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Wójcik M, Alvarez-Pitti J, Kozioł-Kozakowska A, Brzeziński M, Gabbianelli R, Herceg-Čavrak V, Wühl E, Lucas I, Radovanović D, Melk A, González Lopez-Valcarcel B, Fernández-Aranda F, Mazur A, Lurbe E, Borghi C, Drożdż D. Psychosocial and environmental risk factors of obesity and hypertension in children and adolescents-a literature overview. Front Cardiovasc Med 2023; 10:1268364. [PMID: 38054100 PMCID: PMC10694215 DOI: 10.3389/fcvm.2023.1268364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 10/24/2023] [Indexed: 12/07/2023] Open
Abstract
Childhood obesity has become a worldwide epidemic in the 21st century. Its treatment is challenging and often ineffective, among others due to complex, often not obvious causes. Awareness of the existence and meaning of psychosocial and environmental risk factors seems to be an essential element in the prevention and treatment of obesity and its complications, especially arterial hypertension. In this review, we will discuss the role of that risk factors linking obesity and increased cardiovascular disorders including the role of nutritional factors (including the role of unhealthy diet, inadequate hydration), unhealthy behaviors (e.g. smoking, alcohol and drugs, sedentary behavior, low physical activity, disrupted circadian rhythms, sleep disorders, screen exposure), unfavorable social factors (such as dysfunctional family, bullying, chronic stress, mood disorders, depression, urbanization, noise, and environmental pollution), and finally differences in cardiovascular risk in girls and boys.
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Affiliation(s)
- Małgorzata Wójcik
- Department of Pediatric and Adolescent Endocrinology, Chair of Pediatrics, Pediatric Institute, Jagiellonian University Medical College in Kraków, Kraków, Poland
- Interclinical Center for the Treatment of Childhood Obesity, University Children’s Hospital of Kraków, Kraków, Poland
| | - Julio Alvarez-Pitti
- Pediatric Department, Consorcio Hospital General, University of Valencia, Valencia, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
- INCLIVA Biomedical Research Institute, Hospital Clínico, University of Valencia, Valencia, Spain
| | - Agnieszka Kozioł-Kozakowska
- Interclinical Center for the Treatment of Childhood Obesity, University Children’s Hospital of Kraków, Kraków, Poland
- Department of Pediatrics, Gastroenterology and Nutrition, Pediatric Institute, Jagiellonian University Medical College in Kraków, Kraków, Poland
| | - Michał Brzeziński
- Department of Pediatrics, Gastroenterology, Allergology and Pediatric Nutrition, Medical University of Gdansk, Kraków, Poland
| | - Rosita Gabbianelli
- Unit of Molecular Biology and Nutrigenomics, School of Pharmacy, University of Camerino, Camerino, Italy
| | - Vesna Herceg-Čavrak
- Faculty of Health Science, Libertas International University, Zagreb, Croatia
| | - Elke Wühl
- Division of Pediatric Nephrology, Center for Pediatrics and Adolescent Medicine, Heidelberg University, Heidelberg, Germany
| | - Ignacio Lucas
- CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
- Department of Clinical Psychology, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
- Clinical Psychology Unit, University Hospital of Bellvitge, Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviours Group, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Dragan Radovanović
- Department of Medical Sciences, Faculty of Sport and Physical Education, University of Niš, Niš, Serbia
| | - Anette Melk
- Children’s Hospital, Hannover Medical School, Hannover, Germany
| | - Beatriz González Lopez-Valcarcel
- Department of Quantitative Methods for Economics and Management, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Fernando Fernández-Aranda
- CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
- Department of Clinical Psychology, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Artur Mazur
- Department of Pediatrics, Pediatric Endocrinology and Diabetes, Medical Faculty, University of Rzeszów, Rzeszów, Poland
| | - Empar Lurbe
- Pediatric Department, Consorcio Hospital General, University of Valencia, Valencia, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
- INCLIVA Biomedical Research Institute, Hospital Clínico, University of Valencia, Valencia, Spain
| | - Claudio Borghi
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Dorota Drożdż
- Interclinical Center for the Treatment of Childhood Obesity, University Children’s Hospital of Kraków, Kraków, Poland
- Department of Pediatric Nephrology and Hypertension, Chair of Pediatrics, Pediatric Institute, Jagiellonian University Medical College, Kraków, Poland
