« Make healthy hydration the new norm »

13th Annual Hydration for Health Scientific Conference, 2021

We were delighted to have you for our 13th Annual Hydration for Health Conference! This years’ edition handled the following theme: “Water and Hydration Science: Current evidence and future directions”.

Here is a summary of the presentations. You can also watch the replay sessions here.

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1. Hippocrates was right. Now what? Water as a part of healthy aging

Evan Johnson

“Do we age because we drink less, or do we drink less because we age?”

Key findings

  • Ageing is defined as the progressive organism change leading to debility, disease, and death. There are a number of different theories as to how ageing occurs.1
  • Though it has been proven that thirst is impaired due to ageing,4 it has also been shown that in older adults, low water intake is associated with alterations in working memory, blood glucose regulation, incidence of stroke, and falls5-8 as well as a number of processes such as cell signalling and muscle damage.10,11
  • The key ways to improve our hydration and ageing are: increasing research in the field, education regarding recommendations, encouraging physical activity, and enhancing access to clean water.
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2. Vasopressin as a fat hormone: A means for conserving metabolic water

Richard Johnson

Key findings

  • Vasopressin is a key hormone in the regulation of fat and hydration
  • Previous research has shown that dehydration leads to vasopressin stimulation in the brain
  • Prof. Johnson’s work in a mouse model demonstrates that fructose induced obesity is dependent on vasopressin, and suggests that good hydration can limit the impact of fructose-induced obesity
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3. Osmotic thirst and hypovolemic thirst: Recent animal data

Daniel Bichet

Key findings

  • Thirst is a multimodal sensation caused by distinct stimuli
  • There are two unique sets of neurons involved in detection of thirst; neurons activated by osmotic thirst which reside in the SFO, and neurons involved in hypovolemic thirst which reside in the OVLT
  • Our brain senses internal thirst states using a very similar strategy to peripheral sensory systems, such as taste and olfaction
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4. Redefining thirst: Beyond dehydration and towards a holistic biopsychological model

Harriet Carroll

“Old age, marathon runners, ecstasy users - in all cases there is some form of cholinergic disregulation going on."

Key findings

  • The current model of thirst is one-dimensional and unable to explain many thirst-related phenomena, such as why drinking can occur with hypo osmolality or how volume of intake during a drinking occasion is regulated
  • Dr. Carroll’s model aims to unify various lines of thinking from different disciplines by presenting a four-component model comprising of: true thirst (primarily osmo regulated); contextual thirst (e.g., mouth breathing); pharmacological thirst (induced by drugs); and impulsive thirst (everyday spontaneous drinking)
  • This model (based on pharmacological thirst mechanisms) helps to explain everyday drinking patterns, including some anomalies that are thus far unexplained by true thirst, but a lot remains unknown
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5. Fluid intake habits of Spanish children and adolescents: An update of the Liq.In7 survey

Iris Iglesia Altaba

Key findings

  • The poor drinking habits of the young Spanish population are due to low water, and high SSB intake, particularly in male adolescents
  • Interventions to help improve drinking habits are particularly important for children and adolescents, as dietary habits during childhood are carried into adulthood5
  • Encouraging children to drink water instead of SSBs, and to drink water during snack times can help to improve water consumption deficit
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6. Do people have the same fluid intake patterns across the world? Results of Liq.In7 cross functional surveys

Clémentine Morin

Key findings

  • Six clusters of fluid intake were identified across children and adolescents, with water and SSB consumption being the main drivers
  • Country of residence, socio-economic class, screen time, and activity are the main characteristics influencing intake patterns
  • One size fits all solutions will not work. Marked differences between countries demonstrate that targeted, country level intervention is needed to improve drinking habits among children and adolescents
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7. Psychology of hydration habits

Esther Papies

Key findings

  • Creating water drinking habits that support healthy hydration is not simple, and requires careful consideration of daily-life routines, barriers, and a good understanding of the rewards available
  • In this study, the COVID-19 lockdown did not increase the average amount of water consumed, but did drive up the average consumption of sugar-sweetened beverages at home
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8. Associations between water consumption and gut microbiota composition in the American Gut Project Database

