Total fluid and specific beverage intake and mortality due to IHD and stroke in the Netherlands Cohort Study

Abstract

Chronic mild dehydration has been associated with several diseases, including fatal IHD and stroke. It has been suggested that hydration through total fluid intake (or water) is inversely associated with IHD or stroke mortality. The objective of the present study was to evaluate the relationship between total fluid (and specific beverage) intake and IHD or stroke mortality in the Netherlands Cohort Study (NLCS). In 1986, 120 852 participants aged 55 -69 years were enrolled into the NLCS. Mortality data were collected over a 10-year follow-up period. Analysis was done through a case -cohort approach, and it was based on the subjects without a history of heart disease, stroke or diabetes at baseline. A total of 1789 IHD mortality cases and 708 stroke mortality cases occurred during the follow-up. Higher total fluid consumption was not associated with either IHD mortality or stroke mortality in men or women. When analysing specific beverages, a positive association between coffee consumption (increment 270 ml/d) and IHD mortality was observed in men (hazard ratio (HR) 1·09, 95 % CI 1·00, 1·18), while an inverse relationship was observed in women (HR: 0·88, 95 % CI 0·78, 1·00). For tea consumption (increment of 253 ml/d), an inverse relationship with IHD mortality was observed in men (HR: 0·91, 95 % CI 0·83, 1·00). No association with water intake was observed. In the study population, fresh water consumption was very low. In conclusion, total fluid intake was not associated with IHD or stroke mortality in either men or women. Coffee consumption was inversely associated with IHD mortality in women only, while a higher tea intake was associated with lower IHD mortality in men only.Beverage intake: Ischaemic heart disease: Stroke: Mortality: Prospective cohort studies Proper hydration is necessary for the body to sustain normal physiological functioning such as the transportation of nutrients, excretion and the regulation of body temperature. Chronic mild to moderate dehydration has been associated with several disease states, such as fatal CHD and CVD (1) . The association between chronic mild dehydration and CHD may be explained by the elevation in haemorheological factors (2,3) . Haemorheological factors that are independently positively associated with CHD are the whole-blood viscosity, plasma viscosity, fibrinogen and haematocrit levels (4 -8) . These factors respond acutely to changes in hydration, which can occur, e.g. during normal daily activities and the use of medications such as diuretics (9 -12) . Furthermore, it has been suggested that water consumption at night can attenuate nocturnal increase in blood viscosity, and therefore, can prevent morning occurrence of cerebral infarction (9) . Some investigators reported a decrease in blood viscosity with increased water intake (9,13,14) , while others reported no changes in blood haemorheology and chemistry with increased water intake (15) . Only one cohort study analysed the effect of water intake and other fluid intake on fatal CHD (1) . The above-menti...

A prospective study of water intake and subsequent risk of all-cause mortality in a national cohort

“…Therefore, in women, the suggestion of a slight increase in risk of mortality that was seen when high total water intake was due to plain water intake was unexpected. This study finding is contrary to results from reports of an inverse association of fluid or water intake with risk of heart disease and certain cancers (12)(13)(14)(15), which may have been expected to lead to a favorable mortality outcome. The possibility that the observed association may have been spurious because of multiple-hypothesis testing or because of the methodologic limitations later discussed could not be excluded and requires confirmation from other cohorts with comparable exposures and outcomes.…”

“…The association of water intake and body-weight management has also received considerable attention (11). However, the meager published evidence on modification of risks of leading chronic diseases such as heart disease, cancer, and diabetes has largely been limited to plain water or fluid intake (12)(13)(14)(15)(16)(17)(18). To our knowledge, intakes of total water and individual sources of ingested water in relation to health have received relatively little scrutiny.…”

Association between Water Intake, Chronic Kidney Disease, and Cardiovascular Disease: A Cross-Sectional Analysis of NHANES Data

“…In the Adventist Health Study, fatal coronary heart disease was significantly lower among participants who drank ≥5 cups of water daily compared with <2 cups [21], however no association was seen for high intakes of beverages other than water. In a Dutch cohort, neither total fluid intake nor plain water intake predicted fatal ischemic heart disease or stroke over 10 years of follow-up [66], however another prospective study found a significantly reduced risk of stroke recurrence among patients whose total self-reported water intake was >2 l/day compared with ≤2 l/day [26]. …”

Coffee Consumption and Risk of Stroke in Women

“…8 In contrast, in a small cohort study of 499 hypertensive and nonsmoking men (including 76 total stroke events), the risk of ischemic stroke was 2.1-fold higher for men who consumed 3 cups of coffee per day as compared with nondrinkers. 9 Most cohort studies of coffee consumption in relation to stroke mortality among healthy women and men 10,11 or among diabetics 12,13 have found no association. However, in a cohort study of Japanese women and men, coffee consumption was significantly inversely associated with stroke mortality among men but not in women.…”