Introduction
Health hazards vary across different activities and weather conditions. There is one, however, that can be present in any setting, regardless of which activity you participate in: dehydration.
The Mayo Clinic defines dehydration as the situation in which “you use or lose more fluid than you take in, and your body doesn’t have enough water and other fluids to carry out its normal functions.”1
While dehydration can occur from clinical causes such as vomiting and diarrhea, perspiration is the most common cause of dehydration in everyday life. People who don’t drink enough fluids to compensate for this loss will become dehydrated.
There are serious consequences regarding dehydration. One 2018 study found that subjects who experienced 2% body weight loss from dehydration suffered from cognitive and motor impairment - from simple motor disturbances to a decreased visual-motor tracking.2 These impairments, even if temporary, could have serious adverse effects on your safety and health.
Dehydration and Blood Pressure3
Dehydration can also lead to a rise in blood pressure due to the fact that our bodies retain more sodium when we do not drink enough water (with proper hydration, excess sodium leaves the body through perspiration). This increase sodium concentration causes the body to shut down some of its capillary beds (the network of blood vessels where nutrients, gases, and waste are exchanged). As a result, the same volume of blood has to be moved through a smaller number of vessels, leading to an increase in the blood pressure.
In turn, elevated blood pressure places us at risk for heart attack, stroke, and other health conditions. Since dehydration is generally chronic, it should be considered and monitored as a health and safety hazard. To avoid the health conditions and risks associated with dehydration, especially hypertension, everyone should ensure that they stay properly hydrated.
Combating Dehydration with Electrolyte Drinks
Electrolyte drinks seem like a great choice for ensuring everyday hydration. Not only do they provide water, but they also supply the body with essential minerals. Electrolyte drinks are often encouraged as a mandatory companion alongside water to combat intense physical activity. In fact, many health professionals now consider electrolyte replenishment products to be a significant part of a complete hydration plan for situations that involve physical exertion or during extreme activities.
Electrolyte drinks consist of water enhanced with minerals (such as sodium chloride and potassium) which are intended to replenish electrolytes lost through perspiration. Sweat contains a combination of these and other electrolytes, but sodium is the primary electrolyte present in a significant amount lost. On average, we can lose up to 1 gram of sodium (the equivalent of approximately 2.5 grams of salt) for every liter of sweat.4
So far, so good. If these drinks are used only to compensate for the sodium that has been lost (assuming there isn’t already an excess of sodium in the body), this should pose absolutely no problem.
Electrolyte Drinks and Hypertension5, 6
Unfortunately, we have to complicate that simple picture. Remember that an excess of sodium in the body can lead to a rise in blood pressure. According to the Million Hearts 2022 Initiative, 48.1% of the US adult population has hypertension,7 a finding that is backed up by MedAlertHelp’s claim (citing WebMD) that 30 to 50% of people who were hospitalized due to COVID-19 have hypertension.8
These numbers seem to suggest that the percentage of hypertensive adults in the US population has increased dramatically. Prior numbers placed the prevalence at about 33%.
Dehydration encourages the body to retain more sodium, which in turn can increase an individual’s blood pressure. It follows that drinking more water will encourage the body to eliminate more of the sodium through perspiration, thus contributing to lowering the blood pressure. For hypertensive individual, drinking an appropriate rotation of water might provide not only some much-needed hydration, but also a decrease in blood pressure.
It should be noted that today there are numerous electrolyte drink formulas on the market. Across different beverages, sodium content can easily vary from about 100 to 1000 mg per serving. Those who opt for drinks with sodium contents on the higher end of the scale can quickly reach and exceed the US Recommended Daily Allowance (RDA) of sodium (2300 mg for healthy adults) – in as little as two servings, depending on the product.
Moreover, the body loses water at a rate of 1 to 2.5 L/hour through perspiration under intense heat. Consuming an equivalent quantity of high-sodium formulations to help compensate for the water loss will result in a level of sodium intake that severely exceeds the recommended daily amount, even for healthy people.
