“We’re enamored by high technology,” he said at the Council on Foreign Relations. “And we’re not in love with low-tech. Low-tech is always seen in our eyes as second-class. Why would you do this, when you could do that? And I would argue just the opposite.”
Noteworthy that others tried to gatekeep thier low tech approach and experimental efforts. So much "perfection, enemy of the good" in expert circles.
People tried oral rehydration before with isotonic solutions, even going as far as matching the concentration of minerals in plasma. It didn't work well for cholera.
The amazing discovery was that just a bit of glucose made the world of difference.
> Oral rehydration therapy (ORT) is a type of fluid replacement used to prevent and treat dehydration, especially due to diarrhea.[1] It involves drinking water with modest amounts of sugar and salts, specifically sodium and potassium.[1] Oral rehydration therapy can also be given by a nasogastric tube.[1] Therapy can include the use of zinc supplements to reduce the duration of diarrhea in infants and children under the age of 5.[1] Use of oral rehydration therapy has been estimated to decrease the risk of death from diarrhea by up to 93%.[2]
Another unsung hero that contributed to improve the world, IMHO it's a beautiful example of the fact that in the end it's not the degree of sophistication (even of the road to find it is steep) that really matters but how it translates into positive outcome in the physical world that eventually matters.
Rip
> "Too bad the commercial nature of “sports drinks” have dialed up the sugar and broke away from the clinical goal of rehydration."
The ones that come as tablets which dissolve in water give you the electrolytes without the sugar. Less packaging waste, too. SIS (Science In Sport) is good, and other brands are available.
Generic Pedialyte is great for hangovers and migraines—way less sugar. You can even get the individual powder packets instead of having to buy a huge jug of liquid.
So they DID tamper with Gatorade. I thought it was just me.
It used to be when I was sick I could down those literally like water. The last time I got sick, I gagged at how cloying the taste was at my second one. I also noticed it didn't have that characteristic "salty aftertaste".
I guess I'll go have to keep some low-sodium salt on hand for when I get sick and make my own from now on. Bummer.
That's the point. A little sugar is good. Too much sugar is bad. No suger is not as good. It's very modern to have two options, one with waaay too much sugar and one with zero sugar (or some sugar replacement).
Propel and Zero (the first options) both contain sucralose, aka Splenda - I'd prefer to just drink salt water personally, or take the hit on a tablespoon of sugar mixed in and walk it off.
I maje my own electrolyte drink with water, spoonful of sugar and spoonful of "low sodium" salt: they add potassium to those, which completes the electrolyte menu.
Sometimes I add a dash of lime
Veeeey low cost and great. And you can pre-mix it in a zip lock bag to have it always available. And add some orange flavour kool-aid powder if you need flavour.
Commercial Rehydration drinks are overpriced and overhyped IMHO
The majority of Americans are overweight, as far as the science shows artificial sweeteners are the best choice for them vs full calorie.
If you look up the evidence for the downsides of artificial sweeteners anything that finds one is generally an observational study. So for example, the claim that they cause obesity is backed by the observation that obese people consume it in greater amounts than people who are not obese. That's like standing in front of a hospital and noticing everyone with a broken leg is on crutches and coming to the conclusion that crutches are the problem. Double blinded, placebo controlled studies don't find this effect. The best evidence we have indicates they are safer than the obesity that full calorie sweeteners cause in most people.
> The majority of Americans are overweight, as far as the science shows artificial sweeteners are the best choice for them vs full calorie.
This is a false choice and has nothing to do with the above commenter's preferences.
Many people just desperately long for convenient foods/drinks that aren't so sweet in the first place and feel frustrated that the largest brands don't want to bother with them.
Yeah, although worth noting that glucose is useful to promote absorption of the electrolytes, you may not need it in a sports drink but it's an integral part of the diarrhea med.
I was in a cholera study at the University of Maryland for a week. Read a lot of sci fi, played ping pong and drank fluids with electrolytes. There is a first phase which is uncomfortable but otherwise, as the docs said, cholera is a piece of cake if treated with hydration.
I also have a feeling that the pH of rehydration drinks should be low (acidic). To an extent, my body knows pretty well what's good for it. The salt+water tastes terrible, add a little acid and it's delicious. Maybe it takes a little load off of the digestive system by providing the acid that would otherwise need to be generated.
I met him in the late 1970s. I was too young then to understand his work at the time, but he was one of the few famous people I have met who genuinely cared about other people. He was as one of the good ones. RIP.
On a side note, his Wikipedia page has one of the worst, low res leading photographs for a topic I've ever encountered on that site. Surely a man of his stature deserves better?
Other doctors and nurses found their experiment [drinking water w/ sugar+salt] bizarre and tried to stop them.
To me that seemed like professionals clinging to orthodoxy for orthodoxy's sake. They forget that endless reevaluation is needed for a practice to remain 'best'.
And maybe it was that. But I also found this talk from Dr Cash; he gives other examples of resistance (along with their causes).
Whereas, in one country I went to, Jamaica, I was puzzled, even though I was working at that time for PAHO, that there was terrific opposition. It seemed that they wouldn’t cooperate with anything. Even they wouldn’t give my assistant a bed in the residence quarters.
