Mealtime Partners, Inc.

Specializing in Assistive Dining and Drinking Equipment

July 2013 Independent Eating and Drinking Newsletter

	July Topics: How We Become Thirsty The Importance of Having a Healthy Mouth

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How We Become Thirsty

People and animals have an amazingly complex mechanism within their body that keeps all of its systems in balance. This includes the regulation of the amount of fluid that is in the body at any given time. Because of the systems described in this article, the brain recognizes when the body‘s fluid levels are out of balance and sends messages to the body that it is thirsty. The perception of thirst is subjective and produces the urge to consume fluids. When thirst messages are sent by the brain, the body already has a reduced fluid level. Therefore, when someone becomes thirsty, their body is alerting them of the precursor to dehydration and they should take a drink as soon as possible.

The human body is comprised of more than 50% water. In newborn infants the amount of water can be as much as 75%, and this percentage declines through the first years of life to a stable volume in adulthood. About two-thirds of this fluid is contained in the cells of the body and the remaining one-third is outside the cells. The fluid moves in and out of the cells, through the cell walls or membrane, depending upon the concentration of the chemicals in the cells. The cells of the body contain a mixture of chemicals including sodium (salt) and potassium that are dissolved in the intracellular fluid (the fluid inside the cells). The cell chemistry is kept at a stable level by the body either pulling fluid from the cells to increase the chemical concentration, or by pushing fluid through the cell membrane into the cells to dilute the chemicals in the cells.

Our bodies maintain their fluid levels at a relatively stable volume all of the time. The fluid level is ideal when the level of fluid inside the cell walls and that outside the cell walls is equal. This condition is an isotonic condition. When this balance is lost either because the fluid in the cells decreases creating a hypotonic state, and the cell chemistry becomes too concentrated (known as cellular dehydration), or the extracellular fluid decreases due to normal fluid loss like perspiration, urination, etc., the brain triggers the desire for a drink, or thirst. When liquid is consumed it allows the balance to be re-established.

This is all part of human homeostasis. The term “homeostasis” comes from the Greek, homeo or "constant", and stasis or "stable" and means remaining stable or remaining “the same”. In people, homeostasis is essential for maintaining life. The human body is constantly active making adjustments within itself to maintain a constant stable condition. The liver metabolizes toxic substances within the body for them to be more easily excreted from the body. Additionally, it metabolizes simple and complex carbohydrates that provide energy for the body. The kidneys regulate the blood water level in the body, absorption of substances into the blood, and maintain the blood’s salt and iron levels. They are responsible for excretion of waste materials. The brain, including the autonomic nervous system and the endocrine system, “supervises” the regulation of homeostasis.

With human homeostasis, the body regulates itself at an almost constant temperature. Heat is mainly produced by the liver and by muscle contractions. People have an ability to adapt to hostile climates including high humidity and high temperatures. However, if people do not modify their behavior in high temperatures, including the intake of a large volume of fluids, reducing activity level, and sheltering their body as much as possible, their bodies will be stressed. This will eventually lead to them being unable to cope with the situation causing illness, and, if the situation continues, eventual death.

Typically, fluid lost by the body is equal to the fluid intake and is known as “fluid balance”. The amount of fluid in each person varies and will depend upon the individual, their life style, and where they live. In the US it is generally recommended that everyone drink 8 – 8 ounce glasses of water a day. However, despite research in an attempt to substantiate this claim, no evidence has been found to substantiate it. However, enough fluid should be consumed to replace the liquid that is being lost due to activity, respiration, perspiration, excretion, and urination. It is recommended that everyone urinate at least four times per day and that the urine should be pale yellow. If it is dark or bad smelling, more fluids should be consumed.

All of the above discussion can be impacted by various illnesses, diseases, medications and excessive bleeding. It can also be impacted by eating a very salty or spicy meal. For example, diabetes will increase thirst and urination, and force the normal process of homeostasis to change. Because diabetes causes surplus sugar to build up in the blood the kidneys have to work excessively to remove the sugar from the blood. If the kidneys are not able to absorb the extra sugar, it will be excreted in urine along with fluid from the body. This causes frequent urination, which can lead to dehydration, and increased thirst. Also, medicines such as anticholinergics, demeclocycline, diuretics, and phenothiazines will cause thirst.

Regardless of each individual’s health, it is important to consume enough fluids on a daily basis to keep the body properly hydrated. The necessary volume of liquids will vary from person to person and depend upon their activity level, their location, the temperature there, and the specific needs of their body. Remember that the body needs more fluid when muscles are active. This is a basic rule for athletes but it should also be remembered that for those individuals who must exert a lot of energy to accomplish movement, this rule also applies.

To facilitate consuming adequate fluid, for those who are unable to hold or lift a drink independently, Mealtime Partners offers a variety of “hands-free” drinking systems that can be mounted on a wheelchair, bed rail, or table.