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Hydration and Nephrolithiasis in Pediatric Populations: Specificities and Current Recommendations. Nutrients 2023; 15:nu15030728. [PMID: 36771434 PMCID: PMC9920266 DOI: 10.3390/nu15030728] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 01/19/2023] [Accepted: 01/27/2023] [Indexed: 02/05/2023] Open
Abstract
Renal lithiasis is less frequent in children than in adults; in pediatrics, lithiasis may be caused by genetic abnormalities, infections, and complex uropathies, but the association of urological and metabolic abnormalities is not uncommon. The aim of this study is to provide a synthesis of nephrolithiasis in children and to emphasize the role of hydration in its treatment. As an etiology is reported in 50% of cases, with a genetic origin in 10 to 20%, it is proposed to systematically perform a complete metabolic assessment after the first stone in a child. Recent data in the field reported increased incidence of pediatric urolithiasis notably for calcium oxalate stones. These changes in the epidemiology of stone components may be attributable to metabolic and environmental factors, where hydration seems to play a crucial role. In case of pediatric urolithiasis, whatever its cause, it is of utmost importance to increase water intake around 2 to 3 L/m2 per day on average. The objective is to obtain a urine density less than 1010 on a dipstick or below 300 mOsm/L, especially with the first morning urine. Some genetic diseases may even require a more active 24 h over-hydration, e.g., primary hyperoxaluria and cystinuria; in such cases naso-gastric tubes or G-tubes may be proposed. Tap water is adapted for children with urolithiasis, with limited ecological impact and low economical cost. For children with low calcium intake, the use of calcium-rich mineral waters may be discussed in some peculiar cases, even in case of urolithiasis. In contrast, sugar-sweetened beverages are not recommended. In conclusion, even if parents and patients sometimes have the feeling that physicians do not propose "fancy" therapeutic drugs, hydration and nutrition remain cornerstones of the management of pediatric urolithiasis.
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Kozioł-Kozakowska A, Wójcik M, Stochel-Gaudyn A, Szczudlik E, Suder A, Piórecka B. The Severity of Obesity Promotes Greater Dehydration in Children: Preliminary Results. Nutrients 2022; 14:5150. [PMID: 36501180 PMCID: PMC9739486 DOI: 10.3390/nu14235150] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 11/28/2022] [Accepted: 11/30/2022] [Indexed: 12/12/2022] Open
Abstract
The state of hydration of the body depends on the balance between the amount of water and salt consumed and excreted (the urinary extraction of excess sodium requires water). Inappropriate nutrition, particularly consuming too much processed food, causes obesity in children and additionally causes excessive sodium consumption, thus increasing the risk of excessive water loss. The aim of this study was to assess the hydration status of children with obesity and the relation between hydration, body composition, urinary sodium extraction, and nutrient intake. The study group consisted of 27 patients with obesity, with a mean age of 12.89 ± SD 2.79. Each patient's height, weight, body composition (electrical bioimpedance (BIA)), diet (7-day record), and biochemical tests were assessed. The hydration status was assessed using 24-hour urine collection, 24-hour urine osmolality, and an ultrasound of the vena cava (IVC/Ao index). Overall, 55% of children (n = 15) had urine osmolality values above 800 mOsm/kgH2O, which indicates significant dehydration, and 53% (n = 14) were dehydrated, based on the IVC/Ao index. Children with obesity and dehydration had a significantly higher BMI (31.79 vs. 27.32; p = 0.0228), fat mass percentage (37.23% vs. 30.07% p = 0.0051), and fat mass in kg (30.89 vs. 20.55; p = 0.0158), and significantly higher sodium intake from their diet (3390.0 mg vs. 2921.0 mg; p = 0.0230), as well as their sodium/potassium ratio (2.4 vs. 2.0; p = 0.0043). The 24-hour urinary sodium excretion and osmolality values were directly related to fat-mass percentage and fat-mass (in kg) in a simple linear correlation analysis. Our preliminary results confirm that obesity is related to dehydration. The overall high sodium excretion in children with obesity indicates an excessive salt intake along with low potassium intake, which is a significant predictor of dehydration, regardless of the total water intake (TWI).
