HYD: Estimating Fluid Needs (2007)


Adolph EF. The metabolism and distribution of water in body and tissues. Physiological Review. 1933; 13: 336-363

Study Design:
Narrative review
R - Click here for explanation of classification scheme.
Quality Rating:
Negative NEGATIVE: See Quality Criteria Checklist below.
Research Purpose:

The present account aims to define certain problems related to water metabolism and distribution in body and tissues of general importance, as they are illustrated in mammals.

Inclusion Criteria:
  • The present review of experimental results emphasizes the data upon normal men
  • Where these are not available, data from pathological man and from some mammals are referred to
  • It must be kept in mind that differences among species and individuals in the quantitative relationships of water are great enough to discourage broad generalizations based upon observations from diverse sources.
Exclusion Criteria:
Description of Study Protocol:

This paper, published in 1933, represents an extensive narrative review of the published literature related to the metabolism and distribution of water in body and tissues of mammals. 340 papers were reviewed and cited.


Data Collection Summary:
Description of Actual Data Sample:
Summary of Results:

Reconstructed Table Two from page 345, with slight edits for clarity.

Coefficients for Calculating the Water Requirement of an Individual
[Values are in cubic centimeters (cc) per 24 hours. One cubic cm = one ml of volume.]

Fluid Utilized for

Minimum Amount


Average to Liberal Amount


Growth (or storage)


15 A to 30 A


400 A

1000 A to 1500 A


30 A

90 A to 150 A

Basal extrarenal

250 A

390 A or 1.73 X 0.25 E basal

Exercise (sweat)

1.73 x 0.4 E excess

I.73 x 0.55 E excess

Temperature control (sweat)


1800 A (atmospheric “C-32°C.)


24-HOUR TOTAL (approximate)


2100 cc.          


3400 to 5000 cc.

A = surface area of the body (A) measured in square meters.

E = the energy requirement (E) in large Calories.       

An average man requires, therefore, something like 3400 cc. of water per square meter per 24 hours, making allowance for three times the basal consumption of energy.

A typical 3000 Calorie diet as consumed at the table contains perhaps 2000 cc. of preformed plus potential water. Hence 1400 cc. remains to be drunk as such.

 Roughly, a convenient liberal standard of total water intake for any mammal is 1 cc. per Calorie.



Author Conclusion:

The data upon normal tissue composition are today of the most primitive sort. In no tissue except blood are normal values for water content sufficiently established. The interrelations of water content with other measures of hydration are quantitatively almost unknown. The day is still distant when the condition of water balance of any one tissue can be described; even for blood plasma only part of the factors entering the equilibrium have been correlated. It is apparent that the problems of water balance can never be settled alone, 0nly in the light of data concerning the regulation and interrelations of every other constituent and force of the cell and of the body can this familiar substance be fully appreciated.

Funding Source:
Reviewer Comments:

Table 2 on page 345 of this review paper and the author's brief discussion that follows (shown above) may be the source of the commonly used fluid recommendation of 1 cc of water per calorie consumed. The table components appear to be extracted from various papers, including human and animal studies. The author's related conclusion (in bold text) represents a liberal estimate based on his "average man" example.

Most of the language in this abstract was taken verbatim from the paper to give you, the reader, a sense of the language and style of scientfic writing in 1933. The paper appears be a comprehensive review of the body of literature at that time, but does not meet standards for current scientific reviews, therefore the quality rating is negative.

This article did not meet the criteria for inclusion in the hydration evidence analysis project; however it is presented here for its historic relevance.

Quality Criteria Checklist: Review Articles
Relevance Questions
  1. Will the answer if true, have a direct bearing on the health of patients? Yes
  2. Is the outcome or topic something that patients/clients/population groups would care about? Yes
  3. Is the problem addressed in the review one that is relevant to dietetics practice? Yes
  4. Will the information, if true, require a change in practice? Yes
Validity Questions
  1. Was the question for the review clearly focused and appropriate? Yes
  2. Was the search strategy used to locate relevant studies comprehensive? Were the databases searched and the search termsused described? No
  3. Were explicit methods used to select studies to include in the review? Were inclusion/exclusion criteria specified andappropriate? Wereselectionmethods unbiased? No
  4. Was there an appraisal of the quality and validity of studies included in the review? Were appraisal methodsspecified,appropriate, andreproducible? No
  5. Were specific treatments/interventions/exposures described? Were treatments similar enough to be combined? N/A
  6. Was the outcome of interest clearly indicated? Were other potential harms and benefits considered? Yes
  7. Were processes for data abstraction, synthesis, and analysis described? Were they applied consistently acrossstudies and groups? Was thereappropriate use of qualitative and/or quantitative synthesis? Was variation in findings among studies analyzed? Were heterogeneity issued considered? If data from studies were aggregated for meta-analysis, was the procedure described? No
  8. Are the results clearly presented in narrative and/or quantitative terms? If summary statistics are used, are levels ofsignificance and/or confidence intervals included? No
  9. Are conclusions supported by results with biases and limitations taken into consideration? Are limitations ofthe review identified anddiscussed? No
  10. Was bias due to the review's funding or sponsorship unlikely? Yes