The Front Mounted Drinking System

The Front Mounted Drinking System is Mealtime Partners most versatile hands-free drinking system. Available in five different Flex Arm lengths the system can attach to a wheelchair handle or frame, to a table top, or to a metal bed rail. The cup holder can accommodate a wide variety of drink containers including bottles, soda cans, insulated coffee cups, sippy cups, etc. The front mounted drinking system was developed by Mealtime Partners to provide access to fluids to our customers who use wheelchairs but who have a very limited range of head and trunk movement, and/or, who have weak suction. Because the cup is positioned in front of the user, a short straw can be used with this system. This close proximity allows those who have poor suction to be able to drink from this system. The system consists of a heavy-duty Flex Arm that has a Clamp on one end and a cup holder on the other. It also comes with a Koozie for the cup holder. The Front Mounted Drinking System can position a variety of cups and drink containers very close to the user's mouth for hands free drinking and permits a variety of drinks to be made available throughout the day. The user drinks from their own container using a disposable straw. Because the straws and most of the containers can be disposed of or washed in a dishwasher, it is the easiest drinking system to clean.

Front Mounted Drinking System with a 30-Inch Flex Arm	Front Mounted Drinking System with a 18-Inch Flex Arm
Using this drinking system a user can have a coffee in the morning, a bottle of water between breakfast and lunch, ice tea with lunch, a can of soda in the afternoon, and milk before bed (etc.). Simply change out the container as the user desires. It is a quick and easy way to provide drinks throughout the day. For (much) more information about the Front Mounted please refer to our January 2012 Newsletter topic: The Very Versatile Front Mounted Drinking System. For pricing and information about ordering a Front Mounted Drinking System, click here. Click on the following link see all of the Mealtime Partners Drinking Products and for considerations in selecting the most appropriate drinking product for any specific individual.

The Importance of Having a Healthy Mouth

Until quite recently people saw a doctor for health issues and a dentist to care for their teeth and gums. It was most unlikely that the two types of doctors would interact about a patient. However, today it is being recognized that the mouth is the “gateway” to your body’s health. The Department of Health and Human Services (HHS) has selected oral health as one of their 12 leading health indicators for their Healthy People 2020 Initiative. They are providing new funding to facilitate oral disease prevention.

To understand the importance of mouth health, it should be understood that the mouth and saliva contain bacteria. Most of the bacteria are harmless, but unless the mouth and teeth are kept clean by brushing and flossing, the acid level in saliva can increase and can impact the overall health of the mouth. Additionally plaque will build up on teeth. Without healthy teeth and gums, the bacteria that are ever present in the mouth can migrate into the body’s blood stream through bleeding gums or tooth cavities. They can cause a wide range of health problems including heart disease, arthritis and diabetes.

Endocarditis is an infection of the inner lining of the heart and is caused by bacteria spreading to the heart from other parts of the body, including the mouth. Some researchers believe that cardiovascular disease, clogged arteries and strokes may also be linked to these types of infections.

Certain medications including decongestants, antihistamines, painkillers and diuretics contribute to having a dry mouth. The reduction of saliva contributes to both the concentration level of acid in the mouth and the amount of bacteria that remains in the mouth. With the normal production of saliva, the acid concentration is lower and food particles and bacteria are flushed away as we swallow saliva.

If gums become infected and inflamed, they allow infection to become established in the area of the mouth and gums and the infection can spread throughout the body if the problem is not treated. Therefore, your dentist’s care is an extremely important part of maintaining your overall health. Not only does dental health improve your overall health but it reduces the likelihood of oral pain, cavities, tooth loss, gum disease and a variety of other problems. For individuals who are unable to maintain their own oral care, it is sometimes overlooked as a priority and not provided as regularly, or as thoroughly as it should be. This neglect can lead to oral health problems.

Specific steps can contribute to maintaining oral health including: regular dental checkups, brushing and flossing regularly, eating a healthy diet, and drinking water regularly throughout the day. If teeth cannot be brushed, a drink of water can be used as a mouth rinse and will help to wash away food particles. For those who are unable to hold or lift a cup to take a drink, a Mealtime Partners hands-free drinking system should be mounted to their wheelchair or bed to make water available at all times.

Did You Know? Did you know that scientists at the University of Maryland, School of Medicine have discovered taste receptors in the human lung? The taste receptors (i.e., taste buds) on the tongue are clustered together and send signals to the brain when stimulated. The receptors in the lungs are not clustered together and do not send messages to the brain. They are only able to sense bitterness and because most plant-based poisons are bitter it was believed to be a way of alerting the body to the danger of the plant. Stephen Liggett, a pulmonologist at the University of Maryland School of Medicine and director of its Cardiopulmonary Genomics Program, initially thought that the receptors related to triggering a “fight or flight” reaction. However, it is now believed that the receptors, when exposed to bitter substances, cause the airways to open more than any known treatment. The ramifications of this discovery are potential new treatments for asthma, chronic obstructive pulmonary disease, etc. Liggett now believes that the receptors react to bacteria that emit a bitter substance when they are infecting the lungs and cause the airways to open allowing deep breathing that can clear the infected debris from the pulmonary system.

According to the American Lung Association, there are 23 million people in the United States affected by asthma, 7 million of whom are children. Chronic obstructive pulmonary disease is one of the leading causes of death in the US, and, therefore, this new discovery may lead to new treatments that could reduce these illnesses significantly .

Mealtime Partners, Inc.

Specializing in Assistive Dining and Drinking Equipment

July 2013 Independent Eating and Drinking Newsletter

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