Intake of water and beverages of children and adolescents in 13 countries

Impact of mask wearing time on fluid consumption and physical activity during the COVID-19 pandemic

Purpose

To examine the associations between mask-wearing on fluid consumption and physical activity behaviors during the COVID-19 pandemic.

Methods

137 college students (female, 72.5%; age, 26 ± 9 y) completed a survey detailing their fluid intake, physical activity behaviors, and time spent wearing a mask throughout the day during the previous month in the Fall 2020 academic semester.

Results

Increased daily mask wearing time was not associated with total fluid intake (p > 0.05). Participants had greater odds of being 'somewhat active' compared to 'inactive' with an increase in mask wearing time (OR = 1.23 [1.03, 1.47], p = 0.022).

Conclusion

Wearing a mask during the COVID-19 pandemic did not influence fluid intake behaviors, however, it increased the likelihood of reported greater levels of physical activity. These factors may be related to an individual being more likely to globally adopt healthier behaviors, however, this needs further exploration.

Analysis of the pH levels in energy and pre-workout beverages and frequency of consumption: a cross-sectional study

BACKGROUND

Erosive tooth wear is an increasingly common pathology in the youth population. It refers to the chronic, localized, painless loss of dental hard tissues caused by non-bacterial acids, often originating from external sources like acidic beverages. Energy drink consumption is on the rise, frequently preceding physical exercise to enhance perceived energy levels. However, there are other types of beverages that also provide energy, such as pre-workout drinks, classified as sports drinks. The main objective of this research study has been conducted with the purpose of analyzing the pH of energy drinks and pre-workout beverages, and studying the frequency of consumption of such beverages in amateur athletes who practice sports.

METHODS

A total of 67 beverages were examined, comprising 43 energy drinks and 24 sports supplementation beverages, also known as pre-workout or pre-training beverages. The participants were given a survey to complete. They were asked to respond whether they consumed any type of pre-workout or energy drink, and they were also asked about the timing of consumption.

RESULTS

The findings indicated an average pH of 3.3 among the studied beverages, indicating a pH below the critical threshold. Out of the 113 participants, 51% reported taking some form of supplementation.

CONCLUSIONS

Consequently, it was concluded that most of the analyzed beverages recorded pH values low enough to classify them as erosive, posing a threat to enamel surface. When analyzing the frequency of consumption of energy drinks and pre-workout beverages in amateur athletes, we observed that most participants aged 29 years or younger took supplements 3 to 5 times a week, while the older age groups more frequently took supplements 1 to 2 times a week.

Health-Related Behaviors and Perceived Health Status According to Water and Sugar-Sweetened Beverage Intake in Korean Adolescents

The objective of this study was to determine the relationship between water and sugar-sweetened beverage (SSB) intake, health behaviors, and self-perceived health status using data from the 2019 Korea Youth Risk Behavior Web-based Survey (KYRBS). The subjects included in this analysis were 57,302 Korean adolescents from the 7th to 12th grades. The intake patterns of water and SSBs were categorized into four groups: Group I, adequate water intake (≥4 cups/day) and low frequency of SSB intake (≤1-2 times/week); Group II, adequate water intake and high frequency of SSB intake; Group III, inadequate water intake (<4 cups/day) and low frequency of SSB intake; Group IV, inadequate water intake and high frequency of SSB intake (≥3 times/week). Complex sample analyses were used for considering strata, clusters, and weights for samples. Significant differences were observed in the distribution of sociodemographic characteristics between the water and SSB intake groups. As grade levels increased or if students were female, there was a significant increase in the proportion of students characterized by low water intake and high consumption of SSB. Adolescents with healthier beverage habits, characterized by adequate water intake and low frequency of SSB consumption (Group I), generally abstained from smoking and alcohol, were more physically active, and maintained a desirable diet, reporting a better perceived health status. In contrast, those with higher SSB consumption and inadequate water intake (Group IV) were more likely to perceive their health as poor, with higher rates of smoking and alcohol use, lower physical activity levels, and poorer dietary habits compared to Group I. In conclusion, adolescents with desirable beverage consumption habits differed by sex and grade and they reported positive health behaviors and better overall health status. This suggests that there is a need for more active education and intervention in schools and families, as well as increased efforts by adolescents to promote healthy beverage habits.

Support for a hypothetical sugar-sweetened beverage tax in Taiwan

Sugar-sweetened beverages (SSBs) are drinks that contain added sugar or sweeteners and provide calories with no additional nutrients, and some countries have imposed additional taxes on the SSBs to reduce consumption, which is considered an SSB tax policy. This study used a cross-sectional online survey to examine the patterns of public support for an SSB tax in Taiwan. The sample included 1617 adults aged ≥ 20 years, who answered the survey questionnaire between May 2020 and April 2021. The respondents were recruited using convenience sampling, but sampling weights were applied to represent the Taiwanese population. Generalized ordered logit models with sampling weights were used to examine the correlates of public support for an SSB tax. Results showed that ~60% of the respondents supported the SSB tax and 47% perceived the tax to be effective. The respondents who were aware of the perceived health risks of SSBs or those who believed that one should be partly responsible for the health impact of SSBs were more likely to show support for the SSB tax. In adjusted regression models, both one's perceived risk and perceived responsibility of SSBs were positively associated with the perceived effectiveness of the SSB tax after sociodemographic characteristics were controlled. These research findings show evidence that there is public support for implementing an SSB tax to reduce SSB consumption in Taiwan.

Effects of metformin on behavioral alterations produced by chronic sucrose consumption in male rats

Excessive consumption of sugary drinks negatively impacts the developing brain, producing long-lasting behavioral and metabolic disorders. Here, we study whether treatment with the antihyperglycemic agent metformin prevents some of the anxiety and memory alterations produced by chronic sucrose consumption. Male Sprague-Dawley rats had unrestricted access to water (control group) and a bottle containing a 10% sucrose solution (sucrose group, SUC) for 35 days. In parallel, a group of animals from SUC received metformin (25 mg/kg or 50 mg/kg, orally; MET 25 and MET 50 groups, respectively). After 2 weeks of metformin treatment, the animals weighed less than controls. SUC and MET 50 groups compensated for the caloric intake from the sugary solution by consuming less chow. In contrast, total energy intake in MET 25 was higher than the rest of the groups, but they still weighed less than control and SUC groups, suggesting that at this concentration, metformin delays body growth. The animals were then tested for the open field (OF), elevated plus maze (EPM) and novel object location (NOL) tests. In the OF, SUC animals spent more time in the central zone of the arena, evidenced by an increased number of entries and the distance traveled there. In the EPM, SUC animals spent more time in the open arms and less time in the central square. Metformin treatment prevented the decreased anxiety observed in SUC animals in the OF and EPM. In the NOL test, SUC animals showed less interest in novelty and metformin treatment did not improve this alteration. The preference for open spaces in the OF and EPM were associated with increased serum triglycerides (TG) and malondialdehyde levels in the medial prefrontal cortex (mPFC) and the hippocampus (HIP), while poor memory performance was associated with high basal blood glucose levels. In conclusion, the decreased anxiety-like behavior produced by chronic sucrose consumption was prevented by metformin treatment, through a mechanism that probably involves normalization of TG levels and decreased oxidative stress in mPFC and HIP.

Fluid Intake and the Occurrence of Erosive Tooth Wear in a Group of Healthy and Disabled Children from the Małopolska Region (Poland)

Background: The aim of this study was to analyse the relationship between the type and amount of fluid intake and the incidence of erosive tooth wear in a group of healthy children and children with disabilities. Methods: This study was conducted among children aged 6-17 years, patients of the Dental Clinic in Kraków. The research included 86 children: 44 healthy children and 42 children with disabilities. The prevalence of erosive tooth wear using the Basic Erosive Wear Examination (BEWE) index was assessed by the dentist, who also determined the prevalence of dry mouth using a mirror test. A qualitative-quantitative questionnaire on the frequency of consumption of specific liquids and foods related to the occurrence of erosive tooth wear, completed by the children's parents, was used to assess dietary habits. Results: The occurrence of erosive tooth wear was determined for 26% of the total number of children studied, and these were mostly lesions of minor severity. The mean value of the sum of the BEWE index was significantly higher (p = 0.0003) in the group of children with disabilities. In contrast, the risk of erosive tooth wear was non-significantly higher in children with disabilities (31.0%) than in healthy children (20.5%). Dry mouth was significantly more frequently identified among children with disabilities (57.1%). Erosive tooth wear was also significantly more common (p = 0.02) in children whose parents declared the presence of eating disorders. Children with disabilities consumed flavoured water or water with added syrup/juice and fruit teas with significantly higher frequency, while there were no differences in quantitative fluid intake between groups. The frequency and quantity of drinking flavoured waters or water with added syrup/juice, sweetened carbonated, and non-carbonated drinks were associated with the occurrence of erosive tooth wear for all children studied. Conclusions: The group of studied children presents inappropriate drinking behaviours regarding the frequency and amount of beverages consumed, which, especially in a group of children with disabilities, may contribute to the formation of erosive cavities.

