not adequately hydrated.  This state of low-grade dehydration is more common than you might suspect – especially in the elderly.

Many factors contribute to our being dehydrated even when adequate liquids are available.  Contributing factor include diets that are mostly processed foods with low water content, central heating and cooling that keeps rooms at low humidity, certain medications (Benadryl, Sudafed, Xanax, Furosemide, HCTZ, Ambien, etc.), and drinks with caffeine (coffee and sodas) that often make us eliminate more liquid than we retain. Of particular consequence now, your level of hydration impacts the strength of your immune system.  Dehydration also affects the elasticity of your skin, your energy level, how easily you can move, and your body’s overall resistance to aging and disease. It even determines how you feel when you get up in the morning.  This, along with more about hydration, is the subject of the book “Quench” by Dana Cohen and Gina Bria.

The consequences of dehydration can vary from the annoying feeling of discomfort to life-threatening issues.  Dehydration can also lead to fatigue, a decline in cognitive performance, headaches, urinary tract infections, constipation, weight gain, decreased immunity, joint pain, chronic diseases like fibromyalgia, type II diabetes, dry skin, chapped lips, reflux, and slower healing. Unfortunately, drinking tap water or bottled water doesn’t always solve the problem.  Water by itself is not an optimal form of hydration.  Complicating matters is the dilemma that too much water can be counterproductive since it hydrates poorly and also flushes out vital nutrients and electrolytes.

Immobility is another factor in dehydration.  Without movement, tissues that transport water work inefficiently.  Often this is the most overlooked problem in cases of chronic dehydration.  Fortunately, even small movements help water move through the tissues.  It’s not how much water you drink, its how much water can efficiently reach thirsty tissues.

One way that water gets into our body is through tissues call fascia.  Fascia forms a large system in the body that touches all the other systems.  Until recently, the fascia was thought of as connective tissue that helped hold the body together with little other purpose.  As we now better understand, fascia is one of the body’s major water transporting systems. At a microscopic level, the fascia has hollow tubing and slide-like sheets that send the water that you drink into your tissues. This discovery helped explain how the movement of the body helps the fascia hydrate cells throughout the body. Any motion you make (turning, stretching, twisting) helps activate this water delivery system. In effect, fascia works like a hydraulic pump by constriction and release.  Importantly, drinking starts the hydration process, but movement completes it.  This newly recognized need for movement may be part of why activities like yoga, tai chi, qi gong, and dance help improve healthspan and lifespan.

For purposes of hydration improvement, there is an important difference between conventional exercise and the micro-movements that enhance hydration and aid the elimination of waste from our cells. Typically, exercise focuses on specific muscle groups. The micro-movements described in “Quench” are designed to make sure every part of your body is helped to hydrate and cleanse. A simple routine of micro-movements similar to movements in yoga and Tai Chi is recommended.

An understanding of how hydration works were discovered by researching how desert dwellers handle the hydration problem.  As you might expect, to survive in an arid land, you have to become an expert in hydration.  Studies of primitive cultures that inhabit arid lands revealed that instead of depending on water alone they often used the water locked in plants.  What these indigenous people had discovered over centuries was that plants help us hydrate more efficiently than plain water. This happens because plant fibers help us absorb all the liquid whereas water alone often passes through without being delivered to the trillions of cells in our body.  Importantly, protecting yourself from chronic dehydration is not so much about the quantity of water but rather what form the water is in and how body movements work to help transport the water.

The type of water the body uses most efficiently is called gel water – the type of water locked up in plant cells.  As was recently discovered, gel water is a different state of water than the traditional water states of liquids, solids, and gasses.  Being 10% more viscous than the liquid state, gel water hydrates us more efficiently. The science of gel water is relatively new and while gel water seems to be the preferred name, you may find it called structured water, EZ water, liquid crystalline, ordered water, or coherent water.  The change to the gel water phase takes place at the molecular level therefore it’s not something you can view with the naked eye.  What you will notice is that water in the gel state hydrates better with less liquid.

From experience, you may have already discovered that thirst is not always an early warning indication of dehydration.  This makes it easy to fall prey to low-grade dehydration without appreciating the dire situation.  In part, this is because our body makes adjustments as water levels drop.  If you are not fully replacing water loss, the brain sends out hormone signals to divert water away from non-life critical areas to support more important functions like your brain, heart, and liver. As a result, dehydration can sneak up, especially as we get older. 

