Water intake and beverage consumption of pre-schoolers from six European countries and associations with socio-economic status: the ToyBox-study

Abstract

Objective: To study the quantity and quality of water intake from beverages among pre-schoolers and investigate associations with gender and socio-economic status (SES). Design: Kindergarten-based cross-sectional survey within the large-scale European ToyBox-study. A standardized protocol was used and parents/ caregivers filled in sociodemographic data and a semi-quantitative FFQ. Setting: Kindergartens in six European countries (Belgium, Bulgaria, Germany, Greece, Poland and Spain). Subjects: European pre-schoolers (aged 3·5-5·5 years) and their parents/caregivers (n 7051). Results: Mean water intake was 1051 ml/d; plain water, 547 ml/d; plain milk, 241 ml/d; other fruit juice, 104 ml/d; pure fruit juice, 59 ml/d; soft drinks, 55 ml/d; tea, 45 ml/d; sugared and chocolate milk, 37 ml/d; smoothies, 15 ml/d; and light soft drinks, 6 ml/d. Boys had a higher water intake than girls due to a higher consumption of plain water, but more importantly to the consumption of beverages of less quality. Lower-SES pre-schoolers scored better on quantity than high-SES pre-schoolers, but as a consequence of consumption of sugared beverages. Nevertheless, the associations differed by country. Conclusions: The water intake from beverages did not meet the European Food Safety Authority standard of 1280 ml/d; especially in Western European countries water intake from beverages was low. The most important water sources were plain water, milk and fruit juices. Interventions aiming at a proper and sufficient water intake should focus on both quantity and quality. Messages about water and water sources should be clear for everyone and interventions should be sufficiently tailored.

Can Parenting Practices Explain the Differences in Beverage Intake According to Socio-Economic Status: The Toybox-Study

“…Since an unhealthy beverage intake was already found at preschool age and lower SES preschoolers were found to make unhealthier beverage choices than their high SES peers [1], it is important to investigate the underlying mechanisms of these SES-differences in intake to avoid the widening of health inequalities.…”

“…A recent European study in preschoolers showed that only about half of water intake from beverages was derived from plain water (both tap and bottled water without any additives) and nearly a quarter of total water intake from beverages from sweetened beverages (such as soft drinks and especially prepacked fruit juice) [1]. The excessive intake of added sugars through these sweetened beverages can lead to an energy imbalance (i.e., energy intake that exceeds energy expenditure) and thus to overweight [2,3].…”

“…A study on beverage consumption in European preschool children found differences in beverage intake by socioeconomic status. Preschoolers of lower SES drank more sugared beverages and less plain water than their high SES peers [1]. De Coen et al (2012) found similar SES-differences in soft drink consumption in Flemish preschoolers and revealed that this difference was mediated by parenting practices [9].…”

The Influence of Behavioural and Sociodemographic Risk Indicators on Erosive Tooth Wear in Flemish Adolescents, Belgium

“…Of note is that males reported, in all analyses, a significantly higher frequency of soft drink consumption compared with females (per school type, per age, and including all ages). This higher consumption of soft drinks in males has been reported several times [Kassem and Lee, 2004;Pinket et al, 2016;Scully et al, 2017] and suggests that genderspecific interventions should be applied for the prevention of this high consumption of soft drinks.…”

Where are we with Smoothies? A Review of the Latest Guidelines, Nutritional Gaps and Evidence

“…As shown in Table 1, once smoothie data is extracted and analysed separately intakes become lower-37 ml daily amongst 3½ to 5½ years olds [4]. Unfortunately, smoothie intake data amongst UK adults is not reported in Years 5 and 6 of the UK National Diet and Nutrition Survey (NDNS).…”