1
|
Song Y, Zhang F, Wang X, Lin G, He L, Lin Z, Zhang N, Ma G. A Study of Fluid Intake, Hydration Status, and Body Composition of Pregnant Women in Their Third Trimester, and Relationships with Their Infant's Birth Weight in China: A Prospective Cohort Study. Nutrients 2024; 16:972. [PMID: 38613006 PMCID: PMC11013593 DOI: 10.3390/nu16070972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 03/22/2024] [Accepted: 03/25/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND Water intake and hydration status may potentially influence maternal and child health. However, there is little research regarding this topic. OBJECTIVES This study aimed to investigate pregnant women's total fluid intake (TFI) levels, hydration status, and body composition and further explore their relationship with infant birth weight. METHODS A 7-day, 24 h fluid intake recorded was applied to determine participants' TFI levels. Morning urine samples were collected and tested to evaluate their hydration status. Maternal body compositions in their third trimester and infant birth weights were measured. RESULTS A total of 380 participants completed the study. The TFI was insufficient for pregnant women during their third trimester (median = 1574 mL), with only 12.1% of participants meeting the recommended adequate fluid intake level for pregnant women living in China (1.7 L per day). With the increasing TFI values, the urine osmolality decreased, which showed statistical significance among the four groups (χ2 = 22.637, p < 0.05). The participants displayed a poor hydration status. Meanwhile, the percentage of participants who were in dehydrated status decreased (χ2 = 67.618, p < 0.05), while body water content and basal metabolic rate increased with the increase in TFI levels (χ2 = 20.784, p < 0.05; χ2 = 14.026, p < 0.05). There were positive linear relationships between plain water intake, the basal metabolic rate of pregnant women and their infant birth weight (SE = 0.153, p < 0.05; SE = 0.076, p < 0.05). CONCLUSIONS Water intake was insufficient, and poor hydration status was common among pregnant women in China. There may be potential relationships between plain water intake, basal metabolic rate, and infant birth weight.
Collapse
Affiliation(s)
- Yongye Song
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing 100191, China; (Y.S.); (X.W.); (G.M.)
- Laboratory of Toxicological Research and Risk Assessment for Food Safety, Peking University, 38 Xue Yuan Road, Haidian District, Beijing 100191, China
| | - Fan Zhang
- International School of Public Health and One Health, Hainan Medical University, 3 Xue Yuan Road, Longhua District, Haikou 571199, China; (F.Z.); (L.H.)
| | - Xing Wang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing 100191, China; (Y.S.); (X.W.); (G.M.)
- Laboratory of Toxicological Research and Risk Assessment for Food Safety, Peking University, 38 Xue Yuan Road, Haidian District, Beijing 100191, China
| | - Guotian Lin
- School of Health Medicine, University of Sanya, 191 Xue Yuan Road, Jiyang District, Sanya 572022, China;
| | - Limin He
- International School of Public Health and One Health, Hainan Medical University, 3 Xue Yuan Road, Longhua District, Haikou 571199, China; (F.Z.); (L.H.)
| | - Zhixiong Lin
- Haikou Hospital of the Maternal and Child Health, 6 Wen Tan Road, Guo Xing Avenue, Qiongshan District, Haikou 570203, China;
| | - Na Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing 100191, China; (Y.S.); (X.W.); (G.M.)
- Laboratory of Toxicological Research and Risk Assessment for Food Safety, 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; (Y.S.); (X.W.); (G.M.)