So I found out gradually—I was investigating this—and I found out several things. One is, the head of the hospital was so skeptical about this working that he had made a hundred dollar bet with his residents that it would fail. So obviously there was an incentive for it to fail. (Laughs.)
Secondly, the head of hospital stores, I found out, was making a lot of money on kickbacks from the IV company. So he had no interest in terms of resource flow of substituting oral for IV.
> To me that seemed like professionals clinging to orthodoxy for orthodoxy's sake.
There's much I don't know about medicine in Bangladesh, but I'm guessing doctors think it's unethical to treat patients with anything other than the best accepted standard of care, unless engaging in an experiment for which the risk and benefits can be described and there exists a reason to believe the benefits outweigh the risks. I suspect that was not communicated well by the experimenters.
People are so against GMOs without realizing how many millions of lives GMO’ed wheat and rice saved in India and elsewhere.
Both (Norman Borlaug and Dr Cash) go to show that modern and traditional medicines can be carefully manipulated in amazing ways to save millions of lives.
for a few moments I was thinking "saved millions of dollars from dehydration". The title could be clearer if it said "saved millions of people from dehydration".
I wonder if headline writers these days generate several permutations of a headline via GPT, and have some way of A|B testing the early readers to figure out which one generates the most clicks (especially due to people clicking through to satiate curiosity of a freshly quizzical headline from what would otherwise have been an at-a-glance comprehensible one that would fail to elicit the all-lifegiving click.)
“We’re enamored by high technology,” he said at the Council on Foreign Relations. “And we’re not in love with low-tech. Low-tech is always seen in our eyes as second-class. Why would you do this, when you could do that? And I would argue just the opposite.”
Noteworthy that others tried to gatekeep thier low tech approach and experimental efforts. So much "perfection, enemy of the good" in expert circles.
People tried oral rehydration before with isotonic solutions, even going as far as matching the concentration of minerals in plasma. It didn't work well for cholera.
The amazing discovery was that just a bit of glucose made the world of difference.
A spoonful of sugar helps the medicine go down???
Regarding the dehydration work see:
> Oral rehydration therapy (ORT) is a type of fluid replacement used to prevent and treat dehydration, especially due to diarrhea.[1] It involves drinking water with modest amounts of sugar and salts, specifically sodium and potassium.[1] Oral rehydration therapy can also be given by a nasogastric tube.[1] Therapy can include the use of zinc supplements to reduce the duration of diarrhea in infants and children under the age of 5.[1] Use of oral rehydration therapy has been estimated to decrease the risk of death from diarrhea by up to 93%.[2]
* https://en.wikipedia.org/wiki/Oral_rehydration_therapy
ORT seems to have been developed in the mid 1960s, around the same time as Gatorade.
I wonder how much one informed the other.
* https://en.wikipedia.org/wiki/Gatorade#Origin
Another unsung hero that contributed to improve the world, IMHO it's a beautiful example of the fact that in the end it's not the degree of sophistication (even of the road to find it is steep) that really matters but how it translates into positive outcome in the physical world that eventually matters. Rip
Also mitigated many millions of hangovers, including my own.
Too bad the commercial nature of “sports drinks” have dialed up the sugar and broke away from the clinical goal of rehydration.
You can always make your own sports drink, starting with the recipe from the World Health Organization:
https://www.who.int/publications/i/item/WHO-FCH-CAH-06.1
Just 4 ingredients:
Glucose, anhydrous (dextrose)
Sodium chloride (salt)
Potassium chloride
Trisodium citrate, dihydrate
Of course, the batch size of 75 kg may not be the most convenient for home use, but it's easy to scale down.
> "Too bad the commercial nature of “sports drinks” have dialed up the sugar and broke away from the clinical goal of rehydration."
The ones that come as tablets which dissolve in water give you the electrolytes without the sugar. Less packaging waste, too. SIS (Science In Sport) is good, and other brands are available.
You want some sugar, but putting even more than necessary sells better.
Sugar, like salt, is a solute and will impair water absorption.
Generic Pedialyte is great for hangovers and migraines—way less sugar. You can even get the individual powder packets instead of having to buy a huge jug of liquid.
You can always go with a Roman sports drink. Salt, water and some red wine vinegar (apple cider vinegar works too)
So they DID tamper with Gatorade. I thought it was just me.
It used to be when I was sick I could down those literally like water. The last time I got sick, I gagged at how cloying the taste was at my second one. I also noticed it didn't have that characteristic "salty aftertaste".
I guess I'll go have to keep some low-sodium salt on hand for when I get sick and make my own from now on. Bummer.
There's a bananna bag mix you put in water. Comes in packets. Quite invigorating.
they sell sugar free sports drinks
That's the point. A little sugar is good. Too much sugar is bad. No suger is not as good. It's very modern to have two options, one with waaay too much sugar and one with zero sugar (or some sugar replacement).
Gatorade has a entire line of drinks for different purposes. Zero is what OP is looking for: https://performancepartner.gatorade.com/content/products/hyd...
