The short-term consequences of acute dehydration are widely known, but less clinical attention has been paid to the long-term consequences of chronic water deficiency. In a recent review article published in the journal Nature Reviews Nephrology, researchers summarized what is known about the long-term effects of chronic fluid deficiency.
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Epidemiological studies show that even mild but chronic insufficient hydration can lead to the development of coronary heart disease, heart failure, diabetes, obesity, worsening kidney function, premature mortality and faster aging. These results were confirmed by observations of mice exposed to chronic water restriction.
Adaptive response to insufficient hydration
Homeostasis is a state of balance between all body systems necessary for the survival and proper functioning of the body, and water balance is the key mechanism by which this occurs. It is known that osmoregulation, or control of water-salt balance, provides an osmotically stable environment for many cells.
Lack of water leads to adaptive changes throughout the body. In any case, water loss (breathing, urination, sweat, digestion) must be accompanied by water entering the body from food or liquid.
The body needs to maintain a stable composition and volume of intracellular fluid (ICF) and extracellular fluid (ECF). Changes in the body's water content due to excess or deficiency affect all organs, tissues and cells.
One response to water deficiency is the release of the antidiuretic hormone arginine vasopressin (AVP), which reduces water loss. Vasoconstriction occurs, blood pressure stabilizes and heart rate increases, and water reabsorption is facilitated.
Over time, chronic water deficiency can lead to a new steady state of water balance that matches water loss with water consumption. This reaction can work in conditions where access to water is limited. Over time, this can lead to deterioration of physiological systems, but these mechanisms are poorly understood.
Diseases associated with insufficient hydration
Researchers believe that underhydration, or hypohydration, is a mild decrease in body water levels that results in the activation of water-storing mechanisms that help maintain normal plasma and sodium osmolality levels. This contrasts with dehydration, a condition in which water-storing mechanisms are unable to maintain fluid balance.
Acute water loss is most noticeable in military personnel and athletes, increasing heart rate and reducing anaerobic exercise performance. Acute dehydration can also negatively impact cognitive functions, including alertness, concentration, short-term memory, and visual perception.
Certain diseases and conditions are thought to predispose people to fluid deficiency. For example, uncontrolled diabetes can lead to water loss because it reduces the reabsorption of water by the kidneys. Increased urine output may result from nephrogenic diabetes insipidus and some forms of polycystic kidney disease. Conversely, some cancers and medications may also stimulate AVP secretion without low water intake, resulting in hyponatremia.
Interventions to increase water intake
In response to new evidence Given the adverse effects of insufficient hydration, researchers have begun to study whether optimal hydration can prevent or slow metabolic and cardiovascular diseases.
Interventions aimed at increasing water intake found that participants faced barriers such as forgetting to drink, lack of access to water, lack of thirst, dislike of the taste of water, and inability to appreciate the benefits of proper hydration. Another problem was interruptions in performance due to increased urination.
These problems were demonstrated by an experiment that found lower adherence to water intake regimens compared to a control liquid in the form of inactive syrup.
< p>One study that successfully increased hydration in an intervention group found that higher water intake was significantly associated with decreased copeptin levels in people with chronic kidney disease. Another found that the greatest changes were observed in people who typically drink little.
Conclusions
The literature has identified associations between markers of chronic hydration deficiency and an increased risk of developing a number of chronic diseases, but the mechanisms the underlying causes of these phenomena are not well understood. There are indications that hydration may be a preventative measure, but the causal relationship is limited by lack of adherence to hydration.
Even despite these limitations, however, there is evidence that optimal hydration may be beneficial for people who usually drink little. Future studies of interventions to increase water consumption should monitor compliance more closely and continue to focus on chronically water-stressed populations who are expected to benefit the most.