Water intake and urinary hydration biomarkers in children

Kavouras, Stavros A.; Bougatsas, Dimitris; Johnson, Evan C.; Arnaoutis, Giannis; Tsipouridi, Spiridoula; Panagiotakos, Demosthenes B.

doi:10.1038/ejcn.2016.218

Cited by 29 publications

(38 citation statements)

References 44 publications

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“…31 Interestingly, the authors found that despite the adequate water intake, >27% of participants were still found hypohydrated confirming the hypothesis that inadequate water intake is not the only driver of dehydration.…”

mentioning

confidence: 52%

“…19,29 It provides additional support to studies by other investigators that showed that poor hydration status is common among college students. 19,30,31 Inadequate water intake was significantly associated with the highest Odds (OR=6.4, CI 2.121-19.385) for dehydration among participants. This was found in more than half (59.1%) of all dehydrated participants, further confirming the assertion that most children and adults, and in particular school aged children, adolescences and adults do not consume enough water for their age groups as defined by IOM and EFSA.…”

Section: Discussionmentioning

confidence: 99%

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High prevalence and associated risk factors of dehydration among college students: implications for health and academic performance

Ekpenyong

Akpan

2017

Int J Community Med Public Health

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Background: Existing data indicate that poor hydration status adversely affects academic performance and health status of college students, but hydration studies among students have not received sufficient research and educational attention. The aim of this study was to determine the prevalence and associated risk factors of dehydration among college students in Southern Nigeria.Methods: A total of 500 students (190 males and 310 females), ages between 18 and 35 years filled out a supervised questionnaire which included questions pertaining to socio-demographics, lifestyle habits, perceived symptoms, academic performance, urinary characteristics and water/fluid intake. Hydration status was determined using urinary specific gravity during the month of October 2016. Mean values were calculated and used to determine the hydration status of participants. Multivariable regression analysis was used to determine odds ratios (ORs) and 95% confidence interval for factors associated with poor hydration status of participants.Results: About 46.4% of participants were dehydrated. Insufficient water intake (OR=6.41, 95% CI:2.121-19.385, P=0.001), alcohol drinking habits (OR=4.17, 95% CI: 1.313-13.258, P=0.015), night clubbing habits (OR=2.51, 95% CI:1.261-3.822, P=0.034) and being exposed to hot environment (OR=2.16, 95% CI:1.998-4.656, P=0.041) were factors associated with increased odds of dehydration among participants. Other factors associated with higher odds of dehydration include regular coffee intake (OR=2.93, 95% CI:1.788-5.622, P=0.017), experiencing academic stress (OR=1.53, 95% CI:1.041-2.251, P=0.031) and having parents or guardians of middle or low SES (OR=2.21, 95% CI:1.70-4.267, P=0.42) and (OR=3.42, 95% CI:1.655-7.82, P=0.015) respectively.Conclusions: Indeed, there is a high prevalence of dehydration and associated risk factors among college students. Intervention programs to reduce dehydration among students should include these factors among others for improved quality of life and academic performance.

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confidence: 52%

Section: Discussionmentioning

confidence: 99%

High prevalence and associated risk factors of dehydration among college students: implications for health and academic performance

Ekpenyong

Akpan

2017

Int J Community Med Public Health

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“…The results of clinical studies confirmed that many children have highly concentrated urine before or during school, which can suggest that a large proportion of children arrive at school already slightly dehydrated and deepen this state by not drinking adequately during a school day [ 16 , 17 , 19 , 27 , 28 ]. Based on 24 urine osmolality in the NHANES (National Health and Nutrition Examination Survey) study (children aged 6–19), 54.5% of children were inadequately hydrated [ 28 ]. In a study of 529 French children aged 9–11 years, the hydration status in the morning was assessed using the urine osmolality collected after breakfast, and almost two thirds of the examined showed a hydration deficit in the morning, despite having breakfast [ 16 ].…”

Section: Discussionmentioning

confidence: 86%

Body Composition and a School Day Hydration State among Polish Children—A Cross-Sectional Study

