Factors Associated with Low Water Intake among US High School Students-National Youth Physical Activity and Nutrition Study, 2010

Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Hwy, NE, Mailstop K26, Atlanta, GA 30341, USA.
Journal of the American Academy of Nutrition and Dietetics (Impact Factor: 3.47). 06/2012; 112(9):1421-7. DOI: 10.1016/j.jand.2012.04.014
Source: PubMed


Drinking plain water instead of sugar-sweetened beverages is one approach for reducing energy intake. Only a few studies have examined characteristics associated with plain water intake among US youth. The purpose of our cross-sectional study was to examine associations of demographic characteristics, weight status, dietary habits, and other behavior-related factors with plain water intake among a nationally representative sample of US high school students. The 2010 National Youth Physical Activity and Nutrition Study data for 11,049 students in grades 9 through 12 were used. Multivariable logistic regression analysis was used to calculate adjusted odds ratios (ORs) and 95% CIs for variables associated with low water intake (<3 times/day). Nationwide, 54% of high school students reported drinking water <3 times/day. Variables significantly associated with a greater odds for low water intake were age ≤15 years (OR 1.1), consuming <2 glasses/day of milk (OR 1.5), nondiet soda ≥1 time/day (OR 1.6), other sugar-sweetened beverages ≥1 time/day (OR 1.4), fruits and 100% fruit juice <2 times/day (OR 1.7), vegetables <3 times/day (OR 2.3), eating at fast-food restaurants 1 to 2 days/week and ≥3 days/week (OR 1.3 and OR 1.4, respectively), and being physically active ≥60 minutes/day on <5 days/week (OR 1.6). Being obese was significantly associated with reduced odds for low water intake (OR 0.7). The findings of these significant associations of low water intake with poor diet quality, frequent fast-food restaurant use, and physical inactivity may be used to tailor intervention efforts to increase plain water intake as a substitute for sugar-sweetened beverages and to promote healthy lifestyles.

