Don't Drink Water When You Eat

This is a five minute audio excerpt of Dr. John Gildea talking about the dangers of low salt, especially in the elderly population. He discusses how high salt leads to proper stomach acid and when you drink water, that acid gets neutralized, which can causes problems.

Transcript:

Because of a paper that we wrote, it's called the Gastro-Renal Reflex. We defined a physiological response to salt where, when you eat something salty, your stomach sends a signal to your kidneys to get rid of salt. But if you actually want to load up salt, yeah, it would be good to bypass that signal. So the biggest issue with absorbing electrolytes is that you need your stomach to be acidic in order to do so. And generally, the older you get, the more difficult that you have with electrolyte absorption. And so, one of the problems that I see that's out there is that as you get older, you don't reabsorb as much salt. And so, what you need salt for is all kinds of things, but one of the really important ones is the ability to acidify your stomach. And so, this kind of plague that's going on with the elderly and GERD, and reflux, and problems with their stomach is that if you don't make enough acid, right while you're eating, then the upper sphincter to your stomach doesn't close completely, and so the acid that you do produce leaks upwards through your esophagus, and up ,and up causes damage, because it is acidic. So you want your stomach acid to be high, right after you eat. That happens naturally when you're younger, but that goes away as you get older.

So, you need acid to absorb minerals, and then you also need it for intrinsic factor, so that you can absorb B12, methyl B12, which is kind of in the middle of all of your metabolism. So those are kind of two big things with salt and the fact that the whole world is telling you to eat less salt, and you have a salt thermostat in your brain that's very hard to over override, but still over time, you're losing more and more salt as you age. I think that majority people, as they're older, they're low in salt.

But if you are hospitalized with a low salt more than one time, your chance of fatality goes up massively. You go into the ER and they find out your sodium's low, they put you on IV, and you feel great. I hear people talking about this all the time, because they basically put an IV sodium, get your electrolytes back, and send you away, you feel fantastic, and then 10 days later you're back into hyponatremia, hypovolemia and feel like crap again. When that happens, your chances of fatality goes up massively, if you're elderly. We know a lot of people that are elderly and especially friends' parents, and they talk about their clinical scenario, and they'll talk about 20 different symptoms, and I'm like, "Every one of those is low salt."

And so, we talk about, your neuroendocrine system in your stomach is really important. It needs to be dynamic, just like any other part of your endocrine system. To be able to respond strongly to it, and dampening it all the time with one particular drug that pushes it to one side, just obviates the obvious that it needs to be dynamic. When you're eating, you have to produce a huge amount of hydrochloric acid in order to digest protein. But in between meals, you want it to be low. So you want it to be dynamic. High during, low in between, and so, your body has to be able to change dramatically.

There's a couple of really neat papers where you take people that, they pop Tums all the time, because in between meals, they're producing asset all the time, and they want to neutralize it. It's a really cool paper that said drinking water in between meals is equivalent to taking a Tums. All you have to do whenever you feel a little bit off, your stomach hurting because of that acid being a little bit high, you just have to drink water. You dilute it. And it works just as well as the Tums.