Total fluid intake of children and adolescents: cross-sectional surveys in 13 countries worldwide

Abstract

PurposeTo describe total fluid intake (TFI) according to socio-demographic characteristics in children and adolescents worldwide.MethodsData of 3611 children (4–9 years) and 8109 adolescents (10–18 years) were retrieved from 13 cross-sectional surveys (47 % males). In three countries, school classes were randomly recruited with stratified cluster sampling design. In the other countries, participants were randomly recruited based on a quota method. TFI (drinking water and beverages of all kinds) was obtained with a fluid-specific record over 7 consecutive days. Adequacy was assessed by comparing TFI to 80 % of adequate intake (AI) for total water intake set by European Food Safety Authority. Data on height, weight and socio-economic level were collected in most countries.ResultsThe mean (SD) TFI ranged from [1.32 (0.68)] to [1.35 (0.71)] L/day. Non-adherence to AIs for fluids ranged from 10 % (Uruguay) to >90 % (Belgium). Females were more likely to meet the AIs for fluids than males (4–9 years: 28 %, OR 0.72, p = 0.002; 10–18 years: 20 %, OR 0.80, p = 0.001), while adolescents were less likely to meet the AI than children (OR 1.645, p < 0.001 in males and OR 1.625, p < 0.001 in females).ConclusionsA high proportion of children and adolescents are at risk of an inadequate fluid intake. This risk is especially high in males and adolescents when compared with females or children categories. This highlights water intake among young populations as an issue of global concern.Electronic supplementary materialThe online version of this article (doi:10.1007/s00394-015-0946-6) contains supplementary material, which is available to authorized users.

Advances in water intake assessment

“…In 12 out of 13 datasets analyzed by Iglesia et al [4], estimated water intakes are below the EFSA standards for over 20 % of children and adolescents. In many countries, drinking water accounts for less than half of reported fluid intake for children [5].…”

“…Iglesia et al [4], Guelinckx et al [5], and Ferreira-Pêgo et al [6] describe absolute and relative water intake in children, adolescents, and adults from surveys with similar 7-day water intake assessment methodologies in 13 countries.…”

Increasing water intake in pre-school children with unhealthy drinking habits: A year-long controlled longitudinal field experiment assessing the impact of information, water affordance, and social regulation

“…A specific population of children with low plain water and high SSB intake was recruited for this study; this may limit the extrapolation of the results to other populations, especially in countries with different pattern of fluid intake Iglesia, et al, 2015). However, this sample is likely to be representative of a large part of children in Poland as mentioned in the method section above ( sample description).…”

“…This record was previously used and described in publications reporting cross-sectional surveys with large samples of children Iglesia, et al, 2015).The record was completed online. For each drinking occasion, the type and amount of fluid consumed, and the time and the location of consumption were recorded.…”

“…The European Food Safety Authority (EFSA) and the Institute of Medicine (IOM) estimated that 70-80% of total water intake comes from total fluid intake (TFI, intake of plain water and all other beverages) and 20-30% of water from food moisture (EFSA Panel on Dietetic Products Nutrition and Allergies (NDA), 2010; Institute of Medicine & Food and Nutrition Board, 2004). Harmonized cross-sectional surveys performed in 13 countries showed that up to 90% of children aged 4 to 9 years obtained less than an adequate intake of water from fluids Iglesia, et al, 2015). In a study of US children aged 4 to 8 years, at least 75% of children failed to meet the adequate total water intake (Drewnowski, Rehm, & Constant, 2013).…”