- Laboratory of Toxicological Research and Risk Assessment for Food Safety, Peking University, 38 Xue Yuan Road, Haidian District, Beijing 100191, China
| |
Collapse
|
2
|
Xie Z, Li X, Li G, Lu X, Wu J, Lin X, Yang Y, Shi X, Ding Y, Wang Z. Water Intake and Hydration Status among Pregnant Women in the Second Trimester in China: A Three-Day Metabolic Trial. Nutrients 2023; 16:116. [PMID: 38201946 PMCID: PMC10780576 DOI: 10.3390/nu16010116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 12/23/2023] [Accepted: 12/26/2023] [Indexed: 01/12/2024] Open
Abstract
Adequate water intake and optimal hydration status during pregnancy are crucial for maternal and infant health. However, research on water intake by pregnant women in China is very limited. This study mainly aimed to observe the daily total water intake (TWI) of pregnant women and its different sources and to investigate the relationship between their water intake and hydration biomarkers. From October to November 2020, a convenience sample of pregnant women in the second trimester (n = 21) was recruited. Under conditions close to daily life, they undertook a 3-day metabolic trial. Each participant was provided with sufficient bottled water, and the weight of what they drank each time was measured. The intake of other beverages and foods was measured using a combination of weighing and duplicate portion method. Fasting venous blood and 24 h urine samples were collected and analyzed for the hydration biomarkers, including the serum/urine osmolality, urine pH, urine specific gravity, and the concentrations of major electrolytes in urine and serum. The results showed that the mean daily TWI was 3151 mL, of which water from beverages and foods accounted for 60.1% and 39.9%, respectively. The mean total fluid intake (TFI) was 1970 mL, with plain water being the primary contributor (68.7%, r = 0.896). Among the participants, 66.7% (n = 14, Group 1) met the TWI recommendation set by the Chinese Nutrition Society. Further analysis revealed that the TFI, water from beverages and foods, plain water, and milk and milk derivatives (MMDs) were significantly higher in Group 1 than those who did not reach the adequate intake value (Group 2) (p < 0.05). The results of hydration biomarkers showed that the mean 24 h urine volume in Group 1 was significantly higher than that in Group 2 (p < 0.05), while the 24 h urine osmolality, sodium, magnesium, phosphorus, chloride, and creatinine concentrations in Group 1 were significantly lower than those in Group 2 (p < 0.05). However, no significant differences were observed in serum biomarkers. Partial correlation analysis showed that TWI was moderately positively correlated with 24 h urine volume (r = 0.675) and negatively correlated with urine osmolality, sodium, potassium, magnesium, calcium, phosphorus, and chloride concentrations (r = from-0.505 to -0.769), but it was not significantly correlated with serum biomarkers. Therefore, under free-living conditions, increasing the daily intake of plain water and MMDs is beneficial for pregnant women to maintain optimal hydration. The hydration biomarkers in urine are more accurate indicators of water intake and exhibit greater sensitivity compared to serum biomarkers. These findings provide a scientific basis for establishing appropriate water intake and hydration status for pregnant women in China.
Collapse
Affiliation(s)
- Zhencheng Xie
- Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China; (Z.X.)
| | - Xiaocheng Li
- Nanjing Center for Disease Control and Prevention, Nanjing Medical University, Nanjing 210003, China
| | - Genyuan Li
- Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China; (Z.X.)
| | - Xiaolong Lu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China; (Z.X.)
| | - Jieshu Wu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China; (Z.X.)
| | - Xiaofang Lin
- Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China; (Z.X.)
| | - Yue Yang
- Nanjing Center for Disease Control and Prevention, Nanjing Medical University, Nanjing 210003, China
| | - Xi Shi
- Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China; (Z.X.)
| | - Ye Ding
- Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China; (Z.X.)
| | - Zhixu Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China; (Z.X.)
