Prevalence of Inadequate Hydration Among US Children and Disparities by Gender and Race/Ethnicity: National Health and Nutrition Examination Survey, 2009–2012

Kenney, Erica L.; Long, Michael W.; Cradock, Angie L.; Gortmaker, Steven L.

doi:10.2105/ajph.2015.302572

Cited by 127 publications

(117 citation statements)

References 32 publications

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“…For example, finding that the sex gap for nephrolithiasis reverses during the transition from adolescence to adulthood can inform research on modifiable risk factors that are unique to particular populations. Possible factors include poor water intake, because dehydration is common and varies by age, sex, and race (27). Other ecologic trends in dietary habits that also vary by age, sex, and race, such as increasing sodium and decreasing calcium intake, are consistent with the increases in nephrolithiasis incidence that we observed and could contribute to differences in incidence between patient groups (28)(29)(30)(31)(32).…”

Section: Discussionsupporting

confidence: 76%

Annual Incidence of Nephrolithiasis among Children and Adults in South Carolina from 1997 to 2012

Tasian

Ross

Song³

et al. 2016

Clinical Journal of the American Society of Nephrology

210

130

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Background and objectives The prevalence of nephrolithiasis in the United States has increased substantially, but recent changes in incidence with respect to age, sex, and race are not well characterized. This study examined temporal trends in the annual incidence and cumulative risk of nephrolithiasis among children and adults living in South Carolina over a 16-year period.Design, setting, participants, & measurements We performed a population-based, repeated cross-sectional study using the US Census and South Carolina Medical Encounter data, which capture all emergency department visits, surgeries, and admissions in the state. The annual incidence of nephrolithiasis in South Carolina from 1997 to 2012 was estimated, and linear mixed models were used to estimate incidence rate ratios for age, sex, and racial groups. The cumulative risk of nephrolithiasis during childhood and over the lifetime was estimated for males and females in 1997 and 2012.Results Among an at-risk population of 4,625,364 people, 152,925 unique patients received emergency, inpatient, or surgical care for nephrolithiasis. Between 1997 and 2012, the mean annual incidence of nephrolithiasis increased 1% annually from 206 to 239 per 100,000 persons. Among age groups, the greatest increase was observed among 15-19 year olds, in whom incidence increased 26% per 5 years (incidence rate ratio, 1.26; 95% confidence interval, 1.22 to 1.29). Adjusting for age and race, incidence increased 15% per 5 years among females (incidence rate ratio, 1.15; 95% confidence interval, 1.14 to 1.16) but remained stable for males. The incidence among blacks increased 15% more per 5 years compared with whites (incidence rate ratio, 1.15; 95% confidence interval, 1.14 to 1.17). These changes in incidence resulted in doubling of the risk of nephrolithiasis during childhood and a 45% increase in the lifetime risk of nephrolithiasis for women over the study period.Conclusions The incidence of kidney stones has increased among young patients, particularly women, and blacks.

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Section: Discussionsupporting

confidence: 76%

Annual Incidence of Nephrolithiasis among Children and Adults in South Carolina from 1997 to 2012

Tasian

Ross

Song³

et al. 2016

Clinical Journal of the American Society of Nephrology

210

130

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“…Consistent with previous studies and recommendations, individuals with values of 800 mOsm/kg or greater were considered inadequately hydrated. 11,[14][15][16] Bivariate associations between hydration and covariates were performed using independent samples t test and Pearson χ 2 , as appropriate. Models were adjusted for known confounders including age, race/ethnicity, sex, and income-to-poverty ratio.…”

Section: Methodsmentioning

confidence: 99%

Inadequate Hydration, BMI, and Obesity Among US Adults: NHANES 2009-2012

Chang

Ravi

Plegue

et al. 2016

The Annals of Family Medicine

105

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PURPOSE Improving hydration is a strategy commonly used by clinicians to prevent overeating with the goal of promoting a healthy weight among patients. The relationship between weight status and hydration, however, is unclear. Our objective was to assess the relationship between inadequate hydration and BMI and inadequate hydration and obesity among adults in the United States.METHODS Our study used a nationally representative sample from the National Health and Nutrition Examination Survey (NHANES) 2009 to 2012, and included adults aged 18 to 64 years. The primary outcome of interest was body mass index (BMI), measured in continuous values and also categorized as obese (BMI ≥30) or not (BMI <30). Individuals with urine osmolality values of 800 mOsm/ kg or greater were considered to be inadequately hydrated. Linear and logistic regressions were performed with continuous BMI and obesity status as the outcomes, respectively. Models were adjusted for known confounders including age, race/ethnicity, sex, and income-to-poverty ratio. RESULTSIn this nationally representative sample (n = 9,528; weighted n = 193.7 million), 50.8% were women, 64.5% were non-Hispanic white, and the mean age was 41 years. Mean urine osmolality was 631.4 mOsm/kg (SD = 236.2 mOsm/kg); 32.6% of the sample was inadequately hydrated. In adjusted models, adults who were inadequately hydrated had higher BMIs (1.32 kg/m 2 ; 95% CI, 0.85-1.79; P <.001) and higher odds of being obese (OR = 1.59; 95% CI, 1.35-1.88; P <.001) compared with hydrated adults. CONCLUSIONWe found a significant association between inadequate hydration and elevated BMI and inadequate hydration and obesity, even after controlling for confounders. This relationship has not previously been shown on a population level and suggests that water, an essential nutrient, may deserve greater focus in weight management research and clinical strategies. 2016;14:320-324. doi: 10.1370/afm.1951. Ann Fam Med INTRODUCTIONO besity continues to be a prevalent, debilitating, and costly chronic disease in most high-income countries.1 The drivers of obesity are multifactorial and represent a major clinical challenge in both prevention and management. 2,3 In addition to replacing sugar-sweetened beverages with water, improving overall hydration is a strategy commonly used to prevent overeating, with the goal of promoting a healthy weight among patients. [4][5][6] For example, counseling patients to first drink water when they have the urge to eat, as they may actually be thirsty rather than hungry, is a recommendation clinicians give patients and is advice readily found in lay media.Water intake as a weight loss tool, however, is not an evidence-based recommendation. Recent studies have shown mixed results, likely because of limitations in the measurement of hunger and thirst, as well as the numerous social, cognitive, sensory, and logistical factors that influence eating and drinking behaviors.5 Some studies suggest that water intake may be a promising target for obesity prevention and trea...

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“…[1][2][3][4] However, inadequate hydration is an understudied health problem among college students in some geographic regions. 5 Water constitutes a greater proportion (about 60%) of the human body and plays a significant role in virtually all aspects of human life including disease prevention and health promotion.…”

Section: Introductionmentioning

confidence: 99%

“…8 Interestingly, even mild dehydration is reportedly detrimental to human health, including alterations in several aspects of cognitive function such as concentration, alertness and short-term memory. 5,9 Symptoms of dehydration are varied and may depend on the degree of fluid deficit. However, the symptoms range from mild to moderate headache, tiredness, dizziness, confusion, reduced motor activities, reduced cognitive functioning and difficulty in concentrating.…”

Section: Introductionmentioning

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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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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Prevalence of Inadequate Hydration Among US Children and Disparities by Gender and Race/Ethnicity: National Health and Nutrition Examination Survey, 2009–2012

Cited by 127 publications

References 32 publications

Annual Incidence of Nephrolithiasis among Children and Adults in South Carolina from 1997 to 2012

Annual Incidence of Nephrolithiasis among Children and Adults in South Carolina from 1997 to 2012

Inadequate Hydration, BMI, and Obesity Among US Adults: NHANES 2009-2012

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

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