Hydration in Children

Research Institute of Child Nutrition, Heinstück 11, D-44225 Dortmund, Germany.
Journal of the American College of Nutrition (Impact Factor: 1.45). 11/2007; 26(5 Suppl):562S-569S. DOI: 10.1080/07315724.2007.10719659
Source: PubMed


Water supply is a basic public problem. In modern science, three periods with different approaches to define recommended water intake in adults can be distinguished. Pediatricians agree that hydration in children may be optimal only in breastfed infants. More data are required on the health effects of different hydration states and varying water intakes in particular age and gender groups to define optimal ranges of water intake. The fetus grows in an exceptionally well-hydrated environment. Water metabolism shows several peculiarities in preterm and term infants. Infant diarrhea remains a major topic of basic and clinical research. Water intoxication in infants, toddlers, and children is rare and can only be found in exceptional circumstances. Hydration status characterized by hyponatremia may play a role in the pathogenesis of febrile convulsions in toddlers. There is increasing indirect evidence that spontaneous drinking behavior of a population may be fixed and anchored in the age range of toddlers. Sex differences in hydration status are common, but not obligatory. What causes theses differences? What is behind the various circadian rhythms of urine osmolality in children? At what age and in what quantities can alcohol and caffeine consumption be tolerated? How can individual susceptibility be defined? Reflecting on the modern epidemic of obesity in children and adolescents, a public consensus concerning use and misuse of sweetened drinks seems mandatory. Dietary reference intakes of water refer to 24-hour intake. In nutritional counselling, food and meal-based dietary advice is primarily given. Young parents are confronted with a flood of advice of varying quality. Recommendations on fluid consumption should be collated and revised.

