The Benefits of Proper Hydration [Podcast with Dr. Dana Cohen]

As I’m recording this podcast today, we are finishing up PCOS Awareness Month and my 30 day Back on Track PCOS Challenge. And the first daily challenge of that Back on Track Challenge was to drink more water. And as I was researching what I wanted to say about hydration and water, I stumbled upon this awesome book, and I have it right here called Quench. And I invited Dr. Dana Cohen on to the PCOS Diva podcast.

She’s the author of Quench and talks about how hydration is the key to flourishing. And I really believe that, but I didn’t realize that I was drinking lots of water but wasn’t really properly hydrating until I read her book. So I’m thrilled that she wants to come on the PCOS Diva podcast to share. So welcome Dr. Cohen.

Thank you. Thank you for having me, and thank you for that lovely intro.

Well, I want to just give people a little bit more information about you. So for over two decades, you’ve been on the leading edge of integrative and functional medicine, guiding thousands of patients through protocols that initiate cellular repair and restore balance in the body. She worked side by side with the late Dr. Robert Atkins, which is very cool. And she practices with an emphasis on the individual understanding that no two patients are alike, and focuses on nutrition and limits her patients reliance on prescription medications by using diet, lifestyle changes and nutritional supplementation. Honestly, you’re like the ideal type of doctor that I encourage women with PCOS to look for.

It’s just good medicine.

Yes.

It’s good old fashioned medicine. Yeah.

So in your book, you have a little checklist of symptoms if you are chronically dehydrated. And I was going through them and so many of them overlap common PCOS symptoms. So trying everything to lose weight and you can’t lose weight, feeling bloated, brain fog, afternoon fatigue, daytime sleepiness, poor sleep, muscle stiffness, joint pain. So if you’re listening and any of those symptoms you can relate to, then you definitely want to stick with us for the podcast today.

Yeah. So it’s interesting, as you’re saying that, I just recently did a talk on long COVID, and those symptoms overlap as well. It’s any kind of chronic illness. And I always say, before you do any diet regimen, any new supplement regimen, start with hydration. You have to start here. You have to start to learn how to hydrate properly, what that means to hydrate properly. And you have to live in your body, meaning we’re not being cut off from our necks down. Live in your body, know what it feels like to feel fully, properly hydrated.

And unfortunately, there’s no great one single test that you can do to say, “Oh, what does that mean?” You have to experience it. And it is the one thing that I’m a stickler on, meaning day in and day out, you need to stay on top of your hydration. So like diet stuff, I’m like, “Oh, I am a believer in the 80 20 rule. Give me 80%.” But with hydration, it is a day in, day out thing. You can’t mess up one day or else you’re not going to feel good. I mean, you can make it up, but it’s something that we should, for optimal wellness, stay on top of.

The other thing that was surprising to me after reading your book is that so many of us with PCOS or at risk of type two diabetes because of the insulin resistance being just a major driving factor of PCOS. And I was surprised to learn that dehydration puts us at greater risk of developing type two diabetes. So maybe we can start there.

Yeah. And I’m so glad you brought it up because I was going to bring it up if you didn’t. Actually, the book before me, probably about 20 years before I wrote this book, is Dr. Batman is what he is affectionately known as, but it’s Batmanghelidj, it’s called Your Body’s Many Cries for Water. And he does a really good job of explaining the physiology of how diabetes is connected to low grade dehydration. And actually, the late Dr. Nick Gonzalez has a… And all these references are in my book, by the way. Dr. Nick Gonzalez has a great article that he wrote about… I’m not going to remember the name of it, about dehydration.

And really it’s sciency and it’s hard. But for anybody who’s really into it, he really lays it out. It’s complicated of how that this low-grade dehydration… And by the way, I want to differentiate between low grade and overt dehydration. So when I say you need to stay on top of your hydration every day, I’m talking about this low grade, subclinical, we don’t feel anything necessarily dehydration versus overt dehydration where you’ve drank too much and you’re vomiting and something like that and you need to go to the hospital.

So this low-grade dehydration, day in and day out, can be a risk factor for type two diabetes and blood sugar issues later on. And there’s a real physiological mechanism to it that makes complete sense. And so even I also say… So the two big things that when I talk about chronic disease and why you need to stay on top of hydration, diabetes is a huge one, and it’s getting worse. But also Alzheimer’s. Think about, Alzheimer’s is now type three diabetes, so there’s a blood sugar issue there.

