Relevance of Assessment Methods for Fluid Intake

Abstract

Reliable data at population level are essential to firmly establish links between fluid intake, hydration and health, investigate dose-response relationships and develop meaningful public health strategies or reference intake values. However, limited research exists regarding the most appropriate methodology for assessing beverage or total fluid intake (TFI). To date, methodologies have been developed to assess food and nutrient intake without due consideration of water or fluid intake behavior. A recent crossover study showed that a 24-hour food recall significantly underestimated mean TFI by 382 ml (95% CI 299-465) compared with a fluid specific 7-day record. The authors postulated that this average difference was mainly the result of missed drinking acts between meals a 24-hour recall was used. Using a 7-day record administered in paper form or on-line has also been shown to lead to a significantly different mean TFI of 129 ml. Therefore, the choice of methodology might result in measurement errors that limit between-survey or between-country comparisons. Such errors may contribute to variations in estimates of TFI that cannot be explained by differences in climate, physical activity or cultural habits. A recent survey confirmed the variation in methodologies used in European national dietary surveys. Since these surveys form the basis for setting adequate intakes for total water intake, measurement error between surveys should be limited, highlighting the need for the development of a consistent methodology that is validated for water and TFI estimation.

Fluid Intake of Pregnant and Breastfeeding Women in Indonesia: A Cross-Sectional Survey with a Seven-Day Fluid Specific Record

“…Since the investigators visited the subject each day to check the completion, and recuperated the page of the fluid record, this risk was eliminated. In national surveys, a food frequency questionnaire, a 24 h dietary recall, or a mix of methods is more frequently used than a seven-day dietary record [30]. Since a 24 h recall tends to underestimate TFI [31], our results should be compared to other food surveys with caution.…”

Challenges in the assessment of total fluid intake in children and adolescents: a discussion paper

“…Validation is essential for the establishment of dose–response relationships between water and fluid intakes and disease or other outcomes, and to develop robust intake recommendations [17]. …”

“…Currently, the assessment of fluid intake is overwhelmingly based on traditional dietary assessment methodologies, because of lack of evidence to support proof of primacy of one method over another [ 17 ].…”

“…It was noted in a review of the methodologies used to record fluid, beverage and water intakes at a population level in Europe, that none of the ten national surveys were validated for the assessment of water and fluid intakes [ 9 ]. Validation is essential for the establishment of dose–response relationships between water and fluid intakes and disease or other outcomes, and to develop robust intake recommendations [ 17 ].…”

The Comparison of Water Intake Patterns and Hydration Biomarkers among Young Adults with Different Hydration Statuses in Hebei, China

“…There were some strengths and weakness about our study. The methodologies used to assess the uids intake included the food frequency questionnaires and food diaries, which may underestimate TWI as they cannot capture all drinking events [51]. In this study, the total drinking uids were assessed by 7-day 24-h uid intake questionnaire, which included the details of uids intake, such as the amounts, types, places, and time.…”