Download full-text


Available from: Sohyun Park,
1 Follower
111 Reads
  • Source
    • "These initial findings have prompted increased attention on the far ends of the TWI spectrum (Goodman et al. 2013; Park et al. 2012), associating low-TWI with disease and dysfunction (Fetissov and Thornton 2009; Roussel et al. 2011; Thornton and Trabalon 2012) and high TWI as a potential preventative behavior and a therapeutic treatment to improve health or reduce risk factors related to disease (Armstrong 2012; Arnaud and Noakes 2011; Cairncross 1997; D&apos;Arrigo 2007; Lotan et al. 2013; Pan et al. 2013; Pross et al. 2014). Still, little is known regarding the physiological stimuli, and the biological indicators of either increasing or decreasing daily water intake within individuals that habitually occupy the tail ends of the fluid intake distribution. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Human daily total water intake (TWI) has a large inter-individual range. Recently, water supplementation has been suggested as a potential preventative and therapeutic modality. Thus, we aimed to measure hydration biomarkers in women with high (HIGH) versus low (LOW) daily TWI to determine baseline differences, and the efficacy of these markers during a systematic alteration in TWI. This cohort study identified 14 HIGH [3.34 (0.56) L day(-1)] and 14 LOW [1.62 (0.48) L day(-1)] from 120 women. Next, fluid intake was decreased in HIGH [2.00 (0.21) L day(-1)] while LOW increased [3.50 (0.13) L day(-1)] across 4 days. Body mass, fluid intake, serum osmolality (S osmo), total plasma protein (TPP), 24 h urine osmolality, and 24 h urine volume, were measured on each day of modified TWI. Estimated plasma volume (E pv) was calculated using measured body mass and hematocrit values. At baseline, urinary markers and TPP differentiated HIGH from LOW [7.0 (0.3) versus 7.3 (0.3) mg dL(-1), respectively]. Upon TWI intervention, (1) body mass decreased in HIGH [-0.7 (1.1) kg, p = 0.010)] but did not increase in LOW [+0.0 (0.6) kg, p = 0.110], (2) E pv decreased 2.1 (2.4) %, p = 0.004, (3) urine osmolality increased in HIGH [397 (144)-605 (230) mOsm kg(-1), p < 0.001] and decreased in LOW [726 (248)-265 (97) mOsm kg(-1) p < 0.001], and (4) no changes of serum osmolality occurred in either HIGH or LOW (all p > 0.05). Urinary markers and TPP are sensitive measures to habitual high and low TWI and to changes in TWI. Both groups through urinary and some hematological responses following TWI manipulation achieved regulation of hemoconcentration.
    Arbeitsphysiologie 01/2015; DOI:10.1007/s00421-014-3088-2 · 2.19 Impact Factor
  • Source
    • "Kant and Graubard reported that plain water intake was inversely associated with intake of total sugars among youth aged 2-19 years [12]. Most recently, Park and colleagues reported that factors significantly associated with low plain water intake were lower consumption of milk, fruits (including 100% fruit juice), and vegetables, higher consumption of non-diet soda and other SSBs, frequently using fast-food restaurants, and physical inactivity among US high school students [11]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Water is essential for life and plain water instead of sugar-sweetened beverages is one approach for decreasing energy intake. Due to limited data on characteristics associated with water intake among Korean adolescents, this study examined associations of demographic and behavioral characteristics with plain water intake by using nationally representative sample of South Korean adolescents. The data (2007-2010 Korea National Health and Nutrition Examination Survey) for 1,288 high school-aged adolescents (15-18 years) were used. Multivariable logistic regression was used to calculate adjusted odds ratios (OR) for factors associated with low water intake (< 4 cups/day) and very low water intake (< 2.5 cups/day). Nationwide, 38.4% and 19.0% of adolescents reported drinking water < 4.0 cups/day and < 2.5 cups/day, respectively. The mean plain water intake was 5.7 cups/day for males and 4.1 cups/day for females. Females had significantly higher odds for drinking water < 2.5 cups/day (OR = 2.2) than males, whereas adolescents with low milk consumption had significantly lower odds for drinking water < 2.5 cups/day (OR = 0.7). Factors significantly associated with a greater odds for drinking water < 4 cups/daywere being female (OR = 2.8) and not meeting physical activity recommendations (≥ 20 min/day on < 3 days/week) (OR = 1.6). Being underweight, overweight, and obese were significantly associated with reduced odds for drinking water < 4 cups/day (OR = 0.7, 0.4 and 0.5, respectively). However, intake of soda, coffee drinks, fruits, vegetables, and sodium and eating out were not significantly associated with low or very low water intake. These findings may be used to target intervention efforts to increase plain water intake as part of a healty lifestyle.
    Nutrition research and practice 02/2014; 8(1):74-80. DOI:10.4162/nrp.2014.8.1.74 · 1.44 Impact Factor
  • Source
    • "The DRIs were established by the IOM mostly to prevent the adverse effects of dehydration, and the IOM report indicates that considerable inter-individual variation exists in terms of necessary amounts of water to be consumed. Beyond issues of hydration, previous studies have shown that plain water consumption was associated with higher quality diets, better health behaviors, and lower risk for chronic disease in youth and adults [7,14-16]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Few studies have examined plain water consumption among US adults. This study evaluated the consumption of plain water (tap and bottled) and total water among US adults by age group (20-50y, 51-70y, and >=71y), gender, income-to-poverty ratio, and race/ethnicity. Data from up to two non-consecutive 24-hour recalls from the 2005--2006, 2007--2008 and 2009--2010 National Health and Nutrition Examination Survey (NHANES) was used to evaluate usual intake of water and water as a beverage among 15,702 US adults. The contribution of different beverage types (e.g., water as a beverage [tap or bottled], milk [including flavored], 100% fruit juice, soda/soft drinks [regular and diet], fruit drinks, sports/energy drinks, coffee, tea, and alcoholic beverages) to total water and energy intakes was examined. Total water intakes from plain water, beverages, and food were compared to the Adequate Intake (AI) values from the US Dietary Reference Intakes (DRI). Total water volume per 1,000 kcal was also examined. Water and other beverages contributed 75-84% of dietary water, with 17-25% provided by water in foods, depending on age. Plain water, from tap or bottled sources, contributed 30-37% of total dietary water. Overall, 56% of drinking water volume was from tap water while bottled water provided 44%. Older adults (>=71y) consumed much less bottled water than younger adults. Non-Hispanic whites consumed the most tap water, whereas Mexican-Americans consumed the most bottled water. Plain water consumption (bottled and tap) tended to be associated with higher incomes. On average, younger adults exceeded or came close to satisfying the DRIs for water. Older men and women failed to meet the Institute of Medicine (IOM) AI values, with a shortfall in daily water intakes of 1218 mL and 603 mL respectively. Eighty-three percent of women and 95% of men >=71y failed to meet the IOM AI values for water. However, average water volume per 1,000 kcal was 1.2-1.4 L/1,000 kcal for most population sub-groups, in excess of suggested levels of 1.0 L/1.000 kcal. Water intakes below IOM-recommended levels may be a cause for concern, especially for older adults.
    BMC Public Health 11/2013; 13(1):1068. DOI:10.1186/1471-2458-13-1068 · 2.26 Impact Factor
Show more