Tiphaine Vanhaecke

Key findings

  • It is believed that the water humans drink could have an impact on gut microbiota – due to the different sources and numerous treatment approaches
  • Recent evidence suggests an association between water and gut microbiota composition; however, research is still in its infancy
  • Much more research is needed to fully understand the extent of the impact that water composition has on our gut microbiota, as this could have implications for human health


9. The influence of sub-optimal hydration on the immune response

Dorothée Chabas

“The orchestration of an immune response is very complex and it varies between organs. There is a lot we don’t know about it.”

Key findings

  • The immune system is regulated by a subtle orchestration of the innate and adaptive immune system
  • Multiple studies in vitro and in animal models exist, but results on the relationship between hydration and immune response are still controversial and need to be further explored13-16
  • In vitro studies suggest that hypertonic conditions affect innate and adaptive immunity on many molecular and cellular levels, which tends to be pro-inflammatory, however this is not always the case1-5
  • The effect of hypertonic conditions on the immune response is dependent on many factors such as duration of exposure, and timing in relation to priming of the immune system1,8,11,12
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References

Evan Johnson

  1. Rogers K, et al. “Aging”. Encyclopedia Britannica. 2020.
  2. National Institute on Aging. The intersection of basic aging biology, chronis disease, and health. Geoscience. Date accessed: 06/2021.
  3. Rusinger A, et al. Daily water intake among US men and women 2005-2012. National Health and Nutrition Examination Survey Data Brief. 2016; (242): 1-8.
  4. Kenney WL and Chiu P. Influence of age on thirst and fluid intake. Medicine and Science in Sports and Exercise. 2001; 33(9): 1524-32.
  5. Suhr JA, et al. The relation of hydration status to declarative memory and working memory in older adults. The Journal of Nutrition, Health and Aging. 2010; 14(10): 840-3.
  6. Burge MR, et al. Differential effects of fasting and dehydration in the pathogenesis of diabetic ketocidosis. Metabolism. 2001; 50(2): 171-7.
  7. Leurs LJ, et al. Total fluid and specific beverage intake and mortality due to IHD and stroke in the Netherlands cohort study. British Journal of Nutrition 2010; 104(8): 1212-21. Prof. Evan Johnson PhD 01
  8. Hamrick I, et al. Association between dehydration and falls. Mayo Clinic Proceedings: Innovations, Quality and Outcomes. 2020; 4(3): 259–265.
  9. Vanheacke T, et al. A journey through the early evidence linking hydration to metabolic health. Annals of Nutrition and Metabolism. 2020; 76(suppl 1): 4–9.
  10. Haussinger D. The role of cellular hydration in the regulation of cell function. Biochemical Journal. 1996; 313 (Pt 3): 697-710.
  11. Cleary MA, et al. Dehydration and symptoms of delayed onset muscle soreness in normotherimic men. Journal of Athletic Training. 2006; 41(1): 36–45.

Richard Johnson

  1. Enhorning S, et al. Copeptin, a marker of vasopressin, in abdominal obesity, diabetes and microalbuminuria: the prospective Malmö Diet and Cancer Study cardiovascular cohort. International Journal of Obesity. 2013; 37(4): 598-603.
  2. Enhorning S, et al. Plasma copeptin, a unifying factor behind the metabolic syndrome. The Journal of Clinical Endocrinology and Metabolism. 2011; 96: e1065-1072.
  3. Song Z, et al. Role of fructose and fructokinase in acute dehydration-induced vasopressin gene expression and secretion in mice. Journal of Neurophysiology 2017; 117(2): 646-654.
  4. Kanbay M, et al. The Speed of Ingestion of a Sugary Beverage Has an Effect on the Acute Metabolic Response to Fructose. Nutrients. 2021; 3: 1916. Prof. Richard Johnson MD 02
  5. Lanaspa MA, et al. High salt intake causes leptin resistance and obesity in mice by stimulating endogenous fructose production and metabolism. Proceedings of the National Academy of Sciences of the United States of America. 2018; 115: 3138-3143.
  6. Andres-Hernando A, et al. Vasopressin mediates fructose-induced metabolic syndrome by activating the V1b receptor. Journal of Clinical Investigation Insight. 2021; 6(1): e140848.

