Human Water Needs

Healthy humans regulate daily water balance remarkably well across their lifespan despite changes in biological development and exposure to stressors on hydration status. Acute or chronic body water deficits result when intakes are reduced or losses increase, but day-to-day hydration is generally well maintained so long as food and fluid are readily available. Total water intake includes drinking water, water in beverages, and water in food. Daily water needs determined from fluid balance, water turnover, or consumption studies provide similar values for a given set of conditions. A daily water intake of 3.7 L for adult men and 2.7 L for adult women meets the needs of the vast majority of persons. However, strenuous physical exercise and heat stress can greatly increase daily water needs, and the individual variability between athletes can be substantial.     

Water balance, hydration status, and fat-free mass hydration in younger and older adults

BACKGROUND: Older adults are at increased risk of dehydration, yet water balance is understudied in this population. OBJECTIVE: This controlled diet study assessed the effect of age on water input, output, and balance in healthy adults. Hydration status (plasma osmolality and urine specific gravity) and body composition were also measured. DESIGN: Eleven men and 14 women aged 23-46 y and 10 men and 11 women aged 63-81 y were subjects. Water balance was assessed during days 7-10 of three 18-d controlled feeding trials with protein intakes of 0.50, 0.75, and 1.00 g . kg(-1) . d(-1). Total water input included water from the provided foods and beverages, ad libitum intake, and metabolic production. Water output included the losses in urine and stool and the insensible losses from respiration and nonsweating perspiration. RESULTS: Ad libitum water consumption, total water intake, water output through urine, total water output, and net water balance were not different in the older subjects than in the younger subjects. Markers of hydration status were within the range of clinical normalcy for all groups. Total body water (TBW) was not significantly different, fat-free mass (FFM) was significantly lower (P < 0.05), and FFM hydration (TBW:FFM) was significantly higher (P < 0.05) in the older subjects than in the younger subjects. Dietary protein intake did not influence any of these results. CONCLUSIONS: These results show that healthy older adults maintain water input, output, and balance comparable to those of younger adults and have no apparent changes in hydration status. The results support that the hydration of FFM is increased in older men and women.     

Water Intake in Pregnant Women in China, 2018: The Report of a Survey

Background: Adequate water intake in pregnant women plays an important role in their health and in fetal growth and development. However, there is insufficient applicable data to guide and evaluate the water intake of pregnant women in China. Based on a nationwide sample of pregnant women, we mainly aimed to investigate the daily total water intake (TWI) and the contribution of different beverages and food sources to the TWI, to assess the percentage of participants who comply with the adequate intake (AI) value of water set by the Chinese Nutrition Society (CNS) and the European Food Safety Authority (EFSA) and to analyze the contribution of different water sources to the daily total energy intake (TEI). Methods: A multi-stage sampling method was used to recruit pregnant women from 11 provinces and two municipalities in China. A 4-day online diary with a food atlas was used to assess water and dietary intake. Finally, 653 pregnant women were included in the analysis. The Mann–Whitney U test and the independent-sample t-test were used to compare the differences between related variables in different age groups or different gestational periods, and partial correlation was used to explore the correlation between water and energy intake. Results: The median daily TWI of pregnant women was 2190 mL, of which water from beverages and foods accounted for 52.9% and 47.1%, respectively. Approximately 80.5% of the water from beverages was mainly from plain water (r = 0.973), while in the part of the water from foods, dishes (32.4%) were the main contributors (r = 0.663). Only 16.4% and 43.8% of the total population met the TWI recommendation set by the CNS and EFSA, respectively. Among these, the contribution of the water from beverages was higher than that of the water from food. For those whose TWI did not reach the recommended level, the contribution of the water from beverages was almost equal to that of food. The median daily TEI of pregnant women was 1589 kcal, of which beverages accounted for 9.7%. Milk and milk derivatives (71.3%) were the main contributors to energy from beverages, accounting for 71.3% (r = 0.444). Although sugar-sweetened drinks only accounted for 10.1% of the energy from beverages, they were highly correlated with energy from beverages (r = 0.836). Through grouping analysis, age and gestational period had no significant effect on the above main results. Conclusions: This was the beginning of a nationwide study on the TWI of pregnant women in China, and the results provide evidence of the need for interventions to improve water intake among pregnant women and the revision of reference values for AI of TWI in pregnant women in China.     