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Affiliation(s)
- Agnieszka Kozioł-Kozakowska
- Department of Pediatrics, Gastroenterology and Nutrition, Pediatric Institute, Faculty of Medicine, Jagiellonian University Medical College, 30-663 Krakow, Poland
| | - Małgorzata Wójcik
- Department of Pediatric and Adolescents Endocrinology, Pediatric Institute, Faculty of Medicine,, Jagiellonian University Medical College, 30-663 Krakow, Poland
| | - Anna Stochel-Gaudyn
- Department of Pediatrics, Gastroenterology and Nutrition, Pediatric Institute, Faculty of Medicine, Jagiellonian University Medical College, 30-663 Krakow, Poland
| | - Ewa Szczudlik
- Department of Pediatric and Adolescents Endocrinology, Pediatric Institute, Faculty of Medicine,, Jagiellonian University Medical College, 30-663 Krakow, Poland
| | - Agnieszka Suder
- Department of Anatomy, Institute of Basic Sciences, Faculty of Motor Rehabilitation, University of Physical Education in Cracow, 31-571 Krakow, Poland
| | - Beata Piórecka
- Department of Nutrition and Drug Research, Institute of Public Health, Faculty of Health Science, Jagiellonian University Medical College, 31-531 Krakow, Poland
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Abstract
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.
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Affiliation(s)
- Jean-Pierre Chouraqui
- Paediatric Nutrition and Gastroenterology, Division of Pediatrics, Woman, Mother and Child Department, Pediatric Nutrition and Gastroenterology Unit, University Hospital of Lausanne (CHUV), Lausanne, Switzerland
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Evaluation of Water Intake in Spanish Adolescent Soccer Players during a Competition. J Hum Kinet 2022; 83:59-66. [PMID: 36157942 PMCID: PMC9465763 DOI: 10.2478/hukin-2022-0051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
An optimal state of hydration is essential to maintaining health. The objective of this cross-sectional study was to evaluate the water intake of adolescents aged 12 to 16 years and their hydration level during an official soccer match. Three hundred and six players participated in the study (N = 306). Their water intake was recorded and the level of hydration was evaluated using the density of urine as an indicator. Weight measurements were made before and after the match. Water intake control, urine collection and analysis, and the recording of minutes played were carried out after the match. The average weight loss was 746.2 g (SD: 474.07; p < 0.001), with 36.5% with less than 1% loss and 23.3% with more than 2% loss. The mean volume of water ingested was 229.35 ml (SD: 211.11) and a significant correlation was observed between minutes of activity (ρ-value = 0.206; p < 0.001), environmental humidity (ρ-value = - 0.281; p < 0.001), and temperature (ρ-value = 0.200; p < 0.001). The sweat rate was 0.69 l/h (SD: 0.56) and it was significantly associated with playing time (ρ-value = -0.276; p < 0.001). The mean urine density was 1.019 (SD: 0.007), with 64.9% of youth athletes showing dehydration (≥ 1.020). An association was observed between dehydration and activity time (U- value = 4.124; p < 0.001). Approximately 10% of the participants stated that they had not drunk any water during the match. In conclusion, it is necessary to establish individual hydration guidelines based on personal, environmental and activity-related factors, as well as establish a minimum volume of fluids to consume.
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Villatoro-Santos CR, Ramirez-Zea M, Villamor E. Urinary sodium, iodine, and volume in relation to metabolic syndrome in Mesoamerican children and their parents. Nutr Metab Cardiovasc Dis 2022; 32:1774-1783. [PMID: 35637087 DOI: 10.1016/j.numecd.2022.04.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 04/12/2022] [Accepted: 04/28/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND AIMS The roles of sodium or iodine intake on the metabolic syndrome (MetS) etiology remain controversial. We evaluated the associations of 24 h urinary sodium and iodine with MetS among Mesoamerican children and their adult parents. METHODS AND RESULTS We conducted a cross-sectional study among 217 school-age children and 478 parents from 9 Mesoamerican cities. Exposures were high 24 h urinary sodium excretion and concentration (>2000 mg/d or mg/L, respectively) and high 24 h urinary iodine excretion and concentration (≥300 μg/d or μg/L, respectively). In children, the outcome was a standardized metabolic score from five criteria analogous to the Adult Treatment Panel (ATP) III criteria. In adults, MetS was defined according to the ATP III criteria. We estimated adjusted mean differences in the metabolic risk score and adjusted prevalence ratios of MetS between exposure categories using multivariable regression. In children, high sodium concentration was associated with a 0.10 units (43% of a SD) higher score (P = 0.001) and high iodine concentration was related to a 0.09 units (39% of a SD) higher score (P = 0.009). Unexpectedly, high 24 h urinary volume was associated with a lower metabolic score. In adults, high 24 h sodium excretion was related to hypertension and high iodine concentration was related to increased MetS prevalence. CONCLUSION High sodium and iodine concentrations, but not 24 h iodine excretion, are significantly associated with MetS in children, whereas high 24 h urinary volume is related to a decreased metabolic score. In adults, high iodine concentration tends to be related to increased MetS prevalence, but not 24 h iodine excretion.