Even mild dehydration can have an impact. A decrease in hydration decreases the ability of the endothelium (the lining) of blood vessels to constrict and dilate – a function that’s essential for healthy blood flow. No surprise then that dehydration increases the odds of a heart attack.

The foods that produce the best hydration are plant-based whole foods.  It’s that easy! By opting for real food rather than the kind that comes in a box or microwavable package, you’ll greatly improve hydration.

The top 12 commonly available hydrating vegetables include cucumbers 96.7%, romaine lettuce 95.6%, celery 95.4%, radishes 95.3%, zucchini 95%, tomatoes 94.5%, peppers 93.9%, cauliflower 92.1%, spinach 91.4%, broccoli 90.7%, carrots 90%, and sprouts 86.5%.

The top 12 commonly available hydrating fruits include starfruit 91.4%, watermelon 91.4%, strawberries 91%, grapefruit 90.5%,  oranges 88%, pineapple 87%, raspberries 87%, blueberries 85%, Kiwi 84.2%, Apples 84%, pears 84%, and grapes 81.5%.

While all plants contain gel water, chia seeds are rather amazing at retaining gel water along with providing a healthy source of Omega 3 fatty acids that help move water into cells. Chia seeds also have 10 g of fiber per ounce, which helps retain hydration. Chia seed with water or fruit juices is more hydrating than water or fruit juice alone.  For the elderly, using chia seeds in beverages improves hydration.  Keep in mind that unless ground finely, chia seeds need to soak several hours to absorb water.

While the book contains many good ideas, the recommendation for high-fat diets, ketogenic diets, and especially the use of coconut oil, palm kernel oil, and ghee are at odds with many other health issues.  While these fats may improve hydration, there are far healthier ways to achieve the objective.  The claim that high-fat diets result in lower blood pressure, reduce belly fat, and better insulin and blood sugar control are based on short term studies measuring selected biomarkers that contradict what is known from longer studies.

Aside from a rather drawn out and unnecessary introductory section, the book is interesting and offers several health tips.  Most importantly, keeping ourselves hydrated is an essential part of being at our best physically and mentally. Now you know, when you are not at your best one of the first things to check is your hydration.

Nancy Neighbors, MD

What is the Quench Plan

While the book, “Quench”, is about 300 pages in length, the essence of the book’s practical advice can be summed up as follows.

  • When you wake up, drink 8-16 oz. of water with a pinch of salt and a squeeze a lemon.
  • Drink at least one green smoothie every day.
  • Drink six to eight ounces of water before every meal.
  • Get more of your water from food by eating plant-based whole foods.
  • Make sure to move.

When it’s not practical to make a smoothie, adding ground chia seeds provides most of the same benefits. For example, adding ground chia seeds to fruit juice improves hydration.

            Personally, I eat an abundance of fresh fruits and vegetables during the day and rarely need a smoothie to supplement hydration.

Recipe for a Hydrating Smoothie

Grinding chia seeds increases their gel water holding capacity by exposing more surface area.  To create a smoothie that is both tasty and hydrating, make sure it includes:

  • One or more leafy greens and or herbs (98% gel water),
  • A bit of fruit for sweetness,
  • A healthy fat, like avocado, olives, nuts, or seeds in small quantities unless trying to gain weight,
  • An acidic zing from lime juice or raw apple cider vinegar, and
  • A final pinch of coarse sea salt.

            The book includes about 50 smoothie recipes with suggestions for cool weather smoothies, warm weather smoothies, and a few hydrating entrees. 

            Adding refined vegetable oils, as some recipes suggest, is not recommended. Just as refined carbohydrates are substandard nutrition, refined oils are also substandard nutrition.  Whole foods can provide all the fat you need without discarding the essential micronutrients.