So once again, if you want to prevent Alzheimer’s, start with hydration. And let alone all the things that we already know about dehydration, constipation, migraines, joint pains, dry skin, all of those things, chronic fatigue, brain fog. Those things we know a lot about. But the big things like diabetes and Alzheimer’s, that’s new information and important. It also puts you at risk for certain cancers, specifically colon cancer and kidney cancer. We want to be flushing those organs all the time. So start with hydration.

Well, I think a lot of us don’t realize how much our modern lifestyle causes dehydration. And you really do a good job explaining this in your book. But if you’re not exercising a lot and sweating, say, and you’re drinking coffee and you’re feeling like I’m drinking a lot of beverages during the day and I’m not really sweating, so I’m not in danger of getting dehydrated, what am I doing wrong?

Yeah. Well, you may not be doing anything wrong. Once again, it’s very individualized. If you’re eating a diet full of really hydrating foods, vegetables, very plant centric diet, some people may only need one glass of water a day. So it’s very individualized. It’s possible you don’t need anymore. But if you’re not feeling good, if your joints are bothering you, if you’re stiff, if you get that afternoon fatigue or brain fog, think about hydration so you might not be.

And the other thing is, just try it on. Try hydrating a little bit better and seeing if you feel a difference. That’s also a way of looking at it. The big symptom though, the big thing that I often tell people, I think the most important thing to look at, not the color of your urine, I think that’s important, but the biggest thing is, we’re meant to urinate every two or three hours during our waking hours. So if you’re not getting up to pee every two or three hours, you’re probably not hydrating enough. That’s a really important thing to look at our output versus anything else. So that’s something to keep in mind, even if you think you’re doing it right.

You mentioned coffee. I want to talk just quickly about coffee. One or two cups of coffee a day is fine. They’ve done research, anything more than four cups of coffee or tea becomes a diuretic. So it is a little dehydrating after that. I think more importantly is what are you putting in there. Are you putting in fake sugars? Are you putting in tons of sugar? Are you putting in dairy that you’re sensitive to? So that’s more important to me than anything, than just drinking a few cups of coffee.

So what I thought was really interesting is the difference between hydrating or this idea that we think we need to drink eight cups of water a day, and that is hydration. But you really break this down and give us tips in your book on how to really get that water into your cells so that it truly hydrates you. And I was hoping you could share some of those with us.

Yeah. Let me just start with an example so some people may be able to really relate to this. How many people do you know say, “I drink so much water. I’m drinking water all day long and I can’t quench my thirst.” So it doesn’t matter how much water they’re drinking, it’s just not getting in them. And it’s true, especially yogis, my really healthy yogis, “I drink so much water.” But the issue is absorption and holding onto that water. That’s more of the bigger issue.

And we talk a lot about the work of Dr. Gerald Pollack. He’s a world-renowned water researcher based in Seattle who has discovered that there’s a new phase of water, that there’s a… I’m sorry, a fourth phase of water. It’s not new, it’s there. And that fourth phase of water is… So we know that water exists as liquid, ice and vapor. We’ve known that since elementary school. So now, there’s a new phase of water, and he describes it as, he calls it easy water. Some people may have heard of it as structured water or gel water. Whatever you want to call it, it’s this new phase of water.

And it basically has to do with how those H2O molecules layer upon each other. And it’s in that layering that they share electrons and they have different properties. It’s in that sharing of electrons that they have properties where they hold energy like a battery. But the bigger thing is that it’s believed that that phase of water is how it exists in nature. And it’s also in that phase in how it exists within our intracellularly, within our cells. So the idea of the book is we got to eat more of our water. The biggest, the most visually appealing way to think about it is think about cactus, aloe. You open up an aloe and literally gel falls out of it.

Now, there’s other things in that gel, but that gel is loaded with structured water. Think about cucumber seeds. The seeds are loaded with gel water. Chia seeds, you put chia seeds in water, they plump up. And those chia seeds are great at absorbing and holding onto that water and attracting water more into your cells. So that’s really the big idea is a plant. There’s nothing mind blowing here. We need to eat more vegetables. Make it a plant centric diet. I mean, you said I’m somebody who comes from Dr. Akin. I eat meat. I eat good meat, but I eat meat. But I make sure that I have a ton of vegetables also.

And I think that’s where a lot of us are maybe falling a little short. We have to push ourselves to eat more vegetables. I have a few rules. I make people eat a side salad with lunch and dinner. It has to be a rule. And I don’t care if it’s a few leaves of iceberg lettuce with olive oil and vinegar in it. If that’s all you can do, fine. Shovel it in. And that’s a good thing. People always said iceberg lettuce is, there’s no nutritional value in it. It’s probably one of the most hydrating lettuces that you can eat. So there’s a ton-

Oh, that’s great.