Kozioł-Kozakowska

Piórecka

Suder

et al. 2020

IJERPH

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Background: Little is known on the relationship between obesity and hydration level in children. To explore the possible association between children’s hydration status and body composition, we conducted this cross-sectional study. Methods: The survey was carried out in 2018 in Preliminary and High Schools from the Malopolska Province, Poland. The study group consisted of 264 children aged 7–15 years. The level of hydration was assessed based on urine osmolality during a school day. The examined had anthropometric tests and body composition assessment (FM, BF%, FFM, TBW, TBW%). Odds ratio (OR) and 95% confidence interval (CI) were calculated using a logistic regression analysis. Results: In the study group, 9.5% of the examined were overweight, 7.2% obese, and it referred more to the country than towns (p < 0.05). Improper hydration was found in 53% of children, and 16.3% of them were severely dehydrated during a school day (urine osmolality > 1000 mOsm/kgH2O). The level of dehydration was higher in children with excessive body fat (BF%) than in children with normal BF% [903.00 vs. 775 mOsm/kgH2O]. Older age (>10 y) showed inverse association with dehydration [OR 0.52 (95% CI; 0.28–0.99)] and excessed BF% showed 2.3-fold increase in odds of dehydration during a school day [OR 2.39 (95% CI; 1.15–4.94)]. Improper hydration was a risk factor of difficulties with concentration declared by students during a school day OR 2.85 (95% CI; 1.16–6.99). Conclusions: Attention should be paid to appropriate hydration especially in children with excessive body fat content who feature a higher risk of dehydration and fluid demand.

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“…The second sample was obtained at the end of the school day before lunch. This time point has been shown to have a good diagnostic ability for detecting hypohydration in children (35).…”

Section: Discussionmentioning

confidence: 96%

Prevalence of hypohydration in adolescents during the school day in Cyprus: seasonal variations

Stavrinou¹,

Giannaki²,

Andreou³

et al. 2020

East Mediterr Health J.

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Background: Evidence on the hydration status of adolescents and seasonal and time variations is scarce. Aims: This study aimed to assess variations in the hydration status and total water intake of adolescents in Cyprus between winter and summer and between the morning and end of the school day. Subjective feelings and cognitive function associated with hypohydration were also examined. Methods: Fifty-three adolescents (39 boys) with a mean age (standard deviation, SD) of 15.1 (1.9) years were included in the study. Participants provided urine samples and completed a cognitive function test and a questionnaire on subjective feelings upon arrival at school and at the end of the school day. Data were collected in winter and summer in 2016-2017. Hydration level was determined by urine specific gravity and cognitive function was assessed with a symbol cancellation test. Total water intake was estimated from a food and fluid record kept by the participants. Results: A high prevalence of hypohydration was found in both seasons ranging from 72% to 94%. Hypohydration was associated with perceptions of lower concentration and alertness (P = 0.008 and P = 0.047, respectively). Adolescents had significantly higher mean urine specific gravity in winter than in summer: 1.026 (SD 0.007) versus 1.023 (SD 0.007), respectively (P = 0.002). Hydration status was not associated with cognitive function or total water intake. 1 / 11 WHO EMRO | Prevalence of hypohydration in adolescents during the school day in Cyprus: seasonal var Conclusions: The high prevalence of hypohydration and the associated feelings of lower concentration and alertness in adolescents suggests that educational measures are needed to promote good drinking behaviour and improve hydration.

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Water intake and urinary hydration biomarkers in children

Abstract: Failure to meet TWI-F guidelines increased calculated relative risk of hypohydration in children. Boys between 9 and 13 years are at greater hazard regardless of meeting guidelines and may require greater water intake to avoid elevated urine concentration and ensure adequate hydration.

Cited by 29 publications

References 44 publications

High prevalence and associated risk factors of dehydration among college students: implications for health and academic performance

High prevalence and associated risk factors of dehydration among college students: implications for health and academic performance

Body Composition and a School Day Hydration State among Polish Children—A Cross-Sectional Study

Prevalence of hypohydration in adolescents during the school day in Cyprus: seasonal variations

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