Host: Hello, and welcome to Well Wisconsin Radio, a podcast. Discussing health and wellbeing topics with experts from all around the state of Wisconsin. I’m your host, Renee Fox, and my guest today is Becky Kerkenbush, a registered dietician with over 20 years of experience in the acute care setting. Becky is a clinical dietician at Watertown Regional Medical Center in Watertown, Wisconsin, and she served as president of the Wisconsin Academy of Nutrition and Dietetics from 2021 through 2020. She’s passionate about prevention, diagnosis, and treatment of malnutrition, as well as nutrition support, chronic disease management, and gerontological nutrition. Becwky, thank you for joining us today.
Guest: Thank you for having me.
Host: Right now we’re running a well Wisconsin Challenge called Rethink Your Drink where participants are challenged to cut back on sugar sweetened beverage and drink water to stay hydrated. As you know, February is also American Heart Month, a time to focus on cardiovascular health. And so with both of these in mind, I would love to focus our conversation today on hydration and heart health. Let’s get started with hydration. Can you talk about the role water plays in our bodies and why it’s important to stay hydrated?
Guest: Certainly. So 50 to 70% of the human adult body is water. So every cell tissue and organ in our body needs water to work properly and water plays several key functions in our body. So just to give a couple examples, water helps regulate body temperature, it moistens tissues in the eyes, nose, and it helps create saliva, which is important for digestion of the food that we eat. It protects body, organs and tissues. It carries nutrients and oxygen to cells. It lessens the burdens on the kidneys and liver by flushing out waste products, and it dissolves minerals and nutrients to make them more accessible to our body.
Host: So how much water should we aim to drink on a daily basis, and what are some signs that we can check for to see if we should be drinking more?
Guest: So on average, we lose eight to 12 cups of water through breathing, perspiring, urine, and bowel movements. People get about 20% of their daily water intake from food. The rest is dependent on drinking water and water-based beverage. The National Academy of Medicine suggests an adequate intake of daily fluids of about 13 cups for healthy men, and about nine cups for healthy women respectively, and that’s one cup equaling eight ounces. It’s important to note that this amount is not a daily target, it’s just a general guide. The average person drinking less will not necessarily compromise their health. Each person’s fluid needs do vary day-to-day. Some factors that might increase fluid needs include exercise, hot weather, high altitude, a higher fiber or higher protein diet, and increase losses from alcohol intake.
Host: Great examples. Can you talk more about during the life cycle or different circumstances that we might be under where our needs for consuming water might change?
Guest: Right. So daily water intake recommendations really vary by age, sex, pregnancy status, breastfeeding status. For example, pregnant or breastfeeding women may need more fluids to stay hydrated. Individuals that are on a high protein or high fiber diet might also need more water. And then there are certain medical conditions such as someone with severe burns or wounds, infections, or those that are at risk for kidney stones, um, and maybe an illness that’s causing nausea or diarrhea or fever. They would need increased fluid intake. It’s always important though to discuss with your health care provider how much fluid you should take in because some people need to monitor or keep an eye on just how much so that they don’t over drink.
Host: Are there times during increased physical activity that we should increase our water consumption? And what are your thoughts on drinking sports drinks in place of water?’
Guest: I’m so glad you asked about sports drinks. It’s certainly a very hot topic and very prevalent, especially when it comes to adolescents and what they’re drinking day-to-day. So hydration status affects strength, power and endurance. Those are all areas, um, of exercise. So several areas of our body will fight for fluid during. We have our skin, our muscles in our heart, and dehydration can lead to injuries like heat illness or excessive loss of sodium electrolyte imbalances. So it can make exercise seem much more difficult and it increases the strain it places on our body if we’re dehydrated.
Some factors that affect fluid loss during exercise are if you’re at, um, a very high altitude, if the temperatures are extreme. So exercising in heat increases your fluid losses through sweating, but also exercising in cold can impair your ability to recognize fluid Losses can also increase fluid loss through respiration.
So in both cases it’s important to hydrate. Um, some people sweat more than others. So if you sweat a lot, you’re at a greater risk for dehydration. Um, one recommendation can be to weigh yourself before and after, after exercise to judge your sweat loss. And then exercise duration and intensity matter. So some people that are exercising four hours, like endurance athletes means that they need to drink more and more frequently to avoid dehydration.
