You’ve no doubt heard about the supposed need to drink eight glasses of water a day and seen people toting plastic water bottles everywhere. In reality, you don’t need to spend too much time monitoring your water intake or turning yourself into a camel. For most people, according to the Institute of Medicine, “fluid intake, driven by thirst… allows maintenance of hydration status and total body water at normal levels.”
It is true, however, that you may be more likely to neglect your body’s needs for water and other fluids as you get older. Older people often have a reduced sensation of thirst, so it’s easier to miss the warning signs that you’re becoming dehydrated.
Older individuals also tend to have lower reserves of fluid in their bodies, may eat less regularly, and may drink insufficient water following fluid deprivation to replenish their fluid deficit. Because of this, older people may need to pay more attention to their fluid intake, particularly during hot weather, and may need to drink fluids regularly, even if they are not thirsty.
Fluid Recommendations
The Adequate Intake (AI) of fluid is actually more than the popular notion of eight cups a day. But that’s deceptive, because the AI includes water from all food and beverage sources—not just guzzling from water bottles. For men over age 50, the AI is 3.7 liters (almost 4 quarts) a day, which includes about 13 cups from beverages including water; the rest is typically obtained from food. For women over age 50, the AI is 2.7 liters (a little less than 3 quarts) a day, with about 9 cups coming from water and other beverages.
Despite what you may have heard, the water in caffeinated beverages such as coffee and tea does count toward keeping you hydrated. So does the fluid content of foods, which can contribute significantly to your daily fluid intake.
Hydration Basics
To ensure that you’re obtaining enough fluids, eat regular meals and drink plenty of water. And eat plenty of produce with a high water content—fruits like watermelon, grapes, melon, and oranges, and vegetables like cucumbers, celery, cauliflower, and lettuce.
Avoid sports drinks such as Gatorade unless you’re engaged in extended vigorous activity in hot weather. Other sugar-sweetened beverages, such as sodas, sweetened tea and coffee drinks, and energy drinks aren’t healthy choices.
In addition to drinking plenty of water and other healthy liquids to avoid dehydration, you can reduce your risk of becoming dehydrated by exercising regularly. Fit people of any age sweat more, keeping the body cool, but they also have more diluted sweat, losing fewer electrolytes as they perspire.
Dehydration Danger Signs
Especially as you get older, you may not recognize the warning signs of dehydration until you’re in danger. Signs of dehydration include:
- Decreased urine output
- Dark-yellow or amber-colored urine
- Dry, sticky mouth
- Dry skin that doesn’t spring back when pinched
- Sleepiness
- Headache
- Feeling dizzy or lightheaded
- Rapid heartbeat and/or breathing.
Why Nothing Beats Water![]()
As we’ll see, some plant-based beverages offer nutrients with health benefits, but your best daylong choice for staying hydrated is still plain water. It contains zero calories and has none of the potential downsides of drinking alcohol or sugary beverages. Best of all, water is virtually free—most municipal drinking water in the U.S. is safe, meaning you don’t need to spend money on bottled or filtered water.
Water makes up most of your body, ranging from about 75 percent of body weight in infancy to 55 percent of body weight in older age. Your brain and heart are almost three-quarters water, your muscles and kidneys are almost 80 percent water, and even your bones are about 30 percent water. Every cell in your body needs water to function. Water transports nutrients and oxygen throughout your body and flushes away waste materials.
Your kidneys work more efficiently when your body has plenty of water; if they are deprived of adequate fluids, your kidneys must work harder. Recurrent dehydration can lead to kidney damage.
Your brain needs water to manufacture hormones and neurotransmitters. Research on the effects of dehydration on the brain is inconsistent, however, with short-term fluid deficiencies appearing to have the greatest impact on your mood and alertness.
Other ways in which your body uses water include:
- Serving as a “shock absorber” for your brain and spinal cord
- Lubricating your joints
- Making saliva for food consumption and digestion
- Keeping mucosal membranes moist; these include membranes in your mouth, nose, eyelids, windpipe, lungs, stomach, intestines, and urinary system.