When individuals choose to drink electrolyte beverages in high quantities, they should always be made aware of appropriate options and to choose low sodium formulations - especially if hypertension or other medical preconditions are factors.
It’s also important to note the other electrolytes found in these beverages. While sodium levels matter, the amount of necessary potassium in the drink can be just as important. In fact, the AHA cites several meta-data studies that suggest how potassium and calcium act as a counter to sodium and how they might help lower blood pressure.9 Opting for a formulation with beneficial potassium levels can be advantageous, especially those dealing with hypertension.
Electrolyte Drinks and Diabetes
Many typical electrolyte drinks contain carbohydrates (sugars), which help increase the speed that water is absorbed in the intestines. This makes them more effective at hydrating our bodies than plain water. However, those carbs can contain a substantial number of calories – in fact, a 20 fl. oz bottle can pack as much as 30 grams of sugar and around 120 calories which is close to what you might get from a regular can of non-diet soda.
If you exercise hard for an hour or two and medical conditions aren’t a concern, a formulation like this helps you stay hydrated, and the calories absorbed will be surpassed by the calories you’ve burned. According to the FDA, the daily value for added sugar (in a 2000 calories/day diet) is 50 grams. Consuming a second bottle or serving may put you over your recommended daily value - and this assumption doesn’t factor in your intake from your regular meals.
You can easily need to drink more than 10 L of fluid over the course of a day and given the sugar content of most standard electrolyte drink formulations, it would be contraindicated to compensate for all or most of this water loss with this many carbohydrates.
It should be noted that dehydration can also lead to high blood sugar (since fluid loss increases the concentration of a solution), so the problem exacerbates if you have diabetes, which is statistically likely. According to the CDC, 38.4 million people (11.6% of the US population) have been diagnosed with diabetes (with an estimated 8.7 million additional undiagnosed cases), while another 97.6 million people 18 years or older (38% of the US population) have pre diabetes.10 In these cases, the best alternative is plain water supplemented with a sugar-free, low-sodium electrolyte solution.
Conclusion
When looking for an electrolyte product, it’s extremely important to consider the ingredient and nutritional information that meet your health needs. Hydration solutions are critically important for many activities, but a high sodium product may cause more harm than good when dealing with hypertension.
Likewise, sugar-based formulations may encourage you to stay hydrated by being flavorful and palatable, but for those who are diabetic or pre-diabetic, a beverage with a high concentration of sugar can have negative effects that could be avoided with no-sugar or low-sugar formulations.
Many electrolyte drinks are typically marketed as sports drinks, and there’s a reason for that, since they are designed for the intense physical training that athletes undertake and many times, the shorter timeframe they undergo the activity. Their contents reflect certain needs of those athletes, right down to the high sodium and sugar contents.
People performing intense physical activities should look for hydration solutions formulated specifically for their needs. By opting for drinks that have lower sodium concentrations and lower sugar electrolyte solutions, you can stay hydrated without placing yourself in greater risk because of hypertensive, diabetic, and pre-diabetic conditions.
Sources
- https://www.mayoclinic.org/diseases-conditions/dehydration/symptoms-causes/syc-20354086
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6356561/
- https://www.doctorshealthpress.com/does-drinking-water-lower-blood-pressure/
- https://pubmed.ncbi.nlm.nih.gov/26920240/
- https://www.heart.org/en/health-topics/high-blood-pressure/the-facts-about-high-blood-pressure
- https://healthcareers.co/high-blood-pressure-statistics/
- https://millionhearts.hhs.gov/data-reports/hypertension-prevalence.html
- https://medalerthelp.org/blog/high-blood-pressure-statistics/#people-hospitalized
- https://www.ahajournals.org/doi/full/10.1161/01.cir.98.6.613
- https://www.cdc.gov/diabetes/data/statistics-report/index.html
