Article

Effect of fluid intake on skin physiology: Distinct differences between drinking mineral water and tap water

Authors:
  • Rosenpark Klinik
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Abstract

It is generally stated that drinking plenty of water has a positive influence on skin condition. However, there is no published scientific study that has investigated this matter. The aim of our exploratory ‘before-after’ study was to evaluate the in vivo influence of drinking more than 2 L of mineral water or ordinary tap water per day on skin physiology. Ninety-three healthy subjects were included in our prospective study. After an initial run-in phase of 2 weeks to monitor individual drinking habits, subjects had to drink 2.25 L day−1 of either mineral water (n = 53) or tap water (n = 40) for 4 weeks. Bioengineering in vivo measurements on the volar forearm included sonographic evaluation of skin thickness and density, determination of skin surface pH, assessment of skin surface morphology, and measurement of finger circumference. Eighty-six subjects completed the study. In the mineral water group measurements revealed a statistically significant decrease in skin density. Skin thickness increased slightly, albeit not at a statistically significant level. However, when separately analysing those individuals from the mineral water group, who had routinely drunken comparably little before the start of the study, their skin thickness increased at a statistically significant level. Skin surface pH remained almost unchanged in the physiologically optimal range. In the tap water group, skin density increased significantly, while skin thickness decreased significantly. Skin surface pH decreased at a statistically significant level. While in the mineral water group finger circumference decreased significantly, measurements in the tap water group revealed a statistically significant increase. Objective skin surface morphology did not change in any group. In summary, drinking more than 2 L of water per day can have a significant impact on skin physiology. The exact effects within the skin seem to differ depending on the nature of the water ingested. Randomized, controlled, double-blind follow-up trials are warranted to confirm the findings of our exploratory pilot study. Il est généralement établi que boire abondamment de l'eau influence l’état de la peau. Cependant, aucune étude scientifique publiée ne traite de ce sujet. Le but de notre étude exploratoire ‘avant/après « a été d’évaluer in vivo l'influence de l'absorption de plus de 2 litres par jour d'eau minérale ou du robinet sur la physiologie de le peau. 93 sujets en bonne santé ont participéà cette étude prospective. Après une phase initiale de 2 semaines pour contrôler les habitudes individuelles des sujets pour se désaltérer, on leur a demandé de boire 2,25 litres par jour d'eau minérale (n = 53) ou d'eau du robinet (n = 40) pendant 4 semaines. Les mesures biophysiques in vivo sur la face interne de l'avant bras incluaient l’évaluation sono graphique de l’épaisseur de la peau et de sa densité, la détermination de son pH de surface, l’évaluation de sa morphologie de surface et la mesure de la circonférence du doigt. 86 sujets ont terminé cette étude. Dans le groupe traité par l'eau minérale, les mesures révèlent des diminutions significatives de la densité de la peau. Son épaisseur augmente légèrement mais à un niveau non-significatif. Cependant, quand on analyse séparément les individus de ce groupe, on constate que ceux qui habituellement buvaient peu d'eau avant le début de cette étude ont l’épaisseur de leur peau qui augmente de façon significative. Le pH de surface de la peau reste à peu près inchangé dans la fourchette physiologique optimale. Dans le groupe traitéà l'eau du robinet, la densité de la peau augmente de façon significative, alors que son épaisseur diminue significativement. Le pH de surface de la peau diminue de façon significative. Alors que la circonférence du doigt du groupe qui a bu de l'eau minérale diminue de façon significative, celle du groupe traitéà l'eau du robinet augmente de façon significative. La morphologie de la surface de la peau ne change pas, quel que soit le groupe. En résumé, l'absorption de plus de 2 litres d'eau par jour peut avoir un impact significatif sur la physiologie de la peau. Les effets au niveau de la peau semble dépendant de la nature de l'eau ingérée. Des tests aléatoires contrôlés en double aveugle seront nécessaires pour augmenter les résultats de cette étude exploratoire.

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Deep sea water intake improves skin symptoms and mineral imbalance and decreases serum IgE levels mad IgE-inducing cytokines, IL-4, IL-13 and IL-18 in patients with atopic eczema/dermatitis syndrome (AEDS), while distilled water intake fails to do so.
