|
Home--News
Think Before You Drink
As Britain staggers through another
long, hot summer, our consumption of mineral water is set to break
all records. We do need a lot of water to stay healthy - but does
it have to come out of a bottle?
Aida Edemariam
The Guardian
July 13, 2006
Morning rush hour on a sultry, clammy July day in King's Cross, London.
It's been getting hotter for days, and though the forecast is that
the weather will break soon, no one is taking chances. In the queue
at WH Smith a dapper man in dark glasses clutches three one-litre
bottles of Volvic, £1.49 each. A middle-aged woman stands in front
of the refrigeration unit comparing waters and water prices; finally
she goes for a smaller bottle, at £1.29. Much of the refrigeration
unit is given over to water, but already, at 9am, it needs restocking
- even though today water has a bit of competition. Strategically
positioned by the steps down into the Underground (which a day earlier
achieved temperatures of 41C), bouncy young things are handing out
free cans. "Pepsi Max, guys! Free Pepsi Max! Ice cold!" A hurried
businesswoman grabs two as she runs for a train. A slender woman with
carefully curled white hair also takes two, then secretes a third
in her leather rucksack.
By platform four, a low trolley is piled high with bottled water.
I ask the nearest man in uniform how much one costs, expecting the
usual on-board price of £1.20 or so, but he says he doesn't know.
Then - I must be looking peaky - "Do you need one? Are you thirsty?"
That wasn't the point of my question, but as he's offering, sure.
He wanders down the idling train and two minutes later emerges with
a bottle, and hands it over for free. Which, though I worry a little
about what his bosses might say, is sweet of him. More importantly,
I'm interested by the instinct he betrays - that drinking water should
be freely available in public spaces. In this age of Vittel and Volvic,
Malvern and Blue Water, this seems rarely to be the case.
An organisation called the Water for Health Alliance - a loose affiliation
of bodies includiung water companies, public health charities, the
Royal College of Nursing, the Men's Health Forum, local authority
caterers and the Schools Health Education Unit - is hoping to change
this. Think about it: when was the last time you saw fresh, free drinking
water in a public space? Whereas it's possible to stumble on water
fountains, for example, in all manner of places in the US, Canada,
and some of continental Europe, you have to go looking for them in
Britain, and if you do, you'll often be disappointed. (Though at King's
Cross, to my surprise, I found two in the ladies'. One proclaimed,
"Drinking fountain out of order. Please do not use.") The borough
of Westminster provides only seven drinking-water fountains.
This wasn't always the case. "The Victorians were quite keen on providing
water in public places," says Anne Hardy, professor of the history
of modern medicine at University College London and author of Health
and Medicine in Britain Since 1860. Domestic water supplies in England
were erratic until the 1860s and 70s, and even then water companies
would provide water for only about two hours a day. Water fountains
were scattered throughout cities mainly "in order to stop people from
drinking just anything, and especially too much beer". Thus water
provision was partly related to the temperance movement, though it
was noticed that men in factories, who drank beer, were far less likely
to be felled by diarrhoea than women, who were restricted to water,
which at that point was not filtered or chlorinated.
The Victorians were particularly concerned with providing drinking
water to the underclass - not the unemployed, who were sent to poorhouses
or stayed at home, but the semi-employed: the costermongers and flower-girls,
the dock workers and street-sweepers who were more likely to spend
their spare time in the pub. But this underclass began to disappear
in the Edwardian period, and street life became tidier. Levels of
dust dropped with the disappearance of horses, licensing laws controlled
drinking, and the spread of Lyons corner houses, which sold cheap
tea and coffee and welcomed women, meant that alcohol was no longer
the only non-water alternative. Tap water became available in homes,
and the spread of tuberculosis, for example, raised worries about
the sanitariness of drinking fountains (which was good news for the
paper cup). Gradually, they dropped out of sight. For years drinking
water became, in a very western, privileged way, a non-issue.
The popular idea that continuous hydration is necessary for health
and especially that a specific quantity is required, is, says Hardy,
"very, very recent, really appearing only in the past five or six
years. Most people wouldn't have thought twice about it before. People
have taught themselves to need water. I see that in myself. I never
used to drink water except at mealtimes. But nowadays I'm constantly
thinking, 'I'm thirsty, must have a glass of water.' " It is also,
she notes, "a generational thing: the bottle-clutching classes are
mostly the under-30s. People who matured before this fad by and large
thought they could do without it. The bottle of water is now a visible
symbol of 'I care about my health'."
