Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Article
  • Published:

Fluid consumption pattern and hydration among 8–14 years-old children

European Journal of Clinical Nutrition volume 72, pages 420–427 (2018)Cite this article

Subjects

Abstract

Background/objectives

Children consume various fluids to meet dietary water intake needs. However, the contribution of different fluid types on hydration is unclear. The purpose of this study was to develop fluid intake patterns and examine their association with hydration, as indicated by 24-h urine osmolality.

Subjects/methods

Two hundred ten (105 girls) healthy children (height: 1.49 ± 0.13 m, weight: 43.4 ± 12.6 kg, body fat: 25.2 ± 7.8%) recorded their fluid intake for two consecutive days, and collected their urine for 24-h during the 2nd day, while conducting their normal daily activities. Urine samples were analyzed for specific gravity and osmolality. Factor analysis with principal components method was applied to extract dietary patterns from six fluid groups. Linear regression analysis evaluated the associations between the extracted dietary patterns and hydration based on 24-h urine osmolality.

Results

The analysis revealed the following six components: 1, characterized by consumption of milk and fresh juice, but not packaged juice; 2, by regular soda and other drinks, but not water; 3, by fresh juice and other drinks; 4, by packaged juice, but not regular soda; 5, by water and milk; and 6, by fresh juice. Component 5 was negatively correlated with urine osmolality (P = 0.001) indicating better hydration, whereas component 2 was positively correlated with urine osmolality (P = 0.001).

Conclusions

A drinking pattern based on water and milk was associated with better hydration, as indicated by lower urine osmolality, whereas drinking regular soda and other drinks but not water was associated with inferior hydration.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Agostoni CV, Bresson JL, Fairweather-Tait S, Flynn A, Golly I, Korhonen H, et al. Scientific opinion on dietary reference values for water: EFSA panel on dietetic products, nutrition and allergies (NSA). EFSA J. 2010;8(3):1–48. https://doi.org/10.2903/j.efsa.2010.1459

    Article  Google Scholar 

  2. Panel on Dietary Reference Intakes for Electrolytes and Water. DRI FaNB, Institute of Medicine. Dietary Reference Intakes for Water, Potassium, Sodium, Chloride, and Sulfate. Washington^ eDC DC: National Academy Press; 2004.

    Google Scholar 

  3. Ferreira-Pêgo C, Guelinckx I, Moreno LA, Kavouras SA, Gandy J, Martinez H, et al. Total fluid intake and its determinants: cross-sectional surveys among adults in 13 countries worldwide. Eur J Nutr. 2015;54(Suppl 2(S2)):35–43. https://doi.org/10.1007/s00394-015-0943-9

    Article  PubMed  PubMed Central  Google Scholar 

  4. Iglesia I, Guelinckx I, De Miguel-Etayo PM, González-Gil EM, Salas-Salvadó J, Kavouras SA, et al. Total fluid intake of children and adolescents: cross-sectional surveys in 13 countries worldwide. Eur J Nutr. 2015;54(Suppl 2(S2)):57–67. https://doi.org/10.1007/s00394-015-0946-6

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Kavouras SA, Bougatsas D, Johnson EC, Arnaoutis G, Tsipouridi S, Panagiotakos DB. Water intake and urinary hydration biomarkers in children. Eur J Clin Nutr. 2017;71(4):530–5. https://doi.org/10.1038/ejcn.2016.218

    Article  CAS  PubMed  Google Scholar 

  6. Guelinckx I, Iglesia I, Bottin JH, De Miguel-Etayo P, González-Gil EM, Salas-Salvadó J, et al. Intake of water and beverages of children and adolescents in 13 countries. Eur J Nutr. 2015;54(Suppl 2(S2)):69–79. https://doi.org/10.1007/s00394-015-0955-5