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Affiliation(s)
- C R Villatoro-Santos
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - M Ramirez-Zea
- INCAP Research Center for the Prevention of Chronic Diseases, Institute of Nutrition of Central America and Panama, Guatemala City, Guatemala
| | - E Villamor
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA.
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Zhang J, Ma G, Du S, Zhang N. The Relationships between Water Intake and Hydration Biomarkers and the Applications for Assessing Adequate Total Water Intake among Young Adults in Hebei, China. Nutrients 2021; 13:nu13113805. [PMID: 34836061 PMCID: PMC8623709 DOI: 10.3390/nu13113805] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 10/13/2021] [Accepted: 10/19/2021] [Indexed: 11/17/2022] Open
Abstract
Water is an essential nutrient for humans. A cross-sectional study was conducted among 159 young adults aged 18–23 years in Hebei, China. The total drinking fluids and water from food were obtained by 7-day 24 h fluid intake questionnaires and the duplicate portion method, respectively. Pearson’s correlation coefficients were performed to determine the relationship between fluid intake and 24 h urinary biomarkers and plasma biomarkers. A multivariable partial least squares (PLS) model was used to identify the key predictors in modeling the total water intake (TWI) with 24 h urine biomarkers. Logistic regressions of the TWI against binary variables were performed, and the receiver operating characteristic curve (ROC) was analyzed to determine the cutoff value of the TWI for the optimal hydration status and dehydration without adjustments to favor either the sensitivity or specificity. In total, 156 participants (80 males and 76 females) completed the study. Strong relationships were found between the total drinking fluids, TWI, and 24 h urine biomarkers among young adults, especially for the 24 h urine volume (r = 0.784, p < 0.001; r = 0.747, p < 0.001) and osmolality (r = −0.589, p < 0.001; r = −0.477, p < 0.001), respectively. As for the FMU and plasma biomarkers, no strong relationships were found. The percentages of the variance in TWI explained by the PLS model with 13 urinary biomarkers were 66.9%. The optimal TWI values for assessing the optimal hydration and dehydration were 2892 mL and 2482 mL for young males, respectively, and 2139 mL and 1507 mL for young females, respectively. Strong relationships were found between the TWI, total drinking fluids, and 24 h urine biomarkers, but not with the FMU and plasma biomarkers, among young adults, including males and females. The 24 h urine biomarkers were more sensitive than the first morning urinary biomarkers in reflecting the fluid intake. The TWI was a reliable index for assessing the hydration statuses for young adults in free-living conditions.
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Affiliation(s)
- Jianfen Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing 100191, China; (J.Z.); (G.M.)
- Laboratory of Toxicological Research and Risk Assessment for Food Safety, Department of Nutrition and Food Hygiene, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing 100191, China
| | - Guansheng Ma
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing 100191, China; (J.Z.); (G.M.)
- Laboratory of Toxicological Research and Risk Assessment for Food Safety, Department of Nutrition and Food Hygiene, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing 100191, China
| | - Songming Du
- Chinese Nutrition Society, Room 1405, Beijing Broadcasting Building, No. 14 Jianguomenwai Street, Chaoyang District, Beijing 100053, China;
| | - Na Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing 100191, China; (J.Z.); (G.M.)
- Laboratory of Toxicological Research and Risk Assessment for Food Safety, Department of Nutrition and Food Hygiene, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing 100191, China
- Correspondence: ; Tel./Fax: +86-10-8280-526
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Is bioelectrical impedance vector analysis a good indicator of nutritional status in children and adolescents? Public Health Nutr 2021; 24:4408-4416. [PMID: 34034843 DOI: 10.1017/s1368980021002226] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE The study objective is to propose bioelectrical impedance vector analysis (BIVA) ellipses for the population and investigate its use to assess nutritional status through the BMI/age ratio and the cardiovascular risk through waist circumference (WC). DESIGN Age, weight, height and WC were recorded, along with the values of resistance (R), reactance (Xc) and phase angle (PA) by impedance. Student's t test and ANOVA were applied to ascertain the significance between means and a specific programme was applied to investigate the significance between ellipses. SETTING Fortaleza, Brazil. PARTICIPANTS A total of 467 students from public schools participated in the study: 120 children and 347 adolescents were evaluated, with respective means of age, weight and height of 8·2 years, 27·6 kg and 1·29 m and 12·7 years, 48·6 kg and 1·53 m, respectively. RESULTS The mean values of R/H, Xc/H and PA were 569·0 and 424·7 Ohm/m, 59·1 and 50·4 Ohm/m, and 5·9º and 6·8º for children and adolescents, respectively. The mean vectors for R/H and Xc/H show significant differences between for both age ranges and are inversely proportional to the BMI/A. As for WC, individuals without cardiovascular risk had higher R/H and lower Xc/H, but Xc and R in participants without cardiovascular risk were greater than with cardiovascular risk. CONCLUSIONS It was possible to propose confidence and tolerance BIVA ellipses for children and adolescent's clinical evaluation. The method was also suitable to identify cardiovascular risk ellipses in these age groups, but it was not possible to draw nutritional classifications ellipses by BMI/age data.