Article
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Nutritional factors exert promising actions on the skin, but only scant information is available on the modulating effects of physiologic concentrations of nutrients on the skin condition of humans. The objective was to evaluate whether nutrient concentrations in serum and diet are associated with the skin condition of humans. A cross-sectional study was conducted in which data on serum concentrations of nutrients, dietary intake of nutrients, and the hydration, sebum content, and surface pH of skin were obtained from 302 healthy men and women. Skin condition was measured with the use of noninvasive techniques. Dietary intake was assessed with 2 complementary food-frequency questionnaires. Multiple regression analysis was used to evaluate associations of serum vitamins and carotenoids and of dietary micro- and macronutrients with skin condition. After adjustment for potential confounders, including sex, age, and smoking, statistically significant associations were shown in the total population between serum vitamin A and skin sebum content and surface pH and between the dietary intake of total fat, saturated fat, monounsaturated fat, and skin hydration. Monounsaturated fat intake was also associated with surface pH. Associations between serum beta-cryptoxanthin and skin hydration and between surface pH and fluid and calcium intakes were observed in men only. Several associations between nutrients in serum and diet and skin condition were observed, indicating that changes in baseline nutritional status may affect skin condition.
Article
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There are appreciable differences in total fluid intake at the individual and population level, and substantial difficulties in obtaining valid measures of fluid intake. Epidemiological studies have examined the association between fluid intake and different types of cancer. For bladder cancer, fluid consumption has been associated with a moderate increase of risk in some studies, including a multicentric case-control study from the United States, based on about 3000 cases, with a decrease in others, including the Health Professional Follow-up study, or with no material association. The evidence, therefore, is far from consistent. Sources and components of fluids were also different across different types studies. From a biological point of view, a decreased fluid intake could result in a greater concentration of carcinogens in the urine or in a prolonged time of contact with the bladder mucosa because of less frequent micturition. Carcinogenic or anticarcinogenic components of various beverages excreted in the urine may also play a role in the process. It has been suggested that fluid consumption has a favorable effect on colorectal cancer risk. Fluid intake may reduce colon cancer risk by decreasing bowel transit time and reducing mucosal contact with carcinogens. Low fluid intake may also compromise cellular concentration, affect enzyme activity in metabolic regulation, and inhibit carcinogen removal. However, epidemiological data are inadequate for evaluation. Data are sparse and inconsistent for other neoplasms, including breast cancer. The fluid constituent of foods, confounding, interactions and possible influences of specific types of beverages should be investigated further. In conclusion therefore the association between total fluid intake and cancer risk remains still open to debate.
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Topically applied water exerts mechanical stress on individual corneocytes as well as on the whole stratum corneum (SC), resulting in an alteration of barrier function. In this study we used complete skin biopsies and showed that the SC reacts to water stress as a highly optimized and well-regulated structure against osmotic changes. Following a relatively new cryo-processing protocol for cryo-SEM, it is possible to reliably maintain and investigate the hydrated state of the SC and individual corneocytes after treatment with solutions of different ionic strength. Treatment with distilled water results in swelling of SC cells together with formation of massive water inclusions between adjacent cell layers. Treatment with 5-20% NaCl reveals three different hydration zones within the SC: Corneocytes near the live-dead transition zone can swell to nearly double their thickness. The second zone is the most compact, as the corneocytes here show the smallest thickness variation with all treatments. Within the outermost zone, again a massive swelling and loosening of intracellular filament packing can be observed. We therefore conclude that the SC itself is subdivided into three functional zones with individual water penetration and binding potentials. Since the second zone remains nearly unaffected by water stress, we propose that this zone hosts the functional SC barrier.
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Constipation defined as changes in the frequency, volume, weight, consistency and ease of passage of the stool occurs in any age group. The most important factors known to promote constipation are reduced physical activity and inadequate dietary intake of fibres, carbohydrates and fluids. Fluid losses induced by diarrhoea and febrile illness alter water balance and promote constipation. When children increase their water consumption above their usual intake, no change in stool frequency and consistency was observed. The improvement of constipation by increasing water intake, therefore, may be effective in children only when voluntary fluid consumption is lower-than-normal for the child's age and activity level. In the elderly, low fluid intake, which may be indicative of hypohydration, was a cause of constipation and a significant relationship between liquid deprivation from 2500 to 500 ml per day and constipation was reported. Dehydration is also observed when saline laxatives are used for the treatment of constipation if fluid replacement is not maintained and may affect the efficacy of the treatment. While sulphate in drinking water does not appear to have a significant laxative effect, fluid intake and magnesium sulphate-rich mineral waters were shown to improve constipation in healthy infants. In conclusion, fluid loss and fluid restriction and thus de-or hypohydration increase constipation. It is thus important to maintain euhydration as a prevention of constipation.
Article
Moisturizers are a group of products designed to increase the water content of the skin by retarding transepidermal water loss. This is accomplished through the use of occlusives and humectants. Water is essential for maintaining skin plasticity and barrier integrity. Modern moisturizers can assume a therapeutic role if they contain active ingredients designed to improve sun protection, induce exfoliation, or deliver antiaging benefits.
