Health A-Z Archive: Water


I am often asked a lot of questions about water – what sort of water should one drink, how much, how often and which water is best. So here are my feelings on water!


Water is one of the most life-giving substances available to us. Without it, we would die within a few days. No life can exist without water – there would be no animals and no plants in the absence of this precious liquid. As our bodies are made up of approximately 60 per cent water, it is perhaps the single-most important ‘nutrient’. Sadly, it is often the most neglected one too!

Water is an essential component of both protoplasm (cells must be continually bathed in fluid to do their work) and blood. The body relies on water to flush away waste products like urine. Without water to moisten the surface of the lungs, there can be no intake of oxygen or expulsion of carbon dioxide. For food to be digested, absorbed and carried to all parts of the body, water is needed every step of the way. Water is essential for temperature maintenance, many chemical reactions in the body, and for the lubrication and protection of joint surfaces.

Water Comes From Your Diet

It makes sense therefore, that our diet should contain a high percentage of water. By eating a diet high in fresh fruits and vegetables, you would automatically be meeting this basic requirement. We need at least six to eight glasses of water per day, but the more raw fruit and vegetables you or your child consumes, the less water you will need to drink. People on a 70 to 80 per cent raw food diet, find that they naturally drink less water.

Generally, the best advice I can offer is, if you are thirsty drink water first and only then have a hot or cold drink. Always offer your child water. I am constantly amazed at parents who tell me that their child will not drink water. The only reason I believe this happens is that they were not given water right from the word go. Pasteurised, shop-bought juice should be a treat reserved for when you have visitors and for special celebrations.

Bad Alternatives to Pure Water

But even so-called natural juices with no additives or refined sugar are extremely acidic to the teeth and can contribute to tooth decay.

Bottled mineral water here in South Africa, tends to have a bad name, and this is due largely to a lack of integrity at the bottling plants. Many of these plants are situated in industrial areas, or close to informal settlements. This results in waste products and harmful chemicals entering the water source. When choosing bottled water, try to find out as much as possible about the bottling process of various brands on offer before you go ahead and buy.

Municipal water is chlorinated and is contaminated with many harmful substances (for instance, it picks up heavy metals like lead in the piping system). Although the chlorine kills bacteria, it combines with naturally occurring organic substances forming the highly carcinogenic, trihalomethanes or chlorinated hydrocarbons. (For more detailed information on the subject, please refer to my book The Natural Way.)

Filtered water is a far better option, but can still contain some harmful substances if not made by a reputable company. The I recommend Brita water filters as they make a product of exceptional quality, which removes all the carcinogenic trihalomethanes. Brita filters also prevent bacterial growth, which a lot of other filters don’t.

Distilled water (which is very much in vogue these days), although free of everything harmful, tastes dreadful. It also has an acid pH, which usually results in a loss of alkaline minerals such as calcium, magnesium and potassium. I have seen this cause some serious health problems years down the line.

But whatever you decide on, I suggest that you introduce water into your child’s life today. If he is reluctant, try freezing 100 per cent pure fruit juice in an ice tray, and add a few cubes to each glass of water. Gradually reduce the number of juice cubes, and eventually you will find him drinking plain water. I have a friend whose children refused water until she gave them each their own bottle of spring water. Now they love water and no longer ask for juice to quench their thirst.

Spring water at a pH of 6.8 -7.2 is the best quality from a physiological and taste angle

Additives to Water

FLUORIDE (from chapter 9 in “Healthy Kids”)
Fluoride treatment is a widely accepted practice today but it is one that I reject totally. Good teeth in babies and children are as a result of a healthy diet and lifestyle. A child on fluoride with a poor appetite is more likely to suffer from tooth decay than one who is well fed with no added fluoride. In my opinion, by treating your child with fluoride, you are simply abdicating your responsibility as a parent and you are exposing him unnecessarily to an extremely dangerous way of trying to prevent tooth decay.

I first became interested in the fluoride debate as a result of my eldest daughter Melissa. White stains appeared on her two permanent front teeth and I subsequently discovered that this could be attributed directly to the intake of fluoride. When I suffered a bout of severe nausea after my first and last fluoride treatment, I felt angered enough by the information published to investigate the matter for myself.

