Water Retention
Beating the Bloat
Forget that "ashes to ashes, dust to dust" stuff. Water to water is more like it. Our aquatic ancestors brought the sea with them when they crawled on land, and human beings remain mostly fluid. We're 56 percent fluid, to be exact--but sometimes more, sometimes less, depending on the degree of bloat.
People who retain fluid know just how easy it is to swell up like a sponge. "Weight fluctuations of as much as four to five pounds in a single day are not uncommon in women with fluid retention problems," says Marilynn Pratt, M.D., a physician in private practice in Playa del Rey, California, who specializes in women's health.
Bloating occurs when fluid that normally flows through the body in blood vessels, lymph ducts and tissues gets trapped in tissues in the interstitial spaces, the tiny channels between cells. The fluid flows through the membranes of tiny blood capillaries into the tissue cells because of osmotic pressure (cell wall pressure), which is controlled by electrolytes such as sodium. A high sodium level attracts more fluid from the blood into the cells, where the fluid gets trapped and the cells become overhydrated. This occurs more readily in women, because their tissues are designed to fluctuate or expand for pregnancy.
Lots of things can cause waterlogged tissues: allergic reactions to foods, heart and kidney problems and prescription drugs such as hormones. In women, hormonal changes often cause bloating beginning seven to ten days prior to menstruation, as higher levels of estrogen and progesterone during that part of the cycle cause the body to retain salt (sodium) and therefore to retain fluid in tissues. "Replacement hormones (especially estrogen alone) can also cause substantial bloating and weight gain," says Dr. Pratt.
Usually, fluid retention is uncomfortable but not health-threatening. People who retain fluid because of heart or kidney problems, however, or who are taking diuretics (water pills) need to be under a doctor's care for their problems, says Dr. Pratt.
Nutritional changes for fluid retention are meant to counteract hormonal changes, balance the minerals that influence body fluid and eliminate foods that trigger bloating in some people. Here's what doctors say helps.
| Food Factors If you know that bag of salty chips is going to lead to water retention, then you pretty much know what you have to do to avoid the problem. Other dietary choices are not quite so obvious. Here's what many experts recommend. Drink more water. If your fluid retention is caused by excess salt intake, cut back immediately and drink plenty of water, at least eight glasses a day, to help flush out the salt, says Marilynn Pratt, M.D., a physician in private practice in Playa del Rey, California, who specializes in women's health. Watch out for MSG. MSG, or monosodium glutamate, also contains sodium. MSG is found in lots more than Chinese food; it's a common ingredient in processed foods. Read your labels for "MSG" or "hydrolyzed vegetable protein," which contains MSG, and avoid these foods as much as possible. Avoid alcohol. Alcohol does act as a diuretic at first, making you lose excess water. But this loss of fluid can progress to the point of dehydration. And medical experts have another good reason for giving this advice: Alcohol depletes your body of important vitamins and minerals. Try a natural diuretic. Several herbal teas have a mildly diuretic effect. Parsley tea is the best-known type. Brew two teaspoons of dried leaves per cup of boiling water and steep for ten minutes. Drink up to three cups a day. Lose weight if you need to. Overweight women have more estrogen in their systems because fat tissue produces estrogen, Dr. Pratt says. This puts them at higher than normal risk for retaining fluid in their tissues and for adding to their overall weight. Overweight women need lots of water and must drastically reduce salt intake. Ferret out food allergies. If you wake up in the morning congested, with puffy eyes and a headache, suspect a food allergy, says Joseph Pizzorno, Jr., N.D., a naturopathic physician and president of Bastyr University in Seattle. "In my opinion, wheat is by far the most common allergy-causing food, but it could be any food. So it's best to get tested," he says. |
The Salt Connection
Most of us know that too much salt in our bodies can lead to temporary swelling. An evening's overload on movie popcorn or ballpark franks can leave us puffy-eyed and headachy, with stiff, swollen hands and feet, the next morning. "That's because our kidneys retain fluid in our bodies so that the excess salt can be diluted," explains David McCarron, M.D., professor of medicine and head of the Division of Nephrology, Hypertension and Clinical Pharmacology at Oregon Health Sciences University in Portland. And, contrary to what you might think, drinking more water will not worsen fluid retention and may even help.
And some researchers believe that too little salt in the diet can also cause fluid retention, Dr. McCarron says. "We speculate that too little salt may trigger the kidneys to secrete more of a hormone that conserves salt, in part by reducing urinary output," Dr. McCarron says. He recommends keeping salt intake at 2,400 milligrams (a little more than one teaspoon) a day, an amount thought to maintain optimum blood pressure.