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Body Composition and a School Day Hydration State among Polish Children-A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17197181. [PMID: 33008100 PMCID: PMC7579491 DOI: 10.3390/ijerph17197181] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 09/17/2020] [Accepted: 09/28/2020] [Indexed: 12/17/2022]
Abstract
Background: Little is known on the relationship between obesity and hydration level in children. To explore the possible association between children’s hydration status and body composition, we conducted this cross-sectional study. Methods: The survey was carried out in 2018 in Preliminary and High Schools from the Malopolska Province, Poland. The study group consisted of 264 children aged 7–15 years. The level of hydration was assessed based on urine osmolality during a school day. The examined had anthropometric tests and body composition assessment (FM, BF%, FFM, TBW, TBW%). Odds ratio (OR) and 95% confidence interval (CI) were calculated using a logistic regression analysis. Results: In the study group, 9.5% of the examined were overweight, 7.2% obese, and it referred more to the country than towns (p < 0.05). Improper hydration was found in 53% of children, and 16.3% of them were severely dehydrated during a school day (urine osmolality > 1000 mOsm/kgH2O). The level of dehydration was higher in children with excessive body fat (BF%) than in children with normal BF% [903.00 vs. 775 mOsm/kgH2O]. Older age (>10 y) showed inverse association with dehydration [OR 0.52 (95% CI; 0.28–0.99)] and excessed BF% showed 2.3-fold increase in odds of dehydration during a school day [OR 2.39 (95% CI; 1.15–4.94)]. Improper hydration was a risk factor of difficulties with concentration declared by students during a school day OR 2.85 (95% CI; 1.16–6.99). Conclusions: Attention should be paid to appropriate hydration especially in children with excessive body fat content who feature a higher risk of dehydration and fluid demand.
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McGarr GW, Saci S, King KE, Topshee S, Richards BJ, Gemae MR, McCourt ER, Kenny GP. Heat strain in children during unstructured outdoor physical activity in a continental summer climate. Temperature (Austin) 2020; 8:80-89. [PMID: 33553507 PMCID: PMC7849747 DOI: 10.1080/23328940.2020.1801120] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 05/17/2020] [Indexed: 01/19/2023] Open
Abstract
The purpose of this study was to assess the heat strain experienced by children during unstructured physical activity outdoors in a temperate continental summer climate. Eighteen children (7 girls, 12.1 ± 1.7 years) performed up to 4 h of outdoor free-play (duration: 218 ± 33 min; air temperature of 24.5 ± 3.9°C and relative humidity of 66.2 ± 9.2%). Urine specific gravity (USG) was measured pre- and post-free-play, while body core temperature (Tco, ingestible pill) and heart rate (HR) were measured continuously. Physiological strain index (PSI) was calculated from Tco and HR (scale: 0 (none) to 10 (very high)). Activity levels were categorized as rest, light, moderate, and vigorous based on the metabolic equivalent of task, estimated from video analysis. Most children were euhydrated pre (78%, USG ≤ 1.020), but not post-free-play (28%, USG ≤ 1.020). Mean and peak Tco, HR, and PSI responses were 37.8 ± 0.3°C and 38.4 ± 0.3°C, 133 ± 14 bpm and 180 ± 12 bpm, and 4.7 ± 1.1 (low) and 7.4 ± 1.0 (high), respectively. All children reached peak Tco≥38.0°C, with seven ≥38.5°C, and the highest at 38.9°C. The children spent 58 ± 15% of free-play engaged in moderate-to-vigorous intensity physical activity. During free-play, all of the children performed moderate-to-vigorous intensity physical activity, which was associated with pronounced elevations in heat strain.