    Article  PubMed  PubMed Central  Google Scholar 

  7. Kenney EL, Long MW, Cradock AL, Gortmaker SL. Prevalence of inadequate hydration among US children and disparities by gender and race/ethnicity: National Health and Nutrition Examination Survey, 2009-12. Am J Pub Health. 2015;105(8):e113–118. https://doi.org/10.2105/AJPH.2015.302572

    Article  Google Scholar 

  8. Guelinckx I, Frémont-Marquis AS, Eon E, Kavouras SA, Armstrong LE. Assessing hydration in children: From science to practice. Ann Nutr Metab. 2015;66(3):5–9. https://doi.org/10.1159/000381814

    Article  CAS  PubMed  Google Scholar 

  9. 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(5 Suppl):1169–75.

    Article  CAS  Google Scholar 

  10. Fenández-Alvira JM, Iglesia I, Ferreira-Pêgo C, Babio N, Salas-Salvadó J, Moreno LA. Fluid intake in Spanish children and adolescents; a cross-sectional study. Nutrición hospitalaria. 2014;29(5):1163–70. https://doi.org/10.3305/nh.2014.29.5.7420

    Article  PubMed  Google Scholar 

  11. Drewnowski A, Rehm CD, Constant F. Water and beverage consumption among adults in the United States: cross-sectional study using data from NHANES 2005--2010. BMC Pub Health. 2013;13(1):1068 https://doi.org/10.1186/1471-2458-13-1068

    Article  Google Scholar 

  12. Bar-David Y, Urkin J, Kozminsky E. The effect of voluntary dehydration on cognitive functions of elementary school children. Acta Paediatr. 2005;94(11):1667–73. https://doi.org/10.1080/08035250500254670

    Article  PubMed  Google Scholar 

  13. Fadda R, Rapinett G, Grathwohl D, Parisi M, Fanari R, Calò CM, et al. Effects of drinking supplementary water at school on cognitive performance in children. Appetite. 2012;59(3):730–7. https://doi.org/10.1016/j.appet.2012.07.005

    Article  PubMed  Google Scholar 

  14. Carroll HA, Betts JA, Johnson L. An investigation into the relationship between plain water intake and glycated Hb (HbA1c): a sex-stratified, cross-sectional analysis of the UK National Diet and Nutrition Survey (2008-12). BJN. 2016;1-11. https://doi.org/10.1017/S0007114516003688

  15. Mavani GP, DeVita MV, Michelis MF. A review of the nonpressor and nonantidiuretic actions of the hormone vasopressin. Front Med. 2015;2:19 https://doi.org/10.3389/fmed.2015.00019

    Article  Google Scholar 

  16. Melander O. Vasopressin, from Regulator to Disease Predictor for Diabetes and Cardiometabolic Risk. Ann Nutr Metab. 2016;68(Suppl 2(2)):24–28. https://doi.org/10.1159/000446201

    Article  PubMed  Google Scholar 

  17. Rothermel J, Kulle A, Holterhus P-M, Toschke C, Lass N, Reinehr T. Copeptin in obese children and adolescents: relationships to body mass index, cortisol and gender. Clin Endocrinol. 2016;85(6):868–73. https://doi.org/10.1111/cen.13235

    Article  CAS  Google Scholar 

  18. Roussel R, El Boustany R, Bouby N, Potier L, Fumeron F, Mohammedi K et al. Plasma copeptin, AVP gene variants, and incidence of type 2 diabetes in a cohort from the community. J Clin Endocrinol Metab 2016;jc20161113. https://doi.org/10.1210/jc.2016-1113

  19. Taveau C, Chollet C, Waeckel L, Desposito D, Bichet DG, Arthus M-F, et al. Vasopressin and hydration play a major role in the development of glucose intolerance and hepatic steatosis in obese rats. Diabetologia. 2015;58(5):1081–90. https://doi.org/10.1007/s00125-015-3496-9

    Article  CAS  PubMed  Google Scholar 

  20. Wannamethee SG, Welsh P, Papacosta O, Lennon L, Whincup PH. Sattar N. Copeptin, insulin resistance and risk of incident diabetes in older men. J Clin Endocrinol Metab. 2015;100(9):JC20152362–20153339. https://doi.org/10.1210/JC.2015-2362