How to change consumer behaviours

Changing consumer behaviour has potential benefits for health, the economy and the environment. Change is possible, and behavioural change has been the purpose of much research; nevertheless we can still observe limited success, as in the case of food in public policies or individual diets. One reason is that models driving behavioural change interventions tend to neglect some important contextual factors. The three layers of components that channel behaviour ('installations' in the material, embodied and social realms) are described here and how this channelling can be hacked, modified and leveraged to foster behavioural change. Installations scaffold and control individual and collective behaviour at each step of the behavioural path with their three-layered and partly redundant structure. This redundancy makes the channelling resilient enough to train novices and to guide and repair behaviour. The three layers, physical affordances, embodied competences and social regulation are described in detail. To change eating behaviour, installations must be adapted at all steps of behaviour, from procurement to storage, preparation, meal and disposal. This adaptation can be done through the various layers in an opportunistic way, according to the agency of those who endeavour to change behaviour (e.g. budget, time, political power, etc.) Finally the steps necessary to design behavioural change interventions leveraging installations are listed.

Sports and Energy Drink Consumption, Oral Health Problems and Performance Impact among Elite Athletes

Frequent consumption of sports and energy drinks among athletes is of concern due to its detrimental impact on oral health. The present study aimed to assess sports and energy drink consumption, oral health status and impacts on daily activities and sports performance among elite athletes from Pakistan. Data regarding socio-demographic characteristics, sports and energy drink consumption, oral health and hygiene practices, self-reported oral health and psychosocial and performance impact was assessed using a self-administered, structured questionnaire followed by clinical oral examination by a single, experienced dentist. A total of 104 athletes, a majority of whom were male (80.8%), participated in the study. Around two third of the participants reported consumption of sports and energy drinks, energy gels or bars at least once a week, the commonest being Sting. Despite good oral hygiene practices, the athletes generally had poor oral health with high prevalence of dental caries (63.5%), gingivitis (46.1%), irreversible periodontitis (26.9%) and erosive tooth wear (21.2%). More than a quarter (28.8%) of the athletes rated their oral health as fair-very poor. Four in five athletes (80%) also experienced at least one oral problem with negative impacts on daily activities (64.4%) and participation training and sports performance (36.5%). Regression analyses revealed a significant association between periodontal disease and impact on both daily activities and sports performance. To our knowledge, this is the first study reporting that high-prevalence sports and energy drink consumption and oral problems among elite athletes from Pakistan has a negative impact on daily activities and sports performance. These findings may have important implications for oral health education programs, and the need to create awareness among the athletes regarding the use of sports and energy drinks, as well as regular oral health screening of athletes to minimize the impact on performance.

Personalized prediction of optimal water intake in adult population by blended use of machine learning and clinical data

Growing evidence suggests that sustained concentrated urine contributes to chronic metabolic and kidney diseases. Recent results indicate that a daily urinary concentration of 500 mOsm/kg reflects optimal hydration. This study aims at providing personalized advice for daily water intake considering personal intrinsic (age, sex, height, weight) and extrinsic (food and fluid intakes) characteristics to achieve a target urine osmolality (U_Osm) of 500 mOsm/kg using machine learning and optimization algorithms. Data from clinical trials on hydration (four randomized and three non-randomized trials) were analyzed. Several machine learning methods were tested to predict U_Osm. The predictive performance of the developed algorithm was evaluated against current dietary guidelines. Features linked to urine production and fluid consumption were listed among the most important features with relative importance values ranging from 0.10 to 0.95. XGBoost appeared the most performing approach (Mean Absolute Error (MAE) = 124.99) to predict U_Osm. The developed algorithm exhibited the highest overall correct classification rate (85.5%) versus that of dietary guidelines (77.8%). This machine learning application provides personalized advice for daily water intake to achieve optimal hydration and may be considered as a primary prevention tool to counteract the increased incidence of chronic metabolic and kidney diseases.

The Impact of the Sweetened Beverages Tax on Their Reformulation in Poland-The Analysis of the Composition of Commercially Available Beverages before and after the Introduction of the Tax (2020 vs. 2021)

The aim of this study was to estimate changes in the composition of carbonated and non-carbonated sugar-sweetened beverages before and after the introduction of the beverage tax in Poland. Based on the labels of 198 drinks, the composition and nutritional values of the drinks were compared. The nonparametric Mann-Whitney test was applied to compare the differences in the sugar and juice content as well as energy value. After the introduction of the tax, the median sugar content in the carbonated beverages decreased from 8.6 g to 6.9 g/100 mL (p = 0.004), while in the non-carbonated beverages, it decreased from 5.5 g to 4.8 g/100 mL (p < 0.001). In the entire beverage group, there was a significant drop in the proportion of beverages that contained >5 g of sugars/100 mL (44.4% in 2021 vs. 70.2% in 2020). The median juice content in the carbonated beverages increased from 1.0% to 3.3% (p = 0.121), but totalled 20.0% for both periods in the non-carbonated beverages. The percentage of beverages with a tax-exempt composition (juice content ≥ 20% and sugar content ≤ 5 g/100 mL) almost tripled. After the introduction of the tax, beneficial changes in the compositions of 62% of the analysed beverages were observed in terms of their sugar and/or juice content.

Long-Term Memory Function Impairments following Sucrose Exposure in Juvenile versus Adult Rats

We previously described that excessive consumption of sucrose during youth produces fear memory and anxiety-like behavior in adulthood. Here, we evaluated whether high cognitive function is also affected by studying early sucrose consumption in object recognition memory (NOR). Male Sprague Dawley rats were tested for short-term, long-term, and consolidated NOR after 25 days of unlimited sucrose access in juvenile (PD 25–50) or adult age (PD 75–100). All rats spent equal time exploring the two objects during the sample phase T1. When animals were exposed for 2, 24 h or 7 days later to a copy of the objects presented in T1 and a novel object, the sucrose-exposed juvenile group failed to distinguish between the familiar and the novel objects in contrast with the rest of the groups. Sucrose-exposed animals developed hypertriglyceridemia and glucose intolerance, but juvenile animals showed increased fasting glycemia and sustained the glucose intolerance longer. Moreover, sucrose decreased hippocampal proBDNF expression in juveniles while it was increased in adults, and sucrose also increased RAGE expression in adults. The NOR exploration ratio correlated negatively with basal glycemia and positively with proBDNF. Taken together, these data suggest that sucrose-induced alterations in glucose metabolism may contribute to a long-term decline in proBDNF and impaired recognition memory.

Children's water intake and hydration: a public health issue

Optimal hydration is required for all physiologic functions and cognition. Children, especially younger ones, are particularly susceptible to dehydration, given their physiological specificities, in particular, their renal immaturity and relatively large skin surface in early life, but also their dependence on adults and their greater propensity to develop digestive diseases leading to fluid losses. Mild dehydration consequences are dominated by their impact on cognitive functions, whereas more severe dehydration may endanger the health outcome. Studies on this subject in children are scarce; in particular, the long-term consequence on renal function remains questionable. This review considers how children's water intake including fluid intake and water content of food, are worrying. The findings show that, worldwide, most children do not meet adequate water intake recommendations. The main problems likely to explain insufficient water intake are access to safe water, availability of drinking water at school, and healthy-hydration education, which are all points that need to be improved within health policy.

Disparity between Subjective Health Perception and Lifestyle Practices among Korean Adolescents: A National Representative Sample

Background

The relationship between subjective health perception (SHP) and lifestyle practices brings into question the future health status of an individual. Recognition of the disparity between one's health consciousness to the real practices encourages change and promotes development of better health programs. The adolescent stage is the best time to identify this disparity wherein lifestyle practices are still being developed. In Korea, adolescents experienced significant shifts in lifestyle due to the fast economic growth and the breakthrough of the digital era. Thus, determining the disparity between SHP and lifestyle practices among Korean adolescents poses a great deal of interest and importance.

Methods

Utilizing the 2019 Korea Youth Risk Behavior Web-based Survey (KYRBS), self-reported data with a national representative sample-57,303 respondents-of Korean adolescents in the 7-12^th grades, was used from a multistage sampling, stratification, and clustering was obtained. SHP and lifestyle practices were collected and analyzed.

