Health Claims, Water, and the Internet

We are extremely saddened to say that on October 21, 2018, Jeffrey Poehlmann passed away. Jeffrey’s advocacy efforts and writing continue to reach many. He will be deeply missed.

One thing that has become an unavoidable truism in the Internet Age is that Dr. Google is a less than reliable source for most people when it comes to health and wellness claims. This was highlighted for me recently when I did a quick Internet search for the proper temperature of lukewarm water. (I was preparing an oral solution and wanted to ensure that I dissolved the material properly.) Immediately, the search results provided me a range of links on the "proper" temperature for drinking water. Needless to say, they all claimed to offer "scholarly" advice, but there was little agreement between the sites.

As a lung cancer patient, I am often astounded by the health claims I read online.

It is difficult enough wading through the quagmire of legitimate research databases, but opening the doors to the World Wide Web can let in a flood of disinformation ranging from hysterical histrionics to downright frightening fabrications of conspiracies and hidden dangers. Sometimes it is hard to separate truth from fiction, or science from fantasy, without taking the time to examine the material with a critical eye. And with regard to health issues, there are "controversies" everywhere.

The biggest healthcare debate around water appeared to be whether it was "healthier" to drink warm or cold. There was a contingent of moderates pushing for a room temperature agenda, but they were quickly marginalized in the debate. Websites on the hot side claimed that heated water regulates stomach acid, increases metabolism, prevents "bloating," and detoxifies the body while improving the hair and skin. Additional claims include increasing circulation and even protecting internal organs (from what, I am not sure). Oh, and warm water aids in hydration.

Of course, websites promoting cold water share that last claim: apparently hydration is one aspect of water consumption that flows across the aisle. Beyond that, division continues. Cold water enthusiasts claim that the icy variety aids in weight loss and even improves happiness (as well as sex-drive). In an interesting twist, some more extreme hot water proponents attack cold water for causing fats to congeal in the body, hindering digestion and hydration due to constricted blood vessels, creating excess mucus, lowering a person's immunity, and even causing dehydration -- a preposterous claim, considering that all drinkable water increases hydration, regardless of temperature. The cold water camp offers a variety of refutations, of course, but in hardly as heated a manner.

More extravagant claims from Dr. Google...

Regardless of which side is encouraging a more suitable temperature range, there is little or no scientific evidence provided for any of the more extravagant claims. And by that, I mean pretty much everything other than helping with hydration. To be clear, both hot and cold water will help to replenish lost bodily fluids. But there is some science on which does it better.

There is an argument that cold water tastes better than room temperature or warm water, though it is likely that cold water merely offers a more intense stimulation of nerves in the mouth and throat that signal the brain about water being consumed, thus increasing the psychological aspect of satisfying thirst. But multiple studies have shown that cold water ingested during intense exercise has a measurable positive effect in boosting performance, reducing physical and emotional stress, increasing thermoregulation, and enhancing quick hydration. This is especially useful for people exerting themselves physically under very hot conditions but has little bearing on the rest of us.

Water plays a very serious role in our bodily health, and sometimes it is difficult to know whether we are drinking enough -- especially if we have no reason to "feel thirsty." Many people consume foods with high water content (soups, fruits, even milk) and need to drink less clear water. But it is important to monitor one's intake because it affects thermoregulation, cognitive performance, gastrointestinal function, kidney function, and heart function. And when undergoing any intense medical therapy, additional water may be necessary to help flush the patient's system. The bottom line, in spite of the many websites filled with clickbait headlines and pseudoscientific claims that artificially polarize readers, is that clean water is good, regardless of whether it leans warm or cool; and when it comes to finding out what is really healthy or good for us, critical thinking goes a long way, as does knowing where to go for a trusted source.

For those who want to know, lukewarm (or tepid) water is meant to be just slightly warmer than body temperature, or about 105 degrees Fahrenheit. An easy way to approximate this is one part boiling water to two parts room temperature / cool water. Does this mean cooler heads prevail? Only time will tell.^1-4