The use of modified coconut water for oral rehydration.

Pure coconut water should be modified to make it suitable for oral rehydration therapy. The principal objectives in the modification process are: lift the sodium concentration from less than 5 mEq/L to about 50 mEq/L which is the ideal concentration of this ion for the treatment of non-cholera diarrhea as confirmed by previous investigators; reduce the high potassium concentration of 40-50 mEq/L by about 50%; improve the acidic pH of 4-5 to at least neutral; and provide additional glucose which is reduced by the dilution in modification procedure. Pure coconut water obtained from 8-10 month old coconuts was diluted with an equal amount of distilled water on a 1:1 ratio to reduce the K+ concentration by 50%. To this new mixture a fixed quantity of 1 gm NaCI powder A.R. grade 2.5 gms NaHCO3 powder A.R. grade and 15 gms glucose powder was dissolved in 1000 cc of the mixture. The expected change in the composition of coconut water is listed in a table. 58 infants and children who consulted at the pediatric admitting section of a general hospital in the Philippines were the subjects chosen for the study. Treatment of acute dehydration was prescribed for a period of 24 hours which was the period of observation. During the treatment period only the modified coconut water was given orally to the exclusion of other oral feedings or intravenous fluid therapy. The coconut water was given not only for correction of fluid and electrolyte losses but also for provision of the usual requirements of the infants. The 39 male and 19 female subjects ranged in age from 3 months to 6 years. 43 patients (74.14%) displayed satisfactory clinical response (the state of dehydration improved clinically together with a weight gain) and 15 patients (25.86%) were considered as treatment failures. When the group who had satisfactory clinical response (responders) was evaluated it was shown that the weight gain was significant. As a group the nonresponders did not have any significant weight gain. Modified coconut water was well accepted and tolerated by the patients. Coconut water a bountiful indigenous source of fluids for oral rehydration is highly recommended in areas where there is scarcity or absence of suitable oral rehydration mixtures provided that the modification procedure used in this study is followed strictly that the volume of modified coconut water given particularly for infants be closely monitored and provided further that oral intake of modified coconut water be stopped immediately as soon as there is an indication of relapse of diarrhea.