Article
The proliferation and differentiation of mouse epidermal cells can be sequentially analyzed by modification of extracellular calcium. Newborn cells cultured in low calcium medium (less than 0.1 mM) proliferate as a monolayer and maintain a typical basal cell phenotype in culture but have a limited proliferative capacity and short lifespan. Elevation of the magnesium content of the culture medium from 1 to 5 mM stimulated the proliferation of newborn mouse (1-3 days old) keratinocytes. Maximal DNA synthesis rates, as determined on day 5 of culture, were up to 2-3-fold higher in the magnesium-enriched cultures. Exposure to high magnesium caused 3-4-fold increases in the DNA content of newborn keratinocyte cultures, and extended the confluent phase of epidermal cell growth to over 10 days. Other divalent cations (strontium, copper, zinc, nickel, beryllium, and barium) did not improve keratinocyte growth in culture. Keratinocytes from the tail skin of adult (3 months old) mice displayed an absolute requirement for high phosphate in the culture medium. The medium containing an optimal (10 mM) phosphate concentration prevented the cell detachment caused by the standard low (1 mM) phosphate medium, and in combination with an elevated magnesium content (10-15 mM) it markedly increased both DNA synthesis rates and DNA content of the adult cell cultures. Optimally growing, newborn or adult cultures contained less cells in the G1 phase of the cell cycle and more cells in S and G2 +M. The addition of phosphate and magnesium per se did not induce keratinocyte differentiation and did not interfere with the high calcium (1 mM)-induced differentiation.
Article
Mechanisms of drinking have been studied extensively in laboratory mammals, but comparatively little information is available on human consumption of fluids. The assumption that osmotic disequilibrium between extra- and intracellular fluid can be rectified within seconds may not be true for plasma and red blood cell (RBC) fluid in humans inasmuch as stress-induced hyperosmotemia to +13 mosmol/kg does not cause a significant change in mean RBC corpuscular volume. Unlike some mammals, humans have a delay in rehydration (involuntary dehydration) after fluid loss. Two factors unique to humans that probably contribute to involuntary dehydration are 1) upright posture and 2) extracellular fluid and electrolyte loss by sweating from exercise and heat exposure. If drinking is influenced by upright postural changes, it may be related to increased plasma renin activity (PRA) but not to increases in plasma osmolality or arginine vasopressin concentration. Under combined stresses of heat, exercise, and prior dehydration, exercise is the greatest inhibiting factor and heat exposure has the least inhibitory effect on voluntary water intake. The rate of drinking during exercise in heat has a high correlation with sweat rate but is essentially unrelated to the well-established dipsogenic factors of plasma volume, osmolality, and PRA. However, it is likely that some or all of these dipsogenic factors act to initiate drinking in humans.
Article
The availability of the calcium contained in a high-calcium mineral water (Sangemini), popular in Italy, was compared in 18 healthy women with the availability of milk calcium ingested at the same calcium load, using 45Ca as the tracer in a randomized cross-over design. At an ingested calcium load of 2.5 mmol, absorption fraction averaged 0.433 for milk and 0.475 for Sangemini water. The mean quotient of the two (Sangemini/milk) was 1.129 (+/- 0.056, SEM, P < 0.05). The calcium of Sangemini water is thus highly bioavailable, and at least as bioavailable as milk calcium.
Article
Adenomatous polyps are neoplasms that may progress to colorectal cancer. The role of diet and other lifestyle habits in their etiology is now being elucidated. The aim of this study was to evaluate effects of nutritional habits, weight and weight gain, tobacco smoking, and physical activity in adenoma etiology. A quantified dietary history questionnaire was designed to evaluate long-term dietary habits in addition to more recent ones. The study population comprised 196 adenoma patients and matched asymptomatic, screened controls. Statistical analysis used multivariate conditional logistic models, adjusting for total energy intake and physical activity. Odds ratios (ORs) and 95% confidence intervals (CIs) for adenoma associated with highest versus lowest tertiles of mean daily intake were as follows: for energy, OR 3.7 and CI 2.1-6.7; for animal fat, OR 2.4 and CI 1.2-4.7; for tobacco smoking, OR 3.1 and CI 1.1-2.8; and for weight gain, OR 2.2 and CI 1.2-4.1 (P for linear trend for all, < or = 0.01). Significant negative associations were found with intake of total carbohydrates (OR, 0.3; CI, 0.1-0.7) and fluids (OR, 0.4; CI, 0.2-0.8) (P for both < 0.01) as well as for physical activity (OR, 0.6; CI, 0.3-0.9; P = 0.03). Increased risk for adenoma was observed with decreased intake of carotene (OR, 0.6; CI, 0.3-1.0; P = 0.06), vitamin E (OR, 0.6; CI, 0.3-1.0; P = 0.07), and dietary fiber (OR, 0.6; CI, 0.3-1.3; not significant). The OR of interaction between water and dietary fiber was significant (OR, 0.7; CI, 0.6-0.9; P = 0.01), suggesting a synergistic protective effect. Specific dietary and lifestyle habits were identified as independent factors associated with colorectal adenomas; of special interest is the interaction between water and fiber intake. Avoiding these factors might delay or prevent neoplasia.