And of course, water is integral to health. As we all learn at school,
about 85% of the brain, 80% of blood and 70% of muscle is water. It
removes toxins from the body, enables nutrients and oxygen to travel
round it, regulates body temperature, cushions joints. But while contaminated
water is no longer a big problem here, there are public health issues
unrelated to cleanliness. Most are caused by not drinking enough of
it.
It is next to impossible to measure the average dehydration levels
of a national population, as it can vary from hour to hour in each
individual, but there seems to be quite a bit of it about. It is both
anecdotally observable and scientifically measurable (for example,
in a study of the effect of water deprivation on cognitive-motor performance
in healthy men and women published in the American Journal of Physiology
last year) that dehydration adversely affects concentration. In older
people, such dips in concentration contribute to the risk of falls,
and thus bone breakage; a 2005 article in Nutrition Reviews, an American
scientific journal, and a US Institute of Medicine panel on intakes
of water and electrolytes argued that even mild dehydration could
reduce the capacity for physical work by up to a quarter. It can cause
headaches and depression. And a 1998 article in the Lancet even suggested
that the low water content in cabin air might be among the reasons
for the higher incidence of breast cancer in airline attendants. One
1996 study in Cancer Epidemiology, Biomarkers and Prevention, a publication
of the American Association of Cancer Research, has suggested that
drinking four to five glasses of water a day, rather than two or fewer,
can reduce the risk of colon cancer by 45% in women and 32% in men.
Oh, and skin tone seems to improve.
Hence the mantra that we should all drink two litres of water a day;
hence the much-observed fact that no self-respecting celebrity is
ever seen these days without a bottle of Evian. But it's not that
simple. Experts caution that it is actually impossible to say how
much a single person should drink in a day. Two litres of water could
be too much for a small woman who eats lots of vegetables, and too
little for a large man. How much we should drink depends on everything
from body-weight to diet - because about 20% of hydration comes from
what you eat. There is more water in 100g of tomato than in 100g of
cola.
Furthermore, our obsession with hydration ignores the fact that we
were plainly "designed to go quite long periods between drinking",
says Ron Maughan, a professor of sport and exercise nutrition at Loughborough
University, and an adviser to UK Athletics, the governing body of
this field of sport in Britain. "Throughout most of evolution we didn't
have nice plastic bottles to carry water around. People still work
long hours in agricultural and industrial settings with no access
to fluids except at meal breaks, and there's no evidence of harm to
their physiological function." These days "you see people who are
supping water continuously, and it may be providing them with no benefit
whatsoever".
The perception now is that the more you can force down the better
it is for you, but in fact too much water is dangerous because it
dilutes the blood. "There will be people in the country who die because
they allow themselves to become dehydrated," says Maughan, "but at
the same time there will be people in this country who die because
they have overhydrated themselves." Usually this happens during marathons
- at least five have died in distance running events around the world
in the past five years, because they have drunk up to 15 litres -
but it can conceivably also happen in aggressive detox or dieting
regimes.
The trouble is that blanket consciousness-raising drives among the
public, such as that for lower salt consumption, risk reaching mainly
those who are health-conscious already, "and leave untouched those
who really need to change their behaviour," says Maughan. "That's
what drives a large part of the organic market, and a large part of
the supplements market - they're bought by people who already make
healthy choices. Those who make poor food choices don't take them,
because they're just not interested, or can't afford it. We usually
don't hit the people we're aiming at. I fear the same might happen
with the drink-more-water message."
The elderly are of course particularly vulnerable; every time there
is a heatwave, there is an increase in mortality among the elderly,
as was seen in France in 2003. But it's hard to keep the elderly hydrated,
because with age their ability to absorb water decreases, and they
are often on medicines that may have diuretic effects; according to
a detailed fact-sheet produced by Hilary Forrester for Water UK, the
water suppliers' industry body, "a recent survey of water provision
in British care homes for the elderly found that residents consumed
only two to four glasses of water a day", a quarter to half of the
daily amount recommended by the Food Standards Agency. This contributes,
she says, to the fact that 42% of patients admitted to geriatric wards
are suffering from constipation - which in turn increases the possibility
of bowel cancer. Dehydration doubles the mortality of patients admitted
to hospital with strokes.
It has been found that it is generally the very disabled or ill who
get the most water, because staff pay more attention to them; the
less ill are of a generation inclined not to want to put anyone to
any trouble; they are also of a generation that would probably prefer
a nice cuppa to a glass of water. Water UK has sent hydration advice
kits to nearly a thousand care homes so far, and the National Association
of Care Catering and the Royal Institute of Public Health have begun
training carers in how to persuade their charges to drink more H2O.