Beverage consumption and adult weight management: A review

Total energy consumption among United States adults has increased in recent decades, and energy-containing beverages are a significant contributor to this increase. Because beverages are less satiating than solid foods, consumption of energy-containing beverages may increase energy intake and lead to weight gain; trends in food and beverage consumption coinciding with increases in overweight and obesity support this possibility. The purpose of this review is to present what is known about the effect of beverage consumption on short-term (i.e., meal) energy intake, as well as longer-term effects on body weight. Specific beverages addressed include water, other energy-free beverages (diet soft drinks, coffee and tea), and energy-containing beverages (soft drinks, juices and juice drinks, milk and soy beverages, alcohol). Existing evidence, albeit limited, suggests that encouraging water consumption, and substituting water and other energy-free beverages (diet soft drinks, coffee and tea) for energy-containing beverages may facilitate weight management. Energy-containing beverages acutely increase energy intake, however long-term effects on body weight are uncertain. While there may be health benefits for some beverage categories, additional energy provided by beverages should be compensated for by reduced consumption of other foods in the diet.     

我国四城市成年居民夏季饮水量

目的 调查我国4个城市成年居民夏季每天饮水量.方法 采用多阶段随机抽样方法,从北京、上海、成都、广州4个城市中抽取18～60岁城乡居民1483名.采用连续7 d的饮水记录法,了解调查对象的饮水情况,由调查对象利用定量用具估计每次饮水量,并记录每次饮水种类.分析不同城市、性别、城乡调查对象饮水种类和饮水量.结果 调查对象每天饮水量的中位数为1488 ml,北京、上海、成都、广州分别为1579、1793、1150、1467 ml,各城市之间的差异有统计学意义(χ2=154.31,P=0.000);男性每天饮水量中位数(1679 ml)多于女性(1370 ml)(Z=8.34,P=0.000);城区调查对象每天的饮水量中位数(1514 ml)与农村(1466 ml)相比,差异无统计学意义(Z=-0.81,P=0.420).调查对象每天饮用白水、茶水、饮料的中位数分别为786、109和186 ml.在4个城市中,白水饮用量最高的是广州(917 ml);茶水饮用量最高的是上海(257 ml);而饮料饮用量在上海(323 ml)和北京(264 ml)较高.男性茶水的饮用量为229 ml,高于女性的57 ml(Z=7.52,P=0.000);城区调查对象每天白水的饮用量(693 ml)低于农村(914 ml).每天的饮水量不到1200 ml的调查对象占32.4%(480/1483).结论 我国成年居民每天饮水量及白水、茶水、饮料饮用量存在城市、城乡、性别的差异;约1/3的居民每天饮水量未达到目前我国1200 ml的饮水建议量.

Abstract：

Objectives To investigate total drinking water intake of adults in the four cities of China in summer.Methods A total of 1483 adults aged 18-60 yrs from Beijing,Shanghai,Chengdu and Guangzhou were selected using multiple-stage random sampling method.The information of amounts and types of daily drinking water was recorded by subjects for seven consecutive days using a quantitative measurement.The amounts and types of daily drinking water among different cities and between men and women or urban and rural was analyzed.Results The median of daily total drinking water of subjects was 1488 ml,with significant difference among the four cities(1579,1793,1150,1467 ml in Beijing,Shanghai,Chengdu and Guangzhou city,respectively,χ2=154.31,P=0.000).The median of daily drinking water was significantly higher in men(1679 ml) than women(1370 ml)(Z=8.34,P=0.000),but no significant difference was found between urban(1514 ml) and rural (1466 ml)daily drinking water median (Z=-0.81,P=0.420).The median of daily consumption of plain water,tea and beverages were 786,109,186 ml,respectively.Among four cities,the highest consumption of plain water was in subjects of Guangzhou (917 ml),while the highest tea consumption in Shanghai (257 ml) and the highest beverages consumption in Shanghai (323 ml) and Beijing (264 ml).Consumption of tea in men(229 ml)was significantly higher than that in women (57 ml) (Z=7.52,P=0.000).Subjects in urban (693 ml) had lower consumption of plain water than those in rural (914 ml).The proportion was 32.4% (480/1483) for subjects with water drinking less than 1200 ml per day.Conclusion The daily consumption of total drinking water,including plain water,tea and beverages is different in adults among different cities and is different in gender and regions.It is nearly 1/3 of subjects with daily total drinking water less than current Chinese recommended water intake (1200 ml).     