Article
Recovery after exercise poses an important challenge to the modern athlete. Important issues include restoration of liver and muscle glycogen stores, and the replacement of fluid and electrolytes lost in sweat. Rapid resynthesis of muscle glycogen stores is aided by the immediate intake of carbohydrate (I g.kg-1 BM each 2 hours), particularly of high glycemic index carbohydrate foods, leading to a total intake over 24 hours of 7-10 g.kg-1 BM. Provided adequate carbohydrate is consumed it appears that the frequency of intake, the form (liquid versus solid) and the presence of other macronutrients does not affect the rate of glycogen storage. Practical considerations, such as the availability and appetite appeal of foods or drinks, and gastrointestinal comfort may determine ideal carbohydrate choices and intake patterns. Rehydration requires a special fluid intake plan since thirst and voluntary intake will not provide for full restoration of sweat losses in the acute phase (0-6 hr) of recovery. Steps should be taken to ensure that a supply of palatable drinks is available after exercise. Sweetened drinks are generally preferred and can contribute towards achieving carbohydrate intake goals. Replacement of sodium lost in sweat is important in maximising the retention of ingested fluids. A sodium content of 50-90 mmol.L-1 may be necessary for optimal rehydration; however commercial sports drinks are formulated with a more moderate sodium content (10-25 mmol.L-1). It may be necessary to consume 150% of fluid losses to allow for complete fluid restoration. Caffeine and alcohol containing beverages are not ideal rehydration fluids since they promote an increased rate of diuresis.
Article
Little is known about the bioavailability of calcium in water and various beverages. Some mineral waters contain large amounts of calcium that could compensate for insufficient consumption of dairy products. The fractional intestinal absorption of calcium (FCA) was measured in 12 healthy adult volunteers, using a trace dose of radiocalcium and 200 mg of calcium carrier, part of which was calcium contained in mineral water. Measurements were performed in fasting subjects consuming a standard breakfast. In all the subjects, three mineral waters with a calcium concentration of 10.4, 78, and 467 mg/l, respectively, were tested. Calcium absorption occurred with the same kinetics for each of the mineral waters tested, and within 2 h of the oral dose, equilibrium was reached between absorbed calcium and calcium remaining in the gastrointestinal tract, which resulted in a constant FCA value. This level comprising between 34.1 and 37.0% was independent of the daily calcium consumption and the chemical content of the mineral water. In conclusion, calcium contained in mineral waters in available for intestinal absorption. In a given normal subject, the only rate-limiting factor for FCA is the amount of total calcium given with foods and drinks. Mineral waters containing calcium are recommended as a supplemental source of calcium to achieve optimal calcium requirements, especially in aged people with lactose intolerance.
Article
Data from the 1994 USDA nationwide survey (CSFII) on 190 non-smoking males (aged 20-29) were used to propose a method for adjusting total water intake for the diuretic effects of caffeine and alcohol, and evaluate the potential for related misclassification bias. The data were processed on a per meal basis. Under the assumption that subjects were in water balance at the start of the survey day, water losses due to caffeine (1.17 ml/mg caffeine) and alcohol (10 ml/g alcohol) were subtracted from crude intake estimates. If water intake for one meal was inadequate for excretion of the associated osmotic load at 750 mosmol/l, water losses for the subsequent meal were reduced by 32%. Unadjusted and adjusted mean total water intakes differed by 321.5 g. Misclassification appeared worst at higher water intakes. Linear regression models, each with a water intake variable as an independent variable and body mass index as the outcome, were fit to evaluate the potential for alcohol- and caffeine-related misclassification bias. Misclassification resulted in large changes (all >10%) in linear regression estimates of effect. Future studies of water-disease relationships, especially those intending to compare extremes of total water intake, should consider caffeine- and alcohol-related misclassification bias.