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Affiliation(s)
- Gregory W. McGarr
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Samah Saci
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Kelli E. King
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Serena Topshee
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Brodie J. Richards
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Mohamed R. Gemae
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Emma R. McCourt
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Glen P. Kenny
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
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Sawangjang B, Hashimoto T, Wongrueng A, Wattanachira S, Takizawa S. Assessment of fluoride intake from groundwater and intake reduction from delivering bottled water in Chiang Mai Province, Thailand. Heliyon 2019; 5:e02391. [PMID: 31517119 PMCID: PMC6732710 DOI: 10.1016/j.heliyon.2019.e02391] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Revised: 05/14/2019] [Accepted: 08/27/2019] [Indexed: 01/08/2023] Open
Abstract
Fluoride intake from tap water supplied by fluoride-containing groundwater has been the primary cause of fluorosis among the residents of Buak Khang Subdistrict, Chiang Mai Province, Thailand. To reduce fluoride intake, bottled water treated using reverse-osmosis membranes has been made available by community-owned water treatment plants. This study aimed to assess the resultant reduction in fluoride intake from using bottled water for drinking and cooking. Water consumption surveys were conducted by providing bottled water to 183 individuals from 35 randomly selected households and recording the amount of water consumed for drinking and cooking. The mean drinking water consumption was 1.62-1.88 L/capita/day and the cooking water consumption on weekends (5.06 ± 3.04 L/household/day) was higher than that on weekdays (3.80 ± 1.90 L/household/day). The per capita drinking water consumption exhibited a positive correlation with body weight; however, the low-weight subjects consumed more drinking water per kilogram of body weight than the heavy subjects. Although sex and day of the week did not significantly affect drinking water consumption per capita, girls consumed less water in school possibly due to their group mentality. Drinking water consumption per kilogram of body weight was significantly higher among women, children, and the elderly because these groups generally have low body weights. The fluoride intake from using tap water for drinking and cooking was estimated to be 0.18 ± 0.10 mg/kg-body weight/day and 5.55 ± 3.52 mg/capita/day, respectively, whereas using bottled water for drinking and cooking reduced the fluoride intake to 0.002 ± 0.002 mg/kg-body weight/day and 0.07 ± 0.05 mg/capita/day, respectively. Despite the increased cost, 98% and 90% of the subjects selected bottled water over tap water for drinking and cooking, respectively; thus, bottled water delivery services could be used to mitigate fluoride intake in developing countries.
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Affiliation(s)
- Benyapa Sawangjang
- Department of Urban Engineering, Graduate School of Engineering, The University of Tokyo, Japan
| | - Takashi Hashimoto
- Research Center for Advanced Science and Technology, The University of Tokyo, Japan
| | - Aunnop Wongrueng
- Department of Environmental Engineering, Faculty of Engineering, Chiang Mai University, Thailand
| | - Suraphong Wattanachira
- Department of Environmental Engineering, Faculty of Engineering, Chiang Mai University, Thailand
| | - Satoshi Takizawa
- Department of Urban Engineering, Graduate School of Engineering, The University of Tokyo, Japan
- Department of Environmental Engineering, Faculty of Engineering, Chiang Mai University, Thailand
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12
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Johnson EC, Huffman AE, Yoder H, Dolci A, Perrier ET, Larson-Meyer DE, Armstrong LE. Urinary markers of hydration during 3-day water restriction and graded rehydration. Eur J Nutr 2019; 59:2171-2181. [PMID: 31428854 PMCID: PMC7351875 DOI: 10.1007/s00394-019-02065-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 07/17/2019] [Indexed: 11/29/2022]
Abstract
PURPOSE This investigation had three purposes: (a) to evaluate changes in hydration biomarkers in response to a graded rehydration intervention (GRHI) following 3 days of water restriction (WR), (b) assess within-day variation in urine concentrations, and (c) quantify the volume of fluid needed to return to euhydration as demonstrated by change in Ucol. METHODS 115 adult males and females were observed during 1 week of habitual fluid intake, 3 days of fluid restriction (1000 mL day-1), and a fourth day in which the sample was randomized into five different GRHI groups: no additional water, CON; additional 500 mL, G+0.50; additional 1000 mL, G+1.00; additional 1500 mL, G+1.50; additional 2250 mL, G+2.25. All urine was collected on 1 day of the baseline week, during the final 2 days of the WR, and during the day of GRHI, and evaluated for urine osmolality, color, and specific gravity. RESULTS Following the GRHI, only G+1.50 and G+2.25 resulted in all urinary values being significantly different from CON. The mean volume of water increase was significantly greater for those whose Ucol changed from > 4 to < 4 (+ 1435 ± 812 mL) than those whose Ucol remained ≥ 4 (+ 667 ± 722 mL, p < 0.001). CONCLUSIONS An additional 500 mL of water is not sufficient, while approximately 1500 mL of additional water (for a total intake between 2990 and 3515 mL day-1) is required to return to a urine color associated with adequate water intake, following 3 days of WR.