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

Background: Estimates of adequate intake (AI) for water only became available in 2005. The daily water AI for 6–12‐month‐old infants of both sexes is 800 mL. The present study aimed to estimate the water intake of urban infants receiving both breast milk and complementary feeding (CF) and to compare them with the reference AI. Methods: Sixty‐four infants, 42 boys and 22 girls, aged 6–12 months on enrolment, from a low‐income district of Guatemala City, were recruited to the study. Quantitative 24‐h recalls and breastfeeding histories were collected in three serial interviews. The quantity of water was estimated from recipes and food composition moisture values for the CF items reported. The amount of breast milk needed to complement foods and beverages in meeting the individual energy needs was calculated, and breast milk’s water contribution was derived accordingly. The total quantity of water in beverages, including human milk, liquids in recipes and moisture of foods, was tabulated as the infants’ daily intake. Results: Some 56.3% of the water needs for boys and 41.1% for girls were satisfied by just water obtained from plain water, other complementary beverages and moisture of foods within CF, exclusive of breast milk. Adding the estimated breast milk intake, the median water intake for the infant sample was essentially equal to the 800 mL of the AI. Conclusions: The infants in this low‐income community are approximating the recommended AI for daily water through the currently selected pattern of lactation and CF.     

Is tea a healthy source of hydration?

After water, tea is the most commonly consumed beverage worldwide, with over 80% of adults drinking tea in the UK. Lay concerns about caffeine have led to questions about the suitability of tea as a source of hydration. Several controlled trials have examined the effect of moderate caffeine consumption on fluid balance, from tea or other sources, concluding that intakes of up to 400 mg of caffeine, or six to eight servings of tea daily, are consistent with normal hydration. Unlike water, or other caffeinated beverages, tea is rich in flavonoids: plant compounds associated with health. There is now a growing body of evidence linking regular tea consumption with heart health, cognitive health, dental benefits and bodyweight management suggesting that tea may offer a healthy source of hydration. These studies are discussed in the context of typical tea intakes in the UK.     

Assessment of nutrient and water intake among adolescents from sports federations in the Federal District, Brazil

Adolescents aged 11-14 years (n 326), belonging to organized sports federations in the Federal District, Brazil were interviewed. Subjects (n 107) provided four non-consecutive days of food consumption and 219 subjects provided two non-consecutive days of intake. The objective was to assess their nutrient and water intake according to dietary reference intake values and their energy and macronutrient intake by sex and sports groups they were engaged in: endurance, strength-skill or mixed, according to the guidelines established by the American College of Sport Medicine (ACSM). Dietary data were corrected for intra-individual variation. Total energy expenditure was higher among endurance athletes (P < 0.001) following their higher training time (P < 0.001) when compared to adolescents engaged in strength-skill or mixed sports. Total energy intake was only significantly higher among endurance-engaged females (P = 0.05). Protein intake of males was above the guidelines established by the ACSM for all sports groups. All male sport groups fulfilled the intake levels of carbohydrate per kg body weight but only females engaged in endurance sports fulfilled carbohydrate guidelines. Intakes of micronutrients with low prevalence of adequate intake were: vitamins B1, E and folate, magnesium and phosphorus. Few adolescents ( < 5 %) presented adequate intake for calcium, fibre, drinking water and beverages. For micronutrients, prevalence of adequacies were lower for females than males, except for liquids and water. Nutrition guidance is needed to help adolescents fulfil specific guidelines of macronutrient intake for their sports and to improve their intake of micronutrients and water. Special attention should be given to female adolescent athletes.     

Total fluid intake and its determinants: cross-sectional surveys among adults in 13 countries worldwide

Purpose

To evaluate the total fluid intake from drinking water and beverages in adult populations from different countries and assess the percentage of individuals complying with the European Food Safety Agency (EFSA) adequate intake (AI) of water from fluids.

Methods

A total of 16,276 adults (7580 men and 8696 women) aged between 18 and 70 years (mean age 39.8 years) were randomly recruited from 13 different countries from three continents. Information about the total daily fluid intake (sum of drinking water and beverages) was collected using a 24-h fluid-specific record over seven consecutive days.