How Water Helps
Fluids including water can help prevent or ease constipation when coupled with increased fiber intake. In your intestines, fiber needs adequate fluid to create bulkier, softer stools and help keep stools moving. If you increase your fiber intake but don’t get enough fluids, the fiber could cause constipation rather than easing it.
If you suffer from osteoarthritis, staying hydrated can help fight the inflammation associated with that disease. The Arthritis Foundation recommends “prehydrating”—drinking water before you exercise, not just after you’ve worked up a sweat—to help people with arthritis engage in physical activity with less discomfort. Increasing fluid intake also may help reduce the recurrence of gout.
On the other hand, ignore the claims of “water cures” touted in popular magazines, websites, and books: You can’t “cure” heart disease, diabetes, cancer, or chronic pain simply by drinking lots of water. In fact, even the evidence linking healthy hydration to reduced risks of chronic diseases or conditions is relatively thin. The exception is strong evidence that links good hydration with a reduced risk of kidney stones and other stones in the urinary system.
Benefits from Tea
Foods aren’t the only way to get important nutrients as you age—certain beverages also can contribute beneficial nutrients while helping keep you hydrated. You can think of these beverages as a form of “liquid plants,” since they are derived from plants and retain many of their sources’ healthy nutrients, especially the phytonutrients. The most convincing evidence linking plant-based beverages to reduced risks of chronic diseases relates to tea and coffee. When you brew a cup of tea or a mug of coffee, you are extracting many of the nutrients from the tea leaves or coffee beans.
“If there’s anything that can confidently be communicated to the public, it’s the strong association of tea drinking with a lower risk of common chronic diseases, particularly heart disease, and the demonstration of that benefit through clinical trials,” says Tufts expert Jeffrey Blumberg, PhD, who chaired an international symposium on tea and human health.
“About one-third of the weight of a tea leaf is flavonoids, which is high, especially when you consider that they are accompanied by virtually no calories,” Dr. Blumberg explains. “There are a lot of related flavonoids in fruit and vegetables, but many people aren’t consuming the amount of flavonoids in their diets as are being found necessary to promote health. Another way to get them is tea. A cup of tea is like adding a serving of fruit or vegetables to your diet.”
It’s possible to get too much of a good thing, especially if you’re sensitive to caffeine. But tea contains about half the caffeine of coffee, and most of tea’s benefits can be derived from decaffeinated teas (though some of the flavonoids are lost in the decaffeination process).
Research on Tea
Studies have found that tea drinking seems to benefit both your heart and brain. One study reported that drinking three cups of tea daily was associated with an 11 percent drop in the risk of heart attacks. Research on green tea has suggested that it might play a role in reducing the risks of stroke and death from cardiovascular disease and improving total and LDL cholesterol levels.
Studies also have linked tea drinking to beneficial effects on blood pressure. For example, men with high blood pressure who drank just one cup of black tea daily lowered their blood pressure,
even when they ate a meal of foods that tend to constrict blood vessels and boost blood pressure.
Don’t overlook herbal teas, which don’t contain caffeine. Hibiscus, a common ingredient in herbal teas, is rich in antioxidants including anthocyanins, flavones, flavonols, and phenolic acids. Research led by Tufts’ Diane L. McKay, PhD, scientific advisor for this Special Health Report, has shown that a few cups a day of herbal tea containing hibiscus can help lower high blood pressure as effectively as some medications do.
Lowering blood pressure might also have brain benefits, but that’s not the only way tea seems to help protect your brain as you age. A phytonutrient in green tea, epigallocatechin-3-gallate, has antioxidant and anti-inflammatory properties that are believed to benefit brain function. Several animal studies have suggested that green tea extracts enhance learning and memory.
Evidence from human studies suggests a link between the nutrients in tea and improved memory, as well as a possible protective effect against Alzheimer’s disease.
Good News on Coffee
If your mother warned that coffee was a health risk that could “stunt your growth,” she’d be surprised to learn that coffee is now recognized as another “plant food” that can benefit your health. The 2015-2020 Dietary Guidelines for Americans mentions coffee specifically: Drinking three to five 8-ounce cups a day (up to about 400 milligrams of caffeine) is associated with minimal health risks and possible benefits, according to the experts.
Recently, two large studies reported that drinking coffee is associated with a modestly (less than 20 percent) reduced risk of dying from various conditions, compared to not drinking coffee.