Article
The age-adjusted mortality rates of colorectal cancer have been rising in Taiwan over the past 2 decades, and colorectal cancer is now the third leading cause of cancer mortality in the country. We conducted a hospital-based case-control study to clarify the nature of the association between physical activity, water intake and colorectal-cancer risk in Taiwan. A total of 163 subjects (aged 33-80 years) with histologically confirmed primary colorectal cancer and 163 hospital controls were enrolled during 1992. Dietary intake, physical activity and other lifestyle activities were assessed using a comprehensive food-frequency and lifestyle-activity questionnaire. Adjusted odds ratios (OR) and 95% confidence intervals (CI) were estimated using conditional logistic-regression analysis. A strong inverse dose-response relation between increased water intake and rectal cancer was found among men after adjustment for other risk factors (p for trend = 0.0005). The OR for rectal cancer among men in the highest tertile of water intake was 0.08 (95% CI, 0.02-0.35) compared with that among men in the lowest tertile (OR = 1). Similar but not significant trends were seen among women (p = 0.29). The OR for colon cancer among men with active leisure-time physical activity was 0.19 (95% CI, 0.05-0.77) times that among sedentary men (p for trend = 0.03). However, physical activity was not associated with colon-cancer risk among women (p = 0.48). No differences in the amount of water intake were found related to level of physical activity. These findings add to the evidence that leisure-time activity may reduce colon-cancer risk, not only in high-risk but also in low-risk populations, and support the potential beneficial effect of increased water intake in reducing colorectal-cancer risk.
Article
Total body water (TBW) volume is reported to decrease with age, but much of the published data are 20 to almost 50 years old and are cross-sectional. Proper interpretation of clinical levels of TBW and trends with age necessitates the availability of current longitudinal data from healthy individuals. Mixed longitudinal data for TBW of 274 white men and 292 white women (18 to 64 years of age) in the Fels Longitudinal Study were collected on a regular schedule over a recent eight-year period. The concentration of deuterium was measured by deuterium nuclear magnetic resonance spectroscopy. Body composition estimates were made with dual-energy x-ray absorptiometry, and random effect models were used to determine the patterns of change over time with and without covariates. The mean TBW data for the Fels men are either similar to or approximately 2 to as much as 6 liters greater than that reported by most other investigators 20 to 50 years ago. For Fels women, the mean TBW ranges from approximately 2 to as much as 5 liters less than that reported previously. These comparisons with much earlier studies reflect cohort effects and the secular changes in overall body size that have occurred during the past 60 to 70 years. These findings are reinforced by the fact that some early data sets included individuals born almost 140 years ago. After adjusting for the covariate effects of total body fat (TBF) and fat-free mass (FFM) with age, there were no significant age or age-squared effects on TBW in the men. In the women, after adjusting for the covariate associations of TBF and FFM with age, there was a small, but significant, negative linear association of TBW with age. In the men and women, the mean ratio of TBW to weight declined with age as a function of an increase in body fatness and more so for the men than the women. The findings from these mixed longitudinal data indicate that TBW volume, on average, maintains a reasonable degree of stability in men and women through a large portion of adulthood. These TBW data are recommended as current reference data for healthy adults.
Article
To examine the effect of various combinations of beverages on hydration status in healthy free-living adult males. In a counterbalanced, crossover manner, 18 healthy adult males ages 24 to 39, on four separate occasions, consumed water or water plus varying combinations of beverages. Clinical guidelines were used to determine the fluid allowance for each subject. The beverages were carbonated, caffeinated caloric and non-caloric colas and coffee. Ten of the 18 subjects consumed water and carbonated, non-caffeinated, citrus soft drink during a fifth trial. Body weight, urine and blood assays were measured before and after each treatment. Slight body weight loss was observed on all treatments, with an average of 0.30% for all treatments. No differences (p>0.05) among treatments were found for body weight changes or any of the biochemical assays. Biochemical assays conducted on first voids and 24-hour urines included electrolytes, creatine, osmolality and specific gravity. Blood samples were analyzed for hemoglobin, hematocrit. electrolytes, osmolality, urea nitrogen, creatinine and protein. This preliminary study found no significant differences in the effect of various combinations of beverages on hydration status of healthy adult males. Advising people to disregard caffeinated beverages as part of the daily fluid intake is not substantiated by the results of this study. The across-treatment weight loss observed, when combined with data on fluid-disease relationships, suggests that optimal fluid intake may be higher than common recommendations. Further research is needed to confirm these results and to explore optimal fluid intake for healthy individuals.
