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Hydration and Health: Data, Evidence and Recommendations on Water Intake for Healthier Hydration and Healthier Life

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A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Sports Nutrition".

Deadline for manuscript submissions: closed (15 November 2021) | Viewed by 22063

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Prof. Dr. Guansheng Ma

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Guest Editor

Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191, China
Interests: food and nutrition policy; eating behavior; hydration and health; childhood obesity

Special Issue Information

Dear Colleagues,

Water is an important nutrient that is essential for the survival and development of life. The functions of water include participating in the metabolism of the body, modulating normal osmotic pressure, maintaining the balance of electrolytes and regulating the body temperature. Water input and output are in a dynamic balance, with both being maintained at about 2500 mL. Water input includes three sources: drinking water, water obtained from food and metabolic water. Water output includes in urine through the urinary system, in sweat through the surface of the skin, in breath through the respiratory system, and in the feces through the digestive system. Under normal circumstances, the body's own homeostatic regulatory system maintains the dynamic balance of water. Both excessive and insufficient water, which disturb the dynamic balance, have a negative impact on physiological functions, as well as on health. If excessive water intake exceeds the capacity for renal excretion, this results in acute water intoxication, and even hyponatremia. Dehydration caused by insufficient water intake has adverse effects in terms of cognitive performance and physical activity, while also increasing the risk of urinary system diseases and cardiovascular diseases, such as urinary tract infections and coronary heart disease. An adequate water intake is meaningful for maintaining one’s hydration status and health. The results of water intake behavior surveys in different countries revealed that the phenomenon of insufficient water intake among different age groups was common. The proportion of the population that is dehydrated ranges from 16% to 92%. Water requirements vary among people of different genders and ages and between those who have different physical activity levels, dietary factors, environmental temperatures and kidney concentration capacities, among others. It is necessary to develop our knowledge of an adequate water intake to promote public health based on surveys of water intake levels carried out among different types of people and in different countries. However, the importance of water is also insufficiently valued. The scientific research related to water is still insufficient. There is a paucity of data and evidence available in the field of water intake, hydration and health. More surveys about the water intake among populations in normal and special physiological stages and populations with special occupation in different regions, seasons and environmental conditions are needed. Studies about the associations between water intake, hydration and health should also be carried out. Recommendations regarding adequate water intake should be established based on scientific data and evidence and should be revised according to recent research progress. Additionally, it is imperative to transform scientific theories about water intake into action in the form of water-related health education programs and strategies for improving hydration status.

The objective of this proposed Special Issue is to publish papers from multidisciplinary perspectives in relation to water intake and hydration, including water intake behaviors and their association with cognition, physical activity, and health, as well as drinking water safety and sustainability.

Prof. Dr. Guansheng Ma
Guest Editor

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Keywords

water intake
adults, elderly, pregnant women (population)
sports population
adequate hydration
hydration status
beverage consumption
cognitive performance
urine biomarkers

Published Papers (5 papers)

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Research

13 pages, 1098 KiB

Open AccessArticle

Habitual Total Drinking Fluid Intake Did Not Affect Plasma Hydration Biomarkers among Young Male Athletes in Beijing, China: A Cross-Sectional Study