The normal one is for high powered endurance activities and contains some carbs (sugar) to help fuel you through them.
They have one with even more carbs, sodium and potassium for people running marathons.
The last two on that chart aren't a good choice for someone who isn't active. Stick to the first two for that.
Propel and Zero (the first options) both contain sucralose, aka Splenda - I'd prefer to just drink salt water personally, or take the hit on a tablespoon of sugar mixed in and walk it off.
I maje my own electrolyte drink with water, spoonful of sugar and spoonful of "low sodium" salt: they add potassium to those, which completes the electrolyte menu.
Sometimes I add a dash of lime
Veeeey low cost and great. And you can pre-mix it in a zip lock bag to have it always available. And add some orange flavour kool-aid powder if you need flavour.
Commercial Rehydration drinks are overpriced and overhyped IMHO
I like pickle juice. The vinegar helps the salt go down better.
The majority of Americans are overweight, as far as the science shows artificial sweeteners are the best choice for them vs full calorie.
If you look up the evidence for the downsides of artificial sweeteners anything that finds one is generally an observational study. So for example, the claim that they cause obesity is backed by the observation that obese people consume it in greater amounts than people who are not obese. That's like standing in front of a hospital and noticing everyone with a broken leg is on crutches and coming to the conclusion that crutches are the problem. Double blinded, placebo controlled studies don't find this effect. The best evidence we have indicates they are safer than the obesity that full calorie sweeteners cause in most people.
> The majority of Americans are overweight, as far as the science shows artificial sweeteners are the best choice for them vs full calorie.
This is a false choice and has nothing to do with the above commenter's preferences.
Many people just desperately long for convenient foods/drinks that aren't so sweet in the first place and feel frustrated that the largest brands don't want to bother with them.
Yeah, although worth noting that glucose is useful to promote absorption of the electrolytes, you may not need it in a sports drink but it's an integral part of the diarrhea med.
What a legacy to leave behind. RIP Mr. Cash, thank you for your contributions to humanity. May many others follow in your footsteps.
https://archive.ph/wTJu9
So I had cholera.
I was in a cholera study at the University of Maryland for a week. Read a lot of sci fi, played ping pong and drank fluids with electrolytes. There is a first phase which is uncomfortable but otherwise, as the docs said, cholera is a piece of cake if treated with hydration.
Whoa! I didn't know you could do such studies on humans this day and age. Were you compensated handsomely?
https://eukaryotewritesblog.com/2024/10/21/i-got-dysentery-s... is a writeup of a similar trial that hit HN recently. That person got $4000 for 10 days.
Yup, they are called Human Challenge Studies. Compensation is typically modest. Most participants are students at universities.
https://en.wikipedia.org/wiki/Human_challenge_study
I also have a feeling that the pH of rehydration drinks should be low (acidic). To an extent, my body knows pretty well what's good for it. The salt+water tastes terrible, add a little acid and it's delicious. Maybe it takes a little load off of the digestive system by providing the acid that would otherwise need to be generated.
I met him in the late 1970s. I was too young then to understand his work at the time, but he was one of the few famous people I have met who genuinely cared about other people. He was as one of the good ones. RIP.
On a side note, his Wikipedia page has one of the worst, low res leading photographs for a topic I've ever encountered on that site. Surely a man of his stature deserves better?
This caught my attention. From the article:
To me that seemed like professionals clinging to orthodoxy for orthodoxy's sake. They forget that endless reevaluation is needed for a practice to remain 'best'.And maybe it was that. But I also found this talk from Dr Cash; he gives other examples of resistance (along with their causes).
ref: https://www.cfr.org/event/simple-solution-saved-fifty-four-m...> To me that seemed like professionals clinging to orthodoxy for orthodoxy's sake.
There's much I don't know about medicine in Bangladesh, but I'm guessing doctors think it's unethical to treat patients with anything other than the best accepted standard of care, unless engaging in an experiment for which the risk and benefits can be described and there exists a reason to believe the benefits outweigh the risks. I suspect that was not communicated well by the experimenters.
>people clinging to orthodoxy for orthodoxy's sake.
Always been like this. Even something as simple as making them wash hands was a pain.
Reminds me of Norman Borlaug.
Talk about leaving a dent.
People are so against GMOs without realizing how many millions of lives GMO’ed wheat and rice saved in India and elsewhere.
Both (Norman Borlaug and Dr Cash) go to show that modern and traditional medicines can be carefully manipulated in amazing ways to save millions of lives.
If you press them, you'll discover most people are against Monsanto and only a tiny minority actually cares about GMO.
But most people worship vapid celebrities. As a species, we need some more evolving.
for a few moments I was thinking "saved millions of dollars from dehydration". The title could be clearer if it said "saved millions of people from dehydration".
I wonder if headline writers these days generate several permutations of a headline via GPT, and have some way of A|B testing the early readers to figure out which one generates the most clicks (especially due to people clicking through to satiate curiosity of a freshly quizzical headline from what would otherwise have been an at-a-glance comprehensible one that would fail to elicit the all-lifegiving click.)
I thought the same thing before clicking on it.