Coffee, tea and hot chocolate are included on most menus, but they
are caffeinated, and the former two at least are mild diuretics, which
exacerbates the problem. If people insist on hot drinks, carers try
to persuade them to take hot water and lemon, or to grow their own
mint. If all else fails, there's always the argument that an enema
is much less pleasant than downing a few glasses of water.
Children, with their larger ratio of surface area to volume, and thus
a greater potential for water loss, are particularly prone to dehydration.
Teachers taking part in a 40-school pilot project for Food in Schools,
a joint venture between the Department of Health and the Department
for Education and Skills to increase access to water, reported that
"preference for drinking water over other drinks rose by 1.6 times
in primary and 1.4 times in secondary schools, while preference for
carbonated drinks fell. Teachers also reported that the enhanced water
provision contributed to a more settled and productive learning environment,
as well as helping instil good habits."
Dehydration can also be linked to increased levels of obesity, partly
because thirst is often mistaken for hunger, leading to more frequent
snacking, and partly because in digestion fat produces the most metabolic
water when broken down, which in turn can mean that children prefer
fatty foods because they compensate for their lack of water. Of course,
water has to be part of a balanced diet, but the implications are
obvious.
Schools were already concerned about obesity and nutrition - Food
in Schools was in operation before Jamie Oliver's intervention - but
after that the government pledged £220m to schools and local education
authorities; set up a new School Food Trust, which has launched an
online package of advice on healthy eating; and drew up tough new
nutrition standards for school canteens. From September, these standards,
which include the provision of free fresh water, preferably chilled,
will be obligatory. This has apparently been a little tricky for schools
where drinking water is available only in the toilets or from vending
machines. Water coolers are a useful option: and Yorkshire Water has
just installed its 900th water cooler free of charge in primary schools,
says Nick Ellins, health policy adviser with Water UK. "The children
like it, because it makes water special. They get to go up and get
something. And they see going to a water cooler as an adult thing
to do."
Water UK is one of the main partners in the Water for Health Alliance,
and it is important to note that Water UK represents Britain's private
water and waste-water companies, so promoting tap water is in its
interest. But it is also true that far too much of the time, if you're
not at home, the only options are sweet drinks, tea or coffee, or
expensively bottled water, and this is a big reason why the other
partners have signed on. "The marketing of bottled water is like the
marketing of trainers," says Angela Mawle, chief executive of the
UK Public Health Association. "There is peer-group pressure to see
particular brands as more attractive and healthy, and I think it's
really invidious to be doing that with something as basic as water."
It exacerbates what she calls "health inequality", and she compares
the effect to the often unintended exclusivity of the organic food
movement, "which the chattering classes are pushing forward, without
realising that they're complicit in increasing this inequality". A
middle-class professional might feel it's neither here nor there to
pay nearly twice a much for a couple of carrots with earth still clinging
to them, or £1.49 for a bottle of water, but "one pound is a hell
of a lot on a low income. I used to work in disadvantaged areas where
mothers would have to use any spare pound they might have to buy two
packets of biscuits so the kids could get some calories. They're not
going to use it on water. The choice wouldn't even come up."
Of course, there are valid objections to water fountains. If they
exist at all, they are often in toilets, which makes people squeamish
about hygiene. In places such as railway stations, people might be
worried about using fountains in poorly lit areas. So other options
have begun to be explored. At present, cafes, restaurants and pubs
are not obliged to serve free tap water on request, but many do so
- albeit frequently with a measure of snootiness: tap water is cheap,
and that makes you cheap. (New legislation will, however, make the
provision of fresh water mandatory in Scotland from 2009.)
Free, or as near as possible to free vending machines are a possibility
- the water filtration company Brita, for example, could be given
council contracts; filtration and chilling would allay the fears of
those who are still suspicious of tap water. Providing it in bottles
or cups would create waste (another gathering argument against bottled
waters: their impact on the environment, both in terms of long-distance
shipping and the thousands of plastic bottles), but you could be given
the option of using your own refillable receptacle. One company has
launched vacuum-packed foil sachets for drinks; these could be used
to dispense water. And you can market it, just like anything else:
tap water is the official drink for the Sport Relief Mile this Saturday.
Make good, free drinking water cool. It may be an uphill battle, but
it's a good aim.
FAIR USE NOTICE. This document contains copyrighted material whose use has not been specifically authorized by the copyright owner. India Resource Center is making this article available in our efforts to advance the understanding of corporate accountability, human rights, labor rights, social and environmental justice issues. We believe that this constitutes a 'fair use' of the copyrighted material as provided for in section 107 of the U.S. Copyright Law. If you wish to use this copyrighted material for purposes of your own that go beyond 'fair use,' you must obtain permission from the copyright owner.
|