- The Institute of Nutrition and Food Science, Nanjing Medical University, Nanjing 211166, China
| |
Collapse
|
3
|
Water Intake in Pregnant Women in China, 2018: The Report of a Survey. Nutrients 2021; 13:nu13072219. [PMID: 34203390 PMCID: PMC8308335 DOI: 10.3390/nu13072219] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 06/24/2021] [Accepted: 06/26/2021] [Indexed: 11/17/2022] Open
Abstract
Background: Adequate water intake in pregnant women plays an important role in their health and in fetal growth and development. However, there is insufficient applicable data to guide and evaluate the water intake of pregnant women in China. Based on a nationwide sample of pregnant women, we mainly aimed to investigate the daily total water intake (TWI) and the contribution of different beverages and food sources to the TWI, to assess the percentage of participants who comply with the adequate intake (AI) value of water set by the Chinese Nutrition Society (CNS) and the European Food Safety Authority (EFSA) and to analyze the contribution of different water sources to the daily total energy intake (TEI). Methods: A multi-stage sampling method was used to recruit pregnant women from 11 provinces and two municipalities in China. A 4-day online diary with a food atlas was used to assess water and dietary intake. Finally, 653 pregnant women were included in the analysis. The Mann–Whitney U test and the independent-sample t-test were used to compare the differences between related variables in different age groups or different gestational periods, and partial correlation was used to explore the correlation between water and energy intake. Results: The median daily TWI of pregnant women was 2190 mL, of which water from beverages and foods accounted for 52.9% and 47.1%, respectively. Approximately 80.5% of the water from beverages was mainly from plain water (r = 0.973), while in the part of the water from foods, dishes (32.4%) were the main contributors (r = 0.663). Only 16.4% and 43.8% of the total population met the TWI recommendation set by the CNS and EFSA, respectively. Among these, the contribution of the water from beverages was higher than that of the water from food. For those whose TWI did not reach the recommended level, the contribution of the water from beverages was almost equal to that of food. The median daily TEI of pregnant women was 1589 kcal, of which beverages accounted for 9.7%. Milk and milk derivatives (71.3%) were the main contributors to energy from beverages, accounting for 71.3% (r = 0.444). Although sugar-sweetened drinks only accounted for 10.1% of the energy from beverages, they were highly correlated with energy from beverages (r = 0.836). Through grouping analysis, age and gestational period had no significant effect on the above main results. Conclusions: This was the beginning of a nationwide study on the TWI of pregnant women in China, and the results provide evidence of the need for interventions to improve water intake among pregnant women and the revision of reference values for AI of TWI in pregnant women in China.
Collapse
|
4
|
Zhou Y, Zhu X, Qin Y, Li Y, Zhang M, Liu W, Huang H, Xu Y. Association between total water intake and dietary intake of pregnant and breastfeeding women in China: a cross-sectional survey. BMC Pregnancy Childbirth 2019; 19:172. [PMID: 31092215 PMCID: PMC6521377 DOI: 10.1186/s12884-019-2301-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 04/15/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Pregnant and lactating women are at high risk of insufficient water intake. The cross-sectional study was mainly designed to evaluate the water intake, including total water intake (TWI), plain water intake, and water intake from beverages and foods of 200 pregnant women and 150 breastfeeding women in Beijing. METHODS A semi-quantitative Food Frequency Questionnaire (FFQ) was employed to assess their dietary intake, TWI, plain water, and water intake from beverages and foods. Multivariate regression analysis was conducted for evaluating the association between water intake and dietary variables. RESULTS On average, the TWI of pregnant and breastfeeding women was 2638 mL/day and 3218 mL/day, respectively. Only 28% of pregnant women and 27% of breastfeeding women were complied with the adequate intake (AI). Water from foods was the greatest contributor to TWI both in pregnant and breastfeeding women. TWI was positively related to some dietary variables (P < 0.001). For pregnant women, with each 100 kcal/day increase in energy intake, the TWI increased by 67 mL. With each 5 g increase in daily intake of dietary protein, fat, carbohydrate and fiber, TWI increased by 72 mL, 66 mL, 22 mL, 353 mL, respectively. When the energy contribution of protein increased by 5%, TWI increased by 210 mL. The each 100 mg increase in daily sodium intake was accompanied with 52 mL increase in TWI. For breastfeeding women, with each 100 kcal/day increase in energy intake, the TWI increased by 54 mL. With each 5 g increase in daily intake of dietary protein, fat, carbohydrate and fiber, TWI increased by 53 mL, 58 mL, 16 mL, 212 mL, respectively. The each 100 mg increase in daily sodium intake was accompanied with 54 mL increase in TWI. CONCLUSIONS A large proportion of pregnant and breastfeeding women in Beijing were not adherent to AI for TWI set by Chinese Nutrition Society. Water intake from foods was the greatest contributor to TWI both in pregnant and breastfeeding women, and maternal dietary intake posed impacts on water intake during pregnancy and lactation. More researches are required to assess the water intake and hydration status of the populations.
