From State to Process: Defining Hydration

Perrier, Erica T.; Armstrong, Lawrence E.; Daudon, Michel; Kavouras, Stavros A.; Lafontan, Max; Läng, Florian; Péronnet, François; Stookey, Jodi; Tack, Ivan; Klein, Alexis

doi:10.1159/000360611

Cited by 33 publications

(36 citation statements)

References 29 publications

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“…As in adults, markers of urine concentration such as osmolality, specific gravity, and color may be used for day-to-day hydration assessment of children [34,35]. Urine color, in particular, may be used for self-assessment of hydration since it can reliably be self-assessed by children above 8 years of age [36].…”

Section: Hydration Assessment Of Childrenmentioning

confidence: 99%

Hydration in Children: What Do We Know and Why Does it Matter?

et al. 2019

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In children, maintaining adequate fluid intake and hydration is important for physiological reasons and for the adoption of healthy, sustainable drinking habits. In the Liq.In⁷ cross-sectional surveys involving 6,469 children (4–17 years) from 13 countries, 60% of children did not meet the European Food Safety Authority (EFSA) adequate intake for water from fluids. Beyond fluid quantity, the quality of what children drink is important for health. In these surveys, the contribution of sugar-sweetened beverages and fruit juices to total fluid intake (TFI) in children exceeded that of water in 6 out of 13 countries. To assess the adequacy of children’s fluid intake, urinary biomarkers of hydration such as urine osmolality, urine specific gravity, and urine color may be used. To date, while there are no widely accepted specific threshold values for urine concentration to define adequate hydration in children, the available literature suggests that many children have highly concentrated urine, indicating insufficient fluid intake. This is worrisome since studies have demonstrated a relationship between low fluid intake or insufficient hydration and cognitive performance in children. Furthermore, results of the Liq.In⁷ surveys showed that at school – where children spend a significant amount of time and require optimal cognitive performance – children drink only 14% of their TFI. Consequently, it is pertinent to better understand the barriers to drinking water at school and encourage the promotion of water intake through multicomponent interventions that combine educational, environmental, and behavioral aspects to support adequate hydration as well as optimal cognition in children.

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Section: Hydration Assessment Of Childrenmentioning

confidence: 99%

Hydration in Children: What Do We Know and Why Does it Matter?

et al. 2019

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“…Future research would benefit from different measures of hydration, including dehydration, optimal hydration, and hydration process. In particular, hydration process has been found to be important for many different health outcomes in adults, but its importance for cognition in children remains largely unexplored [36]. In summary, the current state of the literature is sparse and would benefit from a more programmatic approach to assessing the effects of optimal and insufficient hydration on cognition and brain functions using a variety of laboratory and field techniques, ranging from brain imaging to academic behaviors.…”

Section: Resultsmentioning

confidence: 99%

Cognitive Assessments in Hydration Research Involving Children: Methods and Considerations

et al. 2019

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The effects of optimal and insufficient hydration on human health have received increasing investigation in recent years. Specifically, water is an essential nutrient for human health, and the importance of hydration on cognition has continued to attract research interest over the last decade. Despite this focus, children remain a relatively understudied population relative to the effects of hydration on cognition. Of those studies investigating children, findings have been inconsistent, resulting from utilizing a wide variety of cognitive domains and cognitive assessments, as well as varied hydration protocols. Here, our aim is to create a primer for assessing cognition during hydration research in children. Specifically, we review the definition of cognition and the domains of which it is composed, how cognition has been measured in both field- and laboratory-based assessments, results from neuroimaging methods, and the relationship between hydration and academic achievement in children. Lastly, future research considerations are discussed.

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“…Shifting the paradigm toward redefining hydration as a dynamic, ongoing process to maintain water balance allows for distinctions between low total water intake, and low urinary output; from high water intake, and high urinary output [30] . Recent studies linking low water intake, low urine output, or high AVP (or its surrogate, copeptin) to various health outcomes or risk factors [31][32][33][34][35][36][37][38][39] suggest that maintaining the hydration state in the face of habitual low intake has a cost.…”

Section: To Be or Not To Be Dehydrated? That May No Longer Be The Qmentioning

confidence: 99%

“…This concept of the "minimum, maximum urine concentrating capacity" was also later explored by Manz and Wentz [67] , who suggested that an upper limit for euhydration could be calculated as the mean maximum U Osm , minus 2 SDs, as way to ensure euhydration for nearly all members of a given population. However, with the emerging distinction between the hydration state and hydration process [30] , and with recent associations between low water intake, low urinary output, higher plasma copeptin, and kidney and metabolic outcomes [31][32][33][34][35][36][37] , a lower target for 24-h urine concentration may be warranted.…”

Section: Reference Values and Cut-offs: What Is The Target For Optimamentioning

confidence: 99%

Shifting Focus: From Hydration for Performance to Hydration for Health

Perrier¹

2017

Ann Nutr Metab

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Over the past 10 years, literature on hydration biomarkers has evolved considerably - from (de)hydration assessment towards a more global definition of biomarkers of hydration in daily life. This shift in thinking about hydration markers was largely driven by investigating the differences that existed between otherwise healthy individuals whose habitual, ad-libitum drinking habits differ, and by identifying physiological changes in low-volume drinkers who subsequently increase their water intake. Aside from obvious differences in urinary volume and concentration, a growing body of evidence is emerging that links differences in fluid intake with small, but biologically significant, differences in vasopressin (copeptin), glomerular filtration rate, and markers of metabolic dysfunction or disease. Taken together, these pieces of the puzzle begin to form a picture of how much water intake should be considered adequate for health, and represent a shifting focus from hydration for performance, toward hydration for health outcomes. This narrative review outlines the key areas of research in which the global hydration process - including water intake, urinary hydration markers, and vasopressin - has been associated with health outcomes, focusing on kidney and metabolic endpoints. It will also provide a commentary on how various hydration biomarkers may be used in hydration for health assessment. Finally, if adequate water intake can play a role in maintaining health, how might we tell if we are drinking enough? Urine output is easily measured, and can take into account differences in daily physical activity, climate, dietary solute load, and other factors that influence daily water needs. Today, targets have been proposed for urine osmolality, specific gravity, and color that may be used by researchers, clinicians, and individuals as simple indicators of optimal hydration. However, there remain a large number of incomplete or unanswered research questions regarding the relationships between water intake, hydration, vasopressin, and health outcomes. Thus, this emerging field represents an excellent opportunity, particularly for young researchers, to develop relevant and novel lines of research.

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From State to Process: Defining Hydration

Cited by 33 publications

References 29 publications

Hydration in Children: What Do We Know and Why Does it Matter?

Hydration in Children: What Do We Know and Why Does it Matter?

Cognitive Assessments in Hydration Research Involving Children: Methods and Considerations

Shifting Focus: From Hydration for Performance to Hydration for Health

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