Results

The findings revealed that most respondents with poor diet, exercise, and sleep behaviors perceived themselves to be normal, healthy, or extremely healthy, which resulted in a negative correlation between SHP and lifestyle behaviors-except in the case of substance use.

Conclusion

There is a significant disparity between Korean adolescents' SHP and lifestyle practices. This highlights the need for lifestyle interventions and re-education among Korean adolescents. Their current lifestyle practices may extend into adulthood, thereby increasing the risks of cardiovascular and other lifestyle-induced diseases.

Dehydration and rehydration affect brain regional density and homogeneity among young male adults, determined via magnetic resonance imaging: A pilot self-control trial

The effects of dehydration and rehydration on brain regional density and homogeneity are unknown and have been infrequently studied. In this pilot self-control study, twelve participants aged 18-25 years were recruited and the brain was scanned using magnetic resonance imaging for three tests under different hydration statuses. In three tests, urine osmolality was determined to assess hydration status. Test 1 was conducted after 12 h of overnight fasting. Test 2 was conducted in a dehydration state induced by 36 h of water deprivation. Test 3 was conducted in a rehydration state, which was induced by 1.5 L of purified water supplementation. Compared with test 1, participants under the dehydration state in test 2 had higher cerebrospinal fluid density (p < 0.001). Compared with test 2, participants under the rehydration state in test 3 showed an extensive increase in gray matter density in widespread brain regions, mainly involving the left middle temporal gyrus, cuneus, right thalamus, left rolandic opercula, Brodmann area 39, right precentral, left postcentral gyrus, and cingulate gyrus (p < 0.001); a higher white matter density in the temporal lobe, sub-lobar, and sub-gyral areas; and a lower cerebrospinal fluid density (p < 0.001). The multimodal, multiscale neuroimaging marker of the human brain connection—the regional homogeneity (ReHo) index—was used for evaluating the connectivity of nodes in the brain. Compared with test 1, participants in test 2 had a lower ReHo value in the right amygdala, left occiput median, right lingual, opercula part of right inferior frontal gyrus, and right precuneus (p < 0.01). Compared with test 2, participants in test 3 had a higher ReHo value in the right amygdala, right lingual, opercula part of the right inferior frontal gyrus, and right precuneus (p < 0.01). Dehydration state increased cerebrospinal fluid density, decreased brain regional homogeneity. Rehydration state increased brain gray matter and white matter density widespreadly, and increased brain regional homogeneity.

Self-reported lifestyle behaviours in families with an increased risk for type 2 diabetes across six European countries: a cross-sectional analysis from the Feel4Diabetes-study

BACKGROUND

A healthy lifestyle decreases the risk of developing type 2 diabetes mellitus. The current cross-sectional study aimed to describe self-reported lifestyle behaviours and compare them to current health guidelines in European Feel4Diabetes-families at risk for developing type 2 diabetes across six countries (Belgium, Finland, Spain, Greece, Hungary and Bulgaria).

METHODS

Parents and their children were recruited through primary schools located in low socio-economic status areas. Parents filled out the FINDRISC-questionnaire (eight items questioning age, Body Mass Index, waist circumference, PA, daily consumption of fruit, berries or vegetables, history of antihypertensive drug treatment, history of high blood glucose and family history of diabetes), which was used for the risk assessment of the family. Sociodemographic factors and several lifestyle behaviours (physical activity, sedentary behaviour, water consumption, fruit and vegetable consumption, soft drink consumption, sweets consumption, snack consumption, breakfast consumption) of both adults and children were assessed by parental questionnaires. Multilevel regression analyses were conducted to investigate families' lifestyle behaviours, to compare these levels to health guidelines and to assess potential differences between the countries. Analyses were controlled for age, sex and socio-economic status.

RESULTS

Most Feel4Diabetes-families at risk (parents and their children) did not comply with the guidelines regarding healthy behaviours, set by the WHO, European or national authorities. Less than half of parents and children complied with the physical activity guidelines, less than 15% of them complied with the fruit and vegetable guideline, and only 40% of the children met the recommendations of five glasses of water per day. Clear differences in lifestyle behaviours in Feel4Diabetes-families at risk exist between the countries.

CONCLUSIONS

Countries are highly recommended to invest in policy initiatives to counter unhealthy lifestyle behaviours in families at risk for type 2 diabetes development, taking into account country-specific needs. For future research it is of great importance to focus on families at risk in order to counter the development of type 2 diabetes and reduce health inequity.

Sugar Content and Warning Criteria Evaluation for Popular Sugar-Sweetened Beverages in Taipei, Taiwan

Sugar intake may increase the risk of obesity, cardiovascular disease, diabetes, and dental caries. In Taiwan, people frequently consume sugar-sweetened beverages (SSBs). This study explored the energy and sugar content of Taiwanese SSBs and evaluated them using the Chilean warning label system (>70 kcal/100 mL and >5 g sugar/100 mL) and the World Health Organization (WHO) sugar guideline (≤25 g sugar). A total of 341 SSBs with volumes ≤600 mL were analyzed. No significant differences were observed in sugar per serving among different types of SSBs, but a great variation in portion size (i.e., package size for individual consumption) was noted. The energy and sugar ratios per serving were lower in soft drinks and coffee and tea containing >1 serving than in those containing only one serving. The calorie and sugar ratios per portion were higher in all types of SSBs containing >1 serving per portion than in those containing exactly one serving. Approximately 70.0% of Taiwanese SSBs were classified as high sugar according to the Chilean criteria, and 41.6% of SSBs exceeded the WHO guideline. Moreover, 40.8% of SSBs that were not considered as high sugar according to the Chilean criteria contained >25 g sugar per portion. For individual consumption, it is more clear that nutrition labeling is based on portion rather than serving. Evaluating SSBs on sugar/portion rather than sugar/100 mL will help consumers make better choices.

Daily Fluid Intake Behaviors and Associated Health Effects Among Australian and United States Populations

Minimal data exist exploring intercontinental differences in fluid intake (FI) beliefs and behaviors and the impact on fluid intake practices (i.e., fluid intake volume, beverage type, and timing of fluid intake). Therefore, this study explored the impact that FI beliefs and behaviors had on FI practices among emerging adults living in the United States (USA) and Australia (AUS). A total of 489 individuals (74.5% female; USA, 79.4%; age, 25 ± 6 years completed a 23-item survey between November 2020 and June 2021). Participants detailed their FI practices. FI beliefs were evaluated to determine their contribution to FI behaviors across the day. Multinomial and multiple linear regression analyses explored the association of daily FI beliefs and behaviors across multiple domains. Independent sample t-tests and chi-square analyses were conducted to compare FI practices, beliefs, and behaviors between individuals in the USA and AUS. FI behaviors were significantly different between countries, with the USA more likely to consume fluids to meet a total target volume (β = 1.150, p = 0.036) and consume fluid at the same time as structured daily activities (β = 0.773, p = 0.046) compared to FI alongside food intake. However, there were no differences in the types of beverage consumed (juice, sugar-sweetened beverages, tea, and coffee), total fluid volume, and physical activity (PA) between countries (p &gt; 0.05). Beverage consumption was higher among USA than AUS residents for water, beer, and wine (p &lt; 0.05). Total fluid consumption was greater among males (3,189 ± 2,407 ml) than females (2,215 ± 1,132 ml; β = 3.61, p &lt; 0.001), individuals who regularly consumed fluid during the day to meet a targeted volume (β = 1,728.5, p &lt; 0.001), and those who regularly consumed fluid as a habitual behavior (β = 3.97, p &lt; 0.001) compared to those individuals who only consumed fluid alongside mealtimes (β = 1,041.7, p &lt; 0.001). FI behaviors differed between the USA and AUS; however, total volume consumed, type of beverage consumed, and FI beliefs were similar. FI practices and behaviors appear to be individualized and context-specific among the studied populations.

Effect of Beverage Consumption Frequency on DMFT Index among Iranian Adult Population: An AZAR Cohort Study

Background

Given the effect of oral and dental condition on emotional and physical health and the different effects of beverage consumption on decayed, missing, and filled teeth (DMFT) as one of the indicators of oral health in different populations, this study aimed to investigate the effect of beverage consumption and its frequency on DMFT among Iranian adult population.

Materials and Methods

The data of this cross-sectional study were obtained from AZAR (Azerbaijan) cohort, conducted on 15,006 adults aged 35 to 70 years old in Shabestar County, Iran. Demographic and nutritional data were collected by nutritionists through the "Food Frequency Questionnaire," and DMFT index by general practitioners trained by a dentist according to the World Health Organization (WHO) guidelines. Beverages including milk, doogh, natural fruit juice, black tea, nonalcoholic beer, coffee, sugar-sweetened beverages, and artificial fruit juice were studied.

