Mealtime Partners, Inc.

Specializing in Assistive Dining and Drinking Equipment

June 2017 Independent Eating and Drinking Newsletter

	June Topics: Drinking Water Pros and Cons of Sports Bottles
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Drinking Water

In the United States there is a general understanding that everyone should drink about eight, 8-ounce glasses of water every day. Even if we do manage to consume that quantity of water, currently there is a discussion as to whether the water should be warm or cold. Many people only find water tolerable to drink if it is icy cold, while other people can only tolerate warm water. The variations can be expanded when adding things to the water; for example, a squeeze of lemon juice to warm or cold water. Considerable research has been conducted examining the most effective temperature for water to help the human body when it is being hydrated.

There are some basics that should be considered before examining the more complex findings of some of the current research about water temperature. The type of water that is being consumed is ultimately the most important factor. Tap water, depending upon where you live in the US, is mostly safe to drink and contains minerals that are natural to the local area. Water can be hard or soft, depending upon the minerals in it; it can come from a lake, well, or spring, or can be distilled. There is an extensive variety of water that is available for purchasing if you are willing, and able, to buy it. In some areas of the country, tap water is not safe to drink. This was brought to the public’s attention when reports of the water supply in Flint, a town 40 miles north of Detroit, Michigan, was found to have extremely high levels of lead in it. Children who have been exposed to elevated levels of lead are at increased risk for cognitive and behavioral problems during development. The lead in Flint was found to be leaching from the pipes that supplied water to homes in the area. This occurred because the water, which was being drawn from the Flint River, was 19 times more corrosive than water from the previous water supply, Lake Huron. Had the river water been treated with an anti-corrosive agent, as federal law requires, the leaching would not have occurred, and the tap water in Flint would still have been safe to drink.

Homeostasis is the process by which the human body keeps itself regulated. Despite differences in environment, the human body maintains properties like its fluid content, temperature, mineral, and glucose content at a relatively stable level. Water is essential for survival. Without water a human can only survive for a few days. Dehydration (the excessive loss of fluid from the body) can happen rapidly, especially in hot environments. The body tries to maintain its core temperature at a constant level. When the body gets hot, sweating begins and the moisture evaporation on the surface of the skin helps to cool the body. Yet, if you do not move to a cooler environment and rehydrate your body, even with sweating, dehydration will worsen. Thirst is the primary signal that the body provides to alert us that our fluid levels are getting low. We should drink regularly and not wait until we are thirsty to take a drink. Thirst is an early indicator that the body is already low on fluid.

The recommended quantity of water that should be consumed on a daily basis varies from country to country. The reasons for this are various. The location of the country impacts the need and frequency of body fluid replacement. Extreme temperatures cause the body to need more fluid. The diet of the inhabitants of a specific location also impacts the fluid intake that they require. (For example, in the US it is estimated that approximately 22% of the fluid that we consume comes from the food that we eat, yet European countries, who consume more fruits and vegetables than the US population, get considerably more water from the food that they eat.) Water quality also affects the amount of liquid consumed. In many countries water must be boiled before it is consumed and thus it is not as readily available as if you can simply turn on a tap and drink. For those who must boil water before drinking it, it is common for them to drink it warm or consume it hot made into tea. In China very little water is drunk and yet tea and warm water are constantly consumed.

Returning to the discussion about water temperature in the process of rehydration requires an explanation of how the body responds to heat and loss of fluids. As mentioned earlier, the first thing that the body does when it starts to get hot is to sweat; however, if it continues to be hot, it eventually stops sweating to conserve body fluids. Sweating will restart rapidly after liquid has been consumed. In addition, it has been found that we drink more fluid when it is cool, not cold or hot. When recovering from dehydration our return to sweating is more rapid and profuse when the liquid consumed is around 16^o C (around 60^o F) or the temperature of cool tap water.

Hopefully, this article will remind readers that warmer weather is upon us and we all need to remember to drink plenty of water. For those who are unable to take a drink without help, Mealtime Partners offers an assortment of hands-free drinking systems. For more information about these systems click here.