Collapse
Affiliation(s)
- Yalin Zhou
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, NO.38 Xueyuan Road, Beijing, 100083 China
| | - Xiaoyu Zhu
- Beijing Northern Hospital, NO.10 Chedaogou Road, Beijing, China
| | - Yong Qin
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, NO.38 Xueyuan Road, Beijing, 100083 China
| | - Yong Li
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, NO.38 Xueyuan Road, Beijing, 100083 China
| | - Minjia Zhang
- Peking University Third Hospital, NO.49 Huayuan North Road, Beijing, 100191 China
| | - Wei Liu
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, NO.38 Xueyuan Road, Beijing, 100083 China
| | - Hanming Huang
- Beijing Northern Hospital, NO.10 Chedaogou Road, Beijing, China
| | - Yajun Xu
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, NO.38 Xueyuan Road, Beijing, 100083 China
- Beijing Key Laboratory of Toxicological Research and Risk Assessment for Food Safety, Peking University, NO.38 Xueyuan Road, Beijing, 100083 China
| |
Collapse
|
5
|
Makris KC, Andra SS. Limited representation of drinking-water contaminants in pregnancy-birth cohorts. THE SCIENCE OF THE TOTAL ENVIRONMENT 2014; 468-469:165-175. [PMID: 24013514 DOI: 10.1016/j.scitotenv.2013.08.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Revised: 08/04/2013] [Accepted: 08/04/2013] [Indexed: 06/02/2023]
Abstract
Water contamination and noise have been consistently the least assessed environmental/lifestyle exposures in pregnancy-birth cohorts (PBC). Water quality surveillance data collected during the past decade within urban drinking-water distribution systems call for re-evaluation of water and health issues in the developed world. The objectives of this scientific commentary were to (i) highlight the extent of appraisal of water contamination in exposure assessment studies of PBC, worldwide, and (ii) propose recommendations to increase awareness of emerging water-related risks through their improved representation into PBC study designs in urban centers. Three scientific literature databases (Scopus, PubMed, and Web of Science) were used for a systematic search on worldwide PBC and their publications that considered water contamination and health outcomes. Publicly-available e-databases (ENRIECO, BIRTHCOHORTS, and CHICOS) were also employed for detailed exploration of existing European Union (EU)-based PBC. Out of the 76 PBC identified in the EU territory, only 12 of them incorporated water contamination into their study designs. Among which only 6 PBC published scientific articles that either included data on water contamination and/or water intake estimates. Trihalomethanes but not other disinfection by-products were mostly studied in the PBC around the globe, while fluoride, atrazine, perfluorinated compounds, tetrachloroethylene, and lead were studied to a lesser extent as water contaminants. It appears that chemical-based water contamination and corresponding human exposures represent a largely underappreciated niche of exposure science pertaining to pregnant mother and children's health in PBC. Future PBC studies should grasp this opportunity to substantially reform elements of water contamination in their exposure assessment protocols and effectively combine them with their epidemiological study designs.
Collapse
Affiliation(s)
- Konstantinos C Makris
- Cyprus International Institute for Environmental and Public Health in association with Harvard School of Public Health, Cyprus University of Technology, Limassol, Cyprus.
| | | |
Collapse
|
6
|
|