Article
Moisturizers have been adapted to perform many important roles on the skin surface. Simple moisturizers combine occlusives and humectants to enhance the water-holding capacity of the skin. The addition of carefully selected emollients can influence the esthetic properties of the moisturizer and the stability of the active ingredients. The addition of sunscreens to moisturizers has created a new product category with an added skin function. Further diversity in moisturizer formulation is created through the addition of specialty ingredients, designed to enhance the functioning of the skin. Moisturizers are an important part of the dermatologist's armamentarium.
Article
Although it is known that the skin acts as a water reservoir and participates in the fluid content of the whole body, no method has been established to quantify the fluid shifts in superficial tissue. The aim of this study was to investigate changes in dermal and subcutis thickness and echodensity at the forehead and lower leg by high-frequency (20 MHz) ultrasound under various physiological conditions influencing water balance. These parameters were measured in the skin of 20 healthy male volunteers at baseline and successively at 30 min after lying down, in a head-down position, after physical activity and after infusion of 10 mL kg-1 body weight of Ringer's solution. Dermal thickness at the forehead showed a significant increase from baseline to a horizontal position and a further increase in the head-down position. Physical activity did not lead to further changes, whereas after fluid infusion the dermal thickness also increased markedly. The echodensity showed inverse changes, with decreasing values. The thickness of the subcutis increased slightly from baseline to a lying position and decreased in the head-down position and after fluid infusion. At the lower leg, skin thickness decreased slightly in the head-down position with elevated legs, and increased after fluid infusion. Our results show that slight changes in the water distribution of the body influence the thickness and the echodensity of the dermis. Changes are more pronounced at the forehead than on the lower legs. Further, the fluid storage takes place mainly in the dermis and not in the subcutis. High-frequency ultrasound is able to quantify these effects and is a sensitive method for measuring fluid intake and balance during anaesthesia and therapy.
Article
To determine if measuring skin tissue thickness by a recently developed 10 MHz ultrasound scan may be used as a valuable parameter to guide fluid therapy and detect fluid shifts to the extravascular space during surgical procedures in addition to central venous pressure (CVP). Prospective, clinical and observational study. An operation theatre of the Ear Nose Throat (ENT) department of an university hospital. Following approval by the local ethics committee 12 otherwise healthy male patients undergoing ENT surgery for oropharyngeal carcinoma were involved in this study. The patients stayed nil per os for 10 h before induction of anaesthesia. INTERVENTIONS/MEASUREMENTS: Crystalline fluids (Ringer's solution) were supplied at a constant rate of 10 ml kg-1 bw h-1. Patients were kept in the supine position during surgery, no further interventions were performed. Additional to routine monitoring, tissue thickness (TT) of proximal pre-tibial skin and CVP were measured every 30 min, haematocrit was determined hourly for 5 h starting at t0. Haematocrit constantly declined during the observation period, showing a significant difference in t0 after 120 min. The increase in TT was strongly correlated with intraoperative positive fluid balance (r=0.96), while the course of CVP did not reflect the amount of fluid application comparably. Non-invasive determinations of skin tissue thickness by the presented ultrasonic device appears to give additional information on fluid intake and distribution during clinical anaesthesia.
Article
Despite the seemingly ubiquitous admonition to "drink at least eight 8-oz glasses of water a day" (with an accompanying reminder that beverages containing caffeine and alcohol do not count), rigorous proof for this counsel appears to be lacking. This review sought to find the origin of this advice (called "8 x 8" for short) and to examine the scientific evidence, if any, that might support it. The search included not only electronic modes but also a cursory examination of the older literature that is not covered in electronic databases and, most importantly and fruitfully, extensive consultation with several nutritionists who specialize in the field of thirst and drinking fluids. No scientific studies were found in support of 8 x 8. Rather, surveys of food and fluid intake on thousands of adults of both genders, analyses of which have been published in peer-reviewed journals, strongly suggest that such large amounts are not needed because the surveyed persons were presumably healthy and certainly not overtly ill. This conclusion is supported by published studies showing that caffeinated drinks (and, to a lesser extent, mild alcoholic beverages like beer in moderation) may indeed be counted toward the daily total, as well as by the large body of published experiments that attest to the precision and effectiveness of the osmoregulatory system for maintaining water balance. It is to be emphasized that the conclusion is limited to healthy adults in a temperate climate leading a largely sedentary existence, precisely the population and conditions that the "at least" in 8 x 8 refers to. Equally to be emphasized, lest the message of this review be misconstrued, is the fact (based on published evidence) that 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. Since it is difficult or impossible to prove a negative-in this instance, the absence of scientific literature supporting the 8 x 8 recommendation-the author invites communications from readers who are aware of pertinent publications.