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Available from: Friedrich Manz, Feb 23, 2015
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    • "Hydration needs of children are a matter of public health concern [8,9]. Adequate intakes (AI) for water are defined on the basis of three factors: observed water intakes in population groups, desirable water volumes per 1,000 kcal, and desirable osmolality values in urine [8,10,11]. "
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    ABSTRACT: Background Few studies have examined water consumption patterns among US children. Additionally, recent data on total water consumption as it relates to the Dietary Reference Intakes (DRI) are lacking. This study evaluated the consumption of plain water (tap and bottled) and other beverages among US children by age group, gender, income-to-poverty ratio, and race/ethnicity. Comparisons were made to DRI values for water consumption from all sources. Methods Data from two non-consecutive 24-hour recalls from 3 cycles of NHANES (2005–2006, 2007–2008 and 2009–2010) were used to assess water and beverage consumption among 4,766 children age 4-13y. Beverages were classified into 9 groups: water (tap and bottled), plain and flavored milk, 100% fruit juice, soda/soft drinks (regular and diet), fruit drinks, sports drinks, coffee, tea, and energy drinks. Total water intakes from plain water, beverages, and food were compared to DRIs for the US. Total water volume per 1,000 kcal was also examined. Results Water and other beverages contributed 70-75% of dietary water, with 25-30% provided by moisture in foods, depending on age. Plain water, tap and bottled, contributed 25-30% of total dietary water. In general, tap water represented 60% of drinking water volume whereas bottled water represented 40%. Non-Hispanic white children consumed the most tap water, whereas Mexican-American children consumed the most bottled water. Plain water consumption (bottled and tap) tended to be associated with higher incomes. No group of US children came close to satisfying the DRIs for water. At least 75% of children 4-8y, 87% of girls 9-13y, and 85% of boys 9-13y did not meet DRIs for total water intake. Water volume per 1,000 kcal, another criterion of adequate hydration, was 0.85-0.95 L/1,000 kcal, short of the desirable levels of 1.0-1.5 L/1,000 kcal. Conclusions Water intakes at below-recommended levels may be a cause for concern. Data on water and beverage intake for the population and by socio-demographic group provides useful information to target interventions for increasing water intake among children.
    Nutrition Journal 06/2013; 12(1):85. DOI:10.1186/1475-2891-12-85 · 2.60 Impact Factor
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    • "Beverages represent an important source of fluids which are essential for maintaining adequate levels of hydration, but fluid needs vary considerably depending on a number of factors including age, body size, level of physical activity and perspiration, food habits, and other individual and environmental contributors (Lieberman 2007; Manz 2007). Numerous methods for assessing hydration status exist, but a single 24-hour recall is not one of them (Kavouras 2002; Shirreffs 2003; Armstrong 2005). "
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    ABSTRACT: Our objective was to describe the fluid and energy consumption of beverages in a large sample of European adolescents. We used data from 2741 European adolescents residing in 8 countries participating in the Healthy Lifestyle in Europe by Nutrition in Adolescence Cross-Sectional Study (HELENA-CSS). We averaged two 24-h recalls, collected using the HELENA-dietary assessment tool. By gender and age subgroup (12.5-14.9 years and 15-17.5 years), we examined per capita and per consumer fluid (milliliters (ml)) and energy (kilojoules (kJ)) intake from beverages and percentage consuming 10 different beverage groups. Mean beverage consumption was 1611 ml/day in boys and 1316 ml/day in girls. Energy intake from beverages was about 1966 kJ/day and 1289 kJ/day in European boys and girls, respectively, with sugar-sweetened beverages (SSBs) (carbonated and non-carbonated beverages, including soft drinks, fruit drinks and powders/concentrates) contributing to daily energy intake more than other groups of beverages. Boys and older adolescents consumed the most amount of per capita total energy from beverages. Among all age and gender subgroups, SSBs, sweetened milk (including chocolate milk and flavored yogurt drinks all with added sugar), low-fat milk and fruit juice provided the highest amount of per capita energy. Water was consumed by the largest percentage of adolescents followed by SSBs, fruit juice and sweetened milk. Among consumers, water provided the greatest fluid intake and sweetened milk accounted for the largest amount of energy intake followed by SSBs. Patterns of energy intake from each beverage varied between countries. European adolescents consume an average of 1455 ml/day of beverages, with the largest proportion of consumers and the largest fluid amount coming from water. Beverages provide 1609 kJ/day, of which 30.4%, 20.7% and 18.1% comes from SSBs, sweetened milk and fruit juice, respectively.
    European journal of clinical nutrition 09/2011; 66(2):244-52. DOI:10.1038/ejcn.2011.166 · 2.71 Impact Factor
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    • "Fluid needs vary in the human species depending on a large number of factors. Age and body size are important, as well as level of perspiration (affected by temperature and intensity of physical exercise, among many factors) and food habits (such as intake of salt), in addition to other individual or environmental contributors (Lieberman, 2007; Manz, 2007). Given this large inter-individual variability of needs, it is difficult to propose recommendations for the general public, as has been done in many countries for energy and nutrient intakes. "
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    ABSTRACT: To assess the intake of fluid in healthy French children, adolescents, adults and seniors, considering amounts, types of beverages, time and place of consumption. Data regarding fluid intake were extracted and analyzed from the National Intake Survey, which was conducted in quota samples of the French population (Comportement et Consommations Alimentaires en France study). Seven-day questionnaires were administered to free-living individuals in 2002-2003. A total of 566 children (aged 6-11 years), 333 adolescents (aged 12-19 years), 831 adults (aged 20-54 years) and 443 seniors (aged >or=55 years) were included in this study. The average total intake of fluid was 1-1.3 l per day depending on age groups. Water accounted for about one-half of daily fluid intake. The contribution of other types of beverages varied with age (for example, dairy drinks in children and adolescents; alcoholic drinks in adults and seniors). Intake of sodas (including regular and light) was highest in adolescents (169 ml a day). Beverages were mainly consumed at home during meals. This is the first description of fluid intake in French children, adolescents, adults and seniors, considering amounts, types of beverages, time and place of intake. It shows that water is the main source of fluid in all age groups. Selection of various types of beverages is different according to age.
    European journal of clinical nutrition 02/2010; 64(4):350-5. DOI:10.1038/ejcn.2010.4 · 2.71 Impact Factor
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