Results

A total of 14,966 adults with the mean age of 49.64 ± 9.28 were enrolled. The participants' mean DMFT value was 21.27 ± 8.95. Weekly consumption of tea and coffee beverages resulted in 13% (95% confidence interval: 3% to 22%) lower DMFT compared to daily consumption (p=0.01). However, there was no association between DMFT and other beverages.

Conclusion

The higher DMFT values with the daily consumption of tea and coffee beverages showed that a part of adults' oral health is affected by beverages; therefore, this should be considered by healthcare authorities in order to manage carries development in the communities.

Determination of the energy expenditure, sources, and loss of water among young adults

Background

Few studies on measuring human energy expenditure with the doubly labeled water method has been conducted in China. The sources and loss of water among human body have never been systematically evaluated. Less data can be available for the development of the recommendation on energy expenditure and water intake. The objective of this study was to determine the energy expenditure, water sources, and loss among young adults.

Methods

In this cross-sectional study, 25 participants were recruited. Double-labeled water was used to determine their energy expenditure. Water loss through skin evaporation and respiration of the lungs and water sources from metabolic water were calculated using corresponding formula, respectively. Water loss through excretion of urine was recorded and evaluated using “3-day, 24-h, real-time urine excretion record” method. All urine samples were collected and weighed in the 3 days. Water loss through excretion of feces was evaluated using “3-day, 24-h, real-time fecal-excretion record” method. All fecal samples were collected and tested by the direct drying method. Water sources from fluid intake were recorded by “7-day, 24-h, real-time fluid intake record” method. Water intake from food was calculated and tested by the weighing method combined with the duplicate portion method and the direct drying method in the 3 days.

Results

The energy expenditure of males was 2187 kcal/d, and that of females was 1987 kcal/d. The median fluid intake, water intake from food, and metabolic water were 887, 1173 and 246 mL, respectively, which accounted for 38.8%, 50.3%, and 11.2% of total water sources. There was a gender difference in the percentage of metabolic water (Z = − 2.135, P = 0.033). The water loss through urine excretion, skin evaporation, respiration, and feces excretion was 1295, 172, 149 and 64 mL, respectively, which accounted for 76.5%, 10.3%, 9.5%, and 3.6% of the total water losses. Gender differences in the amount of water loss through respiration and skin evaporation were found (Z = − 4.125, P < 0.001; Z = − 3.723, P < 0.001).

Conclusions

Energy expenditure of male was higher than that of female. The first major water sources was water intake from food in this study, and the first major water loss was urine excretion.

Trial registration The study was registered on the website of Chinese clinical trial registry, and the code of identification is ChiCTR1900028746.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12986-022-00668-2.

Public Support for the Imposition of a Tax on Sugar-Sweetened Beverages and the Determinants of Such Support in Spain

(1) Background: Taxes on sugar-sweetened beverages are an effective public health intervention, but can be difficult to implement in the absence of public support. This is the first study to analyze the Spanish population’s support for a tax on sugar-sweetened beverages. (2) Methods: We conducted a cross-sectional study of a representative sample of the Spanish adult population (n = 1002), using a computer-aided telephone interview with a questionnaire on nutritional policies. The support for the tax was calculated by the percentage of those who agreed plus those who strongly agreed with the measure. The sociodemographic determinants of support for the tax were analyzed using chi-squared test (χ2) and Poisson multiple regression models with robust variance. (3) Results: Of the participants, 66.9% supported a tax on sugar-sweetened beverages. Support for the tax was 9.2% higher (70% vs. 64.1%) when responders were first asked about support for tax relief and subsidies for healthy foods (p = 0.049). Support for the tax was 16% and 35% lower among persons reporting center and right-wing political sympathies (p < 0.01), and 16% lower among regular consumers of sugar-sweetened beverages (p = 0.01). (4) Conclusions: A clear majority of the Spanish population is in favor of imposing a tax on sugar-sweetened beverages. Awareness-raising campaigns and a policy of combining the measure with subsidies or tax cuts on healthy foods could increase the level of support among those currently against the intervention.

The Analysis of the Nutritional Status and Dietary Habits among Children Aged 6-10 Years Old Attending Primary Schools in Poland

A high prevalence of obesity among children is influenced by serious implications. Obesity mainly results from behavioral factors, such as improper dietary habits. This study aims to evaluate the nutritional status and dietary habits of children aged 6-10 (n = 908) attending primary schools in Poland, Europe. The research tool was a questionnaire that was completed by one of the children's parents. A statistical analysis was made using statistical software. The value of p = 0.05 was considered to be statistically significant. A total of 74.7% of children surveyed have a normal body mass. As many as 91.7% and 76.6% of children, respectively, eat a first and second breakfast daily. Nearly half of parents (48.9%) state that their child consumes milk or other dairy products daily. A total of 74.3% of children drink water daily. A total of 27.6% eats fish less frequently than once a week. A total of 7.6% of children eat fish several times a week. As many as 20.6% of the respondents state that their child eats brown bread several times a week, whereas 19.9% state that their child never eats brown bread. A total of 55.1% of children eat fruits and/or vegetables daily. A total of 14.1% of children surveyed consume sweets daily. The study revealed a positive correlation between BMI and the frequency of mineral water consumption (p = 0.013) in 9 y.o. girls. It was also revealed that the number of consumed fruit/vegetables increases with the BMI value among 10 y.o. boys (p = 0.044). Conclusions: The dietary habits of the investigated children are still improper. There is a great need for education on this issue, but family involvement is also required.

Evaluation of the 'H2NOE Water Schools' programme to promote water consumption in elementary schoolchildren: a non-randomised controlled cluster trial

OBJECTIVE

This study evaluated a simple environmental intervention called 'Water Schools' in Lower Austria providing free refillable water bottles and educational material.

DESIGN

Non-randomised controlled cluster trial with three measurements: at baseline (T0), after the intervention at 9 months (T1) and after 1-year follow-up (T2).

SETTING

Half-day elementary schools in Lower Austria (Austria).

PARTICIPANTS

Third-grade pupils from twenty-two schools in the intervention group (IG) and thirty-two schools in the control group (CG) participated in the study. Data were analysed for 569 to 598 pupils in the IG and for 545 to 613 in the CG, depending on the time of measurement.

RESULTS

The consumption of tap water increased in the IG from baseline to T1 and then decreased again at T2, but this was similar in the CG (no statistically significant difference in the time trend between the IG and CG). Similar results were seen for tap water consumption in the mornings. The proportion of children who only drank tap water on school mornings increased significantly from baseline to T1 in the IG compared to the CG (P = 0·020). No difference in the changes over time occurred between the groups for the proportion of pupils drinking approximately one bottle of tap water during school mornings.

CONCLUSIONS

Not only the children in the IG but also those in the CG drank more tap water after 1 school year than at the beginning. The measurement of drinking habits in the CG may have been intervention enough to bring about changes or to initiate projects.

Sugar-sweetened beverages consumption among New Zealand children aged 8-12 years: a cross sectional study of sources and associates/correlates of consumption

Background

The benefit of reducing sugar-sweetened beverage (SSB) consumption is widely accepted, but updated and in-depth data on New Zealand (NZ) children’s SSB consumption is lacking. The aims of this study were to describe beverage consumption, focusing on SSBs in primary school age children living in Auckland; to examine the association of selected socio-demographic, home, community and school factors and children’s beverage knowledge/attitudes with regards to beverage consumption; to explore the relationship between SSBs consumption and adiposity in children.

Methods

A cross-sectional, Auckland-wide survey of 578 school age children (8-12 years) was conducted using questionnaires to collect data on beverage consumption, beverage knowledge/attitudes, and selected socio-demographic and home, community, school factors. Body fat percentage (BF%) was assessed using bioelectrical impedance (BIA).

Results

Ninety-six percent of children consumed ≥1 serving of SSBs a week; with ≥5 servings reported by 62% of children. Of all SSBs assessed, consumption of ≥1 serving of sugar sweetened milk-based beverages (85%, mainly milk drinks made from powder) was most prevalent, followed by fruit juice (46%) and sugar-containing carbonated drinks (39%, mainly soft/fizzy drinks). Among unsweetened beverages, plain water was reported to be consumed < 2 times a day by 22% of children, and plain milk < 1 serving a day by 53%. Higher consumption of SSBs was associated with socio-economic disadvantage, non-NZ European ethnicities (Māori, Pacific, Asian, others), availability of SSBs in the home, frequent takeaway/convenience shop visits, children’s incorrect perception of adequate SSBs consumption frequency, and higher BF% (females only). School health policy and encouragement of children to consume un-sweetened beverages was not associated with SSBs consumption.