Ideal for People on the Go!
The Front Mounted Drinking System can accommodate most cups and bottles. Therefore you can have a cup of coffee, a bottle of water, or a soda simply by changing out the container. The cup holder can be used with a Koozie in it, or by simply putting the container directly into it.
Front Mounted Drinking System for Slide-Track mounted on Slide-Track rail below seat	Front Mounted Drinking System for Slide-Track mounted on Slide-Track rail below headrest
The black Flex Arms that hold the cup holder come in lengths from 6 inches to 30 inches in 6 inch increments. They can be bent to position the cup holder in the most accessible position for the user. Once bent they will hold their position until they are readjusted. The Front Mounted Drinking System is like buying a custom drinking system! To see all of our drinking products, click here. For more information about the Front Mounted Drinking Systems for manual wheelchairs, click here. For more information about the Front Mounted Drinking Systems for wheelchairs with Slide-Track rails (as pictured above), click here (The drinking systems for both types of wheelchairs are identical. Only the method of clamping to the wheelchair is different.)

Pros and Cons of Sports Bottles

Summer is almost here and we are all enjoying being outside more. With outdoor actives comes the need for cool drinks that will remain cool while we are recreating or relaxing. It is not uncommon to fill a bottle or glass to the brim with ice and then add water or another beverage. When water is added, the water will remain cool for a long time and the ice gradually melts. When a beverage is added to ice, it will eventually become diluted and lose some (or most) of its flavor as the ice melts. Once we have our drink ready, we may put a lid on the bottle or cup to guard against spilling.

Many people use water bottles to maintain their hydration when they go out doors. The types of bottles commonly used are called “sports bottles”. They come with a wide range of different tops. Yet most of the tops have some sort of drinking spout. The spout may flip up when open and look somewhat like a short straw. Regardless of exactly what the spout is like, it requires that the bottle be tipped up to drink from it. This is no different than drinking from any cup, glass or bottle, whether it is a soda bottle or a bottle of water (i.e., containers that lack a straw). The problem with drinking from a bottle, in general, is the way we position our head and chin when we take a drink from it. To avoid spilling, we tend to lift our chin and tilt our head backwards. We then put the bottle top or spout to our lips and allow liquid to pour into our mouth. By controlling the angle of the bottle the volume of liquid that goes into our mouth is regulated. But, and this is a very large but, to drink in this way, though convenient, increases our risk of choking, particularly for individuals with disabilities. When we position our head with our chin tilted upward we extend (or stretch) the laryngeal portion of the pharynx. This makes full closure of the epiglottis more difficult because all of the skin and muscles in the neck are extended, and liquid can more easily penetrate the larynx, causing choking. In more common language, when we tip our head up, the flap in our throat that covers the tube that provides air to our lungs, may not close totally due to the tension of the tissue in our throat due to the upward stretch of the chin and throat. 

How can we lessen the risk of choking and still enjoy the convenience of using sports bottles? If we tuck our chin downward, rather than elevating it when we drink, we will lessen the risk of choking. Drinking from a bottle with the chin tucked downward typically reduces the volume of liquid that can be held in the mouth with each tip of the bottle. Thus each swallow will potentially be of a smaller amount of liquid. Combining the ease with which the epiglottis can close over the larynx and the reduced volume of liquid being swallowed, choking risk is greatly reduced.

This discussion is intended to address anyone drinking from a bottle. But when someone else is holding the bottle for another person to drink, positioning and regulating the volume and flow of the liquid is more difficult. Typically, it is easier to drink from a cup or glass than from a bottle if you are being helped when you drink. For people who are unable to hold a bottle or cup and must be provided a drink by another person, a straw is a very good method of providing a drink. The person drinking can hold their head a downward, rather than tipping their chin up, and they can sip through the straw, choosing how much liquid to drink with each sip.

For those who are unable to hold a cup but who can drink through a straw, Mealtime Partners offers an array of drinking systems that can be accessed hands-free. The Front Mounted Drinking System allows user chosen containers to be easily mounted and exchanged as the day goes by. For example a coffee mug might be provided in the morning, water at lunchtime, and a soda or beer in the evening. For more information click here.