Hydro Coconut Water with Added Electrolytes by Phenom Water LLC

INSUFFICIENT RELIABLE EVIDENCE to RATE

• Androgenic alopecia. Topical coconut water has only been evaluated in combination with other ingredients; its effect when used alone is unclear. Details: In individuals with self-perceived hair loss, preliminary clinical research shows that applying a combination leave-in product containing coconut water modestly improves hair growth rate and density, and reduces hair thinning when compared with baseline. The product contained coconut water solids (Cococin), Indian gooseberry (Saberry), gamma-L-glutamyl-selenomethionine (Peptiselect), and other ingredients; a once daily application of 3.5 mL in females and 2 mL in males was used for 3 months (105353).
• Athletic performance. It is unclear if oral coconut water is beneficial for athletic performance. Details: Preliminary clinical research in males shows that drinking coconut water 10 mL/kg of body mass, taken in seven divided doses every 10 minutes prior to exercise in the heat, increases cycling time to exhaustion by about 2 seconds when compared with drinking plain water (95139). In contrast, a small crossover study in experienced cyclists shows that drinking coconut water 2.5 mL/kg of body mass every 15 minutes for 1.5 hours prior to a cycling time trial does not improve time trial performance when compared with a commercial sports drink (115938). Other clinical research shows that drinking coconut water equivalent to 125% of estimated bodily fluid loss over a period of one hour following exercise-induced dehydration improves subsequent treadmill performance to a similar extent as a sports drink containing carbohydrates and electrolytes (95126). However, drinking coconut water during or following exercise may not be any more effective than drinking plain water (95126,95136).
• Diarrhea-related dehydration. It is unclear if oral coconut water is beneficial for diarrhea-related dehydration. Details: Preliminary reports suggest that drinking coconut water might improve hydration in children with mild diarrhea (17666). But there is no reliable evidence that it is any more effective than other beverages for this purpose.
• Exercise-induced dehydration. It is unclear if oral coconut water is beneficial for exercise-related dehydration. Details: Preliminary clinical research shows that drinking coconut water following exercise is effective for rehydration. It appears to be comparable to sports drinks containing carbohydrates and electrolytes, especially if the coconut water is enriched in sodium (17678,17679,95126,95136). However, coconut water may not be any more effective than drinking plain water (17678). Coconut water equivalent to 120% to 125% of estimated bodily fluid loss has been consumed over a period of 1-2 hours following exercise (17678,17679,95126). Alternatively, 1 liter of coconut water consumed in 4 divided doses has been used during 60 minutes of exercise (95136). Drinking coconut water before exercise might help prevent dehydration from occurring. A small clinical study shows that drinking coconut water 10 mL/kg of body mass, taken in seven divided doses every 10 minutes before exercising in the heat, reduces urine output after exercise without affecting sweat rate when compared with plain water. This suggests that coconut water may have a greater hydration capacity than plain water (95139). However, additional research is needed to confirm this hypothesis.
• Hypertension. It is unclear if oral coconut water is beneficial for hypertension. Details: Preliminary clinical research in adults with hypertension shows that drinking coconut water 300 mL twice daily for up to 2 weeks modestly lowers systolic and diastolic blood pressure when compared with baseline (17680). Any effects of coconut water on blood pressure may be due to its potassium content. Potassium concentrations range from 35-82 mEq/L (17669,95138).
• Ulcerative colitis. It is unclear if oral coconut water is beneficial for ulcerative colitis. Details: A single-center clinical study conducted in India in adults with ulcerative colitis, with most having mild disease, shows that drinking 400 mL of coconut water daily for 8 weeks in addition to standard care is associated with 2.9- and 3.4-fold increased odds of achieving clinical remission and response, respectively, when compared with placebo. However, the odds of endoscopically confirmed remission and response are not improved (115937). The validity of these findings is limited by variations in adherence rates and potential dietary confounders. More evidence is needed to rate coconut water for these uses.

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LIKELY SAFE ...when used orally and appropriately. Several studies show that drinking coconut water is safe (17666,17669,17678,17679,17680,95126,95136). Coconut water is commonly consumed as a beverage. There is insufficient reliable information available about the safety of intravenous use of coconut water.

CHILDREN: POSSIBLY SAFE
when used orally and appropriately. Drinking coconut water appears to be safe when used in children (17666). Coconut water is commonly consumed as a beverage.

PREGNANCY AND LACTATION:
Insufficient reliable information available; avoid using. In one case report, a neonate developed severe hyponatremia (113 mEq/L) with seizures shortly after delivery, which was attributed to the mother's consumption of 3 liters of coconut water at the onset of labor (115939).

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ANTIDIABETES DRUGS Interaction Rating = Minor Be watchful with this combination. Severity = Moderate •  Occurrence = Unlikely •  Level of Evidence = D Theoretically, taking coconut water with antidiabetes drugs might increase the risk of hypoglycemia.  Details Animal research suggests that coconut water might increase insulin levels and/or decrease blood glucose levels (107671,107672).

ANTIHYPERTENSIVE DRUGS Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = D Theoretically, taking coconut water with antihypertensive drugs might increase the risk of hypotension.  Details Preliminary clinical research shows that drinking coconut water might lower systolic and diastolic blood pressure in patients with hypertension (17680).

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General ...Orally, coconut water is well tolerated.

Endocrine ...In one case report, a 35-year-old female consumed 3 liters of coconut water at the onset of labor. After delivery, the full-term neonate experienced seizures, and severe hyponatremia (113 mEq/L) was identified. The infant required treatment with infusions of 3% hypertonic sodium chloride along with 10% dextrose in normal saline (115939).

Gastrointestinal ...When consumed as a rehydration beverage following exercise, some people experience fullness or stomach upset (17678,95126). However, gastrointestinal distress is not reported in all studies (95139). Also, in some cases it appears to occur at a lower rate when compared with drinking plain water or drinking a carbohydrate-electrolyte rehydration fluid (17678).

Neurologic/CNS ...In one case report, a 69-year-old male died within approximately 30 hours of consuming a small amount of coconut water that was found to contain 3-nitropropionic acid due to spoilage with Arthrinium saccharicola. About 3 hours after consumption, the patient developed sweating, nausea, and vomiting, and was in a state of reduced consciousness when presenting to the hospital about 1.5 hours later. Other symptoms included confusion, dystonia, and poor balance, as well as metabolic acidosis. The coconut was pre-shaved and although refrigeration was recommended, it had been stored at room temperature for approximately one month after purchase (107670).

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