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Micronutrients and water

Water: neglected, unappreciated and under researched

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Abstract

Water, an essential nutrient, is often ignored in reports of dietary surveys and nutrition. Although it is ubiquitous in foods and beverages, the attention is often focused on the minerals or calorific values of the fluids imbibed rather than the water per se. Water is often taken for granted by many in Western countries due to its abundant availability through water systems. In developing countries, however, water and sanitation raise significant problems. This review overviews (i) the global perspective of the potable water supply, (ii) human rights and water, (iii) dietary guidelines and sources of water and (iv) the physiology of water balance. Gaps in knowledge and understanding around hydration and water requirements are also discussed. Nutritionists are urged to look at the bigger picture of the global water supply and to use good judgement and common sense when advising on water requirements.

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References

  1. Kleiner SM . Water: an essential but overlooked nutrient. J Am Diet Assoc 1999; 99: 200–206.

    Article  CAS  Google Scholar 

  2. Boeckner LS . Water: The Nutrient. University of Nebraska: Lincoln Extension Publications, 2009.

  3. Jéquier E, Constant F . Water as an essential nutrient: the physiological basis of hydration. Eur J Clin Nutr 2010; 64: 115–123.

    Article  Google Scholar 

  4. Holdsworth JE . The importance of human hydration: perceptions among healthcare professionals across Europe. Nutr Bull 2012; 37: 16–24.

    Article  Google Scholar 

  5. Karowicz-Bilińska A . Water and its importance for female body. Woda i jej znaczenie dla organizmu kobiety 2011; 82: 455–459.

    Google Scholar 

  6. Popkin BM, D'Anci KE, Rosenberg IH . Water, hydration, and health. Nutr Rev 2010; 68: 439–458.

    Article  Google Scholar 

  7. Jéquier E, Constant F . Why do we have to drink water? For maintaining the water balance. Pourquoi faut-il boire de l'eau? Pour maintenir la balance hydrique 2009; 44: 190–197.

    Google Scholar 

  8. European Food Safety Authority (EFSA) Panel On Dietetic Products NaA. Scientific opinion on dietary reference values for water. EFSA Journal 2010; 8: 1459.

    Google Scholar 

  9. Sawka MN, Cheuvront SN, Carter Iii R, Jéquier E, Manz F, Dal Canton A et al. Human water needs. Nutr Rev 2005; 63: S30–S39.

    Article  Google Scholar 

  10. Valtin H, Gorman SA . ‘Drink at least eight glasses of water a day.’ Really? Is there scientific evidence for ‘8 × 8’? Am J Physiol Regul Integr Comp Physiol 2002; 283: 993–1004.

    Article  Google Scholar 

  11. Manz F, Wentz A, Sichert-Hellert W . The most essential nutrient: defining the adequate intake of water. J Pediatr 2002; 141: 587–592.

    Article  Google Scholar 

  12. Vörösmarty CJ, Green P, Salisbury J, Lammers RB . Global water resources: vulnerability from climate change and population growth. Science New York, NY 2000; 289: 284–288.

    Article  Google Scholar 

  13. Vandenbroeck I, Gossens J, Clemens M . Foresight tackling obesities: future choices—obesity system atlas. In: Science GOf (ed). UK Government’s Foresight Programme. Government Office for Science: London, 2007.

    Google Scholar 

  14. A/RES/55/2. United Nations Millennium Declaration: resolution adopted by the General Assembly, 2000.

  15. Gerlak AK, Wilder M . Exploring the textured landscape of water insecurity and the human right to water. Environment: Science and Policy for Sustainable Development 2012; 54: 4–17.

    Google Scholar 

  16. United Nations. Millennium Development Goals: 2011 Progress Chart. http://www.un.org/millenniumgoals/pdf/(2011E)_MDReport2011_ProgressChart.pdf: Accessed 23 January 2013.

  17. Anand PB . Right to water and access to water: an assessment. J Int Dev 2007; 19: 511–526.

    Article  Google Scholar 

  18. Arnell N . Climate change and global water resources: SRES emissions and socio-economic scenarios. Global Environ Change 2004; 14: 31–52.

    Article  Google Scholar 

  19. Fomon SJ, Haschke F, Ziegler EE, Nelson SE . Body composition of reference children from birth to age 10 years. Am J Clin Nutr 1982; 35: 1169–1175.

    Article  CAS  Google Scholar 

  20. Lohman TG . Applicability of body composition techniques and constants for children and youths. Exerc Sport Sci Rev 1986; 14: 325–357.

    Article  CAS  Google Scholar 

  21. Wang Z, Deurenberg P, Wang W, Pietrobelli A, Baumgartner RN, Heymsfield SB . Hydration of fat-free body mass: review and critique of a classic body-composition constant. Am J Clin Nutr 1999; 69: 833–841.

    Article  CAS  Google Scholar 

  22. Jequier E, Constant F . Water as an essential nutrient: the physiological basis of hydration. Eur J Clin Nutr 2010; 64: 115–123.

    Article  CAS  Google Scholar 

  23. Johansson G, Wikman A, Ahren AM, Hallmans G, Johansson I . Underreporting of energy intake in repeated 24-hour recalls related to gender, age, weight status, day of interview, educational level, reported food intake, smoking habits and area of living. Public Health Nutr 2001; 4: 919–927.