Conclusions

The consumption of SSBs is prevalent in NZ school age children, with higher consumption rates observed among those from socially disadvantaged areas. This high consumption is associated with higher BF% in females. Multi-contextual interventions to decrease SSBs should target children, and their families/environment, particularly those from socially disadvantaged areas.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-12345-9.

Iodine Modifies the Susceptibility of Thyroid to Fluoride Exposure in School-age Children: a Cross-sectional Study in Yellow River Basin, Henan, China

Excessive fluoride exposure has detrimental effects on the thyroid gland, which may be modified by iodine. However, the role of iodine in it remains unclear. This study aims to evaluate the role of iodine in thyroid abnormalities caused by fluoride exposure in school-age children. A total of 446 children aged 7-12 years were recruited from Tongxu County, Henan province, in 2017 (ZZUIRB 2017-018). We obtained demographic information through questionnaire surveys. The concentrations of urinary fluoride (UF) and urinary iodine (UI) were determined by the ion-selective electrode method and the catalytic spectrophotometric method, respectively. The radiation immunoassay was used to determine the serum concentrations of total triiodothyronine (TT3), total thyroxine (TT4), and thyroid-stimulating hormone (TSH). The B-mode ultrasound was performed to assess thyroid volumes (Tvols). The associations between fluoride exposure and thyroid-related indicators were tested by linear regression models. We found that Tvols increased by 0.22 (95% CI: 0.14, 0.31) cm³ with each standard deviation increment of UF. Moreover, Tvols in boys were more susceptible to fluoride exposure than those in girls, and the Tvols of children with high urinary iodine are less susceptible to fluoride exposure (P for interaction < 0.05). We also observed that TT3 levels were negatively related to UF concentrations at moderate urinary iodine levels (≤ 300 μg/l). Fluoride exposure can elevate the Tvols of school-age children, especially in boys, and high levels of iodine may alleviate this effect to some extent.

The effect of a cluster-randomized controlled trial on lifestyle behaviors among families at risk for developing type 2 diabetes across Europe: the Feel4Diabetes-study

BACKGROUND

This study investigated the effect of the Feel4Diabetes-intervention, a 2-year multilevel intervention, on energy balance-related behaviors among European families at risk for developing type 2 diabetes. Intervention effects on self-reported physical activity, sedentary behavior and eating behaviors were investigated across and within the participating countries: Belgium, Finland, Greece, Spain, Hungary and Bulgaria.

METHODS

Families were recruited through schools, located in low socio-economic status areas. In total, 4484 families at risk for developing type 2 diabetes were selected using the FINDRISC-questionnaire. Parents' and children's energy balance-related behaviors data were collected by questionnaires at three time points (baseline, mid- and post intervention). Families assigned to the intervention group were invited to participate in a 2-year school-, community-, and family-based intervention to promote a healthier lifestyle, including counseling sessions (first intervention year) and text messages (second intervention year). Families assigned to the control group received standard care, including medical check-up results and recommendations and tips regarding a healthy lifestyle. To assess the intervention-effects, Mixed Models were conducted using the R-Package "lmer "with R v3.2.

RESULTS

Significant intervention effects were found on a certain number of families' lifestyle behaviors. Significant favorable intervention effects were detected on parents' water consumption and consumption of fruit and vegetables, and on children's consumption of sweets and moderate-to-vigorous physical activity. Analyses by country revealed significant favorable intervention effects on water consumption and on moderate-to-vigorous physical activity in Belgian parents and on fruit and vegetable consumption among Belgian children, on sweets consumption among Spanish parents and children, and on moderate-to-vigorous physical activity among Finnish children. Unfavorable intervention effects were found on the consumption of soft drinks and sugar-containing juices among Hungarian children and parents, while when examining the intervention effects for the overall population and per country, 10 from the 112 investigated outcome variables were improved in the intervention group compared to the control group (9%).

CONCLUSIONS

The Feel4Diabetes-intervention managed to improve a certain number of targeted lifestyle behaviors while the intervention was not effective on a large number of targeted lifestyle behaviors. The findings of the current study are encouraging, but further research is needed on how we can further improve effectiveness of lifestyle interventions to prevent type 2 diabetes in families at risk.

TRIAL REGISTRATION

The Feel4Diabetes-study is registered with the clinical trials registry http://clinicaltrials.gov , ID: 643708.

Association between free sugar intake and nutrient dilution among Japanese children and adolescents: the 2016 National Health and Nutrition Survey, Japan

The influence of free sugar intake on nutrient intake remains unclear in Japanese children and adolescents with relatively low free sugar intake. This cross-sectional study aimed to investigate the relationship between free sugar and selected nutrient intakes using data from the 2016 National Health and Nutrition Survey, Japan, based on the WHO recommendations (<5 % or <10 % of energy (%E)) for free sugar intake. A 1-d weighed dietary record was assessed in Japanese children and adolescents (aged 1-19 years; n 2919). Mean intakes for selected nutrients and food groups were compared according to free sugar intake categories (<2·5 %E, 2·5 to <5 %E, 5 to <10 %E and ≥10 %E) with adjustment for sex, age and weight status. Inverse associations were observed between intakes of free sugars and twenty-one of twenty-four micronutrients assessed, except for vitamins A and C and Ca. Significantly reduced intakes were identified for twenty-two and fourteen micronutrients in the ≥10 %E and 5 to <0 %E categories, respectively, compared with the lower categories. Mean micronutrient intakes at the <2·5 %E category did not differ from those at the 2·5 to <5 %E category. Free sugar intake had positive associations with intakes of sugars and jams, confectioneries, fruit and vegetable juices, and soft drinks and negative associations with intakes of pulses and nuts and vegetables. This study showed that nutrient dilution was associated with higher free sugar intake among Japanese children and adolescents. The findings suggest that the WHO recommendations might help prevent nutrient dilution in Japanese children and adolescents.

Caffeine Consumption in a Group of Adolescents from South East Poland-A Cross Sectional Study

Caffeine is the most common psychoactive substance available to adults, as well as to children and adolescents. The safety of its use in younger age groups requires further research. The aim of this study was to evaluate caffeine intake, to identify products and drinks that are the main sources of caffeine intake in the diet of the subjects and the risk of excessive caffeine intake with the diet of adolescents, stratified by gender. A cross-sectional study was conducted among 508 adolescents aged 16–18 years from southern Poland. Black tea, cola-based soft drinks and milk chocolate were the most frequently consumed products containing caffeine in the diet of the examined persons. The average caffeine intake was 95.54 mg/day (1.54 mg/kg b.w.). In 12.2% of the subjects the dose of 3 mg/kg b.w./day was exceeded, and in over 41.3% the dose causing sleep disorders was exceeded. The dose causing anxiety was also exceeded in 18.1% of the respondents, significantly more often in girls than boys (p = 0.0487).

Social Representations of Drinking Water in Schoolchildren and Parents from Two Schools in Zapopan, Mexico

Childhood obesity and children being overweight has increased recently; although they are multi-causal problems, an unhealthy diet is a critical component. In Mexico, drinking water consumption in children from 9 to 18 years only reaches 30% of total fluid consumption. The aim of our study was to describe the social representations (SR) of drinking water in school-children and parents of two schools in Zapopan, Mexico. Associative free listing was used as an information gathering technique. Schoolchildren aged 8 to 12 years (n = 50) and parents (n = 23) from two elementary schools were selected by a convenience sampling from April to June 2015. A similarity analysis was performed using the co-occurrence index; with this, a similarity graph was obtained. Prototypical analysis was performed to explore the structure of the SR. Three dimensions were described in the children’s SR: a functional dimension related to health and nutrition, a practical dimension that describes the instruments used for its consumption, and a theoretical dimension that specifies the characteristics of water and its relationship with nature. In the parents’ SR, a functional dimension was also found; another dimension was described regarding the integral well-being that drinking water provides. A practical dimension describes the features related to its consumption. The investigation describes the structure of the water SR, which help to contextualize and explain the actions of schoolchildren and their parents regarding drinking water consumption.

Food Consumption Patterns of Male and Female Undergraduate Students in Indonesia During New Normal Implementation of Pandemic Covid-19 Era

AIM: This study aimed to analyze the description of Indonesian undergraduate students’ food consumption patterns during the COVID-19 period. METHODS: The design used was cross-sectional with random sampling technique. The correlation test was Chi-Square and analyzed using univariate. The respondents involved were 17–24 years old with 5924 persons; active undergraduate students. Questionnaires were distributed using Google form. RESULTS: The results indicated a relationship between gender and major, education level, social status, and funds source (p = 0.000). However, sex and residence did not correlate (p = 0.16). The same was revealed between gender with consumption patterns, carbohydrates, animal protein, vegetable protein, vegetables, fruit, snacks, water, and supplements. CONCLUSION: Overall, during the new normal period of pandemic COVID-19 era, student food consumption patterns could be categorized as healthier lifestyle changes. Thus, the undergraduate students are suggested to maintain a diverse and balanced diet to boost their immunity optimally.