by Jianfen Zhang, Na Zhang, Yibin Li, Hairong He and Guansheng Ma

Nutrients 2022, 14(11), 2311; https://doi.org/10.3390/nu14112311 - 31 May 2022

Cited by 2 | Viewed by 1626

Abstract

The purposes of this study were to explore the drinking patterns, and urinary and plasma hydration biomarkers of young adults with different levels of habitual total drinking fluid intake. A cross-sectional study was conducted among 111 young male athletes in Beijing, China. Total drinking fluids and water from food were assessed by a 7-day, 24-h fluid intake questionnaire and the duplicate portion method, respectively. The osmolality and electrolyte concentrations of the 24-h urine and fasting blood samples were tested. Differences in groups LD₁ (low drinker), LD₂, HD₁, and HD₂ (high drinker), divided according to the quartiles of total drinking fluids, were compared using one-way ANOVA, Kruskal–Wallis H-tests, and chi-squared tests. A total of 109 subjects completed the study. The HD₂ group had greater amounts of TWI (total water intake) and higher and lower contributions of total drinking fluids and water from food to TWI, respectively, than the LD₁, LD₂, and HD₁ groups (p < 0.05), but the amounts of water from food did not differ significantly among the four groups (all p > 0.05). Participants in the HD₂ group had higher amounts of water than participants in the LD₁, LD₂, and HD₁ groups (p < 0.05); SSBs were the second top contributor of total drinking fluids, ranging from 24.0% to 31.8%. The percentage of subjects in optimal hydration status increased from 11.8% in the LD₁ group to 58.8% in the HD₂ group (p < 0.05). The HD₂ and HD₁ groups had 212–227 higher volumes of urine than the LD₁ and LD₂ groups (p < 0.05). No significant differences were found in the plasma biomarkers (p > 0.05), with the exception of higher concentrations of K in the HD₁ group than in the LD₁ group (p < 0.05). Subjects with higher amounts of total drinking fluids had better hydration status than those with lower total drinking fluids, but not better drinking patterns. Habitual total drinking fluids did not affect the plasma biomarkers. Full article

(This article belongs to the Special Issue Hydration and Health: Data, Evidence and Recommendations on Water Intake for Healthier Hydration and Healthier Life)

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12 pages, 2092 KiB

Open AccessArticle

Dehydration Status Aggravates Early Renal Impairment in Children: A Longitudinal Study

by Nubiya Amaerjiang, Menglong Li, Huidi Xiao, Jiawulan Zunong, Ziang Li, Dayong Huang, Sten H. Vermund, Rafael Pérez-Escamilla, Xiaofeng Jiang and Yifei Hu

Nutrients 2022, 14(2), 335; https://doi.org/10.3390/nu14020335 - 13 Jan 2022

Cited by 6 | Viewed by 2963

Abstract

Dehydration is common in children for physiological and behavioral reasons. The objective of this study was to assess changes in hydration status and renal impairment across school weekdays. We conducted a longitudinal study of three repeated measures of urinalysis within one week in November 2019 in a child cohort in Beijing, China. We measured urine specific gravity (USG) to determine the dehydration status, and the concentration of β₂-microglobulin (β₂-MG) and microalbumin (MA) to assess renal function impairment among 1885 children with a mean age of 7.7 years old. The prevalence of dehydration was 61.9%, which was significantly higher in boys (64.3%). Using chi-square tests and linear mixed-effects regression models, we documented the trends of the renal indicators’ change over time among different hydration statuses. Compared to Mondays, there were apparent increases of β₂-MG concentrations on Wednesdays (β = 0.029, p < 0.001) and Fridays (β = 0.035, p < 0.001) in the dehydrated group, but not in the euhydrated group. As for the MA concentrations, only the decrease on Fridays (β = −1.822, p = 0.01) was significant in the euhydrated group. An increased trend of elevated β₂-MG concentration was shown in both the euhydrated group (Z = −3.33, p < 0.001) and the dehydrated group (Z = −8.82, p < 0.001). By contrast, there was a decreased trend of elevated MA concentrations in the euhydrated group (Z = 3.59, p < 0.001) but not in the dehydrated group. A new indicator ratio, β₂-MG/MA, validated the consistent trends of renal function impairment in children with dehydration. Renal impairment trends worsened as a function of school days during the week and the dehydration status aggravated renal impairment during childhood across school weekdays, especially tubular abnormalities in children. Full article

(This article belongs to the Special Issue Hydration and Health: Data, Evidence and Recommendations on Water Intake for Healthier Hydration and Healthier Life)

