News article

Press release: Children not properly hydrated

Posted:  Monday, October 15, 2012

  • Multi-country studies show fluid intake at breakfast does not suffice to maintain adequate hydration for the whole morning
  • In the USA, most of the children aged 4 to 13 years do not meet the Adequate Intakes (AI) for water from both foods and beverages
  • Experts call for additional research, programmes and policies to guide children’s beverage intake whilst at school

Vevey, Switzerland, – 15 October 2012. At a Nestlé Nutrition Institute Satellite Symposium recently held on October 7th at the Food and Nutrition Conference and Expo (FNCE) in Philadelphia, USA, leading international experts highlighted the importance of maintaining good hydration status in children on a daily basis to ensure optimal body function.

More than two thirds of schoolchildren have a hydration deficit

Professor Gerard Friedlander of the Paris Descartes University Medical School, France, explained that children are more likely to be dehydrated than adults due to their high surface-to-body weight ratio. They also pay less attention to their fluid intake. Professor Friedlander was citing the results of large studies held between 2009 and 2011 in France, Italy, UK and USA1,2,3,4. These revealed that more than two thirds of children have a hydration deficit when they go to school in the morning, despite what they may have had at breakfast time.

The studies involved a cohort of about 500 schoolchildren aged 9-11 years in each of the four countries. Interestingly, just over 60% of the children in each country were found to have a hydration deficit as measured by a urinary osmolality of over 800 mOsmol/kg of water5. Professor Friedlander who oversaw the European studies said, “A majority of children drank less than 400ml of fluid at breakfast and had a greater risk of having a high osmolality after breakfast than children drinking more than 400ml of fluids. These results demonstrate how important it is for children to be adequately hydrated whilst at school. Little data currently exists on the impact of hydration status of children on health, but some studies have shown that it may affect mental performance, such as concentration, short-term memory and attention”.

Creating hydration ‘habits’ for schoolchildren

“Providing water access in schools is a global issue and varies from country to country. Collaborative efforts among school administration, communities, and policy makers are needed to improve school drinking water provision”, said Maureen Pisanick a nutritionist and Industry Consultant. She continued, “Although interventions and policies to encourage healthy beverage intake in schools and child care are increasing, there is a need for additional research, programmes, and policies to guide beverage intake in these settings”.

Ms Pisanick proposed that investigations be implemented that can identify whether provision of water in schools can trigger a reduction in sugar sweetened beverage consumption and whether this could also lead to increased consumption of water outside the school environment. She addressed ways in which water can be promoted in schools such as establishing marketing campaigns to promote water consumption. These campaigns might include integrating the hydration topic in lessons on biology, health, nutrition, and physical education. Also, signs and advertisements can be posted in the cafeteria and throughout schools promoting water consumption.

Evaluating water consumption amongst children and adolescents

“Most of the US population may not meet the Adequate Intakes (AI) for water from both foods and beverages”, said Dr Adam Drewnowski, Center for Public Heath Nutrition, University of Washington, Seattle, USA. He was referring to the National Heath and Nutrition Examination Survey (NHANES) FOR 2005-2010, a comprehensive study amongst almost 5000 children and adolescents. The study examined the consumption of water (bottled and tap) and other beverages, including 100% fruit juices, soda/soft drinks, fruit drinks, sports drinks, milk, and other drinks (e.g., coffee, tea, energy drinks, etc.) by age and gender groups. Additional analyses examined consumption patterns by race, ethnicity and household education and incomes. Total water content of foods and beverages was then compared to Dietary Reference Intake (DRIs) values published by the Institute of Medicine for each age gender group.

Dr Drewnowski said, “The results are quite surprising when you consider that most children in this US study aged 4-8 years (74.6%) and most boys (85.2%) and girls (82.7%) ages 9-13 years failed to satisfy the Adequate Intake values for water published by the Institute of Medicine. Based on national standards, adequate hydration remains an issue in the US population”.

1. US Study:Stookey et al., Public Health Nutrition, 2011
2. French Study:Bonnet et al., Ann Nutr Metab , 2012;
3. Italy Study: Assael et al, J Nutr Disorders Ther, 2012
4. UK Study; Barker et al, FASEB J 2012
5. Sawka MN et al, 2007; D’Anci et al, Nutr Rev 2006; Shirreffs SM, EJCN, 2003

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