Liquid Asset

Plain and simple, water keeps us alive and helps us thrive

WRITTEN BY Stratton Lawrence
PHOTOGRAPHS BY Scott Henderson

Plain, old water. This colorless, flavorless, odorless substance may seem quite ordinary, but the vital combination of two hydrogens and one oxygen taps into every system in the body. A steady flow of H20 boosts everything from skin tone to cognitive ability. Water accounts for about 60 percent of our molecular makeup, but unlike camels, humans don’t store excess; we require a fresh supply daily. As the sweltering summer depletes our water levels (sweat much?), we can keep our bodies on an even keel by getting plenty of hydration.

Fluid Motion

Dr. Salo learned the importance of hydration firsthand when, as a track and field athlete in college, he regularly experienced fatigue and brain fog in the hours following morning workouts. Understanding how dehydration led to that rundown feeling has helped shape his approach to medicine, which looks for underlying lifestyle problems at the root of medical ailments (like not consuming enough water). “Our bodies send us signals about what they need, including, ‘Hey, it’s time to drink some water,’” he says.

Dr. Marcus Salo

As soon as a sip crosses our lips, this liquid powerhouse goes to work, beginning with digestion. “When water hits your gut, it immediately gets your metabolism going,” says Dr. Salo. From there, the water is absorbed into the bloodstream through the intestinal tract, and our circulatory system distributes it throughout the body. “Blood vessels give water an avenue to reach every organ system, traveling all the way up to the brain and down to the skin on our lower legs,” he adds. At the same time, adequate hydration keeps blood fluid in order to carry nutrients to all of our cells.

Water is integral to every body system. Beyond digestion, it lubricates joints, regulates temperature, keeps nerves working properly, allows the lungs to function, cushions the brain, forms saliva and mucus and helps excrete waste. “The ultimate goal of drinking water is to maintain stability within the body. We need a requisite amount of water to function at our best,” explains Dr. Salo.


If you’re thirsty, you’re already dehydrated. We’ve all heard the dramatic warning, but it’s no exaggeration. Even a one-and-a-half percent reduction in our body’s water balance can lead to symptoms of dehydration. Just as water keeps every organ in our body running, lack of water can lead to chronic discomfort and disease.

When we don’t get enough water, our bodies prioritize the most important organs. When a person dies from dehydration, the lungs and heart are the last organs working, but before that, the kidneys shut down and the brain gets muddied. If we don’t get enough water on a daily basis, those effects can play out over long periods of time. Dr. Salo has identified chronic dehydration as an underlying cause of patients’ headaches, gastrointestinal problems and renal diseases. “Prolonged dehydration can contribute to the progression of many chronic diseases,” he says.

While anyone can become dehydrated (and 75 percent of Americans are), infants, seniors, athletes, diabetics and heavy alcohol drinkers are especially susceptible. During summer, when we’re more likely to sweat heavily, it’s common to see acute, short-term effects of dehydration like muscle cramping, constipation, regular headaches, sluggishness or flaky skin. “If you have extreme thirst or a dry mouth and are feeling a little fatigued or light-headed, you’ve likely lost some of your body’s water volume.

Your organ systems aren’t getting the appropriate hydration,” says Dr. Salo. “We don’t always think of the cognitive side of dehydration, but most of us need to be able to make quick decisions. When you don’t get enough water, that ability is compromised,” he continues. For people who work with heavy equipment or in potentially dangerous environments, dehydration can even lead to accidents and injuries. Extreme dehydration also prevents us from sweating to regulate body temperature. That’s when we face the risks of seizure, heat stroke and altered consciousness. If you’re feeling weak or uncoordinated, drink water and seek help.

Big Gulp

Our bodies need water to function, but how much? The simple answer: a lot. In fact, the common recommendation of 64 ounces a day (eight cups) is actually on the low end and the bare minimum recommended by doctors. When you calculate the water we absorb from fruits and vegetables, the average woman needs 11.5 cups a day and men need 15.5 (that’s nearly a gallon!). A healthy diet also contributes to hydration, but even people who consume large amounts of fruits and vegetables fulfill only about 20 to 25 percent of their fluid needs with food.

Of course, individual body mass and activity levels vary, so there’s no standard amount of water intake that suits everyone. People who work outside or have chronic health conditions may need a much higher intake than healthy folks who work inside. The best gauge is to listen to your body; thirst is a symptom of dehydration, so the goal is to never be thirsty. (It is possible to overdo water consumption, though it’s unlikely. Over time, drinking several gallons a day could dilute sodium levels, cause electrolyte imbalances and make the kidneys work overtime to get rid of all that extra water.)

We need to slug a steady supply every day, but drinking sweet and caffeinated drinks doesn’t count. Caffeine is a diuretic, meaning it encourages urination, so the water in coffee and energy drinks gets cancelled out by extra waste. “You’re taking one step forward and one step back,” says Dr. Salo. Soda, sweet tea and sugary drinks also drain your tank, since sugar absorption in the body requires water and can exacerbate some conditions created by dehydration. That goes for Gatorade and Powerade, too. “Sports drinks have a lot of additives, including a decent amount of sugar,” Dr. Salo says. “They can certainly be used to augment hydration—especially by athletes who lose a lot of electrolytes through sweat—but they shouldn’t be your primary source of water during physical activity.”

On a hot afternoon, ice-cold water may be the perfect beverage, but if you prefer a bit more flavor to your fluids, try adding citrus wedges, cucumber slices, frozen berries or fresh herbs like mint or basil. No matter how you drink it, the key to proper hydration, advises Dr. Salo, is carrying a reusable water bottle everywhere you go. “Find a refillable container that you like and make it part of your daily routine.” When good-tasting water is on hand, you’re more likely to be hydrated. And a well-watered body stays cool, energetic and full of life. So drink to your health!

Dry Spell: 10 Warning Signs of Dehydration

  1. Feeling thirsty
  2. Dark yellow, strong-smelling urine
  3. Low energy or fatigue
  4. Dry mouth, lips or eyes
  5. Peeing fewer than four times a day
  6. Bad breath
  7. Sugar cravings
  8. Dizziness, confusion or light-headedness
  9. Fainting
  10. Heart palpitations

A Clear Picture

Water is water, right? Not quite. Let’s examine some of the most common quenchers to determine which ones measure up.

• Tap water: In the Lowcountry and across most of the US, tap water is safe to drink and the best option for staying hydrated.
• Bottled water: Spring and filtered water certainly hydrate, but consider the effects of single-use plastic before relying on these. If you prefer the taste of filtered over tap water, install an in-sink filter or refill larger jugs at a grocery store’s filtered water dispenser.
• Coconut water: Though excellent for hydration, pure coconut water shouldn’t be your sole sipping source because of its natural sweetness and fat and caloric content. Avoid brands with added sweeteners and flavors.
• Sparkling water: Unflavored, carbonated water can safely be a part of your daily water intake, but it’s best not to rely on this fizzy favorite as your only supply, as scientists are still studying the ongoing effects of these more acidic drinks.
• Flavor additives: Flavored powders and drops meant to punch up the taste of plain water are fine every so often, but too many artificial sweeteners could eventually lead to other health issues.


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