Results

Important differences in total fluid intake between countries were found; however, few differences between men and women were reported in most of the countries. Less than 50 % of the women and approximately 60 % of the men do not comply with the EFSA AI of water from fluids. Women were more than twice as likely as men to meet these AI (OR 2.15; 95 % CI 2.02–2.29). The odds of meeting the AI of water from fluids were lower in individuals over 50 years (OR 0.88; 95 % CI 0.80–0.96). Nine percent of the total population consumed less than half of the AI, 40.5 % between 50 and 100 %, and 50.5 % more than the AI.

Conclusions

There were considerable differences in total fluid intake between countries but not between genders. Only 40 % of men and 60 % of women comply with the EFSA AI of water from fluids. Men and elderly individuals had an increased risk of not complying with this reference value.

     

Seasonal and gender differences of beverage consumption in elementary school students

The purpose of this study was to compare the beverage consumption by gender and season in elementary school children and to investigate the role of beverage consumption patterns on their daily nutrient intakes and BMIs. Beverage consumption and dietary energy intake in 160 elementary school students in the Gyeongnam area were measured by a beverage frequency and quantity questionnaire and three 24-hour dietary recalls during winter and summer. The number of drinking moments per month, the amounts of beverage per day, and the energy from beverage consumption were not different between winter and summer. In summer, the contribution of energy from sweetened beverage to the daily energy intake in girls accounted for 13.5% which was significantly higher compared to 7.7% in boys. In girls, the consumption of health beverage showed a significant correlation with various nutrient intakes in winter. Meanwhile, the sweetened beverage intake was negatively correlated with energy, protein, vitamin A and niacin intake in summer. Consumption of most of the beverages, including sweetened beverages, were not related with BMI in both sexes and both seasons, except functional drinks which were related with BMI in boys in winter.     

The importance of human hydration: perceptions among healthcare professionals across Europe

Summary Attitudes of healthcare professionals to the importance of hydration for health, wellness and performance were evaluated in six European countries. These included general medical practitioners (n = 600), nurses (n = 300), pharmacists (n = 550), nutritionists (n = 265) and dietitians (n = 265), spread across France, Germany, Greece, Italy, Spain and the UK, who completed computer‐aided web or telephone interviews. The interviews assessed attitudes to the importance of hydration, how commonly they assess the hydration status of patients, and knowledge about recommended water intakes, sources of water for consumption and contribution from different beverages. All responders considered hydration an important issue and there was little difference in opinion between different healthcare providers. Responders in Mediterranean countries (particularly Italy and Spain, but also Greece to some extent) rated hydration more importantly than those in Germany and the UK (P < 0.001) and this was reflected in the higher frequency with which they reported that they assess the hydration status of patients (P < 0.001) and provide advice on the subject (P < 0.001). It was also demonstrated by a greater percentage of responders citing the necessity of optimal hydration for physical performance in these countries, compared with Germany and those in the UK and France (P < 0.001). Whether this was caused by climatic or cultural differences was not addressed by the study. The contribution of an appropriate hydration status to mental health was relatively poorly recognised, with less than 50% of responders in all countries citing this as a benefit and less than 30% of those in France and Italy citing it as a reason to provide advice. Healthcare professionals were reasonably knowledgeable about European Food Safety Authority adequate intakes for water for men and women but overestimated the contribution from food and underestimated that from beverages. The data highlight opportunities for education and improved clinical practice, especially in respect to the effects of hydration status on mental wellbeing and performance and the contribution of foods and beverages to total water intake.     

Am I Drinking Enough? Yes,No, and Maybe

Adequate fluid intake can be dually defined as a volume of fluid (from water, beverages, and food) sufficient to replace water losses and provide for solute excretion. A wide range of fluid intakes are compatible with euhydration, whereby total body water varies narrowly from day to day by 600 to 900 mL (<1% body mass). One measure of fluid intake adequacy involves enough fluid to prevent meaningful body water deficits outside this euhydration range (i.e., dehydration). Another measure of fluid intake adequacy involves enough fluid to balance the renal solute load, which can vary widely inside the euhydration range. The subtle but important distinction between the 2 types of adequacy may explain some of the ambiguity surrounding the efficacy of hydration status markers. Both perspectives of fluid intake adequacy are discussed in detail and a simple tool is reviewed that may help healthy, active, low-risk populations answer the question, “Am I drinking enough?”