The best way to gauge your hydration status is really pay attention to the color of your urine. If it’s pale and clear, that means you’re well hydrated. If it’s dark, you know, you need to drink more fluids. Um, some other signs and symptoms of dehydration could be headache, dry mouth confusion and dizziness, heart palpitations, fatigue, and fainting. So, it’s very important to make sure that you are drinking adequately during exercise. And there are some, several guidelines about that. You might want to drink, you know, a couple cups of fluid, two to three hours before exercise a cup of fluid, 10 to 15 minutes, then before exercising, and then drinking, you know, a cup every 15 to 30 minutes while you’re exercising, just depending on what you can tolerate. Everyone’s threshold for fluid intake during exercise is a little different. And then as we mentioned, weigh yourself before and after, and then replace those fluids. Um, usually 20 to 24 ounces of water for every pound lost, um, is adequate for replacement. When it comes to sports drinks, the idea is that they will help hydrate quickly and help absorb electrolytes quickly.
So they have carbohydrates which are in the form of sugar, such as glucose and high fructose corn syrup. Some of them do have low calorie sweeteners instead. So the specific amount of sugar and electrolytes and sports drinks, again, is attended for quick hydration and absorption. This type of nutrient depletion though generally only occurs with very high intensity exercise that lasts more than an hour.
So think again of your elite athletes, your endurance athletes, not the average person or the average gym goer. For the non-athlete, a sports beverage is really just another sugary drink. Um, estimates show that sports drinks compromise about 26% of total sugar sweetened beverage intake in adolescence. So we really need to get the word out to, teens, tweens, college-aged students that sports drinks are not going to make you an elite athlete.
So they do contain less sugar than soda and energy drinks, but they still contain unnecessary sugar for the average person. So just as a comparison, a, 12 ounce Cola drink contains 39 grams of sugar, which equals 10 teaspoons of sugar. A sports drink contains about 21 grams of sugar or five teaspoons of sugar. So drinking, you know, these every day, drinking a couple servings every day can certainly add up.
Host: Absolutely. And I, I hear a lot of people, you know, just say they don’t like the flavor, the taste of water plain on its own. But a lot of people are, you know, trying to increase their water take, particularly if they’re participating in our challenge. So do you have some recommendations for people who are just trying to drink more water and learn to enjoy the flavor and taste of water?
Guest: Definitely. I hear quite often that people just don’t like the taste of plain water and that is understandable. And there are many ways that you can certainly flavor your water just by thinking about the types of fruits and vegetables, uh, and herb herbs that you like.
So for example, you can add those options to your water without adding calories and sugar. Some combinations like strawberry with lemon and mint. Orange with lime or a cucumber with lemon and celery. I mean, really there’s a world of flavors out there that you can kind of experiment with. You can also look up online and find some flavor combinations that are already true and tested, um, that are very enjoyable too.
Herbal teas can be a good alternative to water, so you can look for kinds that don’t have sugar or sweetener. Um, those that enjoy green and black tea may wish to sip on the decaffeinated versions though, especially if you’re sensitive to caffeine. The data suggests that more than 180 milligrams of caffeine daily, which is about two cups of coffee, may increase urination in the short term in some people, but it might not necessarily lead to dehydration. So we can include some caffeinated beverages in our daily fluid.
Host: Wonderful. I also love the flavored sparkling waters that do not have any sugar added. That’s one of my favorite go-tos.
Guest: I agree. Something about having sparkling water, seltzer water, just that, you know, change of texture. It is helpful in increasing your fluid intake, and you can also just add a splash of a hundred percent fruit juice to your water if you’re looking for something simple and.
Host: That’s a great idea. So you mentioned several benefits that water plays in terms of our health. Can you talk more about the importance of staying hydrated for cardiovascular health?
Guest: So hydration affects our heart rates or blood pressure, respiratory rates, urine output, and your skin trigger just to name a few. So keeping the body hydrated helps the heart more easily pump blood through the blood vessels, which then goes to the muscles. It also helps our muscles work more efficiently. So if we’re well hydrated, your heart doesn’t have to work as hard, and that’s the ultimate goal for everyone.
Host: Wonderful. So in addition to staying hydrated in terms of just looking at heart health, what foods should be we be focusing on and adding to our diet to maintain or achieve a healthy heart?
Guest: So when I think of heart healthy, I think of foods that are lower in salt or sodium and lower in saturated fat and trans fat. The American Heart Association recommends limiting saturated fat to less than 6% of daily calories in minimizing the amount of trans fat we eat. Reducing these fats means limiting our intake of red meats and dairy products made with whole milk. So we can choose skim milk, low fat milk or fat-free dairy products instead.
And it can also mean limiting fried foods and cooking with healthy oils such as vegetable oils. Our heart healthy diet includes foods that are low on sodium, while also incorporated an adequate amount of fiber and fluids. So some examples could be fruits, vegetables, whole grain. Beans, legumes, nuts and seeds, fish and seafood, and poultry. So there’s a wide range of heart healthy foods available to us out there.
Host: Yeah, absolutely. And for people who maybe don’t like some of the things that you said, there’s such a way to still have a well-rounded diet, you know, and really customize and make that your own with the variety of foods you just mentioned.
