Comparison of beverage consumption in adult populations from three different countries: do the international reference values allow establishing the adequacy of water and beverage intakes?

Abstract

Introduction: Recommendations of adequate total water intake (aTWI) have been proposed by the European Food Safety Agency (EFSA) and the Institute of Medicine (IOM) of the United States of America. However, there are differences in the approach used to support them: IOM recommendation is based on average intakes observed in NHANES III (Third National Health and Nutrition Examination Survey) and EFSA recommendation on a combination of observed intakes from 13 different European countries. Despite these recommendations of aTWI, the currently available scientifi c evidence is not suffi cient to establish a cut-off value that would prevent disease, reduce the risk for chronic diseases or improve health status. Objective: To compare the average daily consumption of fl uids (water and other beverages) in selective samples of population from Mexico, US and Spain, evaluating the quantity of fl uid intake and understanding the contribution of each fl uid type to the total fl uid intake. We also aim to determine if they reached adequate intake (AI) values, as defi ned by three different criteria: IOM, EFSA and water density. Methods: Three studies were compared: from Mexico, the National Health and Nutrition Survey conducted in 2012 (NHNS 2012); from US, the NHANES III 2005-2010 and from Spain the ANIBES study leaded in 2013. Different categories of beverages were used to establish the pattern of energy intake for each country. Only adult population was selected. TWI of each study was compared with EFSA and IOM AI recommendations, as well as applying the criterion of water density (mL/kcal). Results: The American study obtained the higher value of total kcal/day from food and beverages (2,437 ± 13). Furthermore, the percentage of daily energy intake coming from beverages was, for American adults, 21%. Mexico was slightly behind with 19% and Spain ANIBES study registered only 12%. ANIBES showed signifi cantly low AI values for the overall population, but even more alarming in the case of males. Only 12% of men, in contrast with 21% of women, do satisfy the EFSA criterion. The IOM criterion reaches even less with higher recommended values for daily intake. In contrast, 60% of the American population reached the recommended intake of the IOM criterion. However, available data did not allow calculating the percentage reached by the EFSA criterion. Data from the Mexican study did not permit conducting comparisons with IOM or with EFSA. However, the water density criteria (mL/kcal) was higher than 1. Conclusion: There is a notable difference between all three populations in terms of TWI. Furthermore, within the same population, values of adequacy of

European Healthy Hydration Awareness Campaign for Dietitians

“…Fluids and food are also an integral part of diet due to their nutrient and energy content. In particular, data from large population surveys in Spain, Mexico, and the United States revealed that mean energy intakes from foods and beverages ranged from 1,816 to 2,437 kcal with fluids contributing 12% (in Spain) to 21.7% (in Mexico) of total energy intake [19]. Dietitians are particularly concerned about the increased intakes of sugar-sweetened beverages (SSB) due to their detrimental consequences on oral health and body weight in children [20] and adults [21].…”

“…Evidence from large cross-sectional surveys across Europe found that juices and SSB contributed 35-45% of TFI in children and adolescents and 15-20% in adults [3]. In the United States, data from the national survey showed that SSB intake contributed 6% of total caloric intake [19]. Drinking water instead of SSB is recommended by health organizations, as water is free of calories [1], while an increased water intake has been associated with higher diet quality [23].…”