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This year’s sessions offered new opportunities to shed light on the hydration story including the first H4H Academy, keynote talks and the first “Tribute to Hydration” award.
The first H4H Academy session launched on June 28, offering an overview of the hydration research story to new and returning conference attendees. Hydration Academy instructors Prof Stavros Kavouras from the University of Arkansas (US) and Prof Ivan Tack from Toulouse School of Medicine (France) took turns reviewing core hydration topics such as water metabolism, population intake data, hydration biomarkers and suggested research topics. This “refresher” established the building blocks for the following day’s scientific sessions. Stay tuned for more on the H4H Academy and hydration master classes on h4hinitiative.com.
More than 200 hydrationists gathered for the June 29 scientific sessions, led by master of ceremonies, University of Connecticut’s Prof Lawrence Armstrong (US). Launching the session with the day’s first keynote speech, Dr Erica Perrier answered the important question, “How do we know if we are adequately hydrated?”. Looking at cases of high volume drinkers as well as low, Perrier explored the significance of different levels of vasopressin, glomerular filtration rates and various metabolic markers in plasma, as well as urinary markers such as osmolality, specific gravity and color, concluding the simplicity and efficacy of the urine color chart as a strong answer to the posed question.
For the first time, the hydration status of new moms was a core topic of the H4H Scientific Conference. The overall feeling from the session is that there is much work to do in determining the hydration status of women in this phase of the lifespan as well as understanding the implications of dehydration on both mom and baby. Four leading experts addressed the topic from various points of view (from left to right: Prof Ivan Tack, Dr Amy McKenzie, Dr Sabine Boesen and Prof Saptawati Bardosono).
· Prof Ivan Tack reviewed the metabolic pathways of pregnancy and the importance of good hydration. Insufficient hydration during this time could lead to low amniotic fluid, kidney stone and urinary track infections. Prof Tack reviewed the current recommendations, supporting a fluid intake increase by .3 to .5 mL /day, but emphasized that more research needs to be conducted.
· Prof Saptawati Bardosono from the University of Indonesia presented intake data from 300 pregnant and lactating women in three regions of Indonesia. Her survey found that an inadequate intake of water from fluids was observed in 42% of the pregnant women and 54% of the lactating women. Based on this data, Prof Bardosono encouraged intake data to be reviewed further and in other countries as well.
· Next, Dr Amy McKenzie (US) looked at urine biomarkers to determine if they were as effective with pregnant and lactating women as they are in the general population. Her investigation found the standard urine biomarker of the urine color chart was as effective with pregnant and lactating women as it is with the general population and those women who present with a urine color of 4 or higher on the chart, should consider increasing fluid consumption to improve overall hydration status.
· Dr Sabine Boesen concluded the session by unveiling a new tool for pregnant and lactating moms to determine if they are adequately hydrated: the urine color chart for pregnant and lactating women. The tool was verified with both health care practitioners, as well as the moms themselves, as an easy-to-use and effective tool for evaluating hydration status.
Healthy Hydration in Daily Life
A second keynote on dehydration and brain function was delivered by Dr Nathalie Pross, a leading researcher on the impact of mild dehydration on mood, fatigue and cognition. The body of her research shows that as little as 1% dehydration can impact the way individuals feel and interact with others on a daily basis. For this, staying aware of your hydration status with the urine color chart and increasing hydration as necessary can improve daily life for healthy individuals.
The next session looked at water regulation from various angles. Highlights include:
· From Harvard Medical School, Prof Dennis Brown (US) provided an outstanding session, explaining aquaporins and how they fit into the hydration story. Essentially, aquaporins are proteins recently discovered by Peter Agre in 1992 (he received a Nobel Prize for his work in 2005). In humans, aquaporins are evident in at least 12 of our body functions and play a role in processes such as urinary concentration and body fluid homeostasis, brain function, glandular secretion, skin hydration, male fertility, hearing, vision, etc. Look forward to hearing more as research on aquaporins evolves.
· Polycystic Kidney Disease (PKD) is a major cause of end-stage renal failure. Prof Vicente Torres from the Mayo Clinic (US) reviewed the role of vasopressin in the development of PKD and the potential of vasopressin as a therapeutic target to prevent the progression of this condition. Prof Torres reviewed the TEMPO 3:4 trial and the challenges and opportunities faced during his research.
· Quantifying urine in large population studies can be challenging and expensive. Dr Lise Bankir discussed various methods for urinary analysis in large population studies, suggesting feasible alternatives to urine osmolality. Dr Bankir suggested urine osmolarity (eUosm) based on the concentrations of sodium, potassium and urea to be an excellent surrogate for measured urine osmolality. Dr Bankir also reviewed the urine concentrating index (UCI), based on the ratio of creatine concentrations in urine & plasma, but suggested it be used when other biomarkers are not available and with some restriction.
Hydration and Global Obesity
Global obesity is a public health crisis and the role of water in its prevention was at the heart of the final session. Dr Nathalie Farpour-Lambert, reviewed some of the activities conducted by the European Association on the Study of Obesity (EASO) Healthy Hydration Working Group, emphasizing the role of water consumption in the context of other important public health measures to prevent and treat obesity in children. Nutrition epidemiologist Dr Jodi Stookey provided an overview of research around childhood obesity and water drinking and found that multifaceted approaches, such as the ones conducted by the New York City Department of Education, resulted in decreased obesity in children, and that just promoting water alone may not be enough. And to conclude the day, EASO president Prof Helmat Toplak reviewed the work by that organization over the past decades, leading up to the 2015 Milan Declaration made at Expo Milano (Italy). The declaration calls for multifactorial, multidisciplinary approaches to childhood obesity, including an increase in water consumption.
On the award front, two awards were designated this year. First, the Young Researcher of the Year award winner was Dr Colleen Muñoz from the University of Connecticut. Muñoz, the first woman to win the Young Researcher Award, presented her research on “Combined Dehydration, Exercise and Environmental Health Stress Increase Lipid Peroxidation and DNA Damage”.
Also, for the first time, the Tribute to Hydration award was presented to Dr Lise Bankir for her pioneering research on hydration and vasopressin.
Concluding the day, Dr Liliana Jiménez reminded us of the importance of continuing the journey in hydration research, as we have just scratched the surface.
Our Expert Working Group meet regularly to discuss the importance of healthy hydration and to develop strategies to encourage patients and the general public to adopt healthier hydration practices.