Total fluid intake of children and adolescents: cross-sectional surveys in 13 countries worldwide

European Journal of Nutrition, Jun 2015

Purpose To describe total fluid intake (TFI) according to socio-demographic characteristics in children and adolescents worldwide. Methods Data of 3611 children (4–9 years) and 8109 adolescents (10–18 years) were retrieved from 13 cross-sectional surveys (47 % males). In three countries, school classes were randomly recruited with stratified cluster sampling design. In the other countries, participants were randomly recruited based on a quota method. TFI (drinking water and beverages of all kinds) was obtained with a fluid-specific record over 7 consecutive days. Adequacy was assessed by comparing TFI to 80 % of adequate intake (AI) for total water intake set by European Food Safety Authority. Data on height, weight and socio-economic level were collected in most countries. Results The mean (SD) TFI ranged from [1.32 (0.68)] to [1.35 (0.71)] L/day. Non-adherence to AIs for fluids ranged from 10 % (Uruguay) to >90 % (Belgium). Females were more likely to meet the AIs for fluids than males (4–9 years: 28 %, OR 0.72, p = 0.002; 10–18 years: 20 %, OR 0.80, p = 0.001), while adolescents were less likely to meet the AI than children (OR 1.645, p < 0.001 in males and OR 1.625, p < 0.001 in females). Conclusions A high proportion of children and adolescents are at risk of an inadequate fluid intake. This risk is especially high in males and adolescents when compared with females or children categories. This highlights water intake among young populations as an issue of global concern.

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Total fluid intake of children and adolescents: cross-sectional surveys in 13 countries worldwide

Total fluid intake of children and adolescents: cross‑sectional surveys in 13 countries worldwide Iris Iglesia 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 Isabelle Guelinckx 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 Pilar M. De Miguel‑Etayo 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 Esther M. González‑Gil 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 Jordi Salas‑Salvadó 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 Stavros A. Kavouras 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 Joan Gandy 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 Homero Martínez 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 Saptawati Bardosono 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 Morteza Abdollahi 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 Esmat Nasseri 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 Agnieszka Jarosz 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 Guansheng Ma 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 Esteban Carmuega 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 Isabelle Thiébaut 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 Luis A. Moreno 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 0 Human Nutrition Unit, Hospital Universitari de Sant Joan de Reus, Faculty of Medicine and Health Sciences, IISPV (Institut d'Investigació Sanitària Pere Virgili), Biochemistry Biotechnology Department, Universitat Rovira i Virgili , Reus , Spain 1 National Food and Nutrition Institute , Warsaw , Poland 2 Hydration & Health Department, Danone Research , Palaiseau , France 3 Department of Nutrition Research, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences , Tehran , Iran 4 Department of Nutrition and Food Hygiene, School of Public Health, Peking University , Beijing , China 5 GENUD (Growth , Exercise , NUtrition and Development) Research Group, Faculty of Health Sciences, Universidad de Zaragoza , Zaragoza , Spain 6 National Institute for Nutrition and Food Safety, Chinese Center for Disease Control and Prevention , Beijing , China 7 Department of Nutrition, Faculty of Medicine, Universitas Indonesia , Jakarta , Indonesia 8 Hospital Infantil de Mexico Federico Gomez , Mexico City , Mexico 9 RAND Corporation , Santa Monica, CA , USA 10 School of Life and Medical Services, University of Hertfordshire , Hatfield , UK 11 British Dietetic Association , Birmingham , UK 12 Department of Health Human Performance and Recreation, University of Arkansas , Fayetteville, AR , USA 13 CIBERobn (Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición), Institute of Health Carlos III , Madrid , Spain 14 Research Centre of Epidemiology, Biostatistics and Clinical Research, School of Public Health, Université Libre de Bruxelles , Brussels , Belgium Purpose To describe total fluid intake (TFI) according to socio-demographic characteristics in children and adolescents worldwide. Methods Data of 3611 children (4-9 years) and 8109 adolescents (10-18 years) were retrieved from 13 crosssectional surveys (47 % males). In three countries, school classes were randomly recruited with stratified cluster sampling design. In the other countries, participants were randomly recruited based on a quota method. TFI (drinking water and beverages of all kinds) was obtained with a fluidspecific record over 7 consecutive days. Adequacy was assessed by comparing TFI to 80 % of adequate intake (AI) for total water intake set by European Food Safety Authority. Data on height, weight and socio-economic level were collected in most countries. Results The mean (SD) TFI ranged from [1.32 (0.68)] to [1.35 (0.71)] L/day. Non-adherence to AIs for fluids ranged from 10 % (Uruguay) to >90 % (Belgium). Females were more likely to meet the AIs for fluids than males (4-9 years: 28 %, OR 0.72, p = 0.002; 10-18 years: 20 %, OR 0.80, p = 0.001), while adolescents were less likely to meet the AI than children (OR 1.645, p < 0.001 in males and OR 1.625, p < 0.001 in females). Conclusions A high proportion of children and adolescents are at risk of an inadequate fluid intake. This risk is - especially high in males and adolescents when compared with females or children categories. This highlights water intake among young populations as an issue of global concern. Water is essential for life to the extent that hydration is a major key to survival [24]. This is especially true for infants and adolescents who have relatively high requirements for water to maintain an adequate body composition [28]. This high requirement can partially be explained because children have proportionally higher body water content than adults [5]. Besides the higher body water content, body surface area to body mass ratio is higher in children when compared with adults. This difference levels out by adolescence, when children have almost reached their adult size [27]. At this time, gender differences start to appear: females store more adipose tissue than males and therefore water percentages are lower than in males [1]. Dehydration (body water deficit) is a physiologic state that can have profound implications for human health (...truncated)


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Iris Iglesia, Isabelle Guelinckx, Pilar M. De Miguel-Etayo, Esther M. González-Gil, Jordi Salas-Salvadó, Stavros A. Kavouras, Joan Gandy, Homero Martínez, Saptawati Bardosono, Morteza Abdollahi, Esmat Nasseri, Agnieszka Jarosz, Guansheng Ma, Esteban Carmuega, Isabelle Thiébaut, Luis A. Moreno. Total fluid intake of children and adolescents: cross-sectional surveys in 13 countries worldwide, European Journal of Nutrition, 2015, pp. 57-67, Volume 54, Issue 2 Supplement, DOI: 10.1007/s00394-015-0946-6