    Article  CAS  Google Scholar 

  21. Clark WF, Sontrop JM, Huang S-H, Moist L, Bouby N, Bankir L. Hydration and Chronic Kidney Disease Progression: A Critical Review of the Evidence. Am J Nephrol. 2016;43(4):281–92. https://doi.org/10.1159/000445959

    Article  CAS  PubMed  Google Scholar 

  22. Roussel R, Velho G, Bankir L. Vasopressin and diabetic nephropathy. Curr Opin Nephrol Hypertens. 2017;1. https://doi.org/10.1097/MNH.0000000000000335

  23. Arnaoutis G, Kavouras SA, Stratakis N, Likka M, Mitrakou A, Papamichael C, et al. The effect of hypohydration on endothelial function in young healthy adults. Eur J Nutr. 2017;56(3):1211–7. https://doi.org/10.1007/s00394-016-1170-8

    Article  PubMed  Google Scholar 

  24. Mesirow M, Welsh J. Changing beverage consumption patterns have resulted in fewer liquid calories in the diets of US Children: National Health and Nutrition Examination Survey 2001-10. J Acad Nutr Diet. 2015;115(4):559 https://doi.org/10.1016/j.jand.201555554.09.004. e554

    Article  PubMed  Google Scholar 

  25. Duffey KJ, Huybrechts I, Mouratidou T, Libuda L, Kersting M, De Vriendt T, et al. Beverage consumption among European adolescents in the HELENA study. Eur J Clin Nutr. 2012;66(2):244–52. https://doi.org/10.1038/ejcn.2011.166

    Article  CAS  PubMed  Google Scholar 

  26. Adams JD, Kavouras SA, Johnson EC, Jansen LT, Capitan-Jimenez C, Robillard JI, et al. The effect of storing temperature and duration on urinary hydration markers. Int J Sport Nutr Exerc Metab. 2017;27(1):18–24. https://doi.org/10.1123/ijsnem.2016-0098

    Article  CAS  PubMed  Google Scholar 

  27. Panagiotakos D. α‐priori versus α‐posterior methods in dietary pattern analysis: a review in nutrition epidemiology. Nutr Bull. 2008;33(4):311–5. https://doi.org/10.1111/j.1467-3010.2008.00731.x

    Article  Google Scholar 

  28. Storey ML, Forshee RA, Anderson PA. Beverage consumption in the US population. J Am Diet Assoc. 2006;106(12):1992–2000. https://doi.org/10.1016/j.jada.2006.09.009

    Article  PubMed  Google Scholar 

  29. Perrier ET, Buendia-Jimenez I, Vecchio M, ARMSTRONG LE, Tack I, Klein A. Research article twenty-four-hour urine osmolality as a physiological index of adequate water intake. Dis Markers. 2015;1-8. https://doi.org/10.1155/2015/231063

  30. Perrier ET, Armstrong LE, Daudon M, Kavouras S, Lafontan M, Lang F, et al. From state to process: defining hydration. Obesity Fact. 2014;7(Suppl 2):6–12. https://doi.org/10.1159/000360611

    Article  Google Scholar 

  31. Drewnowski A, Rehm CD, Constant F. Water and beverage consumption among children age 4-13y in the United States: analyses of 2005-10 NHANES data. Nutr J. 2013;12(1):85 https://doi.org/10.1186/1475-2891-12-85

    Article  PubMed  PubMed Central  Google Scholar 

  32. Feferbaum R, de Abreu LC, Leone C. Fluid intake patterns: an epidemiological study among children and adolescents in Brazil. BMC Pub Health. 2012;12:1005 https://doi.org/10.1186/1471-2458-12-1005

