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  • Original Article
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Body composition, energy expenditure and physical activity

Water intake and urinary hydration biomarkers in children

European Journal of Clinical Nutrition volume 71, pages 530–535 (2017)Cite this article

Subjects

Abstract

Background/Objectives:

The aims of the study were as follows: (1) examine fluid intake and urinary hydration markers of children in Greece, (2) determine the calculated relative risk of hypohydration in children who did not meet the recommendations for daily water intake provided by the Institute of Medicine and the European Food Safety Authority compared with those who did and (3) analyze the efficacy of the recommendations as a method to achieve euhydration in children.

Subjects/Methods:

One hundred and fifty Greek boys and girls (age 9–13) recorded their fluid intake for 2 consecutive days. A 24-h urine collection was obtained during the second day. Fluid intake records were analyzed for total water intake from fluids (TWI-F), and urine samples were analyzed for osmolality, color, specific gravity and volume. Urine osmolality ⩾800 mmol/kg H2O was defined as hypohydration.

Results:

Water intake from fluids was 1729 (1555–1905) and 1550 (1406–1686) ml/d for boys and girls, respectively. Prevalence of hypohydration was 33% (44% of boys, 23% of girls). Children who failed to meet TWI-F recommendations demonstrated a risk of hypohydration that was 1.99–2.12 times higher than those who met recommendations (P⩽0.01). Boys between 9 and 13 years displayed urine osmolality of 777 (725–830) mmol/kg, and urine specific gravity of 1.021 (1.019–1.022), which was higher than those in girls between 9–13 years (P⩽0.015), and >27% were classified as hypohydrated despite meeting water intake recommendations.

Conclusions:

Failure to meet TWI-F guidelines increased calculated relative risk of hypohydration in children. Boys between 9 and 13 years are at greater hazard regardless of meeting guidelines and may require greater water intake to avoid elevated urine concentration and ensure adequate hydration.

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Acknowledgements

The study was supported by a grant from Danone Research, Palaiseau, France.

Author information

Authors and Affiliations

  1. Hydration Science Lab, University of Arkansas, Fayetteville, AR, USA

    S A Kavouras

  2. Department of Nutrition and Dietetics, Harokopio University, Athens, Greece

    D Bougatsas, G Arnaoutis, S Tsipouridi & D B Panagiotakos

  3. Human Integrated Physiology Laboratory, University of Wyoming, Laramie, WY, USA

    E C Johnson

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  1. S A Kavouras
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Corresponding author

Correspondence to S A Kavouras.

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Competing interests

The study was supported by a grant by Danone Research. SAK and ECJ have active research grants with Danone research. SAK is a Scientific Consultant for Quest Diagnostics and Danone Research. DBP had a research grant by the European Hydration Institute.

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Kavouras, S., Bougatsas, D., Johnson, E. et al. Water intake and urinary hydration biomarkers in children. Eur J Clin Nutr 71, 530–535 (2017). https://doi.org/10.1038/ejcn.2016.218

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