Article
This study focused on the water distribution in human stratum corneum and on the swelling of the corneocytes. For this purpose stratum corneum was hydrated to various levels and used either for Fourier transform infrared spectroscopy or for cryo-scanning electron microscopy. The images were analyzed with respect to water localization and cell shape. The Fourier transform infrared spectra were measured to study the water-lipid interactions. The results show that water only slightly changes the lipid transitions in the stratum corneum even at a hydration level of 300% wt/wt compared to stratum corneum and that water is inhomogeneously distributed in the stratum corneum. No gradual increase in water level was observed in depth. At 57%-87% wt/wt water content the hydration level in the central part of stratum corneum is higher than in the superficial and deeper cell layers. Water domains are mainly present within the corneocytes and not in the intercellular regions. At a very high hydration level (300% wt/wt), the corneocytes are strongly swollen except for the deepest cell layers adjacent to the viable epidermis. The corneocytes in these layers are not swollen. At 300% wt/wt hydration level water domains are also present in intercellular regions. Between 17% wt/wt and 300% wt/wt the cell thickness increases linearly with the hydration level suggesting that swelling of cells mainly occurs in the direction perpendicular to the skin surface. At an increased hydration level, the corneocyte envelope more efficiently surrounds the cell content compensating for the increased cell volume. The changes in stratum corneum morphology with increasing water level have also been observed in dermatomed skin.
Article
To examine the relation of the total intake of fluids and the types of beverages to the risk of bladder cancer, we conducted a hospital based case-control study with 130 newly diagnosed bladder cancer patients and the same number of matched controls. Information of total fluid intake was derived from the reported frequency of consumption of the different types of beverages on the food frequency questionnaire. Univariate and multivariate logistic regression analyses were performed in statistical analysis. There was no statistically significant difference between the cases and the controls in total daily fluid intake. Multivariate logistic regression model showed consumption of: soda (OR=8.32; 95%CI=3.18-21.76), coffee (OR=1.46; 95%CI=1.05-2.01) and spirits (OR=1.15; 95%CI=1.04-1.28) as statistically significant risk factors, while mineral water (OR=0.52; 95%CI=0.34-0.79), skim milk (OR=0.38; 95%CI=0.16-0.91), yogurt (OR=0.34; 95%CI=0.12-0.97) and frequency of daily urination (OR=0.27; 95%CI=0.18-0.41) were statistically significant protective variables. In our study no statistically significant association was observed for total fluid intake. The findings suggest consumption of soda, coffee and spirits were indicated as a risk factors for bladder cancer, while mineral water, skim milk, yogurt and frequency of urination as protective factors for bladder cancer.
Article
High fluid intake has been associated with a decreased risk of bladder cancer development in men. We evaluated whether higher fluid intake can impact tumor recurrence rates in patients with superficial bladder cancer. We conducted a prospective single institution analysis of fluid intake in 267 consecutive patients with superficial bladder cancer undergoing routine bladder cancer surveillance between January 1998 and December 2001. Fluid intake questionnaires, urine cytology and physical examination were routinely performed at each surveillance cystoscopy. Cytological and histological recurrences were recorded. All patients had a minimum followup of 2 years. No relationship between fluid intake and tumor recurrence was demonstrated. Average daily fluid intake was 2,654 ml daily, which was well within the highest protective level (more than 2,531 ml) previously reported. However, multivariate analysis failed to show a protective effect against recurrence at any level of fluid intake. Increasing age correlated with decreased fluid intake (Pearson's correlation coefficient -0.19, p = 0.0015), but did not increase the risk of recurrence (p = 0.59). Single fluid intake data correlated with the average of additional fluid intakes (median 5 per patient) in the same patient (Pearson's correlation coefficient, 0.45, p < 0.0001). Of the study population 123 patients (46%) experienced 1 or more tumor recurrences (range 0 to 11) within a median followup of 2.6 years. Our prospective study of fluid intake in patients with superficial bladder cancer at risk for recurrence did not find any association between daily fluid intake levels and tumor recurrence.
