Hot Topic: Staying Hydrated as Temperatures Rise

As summer starts to sizzle, babies and elderly people are most vulnerable to heat-related illnesses. But you might be surprised at who is more likely to end up in the emergency department: athletes who push themselves beyond safe limits.

Maintaining proper hydration is essential for everyone, from the occasional pickleball player to professional athletes. Even for those accustomed to frequent activities outdoors, South Florida’s oppressive summer climate raises the risk of serious heat-related illnesses, including heat stroke.

“An added danger in South Florida is its high humidity levels,” explains Michael Yurubi, D.O., a board-certified family medicine and sports medicine physician with Baptist Health Orthopedic Care. “When humidity is high, the body sweats less and it does not evaporate as easily from the skin. The body then struggles to cool down, making it prone to heat exhaustion and heat stroke.”

Heat projections for South Florida in 2025 indicate a strong likelihood of above-average temperatures similar to last year’s sweltering summer, when there were 60 days with heat advisories, according to the National Weather Service.

The Importance of Staying Hydrated

Hydration is vital for everyone, Dr. Yurubi says. The very young or older people are most vulnerable because their bodies can’t adapt to heat as efficiently. Also at increased risk are those with chronic medical conditions such as heart disease, high blood pressure and kidney disease; pregnant women; those on certain medications such as antihistamines, antidepressants and beta blockers; and those who are overweight.

People on the more active end of the spectrum often think they can tough it out because they are in good shape, but everyone is susceptible to heat illnesses.

“For amateur and professional athletes alike, maintaining proper hydration before, during and after exercise is essential,” says Michael Swartzon, M.D., primary care sports medicine physician with Baptist Health Orthopedic Care.

What You Should Know About Fluid Intake

Dehydration can be caused by exercise or training intensity, environmental conditions and inadequate fluid intake. It’s important to keep in mind that thirst is a late indicator of dehydration. By the time you experience thirst, your body is already dehydrated at the cellular level, Dr. Swartzon says.

For most people, water is the best fluid to drink before, during and after exercise. However, if you plan to exercise for longer than an hour, you may need to supplement with a sports drink that contains carbohydrates to prevent low blood sugar and electrolytes to replenish sodium and chloride lost from sweating.

A simple way to check hydration status is by looking at urine color. If your urine is clear to light yellow, you likely have adequate hydration. Dark yellow or amber-colored urine is usually indicative of dehydration.

While severe dehydration is something to guard against, most people never reach that point. Mild dehydration, however, is very common. In the short term, it can cause everything from headaches and lack of energy to sleep issues, blood pressure dysregulation, balance problems, moodiness, trouble concentrating, and constipation. In the long term, it can contribute to kidney stones and other problems.

How Much Water Do You Really Need?

So how much water should you drink before, during and after exercise? No single amount fits everyone’s needs. The widely accepted guidance is to 64 ounces or eight glasses of water a day. But physical activity increases that amount.

According to the American Council on Exercise, a person should drink:

• 17-20 ounces of water 2-3 hours before exercise
• 8 ounces of water 20-30 minutes before exercise or during warmup
• 7-10 ounces of water every 10-20 minutes during exercise
• 8 ounces of water within 30 minutes after completion of the activity.

In addition to drinking enough water, other hydration tips include limiting caffeine intake and other diuretics from sources such as teas, coffee and stimulant drinks. These drinks increase the amount of water lost from the body.

Some food choices may also be a good source of hydration. Fresh vegetables and fruits such as grapefruit, watermelon, strawberries and cantaloupe are excellent choices to maintain fluid balance. Proper attire is also a factor to consider.

When Heat Takes A Toll

Your body normally cools itself naturally through sweating, but sometimes it can’t keep up. Heat-related illnesses — including heat cramps, heat exhaustion and heat stroke — occur when a person’s temperature rises to dangerous levels and body fluids are thrown off. In these cases, a person’s temperature rises faster than the body’s ability to cool itself. This can cause damage to the brain and other vital organs.

Immediate action should be taken when a person shows signs of overheating. This includes moving the person to a cooler, shady location or an air-conditioned space; providing water to drink; loosening or removing clothing so sweat can evaporate; and cooling them off by fanning and/or misting them with water. The person should be monitored carefully to make sure they improve.

If the person gets worse and experiences severe cramps, vomiting, disorientation or loss of consciousness, they may be experiencing heat stroke, which is life-threatening. It’s time to call 911.

With less severe symptoms, a trip to the hospital may not be required. Early preventative action should help the person improve within an hour. The key is helping them cool down and take in adequate fluids.

Even when the person starts to feel better, however, they should not resume what they were doing. After a heat-related incident, a person should take time to recover and rest in a cool location for a minimum of 12 hours, or preferably until the next day.

“Here, unfortunately, it’s very hot but also very humid — and that raises the heat index. If the heat index is over 91, you need to be aware and careful of that,” cautions Jose Portuondo, M.D., chief of emergency medicine at Baptist Health Doctors Hospital. “In Miami you can assume that by June it is going to be 90 or above, and that will probably last through September.”

Michael Yurubi, D.O., a family medicine and sports medicine physician with Baptist Health Orthopedic Care

Michael Swartzon, M.D., a primary care sports medicine physician with Baptist Health Orthopedic Care