In both studies, people who reported drinking coffee when they enrolled in the research were less likely than those who didn’t drink coffee to have died during the follow-up period. Greater risk reduction generally was associated with daily intakes of two to three cups or more. The findings held regardless of ethnicity or where people lived and after adjusting for diet, lifestyle, and health status (like smoking and weight). In one study, coffee drinking was associated with a decreased risk of dying from heart disease, cancer, respiratory disease, stroke, diabetes, and kidney disease. In the other study, coffee drinkers had a decreased risk of dying from digestive diseases, including liver disease (men and women) and circulatory diseases, like heart disease and stroke (particularly women).
Coffee vs. Diabetes
Other research has linked increasing coffee consumption with lower risk of developing diabetes. Participants who increased their coffee intake by more than one 8-ounce cup per day over a four-year period were 11 percent less likely to be diagnosed with diabetes during the subsequent four years. On the other hand, people who decreased their coffee consumption by more than a cup per day were at 17 percent greater risk of type 2 diabetes.
Researchers credited phytonutrients in coffee with the apparent benefit—not the caffeine. They noted that effects on glucose metabolism have previously been found in studies of decaffeinated coffee.
Calming A-fib Fears![]()
What about worries that the caffeine in coffee might increase the risk of atrial fibrillation (A-fib, a type of abnormal heart rhythm that can increase the risk of stroke)? Coffee is best known for its stimulating effect that boosts alertness, improves focus, and increases productivity. For some people, however, too much coffee causes “jitters,” and some health experts have voiced concerns that too much stimulation might contribute to A-fib. Researchers who studied this possibility found little reason for worry, however: A meta-analysis concluded that it’s unlikely habitual caffeine intake from coffee and other dietary sources increases A-fib risk. In fact, the analysis found that A-fib risk fell with increasing caffeine intake.
Pros and Cons of Alcohol
The health picture is more complicated for another popular type of beverage—alcohol, such as wine, beer, and spirits. On the plus side, moderate alcohol consumption has been linked to a reduced risk of cardiovascular disease, and the resveratrol compounds in red wine are being studied for a wide range of health effects. Moderate drinking also may reduce osteoporosis risk in postmenopausal women by slowing the rate of bone “remodeling”—the body’s ongoing replacement of old bone with new.
According to a study in Diabetologia, frequent—but not heavy—alcohol consumption might reduce the risk of developing diabetes. The large study followed more than 70,000 Danish men and women for almost five years. Compared to non-drinkers, women who consumed nine alcoholic beverages a week had a 58 percent lower diabetes risk, and men who consumed 14 drinks a week had a 43 percent lower risk than teetotalers. The findings aren’t a license to overdo alcohol, however: Researchers reported a U-shaped curve in associations between drinking and diabetes risk, with the lowest risk in the middle (moderate, frequent consumption) and higher risk both for non-drinkers and heavy drinkers. Men and women who drank alcohol three to four days a week were at lowest risk.
When making decisions about alcohol consumption, don’t overlook the array of harmful effects that may result from alcohol abuse and dependence. The 2015-2020 Dietary Guidelines for Americans advises women who choose to drink alcoholic beverages to limit intake to one glass a day and men to limit their intake to two drinks. Excessive alcohol consumption has health consequences including liver damage and increased cancer risk, as well as social, psychological, and legal risks.
Alcohol and Aging
Even if you could “hold your liquor” when you were younger, your body’s ability to metabolize alcohol declines with age; this is especially true with women. This means that older adults need to be especially cautious with their alcohol use. According to AARP, one in 10 older adults who drink alcohol are at risk of excessive or potentially harmful alcohol use. In older adults, alcohol also is more likely to interact with medications, which may interfere with or amplify the drugs’ intended effects.
The National Institute on Alcohol Abuse and Alcoholism (NIAAA) suggests that people over age 65 limit themselves to no more than one alcoholic drink a day, and not more than two on any occasion. High levels of alcohol in the body can mask or worsen symptoms of stroke, diabetes, memory loss, heart disease, or mood disorders.
