Abstract

With increased life expectancy worldwide, there is an urgent need for improving preventive measures that delay the development of age-related degenerative diseases. Here, we report evidence from mouse and human studies that this goal can be achieved by maintaining optimal hydration throughout life. We demonstrate that restricting the amount of drinking water shortens mouse lifespan with no major warning signs up to 14 months of life, followed by sharp deterioration. Mechanistically, water restriction yields stable metabolism remodeling toward metabolic water production with greater food intake and energy expenditure, an elevation of markers of inflammation and coagulation, accelerated decline of neuromuscular coordination, renal glomerular injury, and the development of cardiac fibrosis. In humans, analysis of data from the Atherosclerosis Risk in Communities (ARIC) study revealed that hydration level, assessed at middle age by serum sodium concentration, is associated with markers of coagulation and inflammation and predicts the development of many age-related degenerative diseases 24 years later. The analysis estimates that improving hydration throughout life may greatly decrease the prevalence of degenerative diseases, with the most profound effect on dementia, heart failure (HF), and chronic lung disease (CLD), translating to the development of these diseases in 3 million fewer people in the United States alone.

Highlights

  • Because of great progress in the prevention and treatment of infectious diseases and technological advances that have improved life and work conditions, the world has seen a tremendous increase in life expectancy

  • A complex network of hormonal and neuroregulatory mechanisms is activated in response to net water loss leading to intravascular volume depletion and increased osmolality above its osmotic “set-point” of 280–290 mosmol/kg. These mechanisms include stimulation of thirst to encourage water intake, increased water reabsorption by the kidneys to decrease water output, and stimulation of vasoconstriction to compensate for decreased intravascular volume mediated by arginine vasopressin (AVP) and renin-angiotensin-aldosterone system (RAAS) [2,3,4,5,6,7,8,9]

  • By analyzing data from the Atherosclerosis Risk in Communities (ARIC) study, we showed that the outcomes of subclinical hypohydration in humans were strikingly similar

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Summary

Introduction

Because of great progress in the prevention and treatment of infectious diseases and technological advances that have improved life and work conditions, the world has seen a tremendous increase in life expectancy With such achievements, aging of the world population creates challenges for medical researchers to find new ways to combat and care for age-dependent chronic disorders that account for a growing proportion of the global burden of disease [1]. A complex network of hormonal and neuroregulatory mechanisms is activated in response to net water loss leading to intravascular volume depletion and increased osmolality above its osmotic “set-point” of 280–290 mosmol/kg These mechanisms include stimulation of thirst to encourage water intake, increased water reabsorption by the kidneys to decrease water output, and stimulation of vasoconstriction to compensate for decreased intravascular volume mediated by arginine vasopressin (AVP) and renin-angiotensin-aldosterone system (RAAS) [2,3,4,5,6,7,8,9]

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