Guest: Very true. And I tell people, you know, our taste preferences, those are ours. Work around those. You don’t have to do something just because it’s recommended to you. If you don’t like it, don’t do it. You know, we can always find other options.
Host: That’s a great guide. I love that. So what about exercise? What should we be focusing on for cardiovascular health in terms of being active?
Guest: So we just talked a little about nutrition, and exercise or activity is also important for good cardiovascular health. A sedentary lifestyle lowers HDL cholesterol. HDL cholesterol would be our, happy cholesterol or our good cholesterol, so less HDL means that there’s less good cholesterol to remove the bad cholesterol from our arteries.
There are four types of exercise. There’s aerobic, strength, balance and flexibility. Ideally, it’s best to include all forms of exercise, but if we focus more on the aerobic or the cardiovascular exercise, the American Heart Association recommends that adults get about 150 minutes of moderate intensity aerobic exercise per week.
Or we can do 75 minutes per week of vigorous exercise or a combination of those. So that could include walking, briskly, running, or jogging, swimming, dancing, there’s many ways of being active and as you get used to it, you can increase your time and intensity to get more benefits. That might include adding muscle building activities like resistance, resistance training, or weight training at least twice a week.
So physical activity is one of the best ways to keep our body and brain healthy. It can lower blood pressure, boost levels of good cholesterol, improve blood flow, keeps our weight under control and can prevent bone loss, which can lead to osteoporosis.
If you’re looking for accountability and motivation to increase your activity level, sign up for the Well Wisconsin Invitational Team Steps Challenge between March 19th and April 18, 2023. During the competition, teams across Wisconsin will go head-to-head against one another to see who can track the most steps. This fun, five-week challenge runs from April 19th through May 24, 2023. Earn incentive credit for your wellbeing activity when you complete the challenge. Now back to our interview on hydration and heart health.
Host: Are there resources that you would recommend for anyone who’s just, you know, wanting to increase physical activity, eat a healthier diet, learn more about hydration or just heart health in general? There are many great resources out there. For more information, you can look into the Academy of Nutrition and dietetics at www.eatright.org, the American Heart email@example.com and the USDA at www.nutrition.gov.
Host: Wonderful. And we will have all of those links on the show notes. So if you just log into the episode page and click on those show notes, you can directly go to those resources. So can you talk a little bit more about some things that people can find through those websites? Are there recipes or more information on what you talked about? Would love just to hear a little bit more.
Guest: Those websites have wonderful heart healthy recipes. They also have tips, guidelines, or suggestions. They’re just very user-friendly and you can take them and make them their your own. And these are credible evidence-based resources that I’m providing. You have to be careful as to what resources that you’re looking at on the internet, just making sure that they are credible.
Host: Wonderful. Thank you. Any additional, um, thoughts or anything you want to include that we just haven’t touched on yet?
Guest: I always advise people to take one or two nuggets of information and start with those. It can be very overwhelming to look at all of the suggestions and all the areas of improvement in your life. So take something very specific, such as I am going to eat two fruits per day for the next three weeks and really work on making that your goal, making that a behavior change.
And then after those three weeks, you pick another small goal. And really, you know, if you don’t hit your goal every single day, that’s okay. Give yourself some grace. The fact that you are trying to make small, measurable improvements in your daily life is very important and you should be congratulated.
Host: Excellent advice. Thank you so much, Guest. I really appreciate you joining us today.
Guest: Well, thank you for having me.
Host: When it comes to making changes, we all can use some help. A WebMD health coach can be the beneficial guide you need to get the real results you’re looking for. Hear how coaching impacted a fellow Wisconsin participant’s life.
Coaching Participant: Okay. I am a successful person that has gone through this health coach, um, system. Uh, my goal was to lose a little weight and little did I know I lost more than I planned. Uh, they held me accountable in a kind way. So glad I participated. Otherwise, I think I probably would way more than I did when I started. Um, just a wonderful program and it’s so convenient just once a month for a five, 10 minutes, so I lost the weight I wanted to lose. I reached my goal. Um, just want to thank you people for holding me accountable and reaching my goal. Thank you.
Host: WebMD coaches are trained health professionals ready to support you whatever your goal—whether you want to improve hydration or heart health, lose a few pounds, sleep better, get some help managing stress or a chronic condition like diabetes or asthma. Get started today by calling 800-821-6591 or send a confidential message on webmdhealth.com/wellwisconsin.
Thanks for listening today. I hope you enjoyed this episode well, Wisconsin Program participants. To earn credit for listening to this podcast for your wellbeing activity, visit webmdhealth.com/wellwisconsin and complete the steps to self-report this activity. You can find our survey transcripts and previous episodes at webmdhealthservices.com/wellwisconsinradio. If you’re listening to this podcast on your platform of choice, be sure to subscribe so you’ll never miss an episode.