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13 pages, 1183 KiB

Open AccessArticle

Young Adults with Higher Salt Intake Have Inferior Hydration Status: A Cross-Sectional Study

by Jianfen Zhang, Na Zhang, Shufang Liu, Songming Du and Guansheng Ma

Nutrients 2022, 14(2), 287; https://doi.org/10.3390/nu14020287 - 11 Jan 2022

Cited by 6 | Viewed by 2647

Abstract

The body’s water and sodium balances are tightly regulated and monitored by the brain. Few studies have explored the relationship between water and salt intake, and whether sodium intake with different levels of fluid intake leads to changes in hydration status remains unknown. The aim of the present study was to determine the patterns of water intake and hydration status among young adults with different levels of daily salt intakes. Participants’ total drinking fluids and water from food were determined by a 7-day 24-h fluid intake questionnaire for 7 days (from Day 1 to Day 7) and duplicate portion method (Day 5, Day 6 and Day 7). Urine of 24 h for 3 days (Day 5, Day 6 and Day 7) was collected and tested for the osmolality, the urine-specific gravity (USG), the concentrations of electrolytes, pH, creatinine, uric acid and the urea. The fasting blood samples for 1 day (Day 6) were collected and measured for the osmolality and the concentrations of electrolytes. The salt intakes of the participants were evaluated from the concentrations of Na of 24 h urine of 3 days (Day 5, Day 6 and Day 7). Participants were divided into four groups according to the quartile of salt intake, including the low salt intake (LS₁), LS₂, high salt intake (HS₁) and HS₂ groups. In total, 156 participants (including 80 male and 76 female young adults) completed the study. The salt intakes were 7.6, 10.9, 14.7 and 22.4 g among participants in the four groups (LS₁, LS₂, HS₁ and HS₂ groups, respectively), which differed significantly in all groups (F = 252.020; all p < 0.05). Compared to the LS₁ and LS₂ groups, the HS₂ group had 310–381, 250–358 and 382–655 mL more amounts of water from the total water intake (TWI), total drinking fluids and water from food (all p < 0.05), respectively. Participants in the HS₂ group had 384–403, 129–228 and 81–114 mL more in the water, water from dishes and staple foods, respectively, than those in the groups of LS₁ and LS₂ (p < 0.05). The HS₂ group excreted 386–793 mL more urine than those in the groups of LS₁ and LS₂ (p < 0.05). However, regarding urine osmolality, the percentage of participants with optimal hydration status decreased from 41.0% in LS₁ and LS₂ to 25.6% in the HS₂ group (p < 0.05). Participants with higher salt intake had higher TWI, total drinking fluids and water from food. Nevertheless, they had inferior hydration status. A reduction in salt intake should be encouraged among young adults to maintain optimal hydration status. Full article

(This article belongs to the Special Issue Hydration and Health: Data, Evidence and Recommendations on Water Intake for Healthier Hydration and Healthier Life)

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12 pages, 859 KiB

Open AccessArticle

The Relationships between Water Intake and Hydration Biomarkers and the Applications for Assessing Adequate Total Water Intake among Young Adults in Hebei, China

