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Brief Report Water Drinking Induces Thermogenesis Through Osmosensitive Mechanisms
Brief Report Water Drinking Induces Thermogenesis Through Osmosensitive Mechanisms
BRIEF REPORT
Water Drinking Induces Thermogenesis through
Osmosensitive Mechanisms
Michael Boschmann, Jochen Steiniger, Gabriele Franke, Andreas L. Birkenfeld, Friedrich C. Luft, and
Jens Jordan
Context: Recently, we showed that drinking 500 ml water induces and 50 ml water had no effect. Heart rate and blood pressure did not
thermogenesis in normal-weight men and women. change in these young, healthy subjects.
Objective: We now repeated these studies in a randomized, con- Conclusions: Our data exclude volume-related effects or gastric
trolled, crossover trial in overweight or obese otherwise healthy sub- distension as the mediator of the thermogenic response to water
jects (eight men and eight women), comparing also the effects of 500 drinking. Instead, we hypothesize the existence of a portal osmo-
ml isoosmotic saline or 50 ml water. receptor, most likely an ion channel. (J Clin Endocrinol Metab 92:
3334 –3337, 2007)
Results: Only 500 ml water increased energy expenditure by 24%
over the course of 60 min after ingestion, whereas isoosmotic saline
3334
Boschmann et al. • Water and Thermogenesis J Clin Endocrinol Metab, August 2007, 92(8):3334 –3337 3335
Results
Resting energy expenditure was 5.66 ⫾ 0.25 kJ/min before
500 ml water, 5.62 ⫾ 0.25 kJ/min before saline, and 5.68 ⫾
0.24 kJ/min before 50 ml water drinking (not significant).
Within 10 min after drinking 500 ml water, energy expen-
diture started to increase, reaching a maximum of 24 ⫾ 3%
above baseline after 60 min (Fig. 1, top). The response to 500
Discussion
Drinking water induces a much greater thermogenic re-
sponse than drinking the same volume of isoosmotic saline.
We do not have a good explanation why water drinking
induced a thermogenic response in some but not in all studies
(7, 8). In the present and in our previous study (7), we applied
a metabolic chamber. Brown et al. (8) obtained measurements
using a canopy system. It is difficult to explain the discrepant
results with these methodological differences. Despite these
issues, we suggest that our observation provides clues re-
FIG. 1. Top, Relative change in energy expenditure (EE) over time in
garding the underlying mechanism of water-induced ther- obese subjects (eight men, eight women) after drinking 50 ml water
mogenesis. We previously showed a gender difference in the (50 water), 500 ml water (500 water), or 500 ml isoosmotic saline (500
substrates used for fueling water-induced thermogenesis (7). NaCl). At 0 min, subjects started to drink the fluids in less than 5 min.
Water drinking increased lipid oxidation in men and carbo- Testing was conducted in a randomized and crossover fashion on
separate days. *, P ⬍ 0.05; **, P ⬍ 0.01, for the comparison between
hydrate oxidation in women. In obese subjects, the response 500 ml water and 500 ml saline; #, P ⬍ 0.001 for the comparison
to water appears to be more uniform, i.e. RQ did not change between 500 and 50 ml water. Bottom, Individual thermogenic re-
significantly in men and women, indicating no change in the sponses to 50 ml water, 500 ml water, or 500 ml normal saline. The
ratio between carbohydrate and lipid oxidation rate. We response was calculated between 0 and 90 min after drinking. The
dotted line indicates the energy that is required to heat 500 ml water
speculate that obese subjects may be less able to switch be-
or saline from room temperature to body temperature. The P values
tween carbohydrate and lipid oxidation; the phenomenon is are given for the analysis with Bonferoni’s post test (PANOVA ⬍
sometimes referred to as metabolic inflexibility. 0.0001).
Similarly to previous studies (3, 4), water drinking did not
elicit a pressor response in younger subjects without auto- afferent stimulus and the afferent pathway causing activa-
nomic dysfunction. In contrast, water raises blood pressure tion of efferent sympathetic neurons is unknown. Water tem-
in autonomic failure patients (4). Thus, intact autonomic perature, distention of gastrointestinal organs, or changes in
cardiovascular regulation appears to attenuate the water- osmolarity could be involved. Water-drinking-induced car-
induced pressor response through baroreflex mechanisms. diovascular and metabolic responses are not solely explained
Similarly, low doses of the sympathetic stimulant yohimbine by a thermal stimulus. In autonomic failure patients, drink-
raise blood pressure in autonomic failure patients (4). The ing colder or warmer water elicited an identical pressor re-
same doses change blood pressure little or not at all in sponse (4). In healthy normal-weight subjects, approximately
healthy subjects. 60 –70% of the water-induced thermogenesis could not be
The mechanism causing sympathetic activation with wa- attributed to heating of the ingested water (7). Indeed, drink-
ter drinking is not fully understood. Studies in tetraplegic ing 37 C warm water elicited a substantial thermogenic re-
patients suggest a spinal mechanism (13). The nature of the sponse (7). Gastric distention increases sympathetic nerve
3336 J Clin Endocrinol Metab, August 2007, 92(8):3334 –3337 Boschmann et al. • Water and Thermogenesis
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