What Characterizes Fluid Intake Patterns across the World?

INTRODUCTION

Total fluid intake and the type of fluids consumed have been reported by many studies [<xref ref-type="bibr" rid="ref1">1</xref>-<xref ref-type="bibr" rid="ref3">3</xref>] and have shown that while an individual may be drinking sufficiently, in terms of volume, to meet or exceed recommendations on fluid intake, there may be a wide variety of combinations of fluids within that total volume [<xref ref-type="bibr" rid="ref4">4</xref>-<xref ref-type="bibr" rid="ref6">6</xref>]. Moreover, considering only volume and fluid types may limit the interpretation of the data [<xref ref-type="bibr" rid="ref7">7</xref>]. In a novel approach, we propose to analyze and understand fluid intake patterns as opposed to only fluid volume or types. The primary aim of this study was to identify patterns of fluid intake in children and adolescents from 6 countries: Argentina, Brazil, Mexico, Uruguay, China, and Indonesia. The secondary aim was to characterize those fluid intake patterns.

METHODS

A validated 7-day fluid specific record (Liq.In7 record) [<xref ref-type="bibr" rid="ref8">8</xref>] was used to collect primary data on fluid intake amongst children and adolescents (10-17 years; N = 1,781). To identify relatively distinct clusters of subjects based on 8 fluid types (water, milk and its derivatives, hot beverages, sugar-sweetened beverages [SSB], 100% fruit juices, artificial/nonnutritive sweetened beverages, alcoholic beverages, and other beverages), a cluster analysis (partitioning around k-medoids algorithm) was used. Clusters were then characterized according to their socio-demographic and lifestyle indicators.

RESULTS

The 6 clusters identified (Fig. 1) were low drinkers - SSB (n = 523), low drinkers - water and milk (n = 615), medium mixed drinkers (n = 914), high drinkers - SSB (n = 513), high drinkers - water (n = 352), and very high drinkers - water (n = 264). Country of residence was the dominant characteristic, followed by socioeconomic level, in all 6 patterns.

CONCLUSION

Fluid intake patterns among children are primarily driven by water and SSB. In addition to country, socio-demographic and lifestyle factors determined the characteristics of each cluster. Therefore, interventions aiming to encourage healthier fluid intake behavior need to target and be tailored to a particular subpopulation.

Are Spanish children drinking enough and healthily? An update of the Liq.in7 cross-sectional survey in children and adolescents

Introduction

Introduction: insufficient and/or unhealthy total fluid intake (TFI), especially in the early stages of life, may have a negative impact on health. Objective: to assess the current patterns of fluid consumption in children and adolescents in Spain, including drinking occasions and locations (e.g., at home or at school), and to compare TFI with adequate intake (AI) of water from fluids as recommended by the European Food Safety Agency (EFSA). Methodology: a Spanish cross-sectional study was performed assessing TFI from all sources of fluid consumption according to drinking occasions during the day and location, using a validated liquid intake 7-day record (Liq.in7). Data collection occurred between April and May, 2018. A sample of 146 (63 % boys) children (4-9 years old) and adolescents (10-17 years old) was included. Parents reported such information when children were under 16 years. Results: a high proportion of children and adolescents did not meet EFSA-derived reference values for fluid intake (73 % and 72 %, respectively). Forty percent of children and about 50 % of adolescents consumed at least one serving of sugar-sweetened beverage (SSB) per day, while about 20 % consumed only one or less servings of water per day. Consumption during the main meals was most important for both children and adolescents (representing 50 % and 54 % of TFI, respectively), and was mainly driven by water (62 %). Consumption at home in children (70 % of TFI) was made of water (47 %). In the same way, at school, water contributed to half intake. However, adolescent girls at school drink more SSBs (41 %) than water (34 %), the former being the most consumed fluid. At other locations, adolescent boys also drink more SSBs (51 %) than either water (29 %) or milk and derivatives (10 %). Conclusion: the drinking habits of Spanish young populations are far removed from current recommendations because of a low fluid intake, specifically water, and a high proportion of SSB consumption in children and adolescents. Interventions to ensure that EFSA TFI recommendations are met are of special importance for children and adolescents, with - according to our results - a special focus on male adolescents.

Eating behaviour of Indonesian adolescents: a systematic review of the literature

OBJECTIVES

Global evidence has shown that behaviour acquired during adolescence often lasts into adulthood. Diet quality of and malnutrition in Indonesian adolescents is a neglected area of research. The current study reviews all studies related to eating behaviour in Indonesian adolescents to support evidence-based policy to improve diets.

DESIGN

We searched electronic databases (six international and one local), from January 2000 to April 2018. The search terms used were (1) prevalence (prevalence OR number* OR case*, incidence OR survey), (2) adolescents (adolescen* OR school-age OR young adult), (3) Indonesia (Indonesia*) and (4) eating pattern (eat* OR fruit OR vegetable OR food recall OR food OR frequenc* OR consumption OR dietary intake). Articles were assessed against a critical appraisal tool.

SETTING

Indonesia.

PARTICIPANTS

10-19 years.

RESULTS

We discovered 15 studies related to eating behaviour, 5 of which were secondary analyses of nationally representative surveys and one was a nationwide survey. Of the nine studies, one study was conducted in multiple cities, and the rest were conducted in a single city or smaller area. There were seven main topics from the included studies: nutrient adequacy, fruit and vegetable consumption, water and beverage intake, Na intake, breakfast habit, snacking frequency and western fast food consumption.

CONCLUSIONS

Adolescents consume inadequate amounts of protein, fruits and vegetables, and excessive amounts of Na and western fast food. Measures are needed to improve and motivate adolescents to adopt healthier eating patterns. Furthermore, there is a need to have one standard definition and measurement of eating behaviour in Indonesia.

Fluid intake, hydration status and its association with cognitive function among adolescents in Petaling Perdana, Selangor, Malaysia

BACKGROUND/OBJECTIVES

A cross-sectional study was undertaken to evaluate fluid intake and hydration status in association with cognitive function among 230 adolescents (10–14 years of age) in Petaling Perdana, Selangor, Malaysia.

SUBJECTS/METHODS

Urine color was used to measure hydration status, while fluid intake was assessed using the 15-item beverage intake questionnaire. Cognitive function was assessed using the Wechsler Intelligence Scale for Children, Fourth Edition.

RESULTS

More than half of the adolescents were mildly or moderately dehydrated (59.6%) and only one-third (33.0%) were well hydrated. Among the daily fluid types, intakes of soft drinks (r = −0.180; P = 0.006), sweetened tea (r = −0.184; P = 0.005) and total sugar-sweetened beverages (SSBs) (r = −0.199; P = 0.002) were negatively correlated with cognitive function. In terms of hydration status, cognitive function score was significantly higher (F-ratio = 4.102; P = 0.018) among hydrated adolescents (100.38 ± 12.01) than in dehydrated (92.00 ± 13.63) counterparts. Hierarchical multiple linear regression analysis, after adjusting for socio-demographic factors, showed that soft drinks (β = −0.009; P < 0.05) and sweetened tea (β = −0.019; P < 0.05) negatively predicted cognitive function (ΔR² = 0.044). When further control for sources of fluid, hydration status (β = −2.839; P < 0.05) was shown to negatively predict cognitive function (ΔR² = 0.021). The above variables contributed 20.1% of the variance in cognitive function.

CONCLUSIONS

The results highlight the links between fluid intake (soft drinks, sweetened tea, total SSBs) and hydration status with cognitive function in adolescents. Interventions aimed at decreasing the consumption of SSBs and increasing hydration status through healthy fluid choices, such as water, could improve cognitive performance in adolescents.

Urban Water Consumption Patterns in an Adult Population in Wuxi, China: A Regression Tree Analysis

Understanding water intake variation is crucial for assessing human exposure to water pollutants. The correlation between water intake and demographic factors warrants further exploration. A cross-sectional study was conducted to estimate urban water consumption and its associated factors among adults in Wuxi, China, in 2015. The water consumption information was obtained by a 24-h self-report diary over seven consecutive days. A classification and regression tree (CART) analysis was applied to detect how water consumption varied with the demographic variables. Finally, a total of 1188 adults (18–87 years old) were included. The results demonstrated that the median water consumption of the adults was 1525 mL/day in summer and 1217 mL/day in winter. The results of the CART analysis demonstrated that body mass index (BMI) and age were the leading factors that were associated with water consumption in summer and winter, respectively. The water consumption threshold of BMI for men differed from women (23 kg/m² vs. 18 kg/m²) in summer, and the threshold of age for men was also different from women (43 years vs. 21 years) in winter. In conclusion, the findings are useful for accurately assessing human exposure to water pollutants and identifying the high-risk subgroups.

