From the desk of Robb Wolf
When it comes to dehydration, seniors are at greater risk than others. Did you know, for instance, that older adults are more likely to have a broken thirst mechanism? They’re also more prone to mobility issues and medications that can impede hydration. And those are just the tangible factors. Misperceptions around what constitutes healthy hydration also play a role.
This has been quantified, believe it or not. In a community of 170 senior citizens, most folks reported drinking over six glasses of water per day, but very few understood the dangers of overhydration. They also overestimated the amount of fluid needed to prevent moderate-to-severe dehydration.
I’m not trying to pick on older folks. Heck, in many circles I already am “old!” Hydration misperceptions are societally based, not age-related. Popular wisdom relentlessly urges us to “drink more water!” Nevermind what our thirst dictates. Yet since seniors are more vulnerable physically, nailing hydration is all the more important for their quality of life and longevity.
Fortunately, it isn’t super complicated. Drinking an appropriate amount of electrolyte water can go a long way. And though most store-bought options are too high in sugar and too low in sodium, making your own electrolyte drinks at home is easier than you think. You can do it yourself with the salt shaker, or get a healthy electrolyte drink mix like LMNT.
But I’m getting ahead of myself. We’ll get to hydration tactics soon, but first, let’s talk about dehydration, overhydration, and a common roadblock: the undeserved fear of salt.
Dehydration (net water loss from the body) is rare in healthy US Americans. Why? Because most of us have easy access to fluids and a fully functional thirst mechanism.
Older folks may have fluids nearby, but they may have trouble with their hypothalamic thirst receptors, so they don’t get thirsty when they should. Add this to the fact that seniors are more likely to take dehydrating medicines (like diuretics)—and that urinary and fecal incontinence are widespread—and I’m not surprised that between 17 and 28% of seniors folks suffer from dehydration.
The symptoms of dehydration include dark urine, dry skin, thirst, nausea, headaches, muscle cramps, and many more. See this article for a deep dive on dehydration in the seniors. Some of these symptoms (like dark urine) are relatively specific to dehydration, while others (like muscle cramps and headaches) can also stem from overhydration. I’ll elaborate in the next section.
Because dehydration is more common in seniors, we make special efforts to get them enough H2O. (As you’ll recall, the average senior in one community drinks over six glasses per day.) Unfortunately, drinking too much plain water can also be a bad thing.
To prevent dehydration, many people overhydrate with plain water. They drink beyond thirst, shooting for eight or more glasses per day. The problem? Drinking in great excess can dilute blood sodium levels. Take that too far, ignore the need to replenish sodium, and hyponatremia can develop.
Elite endurance athletes are “exhibit A” for hyponatremia borne of overhydration (combined with exercise, in their case). When runners take in too much water, they often stumble across the finish line in a confused, light-sensitive, low-sodium daze. In severe cases, hyponatremia can be fatal.
The symptoms of sodium deficiency—less severe than an imbalance like hyponatremia—are often more subtle. Fatigue, headaches, muscle cramps, and low energy are a few examples. Unfortunately, many assume dehydration is the cause, chug more water, and exacerbate the problem.
Remember, the data suggests that very few seniors understand the signs, symptoms, and significance of overhydration. It’s not common knowledge. And overhydration isn’t the only cause of low blood sodium levels. Other hyponatremia causes include:
The overarching risk factor for these conditions? Age. So yes, older folks especially should dedicate special attention to no only adequate water intake, but also their sodium status.
One roadblock? The war on salt has been going on for decades. In 1980, the American government published the first guidelines warning the public to avoid the salt shaker. Since then, it’s tightened up the messaging, urging us to limit sodium intake to 2.3 grams per day.
The case against salt is largely based on animal research from the 1960s. It turns out that injecting generation after generation of rat with unnaturally high doses of sodium leads to a development of salt sensitivity and hypertension at the genetic level. Who would’ve guessed?
The human data tells a different story. For instance, the 1988 Intersalt Study found no correlation between sodium intake and the prevalence of high blood pressure in over 10,000 people across the globe. And other data from the Framingham Offspring Study shows that sodium restriction in line with government recommendations is linked to higher blood pressure on average. Those are just for starters.
Here’s the thing. When you restrict sodium, you deprive your body of an essential mineral. Sodium regulates fluid balance, conducts nerve impulses, and more. Consequently, sodium deficiency is linked to muscular, neurological, and bone density issues.
Sodium is a critical nutrient, yet older adults may need help overcoming their fear of salt. It contradicts what many have believed for decades now. Do what you can to get them on board. Share this article and quality research that vindicates sodium.
There are three main problems with store-bought electrolyte drinks:
To my eye, sugar is the worst problem. Sugar-sweetened beverages (like sports drinks) comprise the main chunk of America’s sugar intake. These empty calories contribute to obesity, metabolic syndrome, and just about every chronic disease in the book. Besides that, it’s safe to assume that a product which turns your tongue red, blue, or purple with artificial colors probably wasn’t formulated with your best interest in mind. They’d prefer to create a fun, marketable beverage over a healthy one.
What about store-bought electrolyte water? These products are clear, pure, and don’t contain sugar, and that’s great. The issue is that they also don’t contain many electrolytes. Just a mere fairy dusting. Not enough to move the needle on sodium, potassium, or magnesium.
A healthful electrolyte drink should have zero sugar, zero artificial junk, and adequate amounts of the right electrolytes. Sodium is the priority. It’s the primary electrolyte lost through sweat and the primary electrolyte affected by overhydration. But it also makes sense to include potassium and magnesium. Most people are deficient in these minerals, and addressing these deficiencies can help with blood pressure, energy production, bone health, and more.
What about phosphorus and calcium? Get these minerals through your diet. Most people consume enough (if not too much) phosphorus, and I’m seeing more research suggesting that calcium supplements increase the risk of heart disease.
So again, a healthful electrolyte drink shouldn’t contain sugar or other junk; just science-backed ratios of sodium, potassium, and magnesium.
If you or your folks have spare time, you could make your own at home. Just add a bit of stevia or lemon for taste. But if you’re looking to make healthy hydration a convenient habit, try LMNT. The stick packs are super easy to carry on your person. Just pour into water and stir!
In summary: seniors must devote extra care to getting enough water. To prevent the sodium deficiency or imbalance that comes with overhydration, this should be electrolyte water. Simple as that!
Stay healthy and Stay Salty.