More About Hydration

  • During a normal day, we breathe, urinate, and sweat out about 3 quarts of water, amounting to 5% to 10% of our body’s water. With the loss of even a quart of water, we can start to lose some cognitive functions, alertness, and ability to concentrate. If you lose a gallon, you’re likely to have a bad headache. If you’re down 2 gallons you going to be sick enough to be in the hospital. At a loss of 3 gallons, you’re likely to be in the morgue.
  • In one sense we are 99% water. To get to that 99% number, we have to count all the molecules of matter in the body. When we do that, we find that 99 out of every 100 of them are water. This is possible because water is the tiniest of molecules.
  • You may be wondering how you can urinate 8 times or more a day and yet go 7 to 9 hours without needing to go at night. You have your brain to thank for that bit of help As you slumber, the brain releases antidiuretic hormone (ADH) that helps your kidneys concentrate urine instead of overfilling your bladder and rousing you with that ‘need to go’ feeling. That’s also why your urine can look so dark in the morning, it’s ultra-concentrated.  Unfortunately, as we age, the body makes less ADH, which is why so many older people wake up to urinate throughout the night when they didn’t do so earlier in their life.
  • In one study, it was found that water increases activity in the sympathetic nervous system, which causes your body to burn more calories. Researchers estimate that drinking three 16-ounce glasses of water a day increases calorie burning enough to help you lose 5 pounds in a year without making any other changes to your lifestyle. In another study, researchers found that drinking a 16-ounce glass of water boosted metabolic rate by 30% – that’s an average of 200 extra calories a day.  A confounding factor, of course, is that when you choose water, you’re not choosing other beverages that are likely to contribute to weight gain.
  • The food we eat can suck hydration out of us or conversely rehydrate us. For example, an apple with a bottle of water hydrates more than two bottles of water. This happens when fibrous material in that apple acts as a sponge to help hold the moisture longer.
  • You may wonder about the rule of thumb that suggests drinking half your body weight in water in ounces. For example, the rule would recommend that a 120-pound woman drink 60 ounces of water per day? While not a bad general rule, it’s best to become sensitive to your body’s signals for drinking rather than a set amount. If committed to a healthy plant-based whole food diet that supplies gel water, the need to supplement with plain water will significantly diminish.
  • Indeed, an excessive amount of common table salt is not good for you. Your kidneys will use water to filter out excess salt and flush it from your system in the form of urine.  Hence, excess salt leads to dehydration and even kidney problems. However, a pinch of sea salt can make a glass of water more hydrating due to the replacement of trace minerals.
  • Blended smoothies made from fruits and vegetables retain the efficient hydrating gel water.  In contrast, juicing usually removes most of the gel water along with the discarded pulp.
  • It’s best to steer clear of sports drinks loaded with artificial colors and added sugar. A simple do-it-yourself sports drink would include 8 to 12 ounces water, a pinch of natural salt (like sea salt), ½ ounce of lemon or lime juice, and a teaspoon of honey.
  • Chewing food only releases about 35% of the nutritional material in that food. In contrast, blending food can makes nutrients up to 90% bioavailable – meaning they are more easily absorbed.
  • Even with a great organic salad, unless you are chewing that forkful into a liquid, you aren’t breaking down the food particles enough to fully extract all the nutrients. This may mean that more than half the value of your expensive salad is being wasted. The good news is that blending does a far better job of helping to make nutrients available.  Better yet, if you keep sips of the smoothie in your mouth for a few seconds before you swallow, you start the digestive process with the digestive enzymes produced when you salivate.  Quickly drinking a smoothie has the downside of reducing the satiety effect and therefore making you hungry sooner.

Do you know Dr. Greger?

            Over the years, I’ve mentioned Dr. Micheal Greger numerous times as a source for reliable nutrition information.  What you may not know is the unusual career path that made him America’s trusted voice for all things about nutrition.  As an expert witness, he defended Oprah Winfrey from a libel claims made by the cattle industry.  Along the way, he helped research the beef industry to prove that downer cattle were being sold for human food.  Other efforts led to recalling 143 million pounds of beef, some of which were headed to school lunch programs. 

            Dr. Greger’s goals include reviewing every new nutrition study (so that you and I don’t have to), educating new doctors, and providing guidance for nutrition policies through his books, lectures, and website at In a field like nutrition where phony nutrition studies are the norm and vested interest spend billions of dollars to promote products that can cause disease, Dr. Greger stands out as a voice of reason that can’t be bought.  To understand why many consider Dr. Greger a national treasure you will find quite a few insights sprinkled into an interview led by Rich Rolls called “Tactics For Sustained Weight Loss.”

Potato Salad with Avocado and Dill

            A mashed ripe avocado is a great substitute for mayo. It’s creamy and tastes great with lemon juice and fresh herbs such as dill. Click here for the recipe

Spinach, Pineapple, and Strawberry Salad

            Juicy strawberries and grilled pineapple are the stars of this salad, while edamame and almonds add protein, color, and crunch. Click here for the recipe.

By Nancy Neighbors, MD

... Dr. Neighbors provides a blend of traditional family medicine and evidence-based lifestyle medicine in Huntsville, Alabama. When indicated, lifestyle change is recommended as the first line of therapy.

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