Key Teaching Points

? Adequate fluid intake can be dually defined as a volume of fluid (from water, beverages, and food) sufficient to replace water losses and provide for solute excretion.

? Fluid needs can differ greatly among individuals due to variation in the factors that influence both water loss and solute balance; thus, adequacy is consistent with a wide range of fluid intakes and is better gauged using hydration assessment methods.

? Adequacy of fluid intake for replacing meaningful water losses (dehydration) can be assessed simply, inexpensively, and with reasonable fidelity among healthy, active, low-risk individuals.

? Adequacy of fluid intake for solute excretion per se can also be assessed among individuals but is more difficult to define and less practical to measure.     

Intake of water and different beverages in adults across 13 countries

Purpose

To describe the intake of water and all other fluids and to evaluate the proportion of adults exceeding the World Health Organisation (WHO) recommendations on energy intake from free sugar, solely from fluids.

Methods

A total of 16,276 adults (46 % men, mean age 39.8 years) were recruited in 13 countries from 3 continents. A 24-h fluid-specific record over 7 days was used for fluid assessment.

Results

In Spain, France, Turkey, Iran, Indonesia and China, fluid intake was characterised by a high contribution of water (47–78 %) to total fluid intake (TFI), with a mean water intake between 0.76 and 1.78 L/day, and a mean energy intake from fluids from 182 to 428 kcal/day. Between 11 and 49 % of adults exceeded the free sugar WHO recommendations, considering solely fluids. In Germany, UK, Poland and Japan, the largest contributors to TFI were hot beverages (28–50 %) and water (18–32 %). Mean energy intake from fluids ranged from 415 to 817 kcal/day, and 48–62 % of adults exceeded free sugar WHO recommendations. In Mexico, Brazil and Argentina, the contribution of juices and regular sugar beverages (28–41 %) was as important as the water contribution to TFI (17–39 %). Mean energy intake from fluids ranged 565–694 kcal/day, and 60–66 % of the adults exceeded the free sugar WHO recommendation.

Conclusions

The highest volumes recorded in most of the countries were for water, mean energy intake from fluids was up to 694 kcal/day, and 66 % of adults exceeded the free sugar WHO recommendation solely by fluids. Actions to create an environment in favour of water consumption and reduce sugar intake from fluids therefore are warranted.

     

Current Hydration Habits: The Disregarded Factor for the Development of Renal and Cardiometabolic Diseases

Improper hydration habits are commonly disregarded as a risk factor for the development of chronic diseases. Consuming an intake of water below recommendations (underhydration) in addition to the substitution of sugar-sweetened beverages (SSB) for water are habits deeply ingrained in several countries. This behavior is due to voluntary and involuntary dehydration; and because young children are exposed to SSB, the preference for a sweet taste is profoundly implanted in the brain. Underhydration and SSB intake lead to mild hyperosmolarity, which stimulates biologic processes, such as the stimulation of vasopressin and the polyol-fructose pathway, which restore osmolarity to normal but at the expense of the continued activation of these biological systems. Unfortunately, chronic activation of the vasopressin and polyol-fructose pathways has been shown to mediate many diseases, such as obesity, diabetes, metabolic syndrome, chronic kidney disease, and cardiovascular disease. It is therefore urgent that we encourage educational and promotional campaigns that promote the evaluation of personal hydration status, a greater intake of potable water, and a reduction or complete halting of the drinking of SSB.     

Factors associated with low water intake among US high school students - National Youth Physical Activity and Nutrition Study, 2010

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.     

深圳市某区成年居民饮水量及其影响因素分析

目的调查深圳某区成年居民每天饮水量及其影响因素,为制定我国不同人群的适宜饮水量积累基础数据。方法采用三阶段随机抽样方法抽取深圳市某区18～60岁居民385名,调查对象利用定量用具对连续7d的每日每次饮水量进行估计,并记录每次饮水量和种类,饮水总量为白水、茶水、饮料和酒的饮用量之和。结果调查对象饮水总量的中位数为1403ml/d,白水、茶水、饮料的中位数分别为814、149和186ml/d。男性饮水总量和茶水饮用量显著高于女性;随年龄增长白水和饮料的饮用量减少而茶水饮用量增加;肥胖者饮料饮用量较高;吸烟者白水饮用量少而茶水多;饮酒者饮水总量和饮料饮用量较多,以上差异均有统计学意义(P<0.05)。结论饮水量影响因素较多,应综合考虑各因素制定适宜饮水量。     