    Article  CAS  Google Scholar 

  24. Singer M . Management of fluid balance: a European perspective. Curr Opin Anaesthesiol 2012; 25: 96–101.

    Article  CAS  Google Scholar 

  25. Schoeller DA, van Santen E . Measurement of energy expenditure in humans by doubly labeled water method. J Appl Physiol 1982; 53: 955–959.

    Article  CAS  Google Scholar 

  26. Schoeller DA, Taylor PB . Precision of the doubly labelled water method using the two-point calculation. Hum Nutr Clin Nutr 1987; 41C: 215–223.

    Google Scholar 

  27. Cole TJ, Coward WA . Precision and accuracy of doubly labeled water energy expenditure by multipoint and two-point methods. Am J Physiol 1992; 263: E965–E973.

    CAS  PubMed  Google Scholar 

  28. Raman A, Schoeller DA, Subar AF, Troiano RP, Schatzkin A, Harris T et al. Water turnover in 458 American adults 40-79 yr of age. Am J Physiol Renal Physiol 2004; 286: F394–F401.

    Article  CAS  Google Scholar 

  29. Bossingham MJ, Carnell NS, Campbell WW . Water balance, hydration status, and fat-free mass hydration in younger and older adults. Am J Clin Nutr 2005; 81: 1342–1350.

    Article  CAS  Google Scholar 

  30. Leiper JB, Carnie A, Maughan RJ . Water turnover rates in sedentary and exercising middle aged men. Br J Sports Med 1996; 30: 24–26.

    Article  CAS  Google Scholar 

  31. Leiper JB, Seonaid Primrose C, Primrose WR, Phillimore J, Maughan RJ . A comparison of water turnover in older people in community and institutional settings. J Nutr Health Aging 2005; 9: 189–193.

    CAS  PubMed  Google Scholar 

  32. Rush EC, Chhichhia P, Kilding AE, Plank LD . Water turnover in children and young adults. Eur J Appl Physiol 2010; 110: 1209–1214.

    Article  Google Scholar 

  33. Fusch C, Hungerland E, Scharrer B, Moeller H . Water turnover of healthy children measured by deuterated water elimination. Eur J Pediatr 1993; 152: 110–114.

    Article  CAS  Google Scholar 

  34. O'Connell BN, Weinheimer EM, Martin BR, Weaver CM, Campbell WW . Water turnover assessment in overweight adolescents. Obesity (Silver Spring) 2011; 19: 292–297.

    Article  Google Scholar 

  35. Reed B, Reed R . How much water is needed in emergencies. In: Reed R, (ed). WHO Technical Notes on Drinking-Water, Sanitation and Hygiene in Emergencies. World Health Organisation: Geneva, 2011.

    Google Scholar 

  36. Popkin BM, Armstrong LE, Bray GM, Caballero B, Frei B, Willett WC . A new proposed guidance system for beverage consumption in the United States. Am J Clin Nutr 2006; 83: 529–542.

    Article  CAS  Google Scholar 

  37. Benelam B, Wyness L . Hydration and health: a review. Nutr Bull 2010; 35: 3–25.

    Article  Google Scholar 

  38. Noakes TD . Is drinking to thirst optimum? Ann Nutr Metab 2010; 57 (Suppl 2), 9–17.

    Article  CAS  Google Scholar 

  39. McCartney M . Health marketing: Waterlogged? BMJ 2011; 343: d4280.

    Article  Google Scholar 

  40. Negoianu D, Goldfarb S . Just add water. J Am Soc Nephrol 2008; 19: 1041–1043.

    Article  Google Scholar 

  41. Buyckx ME . Hydration and health promotion: a brief introduction. J Am Coll Nutr 2007; 26: 533S–534S.

    Article  Google Scholar 

  42. The PLoS Medicine Editors. PLoS medicine series on big food: the food industry is ripe for scrutiny. PLoS Med 2012; 9: e1001246.

    Article  Google Scholar 

  43. Benton D . Dehydration influences mood and cognition: a plausible hypothesis? Nutrients 2011; 3: 555–573.

    Article  Google Scholar 

  44. Cohen D . The truth about sports drinks. BMJ 2012; 345: e4737 (Published 18 July 2012) 2012.

    Article  Google Scholar 

  45. Almond CS, Shin AY, Fortescue EB, Mannix RC, Wypij D, Binstadt BA et al. Hyponatremia among runners in the Boston marathon. N Engl J Med 2005; 352: 1550–1556.

    Article  CAS  Google Scholar 

  46. Food and Nutrition Board. Recommended Dietary Allowances. National Academy Press: Washington, 1989.

  47. Doria MF . Bottled water versus tap water: understanding consumers’ preferences. J Water Health 2006; 4: 271–276.

    Article  Google Scholar 

  48. Hall R, Wilton M . 2011 global bottled water congress and market trends 2011: http://www.zenithinternational.com/pdf/events/00010_webinar.pdf : Accessed 23 January 2013.

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Rush, E. Water: neglected, unappreciated and under researched. Eur J Clin Nutr 67, 492–495 (2013). https://doi.org/10.1038/ejcn.2013.11

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