Daniel Bichet

  1. Allan-Hermann Pool, et al. The cellular basis of distinct thirst modalities. Nature. 2020; 588(7836): 112-117.
  2. Dhruv Zocchi, et al. The cellular mechanism for water detection in the mammalian taste system. Nature Neuroscience. 2017; 20: 927–933

Harriet Carroll

  1. Torres VE, et al. A Case for Water in the Treatment of Polycystic Kidney Disease. Clinical Journal of the American Society of Nephrology. 2009; 4(6): 1140-50.
  2. Robertson GL, et al. Abnormalities of thirst regulation. Kidney International. 1984; 25(2): 460-9.
  3. Jackson CE. Cholinergic System. Encyclopedia of Clinical Neuropsychology. 2011. Available from: https://doi.org/10.1007/978-0-387- 79948-3_1113. Date accessed: 06/2021

Iris Iglesia Altaba

  1. Johnson EC, et al. Validation Testing Demonstrates Efficacy of a 7-Day Fluid Record to Estimate Daily Water Intake in Adult Men and Women When Compared with Total Body Water Turnover Measurement. The Journal of Nutrition. 2017; 147(10): 2001-2007.
  2. European Food Safety Authority. Scientific Opinion on Dietary Reference Values for water. European Food Safety Authority Journal. 2010; 8(3): 1459.
  3. El-Sharkawy AM, et al. Acute and chronic effects of hydration status on health. Nutrition Reviews.2015; 73 Suppl 2: 97-109.
  4. Perrier T, et al. Hydration for health hypothesis: a narrative review of supporting evidence. European Journal of Nutrition. 2021; 60(3): 1167–1180.
  5. Westenhoefer J, et al. Establishing Dietary Habits during Childhood for Long-Term Weight Control. Annals of Nutrition and Metabolism. 2002; 46(Suppl 1):

Clémentine Morin

  1. Perrier ET, et al. Hydration for health hypothesis: a narrative review of supporting evidence. European Journal of Nutrition. 2020; 60: 1167-1180.
  2. Khan NA, et al. The Relationship between Total Water Intake and Cognitive Control among Prepubertal Children. Annals of Nutrition and Metabolism. 2015; 66(Suppl 3): 38-41.
  3. Gandy J, et al. Fluid intake of Latin American children and adolescents: results of four LIQ. IN7 national cross-sectional surveys. European Journal of Nutrition. 2018; 57(Suppl 3): 53-63.
  4. Zhang N, et al. Fluid intake in urban China: results of the 2016 Liq.In7 national cross-sectional surveys. European Journal of Nutrition. 2018; 57(Suppl 3): 77-88. Ms. Clémentine Morin MSc 06
  5. Laksmi PW, et al. Fluid intake of children, adolescents and adults in Indonesia: results of the 2016 Liq.In7 national crossectional survey. European Journal of Nutrition. 2018; 57(Suppl 3): 89-100.
  6. Morin C, et al. Fluid intake patterns of children and adolescents: results of six Liq.In7 national cross-sectional surveys. European Journal of Nutrition. 2018; 57(Suppl 3): 113-23
  7. Johnson EC, et al. Validation Testing Demonstrates Efficacy of a 7-Day Fluid Record to Estimate Daily Water Intake in Adult Men and Women When Compared with Total Body Water Turnover Measurement. The Journal of Nutrition. 2017; 147(10): 2001-2007.

Esther Papies

  1. Wood W and Runger D. Psychology of Habit. Annual Review of Psychology. 2016; 67: 289-314.
  2. Kruglanski AW and Szumowska E. Habitual Behavior Is Goal-Driven. Perspectives on Psychological Science. 2020; 15: 1256–1271.