So what exactly is fluoride?
Sodium fluoride is commonly prescribed to prevent tooth decay. It may be taken orally in tablet form, or may be applied to the teeth in the form of a paste or solution. In some countries fluoride is added to the drinking water in order to prevent dental caries. The fluoride that occurs naturally in rocks and water has a different chemical structure to sodium fluoride, and is present in a far lower concentration than that added to municipal water.

Here are some disturbing facts about the fluoride that you are exposed to in your water, the toothpaste you use and the tablets you give to your children in good faith.

According to the 1984 issue of Clinical Toxicology of Commercial Products, fluoride is more poisonous than lead and just slightly less poisonous than arsenic. It has been used effectively as a pesticide for the control of mice, rats and other small rodents.

The Akron Regional Poison Centre states that fluoride toothpaste contains nearly 200 mg of fluoride, more than enough to kill a 10 kg child.

The United States Pharmacopoeia (a guide to drug information) lists the following possible side-effects from the daily ingestion of fluoridated water: black tar like stools, bloody vomit, faintness, nausea and vomiting, shallow breathing, stomach cramps or pain, tremors, unusual excitement, unusual increase in saliva, watery eyes, weakness, constipation, loss of appetite, aching bones, skin rashes, sores in the mouth and on lips, stiffness, weight loss, and white, brown or black discoloration of teeth. Among the negative side-effects listed here, nausea and loss of appetite are particularly dangerous in a growing child. Those promoting the use of fluoride state that it strengthens teeth and helps prevent osteoporosis.

However, research conducted by Dr Steven Jacobsen in 1990 contradicts this claim. In his study of over half a million people, he found that the incidence of osteoporosis (abnormal loss of calcium from the bones, including the jaw) in fact increased by up to 40 per cent when water was fluoridated!

More startling is the research from both Britain and America which shows that fluoride confuses the immune system, causing it to attack the body’s own tissues resulting in one of many symptoms such as skin rashes, gastro-intestinal disorders, lupus and rheumatoid arthritis.

According to research conducted in Japan, fluoride causes genetic damage, and is also capable of causing cancer. Fluoride damages the hydrogen bonds in the DNA or genetic material in the cells (a typical pre-cancerous condition). With one in every three to four people developing cancer in most Western countries, you are taking an unnecessary and dangerous risk if you give your child fluoride.

So to answer my initial question: fluoride is a dangerous poison that should be avoided at all costs!

The following is from the February 2003 edition of Science in Africa Africa first on line science magazine.

Exercise – to drink or not to drink?

Izelle Theunissen, MRC News

Sometimes it takes time to make your point. After almost 20 years, other experts have come to recognise that Prof. Tim Noakes was right after all. Drinking too much water can do more harm than good to athletes doing prolonged exercise. In fact it can be fatal!

To drink, or not to drink? According to Prof. Noakes, the answer to this question is slightly different than the standard ‘drink, drink and drink some more’ fare that is usually dished out to sports enthusiasts.

“There have been quite a few paradigm shifts in theories about water ingestion during exercise,” says Noakes, who directs the MRC’s Exercise Science and Sports Medicine Research Unit. “Before 1969, the standard belief was that athletes shouldn’t drink during exercise. They accomplished many world records, with only a few problems – despite not drinking much by today’s standards,” he continues.

This was changed by a study by two South African researchers (Wyndham and Strydom) who maintained that too little water caused dehydration, causing the body temperature to rise, leading ultimately to heat stroke. “But they unfortunately neglected to say that it was the intensity of the exercise that led to the rise in body temperature – not the lack of water,” explains Noakes.

Sports drinks

The 1970s saw the rise of the sports drink industry. People were told to drink 1,2 litres of fluid per hour – this was later changed to ‘drink as much as possible’. Paradoxically, the more people were told to drink, the more problems athletes were having in the marathons and ultra-marathons.

Particularly women athletes in North America were literally paying with their lives.