Racial and Sex Differences in 24 Hour Urinary Hydration Markers among Male and Female Emerging Adults: A Pilot Study

The purpose of this study was to examine 24 h urinary hydration markers in non-Hispanic White (WH) and non-Hispanic Black (BL) males and females. Thirteen males (BL, n = 6; WH, n = 7) and nineteen females (BL, n = 16, WH, n = 3) (mean ± SD; age, 20 ± 4 y; height, 169.2 ± 12.2 cm; body mass, 71.3 ± 12.2 kg; body fat, 20.8 ± 9.7%) provided a 24 h urine sample across 7 (n = 13) or 3 (n = 19) consecutive days (148 d total) for assessment of urine volume (U_VOL), urine osmolality (U_OSM), urine specific gravity (U_SG), and urine color (U_COL). U_VOL was significantly lower in BL (0.85 ± 0.43 L) compared to WH college students (2.03 ± 0.70 L) (p < 0.001). Measures of U_OSM, U_SG, and U_COL, were significantly greater in BL (716 ± 263 mOsm∙kg^-1, 1.020 ± 0.007, and 4.2 ± 1.4, respectively) compared to WH college students (473 ± 194 mOsm∙kg^-1, 1.013 ± 0.006, 3.0 ± 1.2, and respectively) (p < 0.05). Differences in 24 h urinary hydration measures were not significantly different between males and females (p > 0.05) or between the interaction of sex and race/ethnicity (p > 0.05). Non-Hispanic Black men and women were inadequately hydrated compared to their non-Hispanic White counterparts. Our findings suggest that development of targeted strategies to improve habitual fluid intake and potentially overall health are needed.

A systematic review and meta-analysis of lead and cadmium concentrations in cow milk in Iran and human health risk assessment

The aim of the current research was to systematically review and summarize the studies that evaluated the concentration of lead (Pb) and cadmium (Cd) in cow milk in different regions of Iran and to perform a meta-analysis of the findings. Moreover, the non-carcinogenic and carcinogenic risks of Pb and Cd through milk consumption in adult and child consumers were assessed. As a result of a systematic search in the international and national databases between January 2008 and October 2018, 17 reports involving 1874 samples were incorporated in our study for meta-analysis. The pooled concentrations of Pb and Cd were estimated to be 13.95 μg mL^-1 (95% CI 9.72-18.11 μg mL^-1) and 3.55 μg mL^-1 (95% CI - 2.38-9.48 μg mL^-1), respectively, which were lower than the WHO/FAO and national standard limits. The estimated weekly intake (EWI) of Pb and Cd through consuming milk was 16.65 and 7 μg day^-1 for adults of 70 kg and 45 and 34 μg day^-1 for children of 26 kg, respectively, which was well below the risk values set by Joint FAO/WHO Expert Committee on Food Additives (JECFA). The maximum target hazard quotient values (THQs) of Pb and Cd were 5.55E-5 and 5.55E-5 for adults and 5.55E-5 and 5.55E-5 for children, respectively, which were lower than 1 value, suggesting that Iranian consumers are not exposed to non-carcinogenic risk through consuming milk. Moreover, the incremental lifetime cancer risk (ILCR) of Pb estimated to be 2.96E-04 in adults and 1.0E-03 in children, indicating that consumers in Iran are at threshold carcinogenic risk of Pb through consuming milk (ILCR > 10^-4). Therefore, planning and policy making for the sustainable reduction of these toxic metals in milk, particularly in industrial regions of Iran, are crucial.

The association between beverage consumption pattern and dental problems in Iranian adolescents: a cross sectional study

BACKGROUND

With regard to the increasing consumption rates of unhealthy beverages among adolescents, the main purpose of the present study was to determine the association between beverage intake pattern and dental caries and tooth erosion in this age group.

METHODS

A total sample of 600 adolescents was recruited in this study using a multistage cluster random sampling method in the city of Kerman, in the southeast of Iran, in 2017. Then, the Decayed, Missed and Filled Teeth (DMFT) index and the Tooth Wear Index (TWI) were registered for each participant. A Beverage Frequency Questionnaire was also employed to estimate typical beverage intake frequency. Correspondingly, negative binominal regression and logistic regression were performed to determine the independent variables associated with the DMFT index and the TWI.

RESULTS

The findings revealed that the highest consumed beverage in daily living was tea in both genders, followed by sweetened soft beverages, as well as milk and kefir/yogurt drink. The results of the DMFT index were also significantly different in participants that had never consumed milk compared with those who had used milk on a daily basis. Moreover, the DMFT index in participants who had never consumed sweetened soft beverages was 39%, less than those who had had a daily intake of such beverages. Also, the chance of tooth erosion for participants who had never used sweetened soft beverages was 94%, lower than that in daily consumers.

CONCLUSIONS

The results of this study revealed that adolescents had an unhealthy beverage intake pattern. Furthermore, milk consumption was beneficial to dental caries, whereas use of soft drinks associated with more dental caries and tooth erosion.

Dairy Intake Would Reduce Nutrient Gaps in Chinese Young Children Aged 3-8 Years: A Modelling Study

Dairy foods are under-consumed among Chinese children. We modeled the impact of increased dairy consumption on nutrient inadequacy and assessed whether the consumption of formulated milk powder for children ≥3 years (FMP3+) is useful for reducing nutrient gaps. Data from 3–8-year-old children, with completed socio-demographic and dietary measurements from the China Health and Nutrition Survey 2015, were used (n = 1122). Dietary intakes were modeled in two scenarios: Scenario 1 added FMP3+ or cow’s milk to reported diet to reach recommended dairy intakes; Scenario 2 replaced the currently consumed milk with an equal volume of FMP3+. Reported nutrient intakes were compared with each model. Only 32.5% of children consumed dairy products; the average intake amount in total was 48.6 g/day. Most children (97.6%) did not meet dairy intake recommendation. Inadequate nutrient intakes were observed for calcium, potassium, thiamin, riboflavin, vitamin C and selenium. In Scenario 1, both FMP3+ and cow’s milk improved the intake of all analyzed nutrients. In Scenario 2, FMP3+ substitution increased the intake of most nutrients, and reduced the proportion of children with an inadequate intake of vitamin C, thiamin, vitamin A, iron, zinc and potassium. Thus, increasing dairy consumption would reduce nutrient gaps, and FMP3+ is a good food source to help children meet nutrient requirements.

High sugar-sweetened beverage intake frequency is associated with smoking, irregular meal intake and higher serum uric acid in Taiwanese adolescents

Types of sugar-sweetened beverages (SSB) can differ greatly between countries, with greater consumption of sweetened tea in Asia. This study aimed to understand changes in SSB consumption by adolescents in Taiwan over 18 years and their association with demographic characteristics and clinical outcome. This study used survey data from the 1993-1996 and 2010-2011 Nutrition and Health Surveys in Taiwan. Participants were high school students aged 13 to 18 years. Data were weighted and analysed using SUDAAN 11.0 and SAS 9.4. Participants were asked about intake frequencies of SSB and were grouped into four different SSB intake groups based on the combination of high or low frequency (including moderate frequency) of intake of sweetened tea and soda/sports/energy drinks. Results indicated over 99 % of teens reported having at least one SSB in the past week. Smoking status was significantly associated with SSB intake types with high tea intake (high tea and low soda (HL) group, OR 7·56, P < 0·001; high tea and high soda (HH) group, OR 9·96, P < 0·001). After adjustment for potential confounders, adolescents in the low tea and high soda (LH) group (β = 0·05, P = 0·034) had significantly higher mean serum uric acid values. In conclusion, sugary tea remains the SSB of choice for Taiwanese adolescents. Those with a frequent intake of soda/sports/energy drinks had a higher chance of being hyperuricaemic.

Impact of an excise tax on the consumption of sugar-sweetened beverages in young people living in poorer neighbourhoods of Catalonia, Spain: a difference in differences study

Background

Sugar-sweetened beverage consumption is contributing to the obesity epidemic. On 28 March 2017, Catalonia enacted a law levying an excise tax on sugar-sweetened beverages for public health reasons. The purpose of this study is to assess the impact of the tax on the consumption of sugar-sweetened beverages in Catalonia (Spain).

