AquaTally is an excellent coaching tool for Registered Dietitians and Clinicians who are looking to help their clients or patients build healthy habits around drinking the right amount each day – whether that means drinking more or less.


Many dietitians and healthcare professionals work with older adults who struggle with dehydration for several reasons, such as, a lower sense of thirst, side effects from medications and demands from dealing with multiple chronic conditions.  In fact, in a 2011 study dehydration was the third most likely reason for a hospitalization that was defined as potentially avoidable (PAH), accounting for nearly 15% of the 699,818 hospitalizations in the PAH category [1].

How can AquaTally help?

A great example of how AquaTally can work well to prevent dehydration comes from Toby Amidor’s article Clinical Uses for AquaTally:

Jamie Vespa, MS, RD, LD/N, a clinical nutrition specialist at a hospital in Tampa, Florida uses AquaTally as a teaching tool for outpatients. “About two months ago, I had an elderly man admitted for dehydration. He lived alone, suffered early signs of dementia and had recently begun taking a medication that suppressed his appetite. Along with becoming desensitized to hunger cues, he also became less sensitive to cues/signs of dehydration.” After reviewing his diet history, Vespa found he was consuming less than half of his daily fluid intake. She recommended AquaTally because of its simplicity. “Considering this patient suffered early signs of dementia, he found the AquaTally to be extremely helpful in tracking his fluid intake.”

AquaTally is easy to use, economical and the visual reminder provides an important cue to stay on track with drinking the right amount each day.

[1] Segal M. Dual Eligible Beneficiaries and Potentially Avoidable Hospitalizations. Washington, DC: Centers for Medicare and Medicaid Services, 2011.

Renal Failure (Dialysis patients on a fluid restriction)

For patients on hemodialysis (HD) successfully managing their fluid restriction between treatments is very important.  A significant challenge in treating these patients is balancing the interdialytic weight gain (IDWG) and adequate nutrition. Excessive IDWG, or fluid overload, between sessions leads to longer run times, heart problems, discomfort, trouble breathing and even death [1]. Too low of IDWG can be associated with malnutrition and higher rates of mortality [2]. Finding better methods to assist patients in managing their fluid restrictions can improve quality of life and reduce costs associated with fluid overload.

AquaTally is a great tool that Dietitians and Clinicians can use to help patients learn their fluid restriction, build a healthy habit, or change behavior and make it easier to follow their fluid restriction.

Toby Amidor Clinical Uses for AquaTally:

Barb Nekula MA, RD, CDN, a renal dietitian working at an outpatient dialysis center, counsels patients with kidney failure on dialysis. She recommended AquaTally to a new dialysis patient as a tool to help her with fluid management. “She purchased three AquaTallys, one for home, at work and in the car.” By having AquaTally accessible throughout the day irrespective of her whereabouts, she was able to manage her fluid restriction and maintain her body weight with no excessive fluid gains.  “She has now been able to move from in-center treatment to peritoneal dialysis (an in-home treatment option for kidney failure).”

Helpful Tip:

  • AquaTally can be used to keep track of other sources of hydration throughout the day.  For example, if you go out to lunch and have a glass of water, just add it to your tally.

[1] Kalantar-Zadeh, Kamyar et al. Fluid retention is associated with cardiovascular mortality in patients undergoing long-term hemodialysis. Harold Simmons Center for Kidney Disease Research and Epidemiology. PubMed. DOI:10.1161/CIRCULATIONAHA.108.807362

[2] López-Gómez JM, Villaverde M, Jofre R, Rodriguez-Benítez P, Pérez-García R. Interdialytic weight gain as a marker of blood pressure, nutrition, and survival in hemodialysis patients. Kidney Int. Suppl. 2005; 93: S63–8.

Kidney Stones

In the United States, 8.8 percent of the population, or one in 11 people, have had a kidney stone [1].  According to The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) “Drinking enough fluid is the most important thing a person can do to prevent kidney stones.”[2]

However, many people have a difficult time drinking the recommended 2 to 3 liters a day. Part of this issue is that people simply lose track of how much they drink, or aren’t able to accurately keep track.  Another factor is that many people haven’t built a habit around drinking the right amount everyday.  For these people drinking 2-3 liters a day may be significantly more than they are used to drinking.  AquaTally simplifies keeping track of how much someone drinks and supports building a healthy routine.

For example, drinking 6 full AquaTallys would be 12 cups, which is close to the higher end recommendation of 3 liters.  Rather than trying to convert ounces on a water bottle, adding up multiple containers for the day, or using an app, users simply turn the tracking ring every time they drink an entire AquaTally.  The ritual of filling the AquaTally and turning the tracking ring helps form a habit, and the numbers on the cup provide a visual reminder of progress throughout the day.

Many users talk about how they begin to build a routine.  For example, someone may need to drink 6 full AquaTallys a day.  As they track throughout the day they learn what number they are typically on at 10 am, at 12 pm, at 3 pm, etc.  The visual reminder that the tracking provides is helping form a habit.  Then it becomes easier for users to reach “their number” each day.

Testimonial from a kidney stone former:

“I had one of my (kidney stone former) clients who needs to drink A LOT of water each day for kidney related issues test the cup. Here are her thoughts: The ring indicator does not slip and turn, during normal use (I expected that it might). I think it’s a clever idea. It’s great for keeping track of intake. It really is difficult when you go through a combination of disposable (yuk) water bottles and regular glassware, which may be of various sizes. Most days, one can only guess actual intake. I believe it promotes incentive to reach your daily goal. It gives a sense of accomplishment, if you reach that “6” mark by day’s end.”

Carlene Thomas R.D.,L.D. Review From Kidney Stone Client

Helpful Tips:

  • Use the AquaTally to track refills instead of cups.  Just turn the band to the next number every time you drink an entire AquaTally.  For example, if you reach 6 at the end of the day you know that you drank 12 cups.
  • Add other sources of hydration to your tally throughout the day to accurately keep track.

[1] Scales CD, Smith AC, Hanley JM, Saigal CS. Prevalence of kidney stones in the United States. European Urology. 2012;62:160–165.

[2] NIDDK reference:

Article: Clinical Uses for AquaTally

AquaTally worked with Toby Amidor, RD on an article Clinical Uses for AquaTally to highlight some of the ways that Registered Dietitians have used AquaTally to help their clients and patients build healthy habits.

The article was published on, an online community that brings together food and nutrition experts to make living healthy simple: Full Article.