Water: a neglected nutrient in the young child? A South African perspective

Abstract

Water is considered an essential nutrient because the body cannot produce enough water itself, by metabolism of food, to fulfil its need. When the quantity or quality of water is inadequate, health problems result, most notably dehydration and diarrhoea. As a result of contaminated water and poor hygiene, related infections are still a serious problem. Indeed, in the South African setting water availability and sanitation are critical issues because of the prevalence of childhood diarrhoea and also the HIV/AIDS crisis. Though considerable efforts have been made to improve the water and sanitation problems in South Africa -especially with regard to water supply infrastructure -there is still room for much improvement. Water is a healthy alternative to calorie-dense, non-nutritive beverages, such as artificial fruit drinks and soda. The latter should be avoided as they contribute little other than energy and may contribute to overweight and obesity. Also, they displace more nutritious foods from the child's diet. Consumption of fruit juice should also be limited. These issues highlight the need for a specific guideline relating to water intake in the paediatric food-based dietary guidelines.

Beverage consumption and anthropometric outcomes among schoolchildren in Guatemala

“…By adding to volume, without contributing energy, water lowers energy intake and hence the chance of being overweight or obese. Contaminated water, on the other hand, is a risk factor for infectious disease, contributing to childhood diarrhoea (Bourne et al . 2007) and under‐nutrition (Patwari 1999).…”

Contribution of complementary foods to the total daily water needs of urban Guatemalan infants

“…The latent threat of episodes of dehydrating diseases such as diarrhoea and respiratory infection, especially in low‐income settings with poor sanitation, is another challenge to adequate hydration (Finberg, 2002). These features combine to raise the profile of water nutriture as an interest of public health for infants (Bourne et al. , 2007; Campbell, 2007).…”

Feeding the 1 to 7‐year‐old child. A support paper for the South African paediatric food‐based dietary guidelines

“…The consumption of water should be encouraged from an early age as early food and drink preferences (2–4 years of age) are highly predictive of preferences later in childhood. Consequently, water should be offered in place of sugar‐rich drinks (Nicklas 2003), this is discussed further in this issue by Bourne et al . (2007a).…”

“…Mineral water and sports drinks are not recommended in young children as they are often high in electrolytes. An excess of any fluid should be discouraged (Nicklas 2003; Bourne et al . 2007a).…”