    Article  Google Scholar 

  33. Stachenfeld NS. Sex hormone effects on body fluid regulation. Exerc Sport Sci Rev. 2008;36(3):152–9. https://doi.org/10.1097/JES.0b013e31817be928

    Article  PubMed  PubMed Central  Google Scholar 

  34. Mahler B, Kamperis K, Ankarberg-Lindgren C, Frokiaer J, Djurhuus JC, Rittig S. Puberty alters renal water handling. Am J Physiol Renal Physiol. 2013;305(12):F1728–1735. https://doi.org/10.1152/ajprenal.00283.2013

    Article  CAS  PubMed  Google Scholar 

  35. Hancock ML, Bichet DG, Eckert GJ, Bankir L, Wagner MA, Pratt JH. Race, sex, and the regulation of urine osmolality: observations made during water deprivation. Am J Physiol Regul Integr Comp Physiol. 2010;299(3):R977–980. https://doi.org/10.1152/ajpregu.00289.2010

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Hu FB. Dietary pattern analysis: a new direction in nutritional epidemiology. Curr Opin Lipidol. 2002;13(1):3–9.

    Article  CAS  Google Scholar 

  37. Fiorito LM, Marini M, Mitchell DC, Smiciklas-Wright H, Birch LL. Girls’ early sweetened carbonated beverage intake predicts different patterns of beverage and nutrient intake across childhood and adolescence. J Am Diet Assoc. 2010;110(4):543–50. https://doi.org/10.1016/j.jada.2009.12.027

    Article  PubMed  Google Scholar 

  38. Te Morenga L, Mallard S, Mann J. Dietary sugars and body weight: systematic review and meta-analyses of randomised controlled trials and cohort studies. BMJ. 2013;346:e7492 https://doi.org/10.1136/bmj.e7492

    Article  Google Scholar 

  39. Fyhrquist F, Saijonmaa O. Renin-angiotensin system revisited. J Intern Med. 2008;264(3):224–36. https://doi.org/10.1111/j.1365-2796.2008.01981.x

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

The study was funded by a research grant from Danone Research. No other financial or in kind support was provided by Danone Research. Funder did not have a role in the study design, sample, and data analysis. However, one of the funder’s employees (JHB) contributed to the manuscript.

Author information

Authors and Affiliations

  1. Department of Nutrition and Dietetics, Harokopio University, Athens, Greece

    Dimitris Bougatsas, Giannis Arnaoutis, Demosthenes B. Panagiotakos & Spiridoula Tsipouridi

  2. University of Arkansas, Hydration Science Lab, Fayetteville, AR, 7270, USA

    Adam D. Seal & Stavros A. Kavouras

  3. University of Wyoming, Human Integrated Physiology Laboratory, Laramie, WY, USA

    Evan C. Johnson

  4. Danone Research, 91767, Palaiseau, France

    Jeanne H. Bottin

  5. University of Arkansas for Medical Sciences, Division of Endocrinology, Little Rock, AR, USA

    Stavros A. Kavouras

Authors
  1. Dimitris Bougatsas
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Giannis Arnaoutis
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Demosthenes B. Panagiotakos
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Adam D. Seal
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Evan C. Johnson
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jeanne H. Bottin
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Spiridoula Tsipouridi
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Stavros A. Kavouras
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Stavros A. Kavouras.

Ethics declarations

Conflict of interest

SAK was a scientific consultant for Quest Diagnostics. SAK and ECJ have active grants with Danone Research. DBP had a grant from the European Hydration Institute and SA Coca-Cola Services NV. ADS is a scientific consultant for Gatorade Sports Science Institute. JHB is a Danone Research employee. The remaining authors declare that they have no competing interests.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Bougatsas, D., Arnaoutis, G., Panagiotakos, D.B. et al. Fluid consumption pattern and hydration among 8–14 years-old children. Eur J Clin Nutr 72, 420–427 (2018). https://doi.org/10.1038/s41430-017-0012-y

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41430-017-0012-y

This article is cited by

Search

Advanced search

Quick links