Drink When Thirsty, But Hold the Salt

An obsession with "hydration" may have spawned an entire industry of little water bottles, water bottle holders and regular drink breaks at gyms, but most people get plenty of fluids, the Institute of Medicine panel said.

But nearly all U.S. and Canadian adults get far more salt than recommended, and too little potassium, the panel of experts said.

The Institute, an independent body that advises the federal government on health matters, set general recommendations for water intake based on dozens of studies that show women need about 91 ounces (2.7 liters) on average of water a day and men need 125 ounces (3.7 liters).

Food, coffee and even beer or other drinks all contribute, so it is impossible to say how many glasses of plain water someone should drink, the panel said.

Only those who are very physically active or who live in hot climates may need to drink more water, the researchers said.

"While drinking water is a frequent choice for hydration, people also get water from juice, milk, coffee, tea, soda, fruits, vegetables, and other foods and beverages as well," Dr. Lawrence Appel, a professor of medicine at Johns Hopkins University in Baltimore and chairman of the panel, said in a statement.

"Moreover, we concluded that on a daily basis, people get adequate amounts of water from normal drinking behavior -- consumption of beverages at meals and in other social situations -- and by letting their thirst guide them."

But the panel said most North Americans eat far too much salt, much of it in processed foods.

Healthy 19- to 50-year-old adults should consume 3.8 grams of salt a day. Any more can, in some people, lead to high blood pressure, which in turn causes stroke, heart and kidney disease.

The panel of advisers, which included experts on nutrition, pediatrics, geriatrics and other areas, said the most salt anyone should eat a day is 5.8 grams .

Almost everyone gets more than this -- U.S. men's median intake of salt is between 7.8 and 11.8 grams per day, and women take in between 5.8 and 7.8 grams every day, the panel found.

Canadian adults consume between 5.1 and 9.7 grams a day.

"Older individuals, African Americans, and people with chronic diseases including hypertension, diabetes, and kidney disease are especially sensitive to the blood pressure-raising effects of salt and should consume less than the upper limit," the panel said in a statement.

It said more than 95 percent of American and 75 percent of American women get more than this.

And Americans get far too little potassium every day -- adding to their risk of high blood pressure and bone loss, the panel found.

It said adults should consume 4.7 grams of potassium per day but most American women 31 to 50 years old consume no more than half this. Canadians typically get more potassium, which is found in fresh fruits and vegetables.

The typical Western diet is high in salt and low in potassium -- just the opposite of scientific studies have shown is needed for good health, the panel said.

"Research is needed to find ways to help people select better food choices to reduce their salt intake and boost their potassium consumption," Appel said.

The panel recommended that researchers help food processors develop better ways of making food that is low in salt.

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