For most people, this still means cutting back by about 1,000 milligrams (about a half-teaspoon) a day. Since most of our salt comes from processed foods, not from the shaker, the best way to cut back is to look for sodium-free or low-sodium versions of cheeses, nuts, crackers, lunchmeats, canned soups and vegetables.
"And women who are dieting may be eating a lot of celery, which has a higher level of sodium than any other vegetable," Dr. Pratt says. Munch on carrot sticks instead, she suggests.
Mix-and-Match Minerals
Getting too little potassium, calcium or magnesium in your diet can also contribute to fluid retention, Dr. McCarron says. "These minerals all play important roles in the fluid balance in your body--your body's ability to move fluid into and out of cells and from the bloodstream or lymphatic system into tissues and back again," he says.
He recommends getting about 3,500 milligrams of potassium a day (the Daily Value), an amount you can obtain by eating at least five servings of fruits and vegetables. (Potassium is lost in cooking water, though, so don't count on boiled potatoes or greens for this mineral unless you consume the water that they're cooked in.)
For magnesium, aim for the Daily Value of 400 milligrams, Dr. McCarron suggests. Most people fall short of this amount, with men getting about 329 milligrams a day and women averaging 207 milligrams a day. Nuts, legumes and whole grains supply the most magnesium; other good food sources are green vegetables and bananas.
And for calcium, doctors recommend striving for 1,000 to 1,500 milligrams a day. One quart of skim milk contains about 1,400 milligrams of calcium. On average, men between ages 30 and 70 get close to 1,000 milligrams a day, while women in the same age group consume only about 700 milligrams daily, at least 300 milligrams less than they need.
If you have heart, kidney or liver problems or diabetes, or if you're taking a diuretic to relieve fluid retention or high blood pressure, you should supplement these minerals only under medical supervision to make sure you don't develop dangerously high blood levels, says Dr. McCarron. People who are taking nonsteroidal anti-inflammatory drugs, potassium-sparing diuretics, ACE inhibitors or heart medications such as heparin should also check with their doctors before supplementing potassium.
| Prescriptions for Healing There are a number of nutrients that can help relieve some cases of water retention. Here's what some experts recommend. Nutrient Daily Amount
Calcium 1,000-1,500 milligrams Magnesium 400 milligrams Potassium 3,500 milligrams Vitamin B6 200 milligrams, taken as 4 divided doses for 5 days before the start of menstruation Plus a B-complex supplement
MEDICAL ALERT: Doctors recommend limiting your sodium intake to no more than 2,400 milligrams a day. Some doctors advise against supplementing calcium, magnesium or potassium without medical supervision if you have diabetes or heart, kidney or liver problems or if you are taking diuretics. People who are taking nonsteroidal anti-inflammatory drugs, potassium-sparing diuretics, ACE inhibitors or heart medications such as heparin should also check with their doctors before supplementing potassium. Vitamin B6 can be toxic in large amounts. Do not take more than 100 milligrams a day without medical supervision. The higher dose suggested here may safely be consumed for the number of days noted to relieve premenstrual bloating. |
Vitamin B6 May Aid Hormone-Related Bloating
Most women don't need a calendar to tell them when that time of the month is imminent. Their tender breasts, swollen hands and feet and tightening blue jeans from abdominal swelling--all signs of fluid retention--mark time as well as any calendar.
In addition to the changes in mineral intake outlined above, some doctors recommend increases in the B vitamins, B6 in particular. "Vitamin B6 plays a role in the body's use of several hormones associated with fluid retention, including estrogen and progesterone," says Dr. Pratt. "By helping the body to metabolize these hormones, B6 may help the liver metabolize excess amounts, which may be present during the premenstrual period."
In one study, in fact, 500 milligrams of vitamin B6 daily relieved the breast tenderness, headaches and weight gain associated with water retention in 215 women.
If you'd like to try vitamin B6 for hormone-related fluid retention, Dr. Pratt recommends taking 200 milligrams a day (50 milligrams four times a day) for the five days before your period begins. Take a B6 supplement along with a supplement containing the rest of the B-complex vitamins. "These nutrients interact, so they work better when adequate amounts of all are available," Dr. Pratt says.
Vitamin B6 can be toxic and can cause serious nerve damage in excessive amounts. For these reasons, it's best not to take more than 100 milligrams a day without checking with your doctor. You may, however, safely take up to 200 milligrams daily for five days to relieve premenstrual bloating, Dr. Pratt says. If your hands or feet start to feel numb or clumsy, stop taking B6 and tell your doctor.