Noakes explains why: “These athletes were running the marathons at very slow speed – contrary to the elite athletes, who would finish in 2-3 hours, these runners were running times of 5-6 hours. This meant that they were ingesting 1,2 litre of water, every hour, for up to 6 hours. This led to massive over-hydration and our Unit was the first to report this problem in the Comrades Marathon in 1985,” he explains.


Over-hydration is no joke. It causes the body – and brain – to swell. The pressure of the brain against the skull increases, leading to convulsions, heart failure and cessation of breathing.

Dr Tony Irving from Prof. Noakes’ Unit then studied a group of 8 Comrades runners who were hospitalised with hyponatraemia after the 1988 Comrades Marathon. “We showed that, during recovery, they were passing out large quantities of water. They didn’t need any salt to make them better, so they weren’t salt deficient, but purely water overloaded,” Noakes says.

This theory was scoffed at by experts from all over the world. Athletes were still encouraged to drink as much as possible. But the Houston Marathon of 2000 changed at least one researcher’s mind. Before the race, pamphlets were given out that stated ‘when you’ve drunk enough, you must drink some more’. Many athletes landed into trouble and Dr Tamara Hew was in the medical tent when they were admitted.

“Many of the athletes were unconscious when they were brought in, and were given intravenous fluid immediately. But this only made them worse.

So Dr Hew decided to study runners in the next Houston Marathon. She was able to show that there was a direct linear relationship between the amount of fluid these ill athletes had consumed, and the severity of their hyponatraemia at the end of the race. One lady who finished the race in desperate condition had managed to drink more than 100 cups of fluid during the race as well as substantial amounts of fluid the day before the race. Dr Hew has been working with us more recently and Jonathan Dugas, a Texan currently studying for his Ph.D. in this Unit, will be completing a joint study with Tamara’s group at the 2003 Houston Marathon,” says Prof. Noakes.

More theories and experiments

Still the penny hadn’t dropped, and the following year athletes were asked to participate in an experiment – they were asked to drink as much as they could. One group was given water and the other group a well-known American sports drink. Predictably, it didn’t make a difference to the result – runners who overdrank were equally hyponatramic, whether they had water or the sports drink.

“The organisers of the Marathon finally got the message. So for next year’s race they will be halving the number of water stations on the course during the race. But that did not stop the sports drink company producing an advertisement in January 2002 stating that runners should drink 1,2 litres of fluid per hour. This was followed by another advertisement in June 2002, which said that you could drink up to 1,6 litres per hour during exercise,” Noakes says.

Noakes then wrote a letter to the running magazine in which the advert was featured, pointing out the dangers of this advice. But the magazine refused to publish it because Noakes’ view conflicted with those of one of their chief sponsors.

About turn

Then suddenly, within a month, the same magazine ran a completely different advert warning runners that they should not overdrink during exercise. “It was the most remarkable change I have ever seen in my medical career – in less than 30 days, the advice of how athletes should drink during exercise was suddenly reversed”, he laughs.

Prof. Tim Noakes recently received an award for this research at the prestigious Prix Nationale 4th International Symposium of Water in Cannes. Nine awards are given for excellent research, and Prof. Noakes bagged the prize in the Medical Section.

Noakes believes that this has something to do with the death of an athlete taking part in the Boston Marathon in April 2002. This was a women amateur runner who, literally, had too much sports drink during the event. Then in August, the Boston Globe and New York Times newspapers carried front page reports of the autopsy findings in this case. The conclusion was that the young lady had died because she had drunk too much Gatorade (sports drink) during the race and that this had directly caused her death. “So sadly it has taken all these years, with numerous deaths, to believe something that had been proposed in 1985 and definitively proven by 1991,” Noakes says.

Noakes has a very down-to-earth explanation for the over-hydration phenomenon. “I believe that the body is adapted for conditions of mild dehydration. We evolved from hunters – we had to run and chase animals on the hot African plains. We didn’t have time to pause for a drink! Physiologists who did not understand either human’s prehistory and the history of running then came along with the unproven hypothesis that to become even the slightest bit dehydrated during exercise would kill you. And then the sports drinks industry in the United States used this bad, indeed non-existent science to market their products.”

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