The Importance of Adequate Hydration

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“Water is defined as an essential nutrient because it is required in amounts that exceed the body’s ability to produce it. All biochemical reactions occur in water. It fills the spaces in and between cells and helps form structures of large molecules such as protein and glycogen. Water is also required for digestion, absorption, transportation, dissolving nutrients, elimination of waste products and thermoregulation” (regulation of body temperature) (Kleiner, 1999).Hydration fact sheet- facebook (1)

cucumber-salad-food-healthy-37528mineral-water-lime-ice-mint-158821Key Facts 

Up to 2 litres of Water is lost daily due to bodily functions, such as perspiration, respiration, urination and defecation.

Diuretic substances in your diet such as caffeinated beverages, alcohol, high sugar and salty foods will increase water loss from the body.

Water requirements range from 8-10 glasses per day depending on diet and physical activity levels. As we age, we have a diminished sense of thirst and tend to drink less fluid, although water is still required. It is therefore important to ensure we drink an adequate amount of water, even in the absence of thirst.

Water can be consumed from drinking pure water as well as from eating certain foods. Depending on diet, up to 50% of your daily water intake can be derived from foods provided they are high in water content such as fruit, salad, soup and vegetables (i.e. iceberg lettuce and cucumber).

How dehydration impacts your skin condition

Key signs of mild to moderate dehydration include increased sensation of pexels-photo-136871pain, thirst, stiffness, headaches, lack of concentration, fatigue and skin problems.

The skin contains approximately 30% water. “Water intake, particularly in individuals with low initial water intake, can improve skin thickness and density and offsets transepidermal water loss (water lost through the skin surface)” (Popkin, Rosenberg & D’Anci, 2010). Hydration improves skin resiliency, elasticity and texture.

The water content in the skin contributes to important functions of the skin such as the development of a healthy skin barrier. The skin barrier guards the skin from microbial infections and infiltration of foreign substances which can cause skin flare ups.

Water deficiency can also lead to impaired skin processes, which can then worsen skin disorders such as dermatitis, psoriasis, acne and rosacea (Rodrigues, Palma, Tavares Marques & Bujan Varela, 2015).

Key tips to keeping hydrated

Create a routine: If you aren’t used to drinking water on a regular basis, start with four glasses of water a day. One glass on rising, one mid-morning, one mid-afternoon and one on retiring. This eliminates 4 out 8 glasses per day. Once you establish this routine, start adding additional glasses of water throughout the day, for example before meals

Convenience: Keep water with you at all times. Keep a refillable water bottle with you at work, in your car, and to take with you when you go on walks etc. Get used to sipping on water as part of your daily routine. Convenience is key, otherwise if it’s out of sight, it’s often out of mind!

Flavour: If you don’t like the taste of water, there are several ways to make it more enticing. Add some fresh herbs like mint, or fresh fruit, or a very small amount of juice (just enough to add a hint of flavour).

Variety: Mix up your water variety and add in some natural sparkling mineral water.

Eat foods high in water content: Eat plenty of fresh fruit and vegetables, in doing so will assist in keeping your body hydrated (this information should not replace any dietary information given by your psoriasis eczema clinic practitioner).

Be aware of cravings: if you are craving salty foods as this can be a signal from the body that you are dehydrated. Try drinking a glass of water before reaching for salty foods.

For more information on the health benefits of water and charts for daily consumption visit: https://www.nrv.gov.au/nutrients/water

Reference:

  1. Popkin, B., Rosenberg, I., & D’Anci, K. (2010). Water, Hydration and Health. National Institute of Health68(8), 439–458. http://dx.doi.org/doi:10.1111/j.1753-4887.2010.00304.x
  2. Kleiner, S. (1999). Water. Journal Of The American Dietetic Association99(2), 200-206. http://dx.doi.org/10.1016/s0002-8223(99)00048-6
  3. Rodrigues, L., Palma, L., Tavares Marques, L., & Bujan Varela, J. (2015). Dietary water affects human skin hydration and biomechanics. Clinical, Cosmetic and Investigational Dermatology4(411), 413. http://dx.doi.org/10.2147/ccid.s86822

PSORIASIS AND COMORBIDITIES

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WHAT IS COMORBIDITY?

Comorbidity is a concurrence of multiple diseases or disorders in association with a given disease, in this case, psoriasis.

INCREASED RISK

The patient with psoriasis has an increased risk of developing one or more of a number of other diseases/conditions that share many immunological features with psoriasis.

CHART 1: Comorbidities Associated with Psoriasis

Occular Inflammation –

Iritis

Uveitis

Episcleritis

Psychological and Psychiatric Disorders – Depression

anxiety

Suicide

Addiction

Inflammatory Bowel Disease –

Crohn’s Disease

Ulcerative Colitis

Celiac Disease

Irritable Bowel Syndrome

Metabolic Syndrome –

Cardiovascular Disease – Arterial hypertension/ Atherosclerosis Nonalcoholic fatty liver disease Lymphoma

Chronic obstructive pulmonary disease

Sleep apnea

Celiac disease

Parkinson’s disease

Lymphomas

Insulin Resistant Diabetes

Obesity

Dyslipidemia (Raised cholesterol)

Psoriatic Arthritis

Spondyloarthropathies

Periodontitis

Desquamative gingivitis 

Fissured and geographical tongue 

Renal Disease

Chronic Kidney Disease

Sudden sensorineural hearing loss (SSNHL) 

1, 2, 3

Overall, ophthalmological (eye) problems occur in about 10% of the cases of psoriasis and include blepharitis, conjunctivitis, keratitis, xerophthalmia, corneal abscess, cataract, orbital myositis, symblepharon, chorioretinopathy, uveitis and ectropion with trichiasis and madarosis secondary to eyelid involvement.