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Affiliation(s)
- Evan C Johnson
- Human Integrated Physiology Laboratory, University of Wyoming, 1000 E. University Ave, Laramie, WY, 82071, USA.
| | - Ainsley E Huffman
- Human Integrated Physiology Laboratory, University of Wyoming, 1000 E. University Ave, Laramie, WY, 82071, USA.,University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Hillary Yoder
- Human Integrated Physiology Laboratory, University of Wyoming, 1000 E. University Ave, Laramie, WY, 82071, USA.,Department of Kinesiology, University of Alabama, Tuscaloosa, AL, USA
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13
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Merhej R. Dehydration and cognition: an understated relation. INTERNATIONAL JOURNAL OF HEALTH GOVERNANCE 2019. [DOI: 10.1108/ijhg-10-2018-0056] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Rita Merhej
- Department of Psychology, Faculty of Social and Behavioral Sciences, Haigazian University, Beirut, Lebanon
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14
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Dias FC, Boilesen SN, Tahan S, Melli LCFL, Morais MB. Prevalence of voluntary dehydration according to urine osmolarity in elementary school students in the metropolitan region of São Paulo, Brazil. Clinics (Sao Paulo) 2019; 74:e903. [PMID: 31576922 PMCID: PMC6751363 DOI: 10.6061/clinics/2019/e903] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 06/24/2019] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVES To evaluate the prevalence of voluntary dehydration based on urine osmolarity in elementary school students from two public educational institutions in the metropolitan region of São Paulo and evaluate whether there is a relationship between voluntary dehydration and nutritional status or socioeconomic status. METHODS Analytical cross-sectional study with students from two public schools in the city of Osasco. The determination of urine osmolarity was performed using the freezing method of the Advanced® Osmometer Model 3W2. Urine osmolarity greater than 800 mOsm/kg H2O was considered voluntary dehydration. During data collection, the weights and heights of the students, environmental temperatures and air humidity levels were obtained. RESULTS A total of 475 students aged six to 12 years were evaluated, of whom 188 were male. Voluntary dehydration occurred in 63.2% of the students and was more frequent in males than in females. The prevalence of voluntary dehydration was more frequent in males aged six to nine years than in females. However, no statistically significant difference was observed between males and females aged 10 to 12 years. No association was found between voluntary dehydration and nutritional status or socioeconomic status. CONCLUSION The prevalence of voluntary dehydration was high in elementary school students and was more frequent in males. No association was found between voluntary dehydration and nutritional or socioeconomic status.
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15
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Suh H, Kavouras SA. Water intake and hydration state in children. Eur J Nutr 2018; 58:475-496. [PMID: 30506317 DOI: 10.1007/s00394-018-1869-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 11/21/2018] [Indexed: 01/09/2023]
Abstract
PURPOSE Although low water intake has been associated with adverse health outcomes, available literature indicated that the majority of children do not meet the water intake guidelines and they are underhydrated based on elevated hydration biomarkers. This review examined the water intake habits and hydration status in children from 32 observational studies (n = 36813). METHODS PubMed, Web of Science, and CINAHL were used to identify relevant articles. Total water/fluid intake from 25 countries was compared with water intake recommendations and underhydration (urine osmolality greater than 800 mmol kg-1) was assessed. Risk of bias was assessed using customized categories following the review guideline for observational studies. RESULTS From 32 studies, only 11 studies reported both water intake and hydration status. 12 out of 24 studies reported mean/median water/fluid intake below the guidelines, while 4 out of 13 studies that assessed hydration status indicated underhydration based on urine osmolality (greater than 800 mmol kg-1). Among the 19 countries that reported comparison of water/fluid intake with guidelines, 60 ± 24% of children (range 10-98%) failed to meet them. CONCLUSION These findings suggest that children are not consuming enough water to be adequately hydrated.
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Affiliation(s)
- HyunGyu Suh
- Hydration Science Lab, Arizona State University, Arizona Biomedical Collaborate, Suite 133, 425 N 5th St, Phoenix, AZ, 85004, USA
| | - Stavros A Kavouras
- Hydration Science Lab, Arizona State University, Arizona Biomedical Collaborate, Suite 133, 425 N 5th St, Phoenix, AZ, 85004, USA.