Article
Despite recent interest in water intake, few data are available on water metabolism in adults. To determine the average and range of usual water intake, urine output, and total body water, we administered 2H oxide to 458 noninstitutionalized 40- to 79-yr-old adults living in temperate climates. Urine was collected in a subset of individuals (n = 280) to measure 24-h urine production using p-aminobenzoic acid to ensure complete collection. Preformed water intake was calculated from isotopic turnover and corrected for metabolic water and insensible water absorption from humidity. Preformed water intake, which is water from beverages and food moisture, averaged 3.0 l/day in men (range: 1.4-7.7 l/day) and 2.5 l/day in women (range: 1.2-4.6 l/day). Preformed water intake was lower in 70- to 79 (2.8 l/day)- than in 40- to 49-yr-old men and was lower in 70- to 79 (2.3 l/day)- than in 40- to 49- and 50- to 59-yr-old women. Urine production averaged 2.2 l/day in men (range: 0.6-4.9 l/day) and 2.2 l/day in women (0.9-6.0 l/day). There were no age-related differences in results in women, but 60- to 69-yr-old men had significantly higher urine output than 40- to 49- and 50- to 59-yr-old men. Only the 70- to 79-yr-old group included sufficient blacks for a racial analysis. Blacks in this age group showed significantly lower preformed water intake than did whites. Whites had significantly higher water turnover rates than blacks as well. Multivariate regression indicated that age, weight, height, and body mass index explained <12% of the gender-specific variance in water input or urine output, yet repeat measures indicated that within-individual coefficient of variation was 8% for preformed water intake (n = 22) and 9% for 24-h urine production (n = 222). These results demonstrate that water turnover is highly variable among individuals and that little of the variance is explained by anthropometric parameters.
Article
Over the past decade, great progress has been made toward elucidating the structure and function of the stratum corneum (SC), the outermost layer of the epidermis. SC cells (corneocytes) protect against desiccation and environmental challenge by regulating water flux and retention. Maintenance of an optimal level of hydration by the SC is largely dependent on several factors. First, intercellular lamellar lipids, organized predominantly in an orthorhombic gel phase, provide an effective barrier to the passage of water through the tissue. Secondly, the diffusion path length also retards water loss, since water must traverse the tortuous path created by the SC layers and corneocyte envelopes. Thirdly, and equally important, is natural moisturizing factor (NMF), a complex mixture of low-molecular-weight, water-soluble compounds first formed within the corneocytes by degradation of the histidine-rich protein known as filaggrin. Each maturation step leading to the formation of an effective moisture barrier--including corneocyte strengthening, lipid processing, and NMF generation--is influenced by the level of SC hydration. These processes, as well as the final step of corneodesmolysis that mediates exfoliation, are often disturbed upon environmental challenge, resulting in dry, flaky skin conditions. The present paper reviews our current understanding of the biology of the SC, particularly its homeostatic mechanisms of hydration.
Article
Our understanding of the formation, structure, composition, and maturation of the stratum corneum (SC) has progressed enormously over the past 30 years. Today, there is a growing realization that this structure, while faithfully providing a truly magnificent barrier to water loss, is a unique, intricate biosensor that responds to environmental challenges and surface trauma by initiating a series of biologic processes which rapidly seek to repair the damage and restore barrier homeostasis. The detailed ultrastructural, biochemical, and molecular dissection of the classic "bricks and mortar" model of the SC has provided insights into the basis of dry, scaly skin disorders that range from the cosmetic problems of winter xerosis to severe conditions such as psoriasis. With this knowledge comes the promise of increasingly functional topical therapies.
Article
The Journal of Investigative Dermatology publishes basic and clinical research in cutaneous biology and skin disease.
Article
There is increasing evidence that mild dehydration plays a role in the development of various morbidities. In this review, the effects of hydration status on chronic diseases are categorized according to the strength of the evidence. Positive effects of maintenance of good hydration are shown for urolithiasis (category lb evidence); constipation, exercise asthma, hypertonic dehydration in the infant, and hyperglycemia in diabetic ketoacidosis (all category IIb evidence); urinary tract infections, hypertension, fatal coronary heart disease, venous thromboembolism, and cerebral infarct (all category III evidence); and bronchopulmonary disorders (category IV evidence). For bladder and colon cancer, the evidence is inconsistent.
Correspondence re: 137 Effect of fluid intake on skin physiology S. Williams et al. Relationship of food groups and water intake to colon cancer risk
  • J D Stookey
  • P E Belderson
  • J M Russell
  • M J Barker
  • Shannon
Stookey, J.D., Belderson, P.E., Russell, J.M. and Barker, M. Correspondence re: J. Shannon et al. ª 2007 International Journal of Cosmetic Science, 29, 131–138 137 Effect of fluid intake on skin physiology S. Williams et al. Relationship of food groups and water intake to colon cancer risk. Cancer Epidemiol. Biomarkers Prev. 6, 657–658 (1997).
In: Dietary Reference Intakes for Water, Potassium, Sodium, Chloride and Sul-fate. Chap 4
  • Nutrition Food
  • Board
Food and Nutrition Board. In: Dietary Reference Intakes for Water, Potassium, Sodium, Chloride and Sul-fate. Chap 4. pp. 73–185.
Untersuchungen zur ernä-chen Bedeutung von Trinkwasser in Deutschland
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