Right? And I love iceberg lettuce. And now I have a real great reason to eat it.

Yeah. But, you know what? You’ll make my son very happy because I’ve stopped buying it because of that idea that it has low nutritional value, and he’s always… You go to these cheaper restaurants or whatever and they give you a salad with iceberg lettuce. He’s like, “Mom, why can’t you buy this lettuce?” So now you’ve given me permission, I guess.

Awesome. I love it. It’s great. For that reason alone, it’s so nutritious. It’s a powerhouse as far as I’m concerned. You could throw on some herbs and spices on there, like our parsley. You could add some other things in there. Tomatoes, cucumbers. But yeah, really hydrating. So I lost my train of thought.

Oh. So I’m a big proponent of smoothies for breakfast. Women with PCOS, a lot of us are stuck in that American diet, muffins and pancakes and toast for breakfast, and that just sends our blood sugar just to the roof.

Yeah.

But smoothies, I think it’s a palatable way to get in. I think of it as a protein with a really good high quality protein powder. A way that a lot of women who are nauseous in the morning, you can sip on a smoothie. But you view smoothies from probably a different vantage point than I do. So you could share a little bit about that.

So yeah, I love the idea of a smoothie for a meal replacement. That’s fantastic. I mean, the essence of the book is, it’s a smoothie book. It’s really the essence. So I can’t tell you how many lives I’ve changed by just adding in one green smoothie a day. It’s life changing for people who don’t do that already. So when I talk about a green smoothie in the book, we differentiate it. So it’s not a meal replacement, which I think is a great idea, but it is a blended green with water, and then whatever else you want to put in there. You can put lemon, ginger, berries, green apple, whatever else you want to put in there, as opposed to yogurt, a milkshake.

This is a green drink that’s very low glycemic unless you put a ton of bananas and other. But a half a banana, quarter of a banana for taste, a half a green apple, a lots of berries, it’s a great way to get hydration in. And we liken that to, one green smoothie is probably as hydrating as drinking the three times the amount of bulk water, regular water. And that’s a made up number by the way, but I know it to be true. It’s just so much more hydrating than drinking three times the amount of bulk water. Two or three glasses of bulk water versus one green smoothie.

And then let alone the nutritional punch that you get. All the things that you’re putting in there. There was a recent study that came out, I’m not sure, a year or two ago about getting 30 different plants into your diet a week. That sounds like, oh, that’s difficult, but it’s really not. When you think about spices and nuts and fruit, vegetables, grains. 30 different plants a week, those people had the most diverse gut microbiomes, which is really good and important. And that’s where I’m really leading all of my patients now. The idea of a keto diet, I still put some people on a keto diet, except it doesn’t work long term. You can’t stay on it long term. Cycling maybe the answer. But we need to learn how to eat and get real nutrient dense foods into our diet.

So do you have an opinion of smoothies versus juicing? Yeah.

Yeah, I do. Juicing, you’re not getting the fiber. You’re taking out all the fiber. I think there’s a place for juicing. I think there’s a real place for it in cancer patients. I think there’s something there. And I think juicing, sometimes I’ll go, even on the street if I go into a store, for some reason, people don’t make smoothies when you’re out. They make juices. They press their juices. So it’s hard to find a good green smoothie place versus a green juice. So if I’m stuck, I’ll buy a green juice. It’s just not as filling. It’s still very hydrating. You’re still getting some nutrients. I think smoothies are better.

So could you share us what your favorite green smoothie combination would Be?

Yeah, I’ll give you just a real foundational one. So whatever greens you choose, it could be Swiss chard, it could be kale, it could be spinach. I tend to use more spinach. I try to switch it up though, get those three 30 different things in. So I do try to switch it up. I do misfits market. I don’t know if you’ve heard of them. Misfits markets gives you ugly fruit and vegetables that they can’t sell. So sometimes, they’ll send me some interesting things. Like, “I’ll play with that.”

So whatever green you want. Water. I do add a little chia to it. I love ginger. So with my ginger, I don’t even peel it.

Oh, okay.