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16
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Warren J, Guelinckx I, Livingstone B, Potischman N, Nelson M, Foster E, Holmes B. Challenges in the assessment of total fluid intake in children and adolescents: a discussion paper. Eur J Nutr 2018; 57:43-51. [PMID: 29923117 PMCID: PMC6008368 DOI: 10.1007/s00394-018-1745-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 06/07/2018] [Indexed: 11/30/2022]
Abstract
Purpose In recent years, evidence has emerged about the importance of healthy fluid intake in children for physical and mental performance and health, and in the prevention of obesity. Accurate data on water intake are needed to inform researchers and policymakers and for setting dietary reference values. However, to date, there are few published data on fluid or water intakes in children. This is due partly to the fact that drinking water is not always reported in dietary surveys. The aim of this paper is to review the current status of the literature and highlight the challenges of assessing total fluid intake in children and adolescents. Results From the dietary assessment literature it is apparent that children present unique challenges to assessing intake due to ongoing cognitive capacity development, limited literacy skills, difficulties in estimating portion sizes and multiple caregivers during any 1 day making it difficult to track intakes. As such, many issues should be considered when assessing total fluid intakes in children or adolescents. Various methods to assess fluid intakes exist, each with its own strengths and weaknesses; the ultimate choice of method depends on the research question and resources available. Based on the literature review, it is apparent that if the research focus is to assess only fluid intake, a fluid-specific method, such as a diary or record, appears to be a feasible approach to provide an accurate estimate of intakes.
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Affiliation(s)
| | - Isabelle Guelinckx
- Danone Nutricia Research, Route Départementale 128, 91767, Palaiseau, France.
| | - Barbara Livingstone
- Nutrition Innovation Centre for Food and Health, Ulster University, Coleraine, UK
| | - Nancy Potischman
- Office of Dietary Supplements, National Institutes of Health, Bethesda, USA
| | - Michael Nelson
- Public Health Nutrition Research Ltd, King's College London, London, UK
| | - Emma Foster
- Human Nutrition Research Centre, Newcastle University, Newcastle, UK
| | - Bridget Holmes
- Danone Nutricia Research, Route Départementale 128, 91767, Palaiseau, France
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Bougatsas D, Arnaoutis G, Panagiotakos DB, Seal AD, Johnson EC, Bottin JH, Tsipouridi S, Kavouras SA. Fluid consumption pattern and hydration among 8-14 years-old children. Eur J Clin Nutr 2017; 72:420-427. [PMID: 29238038 DOI: 10.1038/s41430-017-0012-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 07/26/2017] [Accepted: 08/10/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND/OBJECTIVES Children consume various fluids to meet dietary water intake needs. However, the contribution of different fluid types on hydration is unclear. The purpose of this study was to develop fluid intake patterns and examine their association with hydration, as indicated by 24-h urine osmolality. SUBJECTS/METHODS Two hundred ten (105 girls) healthy children (height: 1.49 ± 0.13 m, weight: 43.4 ± 12.6 kg, body fat: 25.2 ± 7.8%) recorded their fluid intake for two consecutive days, and collected their urine for 24-h during the 2nd day, while conducting their normal daily activities. Urine samples were analyzed for specific gravity and osmolality. Factor analysis with principal components method was applied to extract dietary patterns from six fluid groups. Linear regression analysis evaluated the associations between the extracted dietary patterns and hydration based on 24-h urine osmolality. RESULTS The analysis revealed the following six components: 1, characterized by consumption of milk and fresh juice, but not packaged juice; 2, by regular soda and other drinks, but not water; 3, by fresh juice and other drinks; 4, by packaged juice, but not regular soda; 5, by water and milk; and 6, by fresh juice. Component 5 was negatively correlated with urine osmolality (P = 0.001) indicating better hydration, whereas component 2 was positively correlated with urine osmolality (P = 0.001). CONCLUSIONS A drinking pattern based on water and milk was associated with better hydration, as indicated by lower urine osmolality, whereas drinking regular soda and other drinks but not water was associated with inferior hydration.
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Affiliation(s)
- Dimitris Bougatsas
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - Giannis Arnaoutis
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | | | - Adam D Seal
- University of Arkansas, Hydration Science Lab, Fayetteville, AR, 7270, USA
| | - Evan C Johnson
- University of Wyoming, Human Integrated Physiology Laboratory, Laramie, WY, USA
| | | | | | - Stavros A Kavouras
- University of Arkansas, Hydration Science Lab, Fayetteville, AR, 7270, USA. .,University of Arkansas for Medical Sciences, Division of Endocrinology, Little Rock, AR, USA.
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