Alcoholic beverages also provide a significant number of calories without contributing any important nutrients. A 12-ounce glass of beer has about 150 calories, a 5-ounce glass of red wine has about 125 calories, and a 1.5-ounce shot of liquor has about 100 calories, according to the NIAAA. Your brain doesn’t process the signals from beverage calories the same way it does from food calories, so drinking doesn’t decrease feelings of hunger. Instead, it can loosen your inhibitions and lead to excess eating or snacking.
Skip Sugary Beverages
Sugary beverages such as soft drinks account for almost half the added sugar in the American diet. These beverages also include sports drinks, energy drinks, “gourmet” tea and coffee drinks, and juice drinks that are not 100-percent fruit juice. Such beverages are major contributors to the obesity epidemic. It doesn’t matter what sweetener is used: High-fructose corn syrup, dextrose, honey, evaporated cane juice, agave nectar, and many other forms of sugar all contain calories and affect the body similarly.
Sugary beverages can quickly add up to meet or exceed the dietary guidelines’ limit on added sugars of less than 10 percent of calories per day. In a 2,000-calorie daily diet, that means no more than 200 calories from added sugars, or roughly 12 teaspoons—about the amount in just one regular 16-ounce soft drink.
Health Effects
The risks of consuming sugar-sweetened drinks are not limited to putting on a few pounds. These beverages also contribute to conditions linked with obesity, including cardiovascular disease and type 2 diabetes. For example, people who averaged seven non-diet soda servings per week—just one a day—were 29 percent more likely to die from cardiovascular causes than those consuming less.
Tufts researchers have reported that sugary drinks may also increase your odds of developing non-alcoholic fatty liver disease (NAFLD). NAFLD, which is characterized by a buildup of fat in the liver unrelated to alcohol consumption, may cause the liver to swell and become inflamed, which can lead to scarring (cirrhosis) and, eventually, to liver failure. CT scans showed a higher prevalence of NAFLD among people who reported drinking more than one sugar-sweetened beverage per day compared to people who said they drank none.
Debating Diet Soda![]()
You may be tempted to avoid sugary beverages simply by choosing a “diet” version of the same type of drink. However, concerns also have been raised about the safety of non-caloric sweeteners such as aspartame used in diet sodas. Some have suggested that non-caloric sweeteners might somehow contribute to weight gain. One study even linked diet soda consumption to increased stroke and dementia risk.
According to the FDA, however, “Food safety experts generally agree there is no convincing evidence of a cause-and-effect relationship between these sweeteners and negative health effects in humans.” While it’s best not to overdo diet drinks, based on current evidence, artificial sweeteners remain an acceptable option for people who are working to control their weight—but water or unsweetened coffee, tea, or low-fat milk are healthier choices.
Cola Caution
Cola drinks, whether sugared or diet, may present special concerns about bone health, especially for postmenopausal women. In one study, women who drank three or more cola drinks daily had lower bone mineral density (BMD) in areas of bones that are common sites for fractures. In men, however, there was no link between cola consumption and lower BMDs, and consumers of non-cola soft drinks did not have lower BMDs.
Phosphoric acid, an ingredient found in cola drinks but not other flavors of sodas, might be to blame. In addition, caffeine, also found in colas but not most other soft drinks, can interfere with calcium absorption, and the study found a greater decrease in bone density among caffeinated soda drinkers.
Another factor may simply be that people who drink soft drinks and sweetened beverages of any type tend to drink less milk, which reduces their intake of calcium necessary to build healthy bones. If you’re an all-day soda drinker, consider substituting water for some of those sodas.
Eating for Healthy Aging
Making smart choices—whether beverages or foods—as part of an overall healthy dietary pattern is increasingly important as you get older. Following a scientifically proven nutrition plan such as that shown in Tufts’ MyPlate for Older Adults can help you lower your risks of illness and live healthier longer.
While minimizing your risks of chronic diseases is a lifelong concern, as you get older, this concern inevitably looms larger. As peers, friends, and loved ones are diagnosed with chronic conditions more common among older adults, it’s natural to wonder: What can I do to improve my odds? As we’ve seen throughout this book, with many of these conditions, making healthy modifications to your diet can protect you as you age.
It’s never too late to benefit from eating better, and there’s no better time to start than right now.
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