Methods

Before-and-after study to assess changes in the prevalence of consumption of sugar-sweetened beverages among 1929 persons aged 12 to 40 years residing in low-income neighbourhoods of Barcelona (intervention) and Madrid (control). Beverage consumption frequency was ascertained via a validated questionnaire administered during the month prior to the tax’s introduction (May 2017) and again at 1 year after it had come into force. The effect of the tax was obtained using Poisson regression models with robust variance weighted using propensity scores.

Results

While the prevalence of regular consumers of taxed beverages fell by 39% in Barcelona as compared to Madrid, the prevalence of consumers of untaxed beverages remained stable. The main reason cited by more than two-thirds of those surveyed for reducing their consumption of sugar-sweetened beverages was the increase in price, followed by a heightened awareness of their health effects.

Conclusions

The introduction of the Catalonian excise tax on sugar-sweetened beverages was followed by a reduction in the prevalence of regular consumers of taxed beverages.

Factors associated with water consumption among children: a systematic review

BACKGROUND

Water is recommended as the main beverage for daily fluid intake. Previous systematic reviews have studied the consumption of sugar-sweetened beverages (SSBs) among children, but none have focused on water consumption. Insight into factors that are associated with children's water intake is needed to inform the development of interventions aimed at the promotion of water consumption. The objective of this review was therefore to summarize the current evidence on factors associated with water consumption among children aged 2 to 12 years.

METHODS

A systematic literature search in seven electronic databases was conducted in May, 2018 and retrieved 17,850 unique records. Two additional studies were identified by hand-searching references of included articles. Studies were selected if they had a cross-sectional or longitudinal study design, focused on children aged 2-12 years and published in an English language peer-reviewed journal. Participants from clinical populations, studies that included data of < 10 participants and non-human studies were excluded.

RESULTS

A total of 63 articles met inclusion criteria and were included in the analysis. We identified 76 factors that were investigated in these studies; 17/76 were investigated in a longitudinal study. There was evidence of positive associations between water consumption and child's self-efficacy, parental education level, parental self-efficacy, use of feeding practices such as restriction or encouraging healthy eating and study year. Evidence was inconsistent (< 60% of studies reported an association) for child's age, sex, BMI, consumption of SSBs and ethnic background of the parent. There was no evidence (≤33% of studies reported an association) of associations between consumption of milk or juice, parental emotional-, modelling- or instrumental feeding practices, eating school lunch or outside temperature and water consumption. The remaining 54 factors were investigated in fewer than three studies.

CONCLUSIONS

There is some evidence for an association between potentially modifiable parental and child-related factors and water consumption. However, most factors identified in this review were only studied by one or two studies and most studies were cross-sectional. More longitudinal research is necessary to investigate environmental, parental and child-related factors associated with water consumption that are currently under-studied and could further inform intervention strategies.

TRIAL REGISTRATION

PROSPERO ID# CRD42018093362 , registered May 22, 2018.

Drink Choice is Important: Beverages Make a Substantial Contribution to Energy, Sugar, Calcium and Vitamin C Intake among Australians

It is important to understand the role of beverages in population dietary intake in order to give relevant advice. Population estimates were derived from one-day food recall dietary data from 12,153 participants in the 2011–2012 Australian National Nutrition and Physical Activity Survey. Almost all Australians (99.9%) consumed at least one beverage on the day of the survey, accounting for 16.6% of the total energy intake for adults (aged 19 years and over) and 13.0% for children (aged 2–18 years). Similarly, beverages contributed 26–29% to calcium intake, 22–28% to vitamin C intake, and 35–36% to sugar intake. Water was consumed on the day of the survey by 84.1% of Australian adults and 90.5% of children. For adults, the greatest beverage contributors to total energy intake were alcoholic drinks (5.6%), coffee (3.1%), and soft drinks (1.9%), and for children, plain milk (3.1%), flavoured milk (2.8%), and fruit juice (2.6%). Coffee (10.6%) made the greatest contribution to calcium intake for adults; and plain milk (9.9%) and flavoured milk (7.6%) for children. The greatest contributors to vitamin C intake were fruit juice (13.4%) and alcoholic drinks (6.1%) for adults; and fruit juice (23.4%) for children. For total sugar intake, soft drinks (8.0%), coffee (8.4%), and fruit juice (5.9%) made the highest contribution for adults; and fruit juice (9.8%) and soft drinks (8.7%) for children. The type and amount of beverage consumption has considerable relevance to dietary quality for Australians.

Hydration status, total water intake and subjective feelings of adolescents living in a hot environment, during a typical school day

AIM

Individuals living in a hot environment appear to face increased risk of dehydration. Currently there is not extensive literature on the adolescent population in relation to hydration. The aim of the present study was to assess hydration status and total water intake (TWI) at school, of adolescents living in a hot environment, and to investigate the association of hydration and TWI with various subjective feelings.

METHODS

The hydration status of 141 adolescents (boys n = 102), age 15-17 years, was assessed via urine specific gravity (USG), at the beginning (07:30 am) and at the end (1:30 pm) of one school day. TWI from fluids and solid food was assessed via detailed food and fluid records. Subjective feelings (i.e. thirst, alertness, ability to concentrate) were recorded by specific scales.

RESULTS

Ninety percent of the students arrived dehydrated at school (USG >1.020). Thirteen students were hydrated (USG <1.020), 67 students were slightly dehydrated (USG 1.021-1.029), and 50 students were seriously dehydrated (USG >1.030). There was no difference in TWI between the three groups (765 ± 451 mL). TWI correlated with alertness (p = 0.005) and the ability to concentrate (p = 0.015), and inversely correlated with fatigue (p = 0.015). Seriously dehydrated students felt less alert in the morning (p < 0.035) whereas the feeling of thirst was similar between all groups.

CONCLUSIONS

The prevalence of the dehydration of the adolescents during school time appeared to be extremely high, and thirst was not driving those adolescents to drink enough. Apart from health concerns, school performance could be affected by dehydration and inadequate water intake.

Beverages Consumption is not Related to Weight Status Among Adolescents Living in the Capital of Jordan

Methods:

A cross-sectional survey was conducted at government and private schools in Amman city, the capital of Jordan. Seven hundred and ninety five adolescent students (400 boys and 395 girls) aged 15-18 years were recruited using a multistage stratified sampling method. Students were asked to complete a validated questionnaire to assess their beverage consumption during school year 2013- 2014. Students&#039; body weight was categorized as non-obese and obese according to the International Obesity Task Force standard.

Results:

The average beverage consumption was found to be significantly higher in Jordanian adolescent boys than in girls. However, both boys and girls had similar beverage consumption frequencies except for whole milk and sweetened coffee with or without milk or non-dairy coffee creamer. The boys consumed 1-2 cups of whole milk and sweetened coffee with or without milk or non-dairy coffee creamer/day (58.5% and 55.5% respectively), while the girls consumed less than one cup/ day of whole milk and sweetened coffee with or without milk or non-dairy coffee creamer/day (57.7% and 49.9% respectively). No significant associations were established between the investigated beverage consumptions and the weight status for Jordanian adolescents.

Conclusion:

Although beverage consumption was significantly higher in Jordanian adolescent boys than girls, it was not associated with the obesity among Jordanian adolescents.

Beverage consumption among Korean adolescents: data from 2016 Korea Youth Risk Behavior Survey

BACKGROUND/OBJECTIVES

Association between the consumption of sugar-sweetened beverages (SSBs) and obesity is universally a controversial issue. This study was undertaken to examine the beverage consumption pattern of Korean adolescents.

SUBJECTS/METHODS

Data was collected from the 2016 Korea Youth Risk Behavior Survey involving 65,528 adolescent respondents. A list of the most frequently consumed beverages was analyzed, and the consumption frequency of carbonated beverages, SSBs, and energy drinks during the past seven-days was assessed. The main reasons for the adolescents to consume the beverages were also determined.

RESULTS

The beverage preference of adolescents were carbonated beverages (31.0%), ‘fruit and vegetable beverages (17.7%)’, ‘milk (13.6%)’, and ‘coffee (12.7%)’. Carbonated beverages and SSBs were consumed more than three times a week by 27.1% and 41.1% of the respondents, respectively. About 86.2% of adolescents did not take of any energy drinks during the last seven-days. Taste was the most common reason that adolescents considered when choosing a drink. Carbonated beverages consumed more frequently by boys than girls, and high school students drank coffee more frequently than middle school students.

CONCLUSIONS

Boys had a higher preference for unhealthy beverages than girls, whereas consumption of high-caffeine drinks was greater amongst high-school students than middle school students.