Tiphaine Vanhaecke

  1. Dias MF, et al. Changes in mouse gut bacterial community in response to different types of drinking water. Water research. 2018; 132: 79-89.
  2. Jha AR, et al. Gut microbiome transition across a lifestyle gradient in Himalaya. Public Library of Science Biology 2018; 16(11): e2005396-e.
  3. Bowyer RCE, et al. Associations between UK tap water and gut microbiota composition suggest the gut microbiome as a potential mediator of health differences linked to water quality. Science of the Total Environment. 2020; 739: 139697.
  4. Willis JR, et al. Citizen science charts two major “stomatotypes” in the oral microbiome of adolescents and reveals links with habits and drinking water composition. Microbiome. 2018; 6(1): 218.

Dorothée Chabas

  1. Stookey D, et al. Hypotheses about sub-optimal hydration in the weeks before coronavirus disease (COVID-19) as a risk factor for dying from COVID-19. Medical Hypotheses. 2020; 144.
  2. Kølsen-Petersen J. Immune effect of hypertonic saline: fact or fiction? Acta Anaesthesiologica Scandinavia. 2004; 48(6): 667-678.
  3. Ciesla DJ, et al. Hypertonic saline attenuation of polymorphonuclear neutrophil cytotoxicity: timing is everything. The Journal of Trauma and Acute Care Surgery. 2000; 48(3): 388-95.
  4. Pascual JL, et al. Hypertonic saline resuscitation of hemorrhagic shock diminishes neutrophil rolling and adherence to endothelium and reduces in vivo vascular leakage. Annals of Surgery. 2002; 236(5): 634-42.
  5. Mitra S, et al. Hypertonic saline attenuates the cytokine-induced pro-inflammatory signature in primary human lung epithelia. Public Library of Science One. 2017.
  6. Yi B, et al. Effects of dietary salt levels on monocytic cells and immune responses in healthy human subjects: a longitudinal study. Translational Research. 2015; 166(1): 103-10. Dr. Dorothée Chabas PhD 09
  7. Mickleborough TD, et al. Dietary salt, airway inflammation, and diffusion capacity in exerciseinduced asthma. Medicine and Science in Sports and Exercise. 2005; 37(6): 904-14.
  8. Kølsen-Petersen JA, et al. Infusion of hypertonic saline (7.5% NaCl) causes minor immunological changes in normovolaemic women. Acta Anaesthesiologica Scandinavica. 2004; 48(2): 224-33.
  9. Schatz V, et al. Elementary immunology: Na+ as a regulator of immunity. Pediatric Nephology. 2017; 32, 201–210.
  10. Cvetkovic L, et al. The Impact of Hyperosmolality on Activation and Differentiation of B Lymphoid Cells. Front Immunol. 2019; 10-828.
  11. Alberdi M, et al. Context-dependent regulation of Th17-associated genes and IFNγ expression by the transcription factor NFAT5. Immunology and Cell Biology. 2017; 95(1): 56-67.
  12. Wu C, et al. Induction of pathogenic TH17 cells by inducible salt-sensing kinase SGK1. Nature. 2013; 496(7446): 513-7.
  13. Kleinewietfeld M, et al. Sodium chloride drives autoimmune disease by the induction of pathogenic TH17 cells. Nature. 2013; 496(7446): 518-22.
  14. Na SY, et al. High-salt diet suppresses autoimmune demyelination by regulating the blood–brain barrier permeability. Proceedings of the National Academy of Sciences of the United States of America. 2021; 118(12): e2025944118.
  15. Ascherio A, et al. People with MS should consume a low-salt diet – NO. Multiple Sclerosis. 2016; 22(14): 1779-1781.
  16. Farez MF, et al. Sodium intake is associated with increased disease activity in multiple sclerosis. Journal of Neurology, Neurosurgery, and Psychiatry. 2015; 86(1):26-31.