The association between obesity and psoriasis has been the subject of several reviews and studies confirm that a positive correlation exists between body weight and the prevalence and severity of psoriasis. It has been proposed that psoriasis might lead to obesity through progressive social isolation, poor eating habits, depression, increased alcohol consumption, and decreased physical  activity (more pronounced in patients with psoriatic arthritis). But another hypothesis is that obesity predisposes patients to psoriasis.

Dollarphotoclub_89167346 Obesity dollarphotoclub_78137972-liver-disease dollarphotoclub_92450146-diabetes

It is considered, however, that the low-grade chronic proinflammatory state present in both these conditions increases the risk of comorbidity, including a higher likelihood of developing diabetes or metabolic syndrome, and an increase in cardiovascular disease. 6

It is very important for newly diagnosed psoriasis patients to be screened for diabetes, liver disease, renal disease, and dyslipidaemia (high cholesterol) at the time of diagnosis, due to the fact that treatment for psoriasis may complicate treatment for the comorbid condition, or the comorbid condition may complicate the treatment for psoriasis.

SSNHL is defined as hearing loss of at least 30 dB (decibels) in 3 sequential frequencies in the standard pure tone audiogram for 3 days or less. The condition has an estimated incidence of between 5 and 30 cases per 100,000 per year. According to background information provided by the study authors, the average age at which SSNHL occurs is 50 to 60 years, and it equally affects men and women. Most cases are unilateral (one ear), with only 5% being bilateral (two ear involvement). The condition can be mild, moderate, or severe to profound and can affect high, low, or all frequencies. Tinnitus occurs in about 80% of patients and vertigo in about 30%. Up to 80% of patients report a feeling of ear fullness.7 Auto-immunity is described as an etiology of Sudden or Progressive Sensory neural Hearing Loss; similarly autoimmunity is described as an etiology for many skin diseases like Psoriasis etc. In one study researchers found that Psoriasis patients have, after 6 years of follow up; a 1.51 times higher risk incidence of developing SSNHL than those in the control group.8

For psoriasis patients who have had their psoriasis for several years, it is important that they have a yearly medical check up to ensure that they have not developed any comorbid conditions.

Changing one’s lifestyle may also be of benefit in either delaying comorbidity, or in controlling both their psoriasis and their comorbid condition. Such changes would include cessation of smoking, reducing or ceasing intake of alcohol, reducing sugar intake, changing ones diet to include more green vegetables, less red meat and if obese, losing weight.

 Read our BLOGS – Psoriasis and Diet – Part 1 and 2, Psoriasis and Alcohol, Psoriasis and Smoking

REFERENCES

  • Arzu K?l?ç, Seray Cakmak; PSORIASIS AND COMORBIDITIES; EMJ Dermatol. 2013;1:78-85.
  • Howa Yeung et al.;Psoriasis Severity and the Prevalence of Major Medical Comorbidity – A Population-Based Study; JAMA Dermatol. 2013;149(10):1173-1179. doi:10.1001/jamadermatol.2013.5015
  • Aurangabadkar SJ. Comorbidities in psoriasis. Indian J Dermatol Venereol Leprol 2013;79, Suppl S1:10-7
  • Agnieszka B. Owczarczyk-Saczonek , Roman Nowicki; The association between smoking and the prevalence of metabolic syndrome and its components in patients with psoriasis aged 30 to 49 years; Postep Derm Alergol 2015; XXXII (5): 331–336 DOI: 10.5114/pdia.2015.54743
  • Dediol I. et al.; ASSOCIATION OF PSORIASIS AND ALCOHOLISM: PSYCHODERMATOLOGICAL ISSUE; Psychiatria Danubina, 2009; Vol. 21, No. 1, pp 9–13
  • Carrascosa J.M. et al.; Obesity and Psoriasis: Inflammatory Nature of Obesity, Relationship Between Psoriasis and Obesity, and Therapeutic Implications; Actas Dermosifiliogr.2014;105:31-44 – Vol. 105 Num.1 DOI: 10.1016/j.adengl.2012.08.024
  • Schreiber BE. et al.; Sudden sensorineural hearing loss.; Lancet.2010 Apr 3;375(9721):1203-11. doi: 10.1016/S0140-6736(09)62071-7.
  • Sesha Prasad, M. Sreedhar Rao, A. V. S. Hanumantha Rao, D. Satyanarayana, S. Muneeruddin Ahmed, M. Mahendra Kumar. “Audiological Evaluation in Auto: Immune Skin Diseases- A Clinical Study of 124 Patients”. Journal of Evolution of Medical and Dental Sciences 2015; Vol. 4, Issue 30, April 13; Page: 5128-5137, DOI: 10.14260/jemds/2015/749