I clean it, brush it off, clean it, I cut it into little knuckles, little chunks, and I freeze it. And so I pull one of the little chunks out, throw it in. I’ll do a half a green apple mostly. I do do a lot of apple, probably more than anything. I have frozen berries too that I’ll use, real berries in the summer. And lemon. Just that’s a real foundational. Sometimes, I play around. And when misfits, whatever they send me, I’ll play around with it. Sometimes it’s a hit, sometimes it’s a miss. I’ll hold my nose. But I feel like it’s fun. It’s kind of fun to blend things. And I just love that. It’s so fun.

And you really need a high speed blender. If you’re going to be blending up really fibrous vegetables, you have to have something like a Vitamix.

Well, let me just tell you, and full disclosure, I’m in the process of writing a book with this gentleman. So the inventor of the NutriBullet has come out with a new blender and it’s a personal blender and it’s called The Beast. And it’s less than half the price of a Vitamix, but it is a personal blender. So you’re only making one or two drinks in there. Vitamix is a big thing. And it is functional and beautiful. It’s really the best blender on the market today. It’s called The Beast.

Oh, so it’s already out? [inaudible 00:19:15].

It’s out. Yeah. It’s in Bed Bath and Beyond. It’s on Amazon. I’m sure you’ll start to see Instagram ads now that we talked about it.

Especially in time for the holidays.

Oh yeah. It was on Oprah’s Favorite Things last year. So yeah.

Oh, Okay. It’s not on my radar. Yeah.

It’s fantastic. And it’s gorgeous too, which is nice.

So we talked about smoothies and chia. I also wanted for you to share the importance of salt and getting electrolytes and how that increases hydration.

Yeah. So salt is not the demon it once thought it was. And there’s lots of research to back that up. I always like to say though, if you have high blood pressure or heart disease, you may need to be a little careful. But for the most part, when doctors have been talking about salt in the past, they’re really talking about sodium. So these foods are loaded with sodium chloride. Versus salt, we’re talking about natural salt, real salt, sea salt, rock salt. Literally there’s a brand called Real Salt that I love.

And just do a taste test. Take Real Salt and the umbrella girl salt, table salt, tip your finger in one, you’ll taste the difference. So the difference is that they have the whole spectrum of minerals in real salt and rock salt and sea salt versus just sodium chloride in table salt. And I think that that’s the difference in what has caused problems in the past with people with heart failure and heart disease and that kind of thing.

And in fact, there’s so much so that they were recently… I’m not going to say it because I don’t have the full details in my head to give you, I don’t want to give you wrong information, about congestive heart failure and salt.

Oh, okay.

So I’m not going to say it. But yeah, salt is important, especially for those yogis that I was talking about earlier. If you’re sweating a lot, especially you’re doing a hot yoga or you’re a sweater, you’re exercising and you’re not replenishing the minerals that you’re losing through sweat, it’s going to be harder for you to hydrate. And by adding a little bit of salt sometimes in that morning water and a squeeze of lemon for maybe even more vitamins and minerals is a great way to hydrate, especially those who maybe feel a little dizzy when they get up, those kind of things. Yeah. So salt is not the demon it once was. I think sodium is the demon that they’re really talking about.

So the other thing that I wanted you to discuss with us was, and I think I was trying to get to this when we were talking about living in the modern lifestyle, but this concept of environmental dehydration, and just being in an office all day with fluorescent lights and phones and technology.

Yeah. It’s simple. It’s simple. Think about it. Think about when you put your phone up to your ear, there’s heat. I mean, this is the simplest way to think about it. There’s heat. And people have this phone up to their ear all the time. There’s heat that’s coming. It’s sucking hydration out of us. Fluorescent lights are sucking hydration out of us. Our modern day diets, processed foods, prescription medications, or even over the counter medications.

We looked at a list from the FDA of people that had recorded overt dehydration from medications to the emergency room. And they were things like the purple pill, Ambien. And so we’re not even talking about antihistamines. We know that you take an antihistamine, your lip surface is like, oh. Aspirin. These are things that cause dehydration. Your body has to process them, it has to work hard, it needs water to process them. And then the other big thing, let alone the environment. So we’re living in air conditioning and heat.

People think that the winter’s not as dehydrating as the summer. I actually think, I live in New York, it’s worse because we have all those radiator heating. Our environments are super dry. But the bigger thing and the more interesting thing is that sitting all day long is dehydrating. I’m using that word loosely, but there’s a whole chapter on movement. And a few years ago, there was this brilliant French surgeon who decided to put a camera under the living skin of somebody to look at fascia. Fascia is that connective tissue that surrounds every joint, every muscle, every cell, it’s everywhere.

