Three WHO Recipes

Oral Rehydration Salts (ORS) is the name of the World Health Organization's glucose-electrolyte protocol, first used in 1969 and approved, recommended, and distributed by UNICEF and WHO for dehydration. To date, there are three formulations. The ORS recipes have been a breakthrough that saves many lives due to the realization that adding glucose to electrolyte salts in a hydrating solution makes them more available to the human body than a salt solution alone.

Researching ORS

I found it easier to use a search engine to search for WHO publications to try to find them them directly via their official site. This WHO publication from 2006 provides a good overview of their advice about the Low Osmolarity ORS. There is an earlier version from 1998 that has more details on the earlier two WHO ORS recipes. I appreciate that their material is written toward medical practitioners as well as field workers and everyday people who might be preparing rehydration solutions at home. 

The Wikipedia article Oral rehydration therapy is grounded in the World Health Organization protocol and history, and it's relatively thorough.

Hints and TIPS

• Granulated table sugar breaks down into 50% fructose and 50% glucose when digested. I have seen recipes that substitute table sugar for situations when glucose is not available and my impression is that this substitution is relatively common, but I do not have research links yet.

• For around $25 you can purchase a digital scale that is precise at these weights and is rated for "reloading", which is an important feature when weighing several ingredients in a row. Here's an Amazon link to one scale that would work well.

• Don't assume that 1 gram of powder equals 1 gram of the ingredient you are using. Make sure you are aware of the ratio to any inactive ingredients that are blended together.

• Once you are comfortable with your recipe, use your scale to find cups or spoons that are the correct size for each of your ingredients, or that you can mark with a line to indicate the filling point. This way you don't have to weigh each ingredient every time.

What about flavor?

The glucose in these recipes provides sweetness, but it is overall not an appealing flavor, at least for me.

One option is to mix these ingredients into a juice, broth, or other liquid that will taste better. If I'm mixing a recipe at home, I enjoy citrus flavors in the form of a squirt of lemon juice or lime juice, which are affordable online if you order a bit more at once.

The brand Real Citrus turns juice into a tasty crystal powder that can be added to these recipes. I also use these citrus crystals in other ways (try Real Lime crystal powder sprinkled on popcorn sometime!)

Many folks use Crystal Light products for this purpose.

Recipe: Bicarbonate Oral Rehydration Solution

This recipe has been in use by the WHO since 1969 and includes sodium bicarbonate or baking soda. This is a common ingredient in many areas, but it is not as shelf-stable as trisodium citrate in hot and humid climates.

• Sodium chloride 3.5g/L (Amazon: Morton Regular Salt 26-ounce 3-pack)

• Sodium bicarbonate 2.5g/L (Amazon: Bob's Red Mill Baking Soda 16 ounce)

• Potassium chloride 1.5g/L (Amazon: NOW Supplements 8-Ounce)

• Glucose, anhydrous 20.0g/L (Amazon: Modernist Pantry 1kg)

Recipe: Citrate Oral Rehydration Solution

In 1984, another recipe was approved containing trisodium citrate instead of baking soda. Trisodium citrate is not as readily available in the United States, but can be purchased via mail order and has reportedly been available at some specialty grocery stores. Note: Sometimes trisodium citrate is also sometimes labeled simply as sodium citrate, be sure to know your ingredients.

• Sodium chloride 3.5g/L (Amazon: Morton Regular Salt 26-ounce 3-pack)

• Trisodium citrate, dihydrate 2.9g/L (Amazon: Judee's Sodium Citrate 11.25oz)

• Potassium chloride 1.5g/L (Amazon: NOW Supplements 8-Ounce)

• Glucose, anhydrous 20.0g/L (Amazon: Modernist Pantry 1kg)

Recipe: Low Osmolarity Oral Rehydration Solution

In the early 2000s, the WHO approved a new formulation which improved outcomes for children with diarrhea. Note: Sometimes trisodium citrate is also sometimes labeled simply as sodium citrate, be sure to know your ingredients.

• Sodium chloride 2.6g/L (Amazon: Morton Regular Salt 26-ounce 3-pack)

• Potassium chloride 1.5g/L (Amazon: NOW Supplements 8-Ounce)

• Trisodium citrate, dihydrate 20.5g/L (Amazon: Judee's Sodium Citrate 11.25oz)

• Glucose, anhydrous 13.5g/L (Amazon: Modernist Pantry 1kg)