by Jianfen Zhang, Guansheng Ma, Songming Du and Na Zhang

Nutrients 2021, 13(11), 3805; https://doi.org/10.3390/nu13113805 - 26 Oct 2021

Cited by 4 | Viewed by 2340

Abstract

Water is an essential nutrient for humans. A cross-sectional study was conducted among 159 young adults aged 18–23 years in Hebei, China. The total drinking fluids and water from food were obtained by 7-day 24 h fluid intake questionnaires and the duplicate portion method, respectively. Pearson’s correlation coefficients were performed to determine the relationship between fluid intake and 24 h urinary biomarkers and plasma biomarkers. A multivariable partial least squares (PLS) model was used to identify the key predictors in modeling the total water intake (TWI) with 24 h urine biomarkers. Logistic regressions of the TWI against binary variables were performed, and the receiver operating characteristic curve (ROC) was analyzed to determine the cutoff value of the TWI for the optimal hydration status and dehydration without adjustments to favor either the sensitivity or specificity. In total, 156 participants (80 males and 76 females) completed the study. Strong relationships were found between the total drinking fluids, TWI, and 24 h urine biomarkers among young adults, especially for the 24 h urine volume (r = 0.784, p < 0.001; r = 0.747, p < 0.001) and osmolality (r = −0.589, p < 0.001; r = −0.477, p < 0.001), respectively. As for the FMU and plasma biomarkers, no strong relationships were found. The percentages of the variance in TWI explained by the PLS model with 13 urinary biomarkers were 66.9%. The optimal TWI values for assessing the optimal hydration and dehydration were 2892 mL and 2482 mL for young males, respectively, and 2139 mL and 1507 mL for young females, respectively. Strong relationships were found between the TWI, total drinking fluids, and 24 h urine biomarkers, but not with the FMU and plasma biomarkers, among young adults, including males and females. The 24 h urine biomarkers were more sensitive than the first morning urinary biomarkers in reflecting the fluid intake. The TWI was a reliable index for assessing the hydration statuses for young adults in free-living conditions. Full article

(This article belongs to the Special Issue Hydration and Health: Data, Evidence and Recommendations on Water Intake for Healthier Hydration and Healthier Life)

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19 pages, 965 KiB

Open AccessFeature PaperArticle

Effects of Water Restriction and Supplementation on Cognitive Performances and Mood among Young Adults in Baoding, China: A Randomized Controlled Trial (RCT)

by Jianfen Zhang, Guansheng Ma, Songming Du, Shufang Liu and Na Zhang

Nutrients 2021, 13(10), 3645; https://doi.org/10.3390/nu13103645 - 18 Oct 2021

Cited by 7 | Viewed by 11046

Abstract

The brain is approximately 75% water. Therefore, insufficient water intake may affect the cognitive performance of humans. The present study aimed to investigate the effects of water restriction and supplementation on cognitive performances and mood, and the optimum amount of water to alleviate the detrimental effects of dehydration, among young adults. A randomized controlled trial was conducted with 76 young, healthy adults aged 18–23 years old from Baoding, China. After fasting overnight for 12 h, at 8:00 a.m. of day 2, the osmolality of the first morning urine and blood, cognitive performance, and mood were measured as a baseline test. After water restriction for 24 h, at 8:00 a.m. of day 3, the same indexes were measured as a dehydration test. Participants were randomly assigned into four groups: water supplementation group (WS group) 1, 2, or 3 (given 1000, 500, or 200 mL purified water), and the no water supplementation group (NW group). Furthermore, participants were instructed to drink all the water within 10 min. Ninety minutes later, the same measurements were performed as a rehydration test. Compared with the baseline test, participants were all in dehydration and their scores on the portrait memory test, vigor, and self-esteem decreased (34 vs. 27, p < 0.001; 11.8 vs. 9.2, p < 0.001; 7.8 vs. 6.4, p < 0.001). Fatigue and TMD (total mood disturbance) increased (3.6 vs. 4.8, p = 0.004; 95.7 vs. 101.8, p < 0.001) in the dehydration test. Significant interactions between time and volume were found in hydration status, fatigue, vigor, TMD, symbol search test, and operation span test (F = 6.302, p = 0.001; F = 3.118, p = 0.029; F = 2.849, p = 0.043; F = 2.859, p = 0.043; F = 3.463, p = 0.021) when comparing the rehydration and dehydration test. Furthermore, the hydration status was better in WS group 1 compared to WS group 2; the fatigue and TMD scores decreased, and the symbol search test and operation span test scores increased, only in WS group 1 and WS group 2 (p < 0.05). There was no significant difference between them (p > 0.05). Dehydration impaired episodic memory and mood. Water supplementation improved processing speed, working memory, and mood, and 1000 mL was the optimum volume. Full article

(This article belongs to the Special Issue Hydration and Health: Data, Evidence and Recommendations on Water Intake for Healthier Hydration and Healthier Life)

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