Contemporary nutritional transition: determinants of diet and its impact on body composition

The world has experienced a marked shift in the global BMI distribution towards reduced undernutrition and increased obesity. The collision between human biology, shaped over the millennia and modern technology, globalization, government policies and food industry practices have worked to create far-reaching energy imbalance across the globe. A prime example is the clash between our drinking habits and our biology. The shift from water and breast milk as the only beverages available, to a vast array of caloric beverages was very rapid, shaped both by our tastes and aggressive marketing of the beverage industry. Our biology, shaped over millennia by daily consumption of water and seasonal availability of food, was not ready to compensate for the liquid energies. Other dietary changes were similarly significant, particularly the shift towards increased frequency of eating and larger portions. The roles of the food and beverage production, distribution and marketing sectors in not only shaping our diet but also accelerating these changes must be understood. Apart from the role of beverages, there is much less consensus about the role of various components of our diet in energy imbalance. Understanding the determinants of change in the key components of our diet through an array of research provides insights into some of the options we face in attempting to attain a great balance between energy intake and expenditures while creating an overall healthier dietary pattern. A few countries are systematically addressing the causes of poor dietary and physical activity patterns and high energy imbalance.     

四城市成年居民夏季不同时间段饮水行为的分析

目的分析北京、成都、上海、广州居民的夏季一天不同时间段的饮水行为。方法采用多阶段随机抽样方法从四城市抽取18～60岁成年人1483名,使用连续7天的饮水记录表,由调查对象利用定量用具详细记录每天8个时间段内每次饮水的种类及饮水量。结果调查对象早、中、晚餐后的饮水率(97%～99%)及饮水量(290～471ml)较其他5个时间段高(饮水率:49%～88%;饮水量:54～166ml,F=972.55,P<0.01);白水、茶水、饮料的饮水人数与饮水量的分布情况同总水趋势一致。调查对象上午(719ml/d)的饮水量最高,其次是下午(539ml/d),晚上(417ml/d)的最低(F=265.49,P<0.01)。白水和饮料的饮用量均是上午最高;茶水上午和下午的接近,同时高于晚上(t=-52.13,P<0.01)。非就餐时(1436ml/d)的饮水量高于就餐时(240ml/d)的饮水量。就餐时饮料的饮用量最高;非就餐时白水的饮用量最高(P<0.05)。结论我国四城市居民在上午、下午、晚上均以饮用白水为主;就餐时以饮用饮料为主,非就餐时以白水为主。     

The Relationship between Health-Related Knowledge and Sugar-Sweetened Beverage Intake among US Adults

Because there is limited information on associations between health-related knowledge and sugar-sweetened beverage (SSB) intake, our cross-sectional study examined this question using the 2010 HealthStyles Survey data for 3,926 adults (aged ≥18 years). Multivariable logistic regression analysis was used to estimate the adjusted odds ratios and 95% CIs for drinking SSBs ≥2 times per day. About 31% of adults consumed SSBs ≥1 time per day, with 20% doing so ≥2 times per day. About eight of 10 adults agreed that drinking SSBs can contribute to weight gain, yet, eight of 10 adults in this study did not know the actual kilocalorie content of a 24-oz fountain soda. After controlling for age, sex, race/ethnicity, education level, annual household income, and geographic region, the odds for drinking SSBs ≥2 times per day were significantly higher among adults who neither agreed nor disagreed (ie, were neutral) that drinking SSBs can contribute to weight gain (odds ratio 1.61, 95% CI 1.15 to 2.25 vs agree); however, knowledge about the energy content of regular soda was not associated with SSB intake. Our finding that knowledge about the adverse effects of SSB intake is significantly associated with SSB intake among adults suggests that health education regarding the potential contribution of excess energy intake from SSBs to weight gain could contribute to lowered consumption and lower rates of obesity. Although knowledge about the kilocalorie content of regular soda was unrelated to SSB intake, health education on the kilocalorie content of SSBs may still be beneficial because most adults did not know the actual kilocalorie content of SSBs. Longitudinal studies are needed to explore associations between knowledge about energy provided by SSBs and SSB intake.