Before this, nobody ever looked at fascia. It was only done on dried desiccated cadavers. And you basically cut through to get to the organ or to get to the vessel. And what we see is that fascia actually acts as a delivery system of hydration. It acts as a hydraulic pump. So this, moving your bicep, doing a curl is actually squeezing water in and out of your joints. So the idea of you have to move your joints to lubricate them, we actually now understand there’s a real physiological thing that’s happening.

So when we’re sitting, we’re squelching delivery of hydration to our periphery. And there’s actually tons of studies about people who fidget live longer. They’ve done muscle biopsies, and they found that if they dehydrate somebody and do a vessel biopsy that that vessel low-grade dehydration 2%, which by the way, we all get to that in every afternoon. Losing 2% of our body water is nothing. It’s very easy to do. You dehydrate somebody 2%, do a vessel biopsy, and the damage is equivalent to the damage of what smoking a cigarette does to your vessels.

Oh my goodness.

Yeah.

Wow.

Yeah. So we’re sitting, we’re squelching that delivery to our periphery. So once again, we want to get up to pee every two hours. It not only gets us up and moving, but we know that we’re hydrated.

Yeah. So you have a whole program in your book on how to stay hydrated through the day. And it does include a series of what you call as micro movements.

Yeah.

Making sure that you are getting up.

It’s simple. It’s so simple. I don’t want people to get scared. It’s a five day, simple program. You can do it during your work week. And it’s basically just pushing you to feel what it feels like to feel well hydrated. And the movements, we made them up, we call them micro movements. So bobbing your head up and down is a micro movement. Twisting. Twisting is important. We don’t twist enough. I use this example a lot, but think about our cars now have rear backup cameras, so we don’t even turn around in our driveway to pull out the car.

And there’s some interesting anthropological studies that we’re born… I’m making this number up, but it’s something like three or 400 different movements we’re born with. And by the time we’re 40, we have 40 movements. We lose all those things. So it’s important to keep moving. And it’s interesting because now this is the time that if I’m giving this lecture to people, you see the audience start to move and-

I know. Fidget.

… fidget. Yeah. So we have to move. We have to stay on top of that too. It’s important.

Well, I’ll tell you, just having your book on my desk the last month or so as I was getting ready for this podcast, every time I saw it, it would remind me, “Oh, I need to go drink a glass of water.”

Oh, mission accomplished. I love that.

Yeah, I know. So I think the question I want to end with is, do you have any great way to remind ourselves to drink more? I know there’s phone alarms. And actually, someone had a brilliant idea when we were talking about this challenge on day one is she puts hair elastics on her water bottle.

Wow. I love that.

And moves them up and down based on how many glasses of water she drink. I thought that was a great idea. But any-

That’s so great. I love that.

… any tips or tricks for us?

Yeah. So I’m going to give you a couple things. Instead of counting or knowing how much water you have to drink, I have rules. So I gave you one rule already, a salad with lunch and a salad with dinner, a side salad. That’s a rule. Before you eat your meal, eat your side salad. The second thing, wake up six to 18 ounces of water with a little pinch of salt, a little squeeze of lemon every day. That’s a rule. One green smoothie a day. That’s a rule.

So I think if you do those things… And the other thing is keep a bottle of water at your desk. Buy a good water container, keep it at your desk, keep it in front of you and take a look at that note. I just want to just say though, we don’t have to be drinking eight to 10 bottles of water all day long. It’s not necessarily about drinking more and more water, it’s about knowing how to hydrate. So that cutoff could be just one big container of water that you’re sipping out all day long. The one thing you may want to count is how often are you getting up to pee.

Okay.

That maybe would be the one thing that I would say to try to keep on top of, like do a little slash and cross thing.

Okay. Yeah. And I really encourage you to pick up this book. It was really enlightening for me. A lot of things that I hadn’t learned before. So thank you so much for coming on and sharing your wisdom with us.

Oh, thank you.

Can you tell us, if somebody’s listening… And gosh, they could really use an integrative doctor that does just what you do, looks at the unique individual and isn’t pushing pharmaceuticals. There is a time and place for those, but looking at lifestyle factors. And I love that prescription of two salads a day. So tell us how we can reach out to you.

So my website is www.drdanacohen.com. So drdanacohen.com. D-A-N-A-C-O-H-E-N. That’s the best way to see what I do. Follow me on Instagram. That would be great. It’s @drdanacohen. Yeah.

Okay. Excellent. Well, thank you so much Dr. Cohen for joining us. And thank you everyone for listening. I look forward to being with you again very soon. Bye-Bye.