European Journal of Nutrition

, Volume 56, Issue 2, pp 793–805 | Cite as

Belgian primary school children’s hydration status at school and its personal determinants

  • Nathalie Michels
  • Karen Van den Bussche
  • Johan Vande Walle
  • Stefaan De Henauw
Original Contribution
  • 202 Downloads

Abstract

Purpose

Dehydration has been related to several health aspects, and children are especially vulnerable. Since children spend a large time at school, we aim to examine children’s hydration status at school-start and its change during the school-day by objective measures. To identify subpopulations at risk, determinants of hydration were tested.

Methods

In 371 Belgian 7–13-year-old children, hydration was measured by (1) urinary osmolality at school-start and by a pooled school-day sample; (2) body water% by impedance; (3) parental reported beverage consumption; (4) urination frequency. Linear regression analyses were used to test putative predictors of hydration status: age, sex, parental education, region (Dutch-speaking versus French-speaking part of Belgium), diet quality and adiposity.

Results

A mean osmolality of 888 mosmol/kg was found in the school-start sample and 767 mosmol/kg in the school-day sample. This resulted in, respectively, 76 and 54 % of the children being dehydrated (>800 mosmol/kg). In 45 % of the children, the hydration level decreased over the school-day. Also the body water% as derived from bio-impedance (57 % ±4), the reported average daily beverage intake (911 ml) and the lower urination frequency during weekdays versus weekend days confirmed the low hydration status in our school population. Boys, Walloon children and those with higher adiposity were at increased risk of low hydration level. Diet quality was not the predictor of hydration status.

Conclusions

Hydration status at school appeared problematic in this population. This emphasizes the need for more resources and attention by school management and governmental organizations. Herein, especially Walloon schools and boys should be reached.

Keywords

Hydration Urinary osmolality Sociodemographic Adiposity Diet quality 

Notes

Acknowledgments

This study was unconditionally financed by Spadel N.V. This did not affect our scientific integrity. We would also like to thank the participating children, schools, parents and the fieldworkers.

Compliance with ethical standards

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Supplementary material

394_2015_1126_MOESM1_ESM.docx (354 kb)
Supplementary material 1 (DOCX 354 kb)

References

  1. 1.
    Armstrong LE (2012) Challenges of linking chronic dehydration and fluid consumption to health outcomes. Nutr Rev 70(Suppl 2):S121–S127. doi: 10.1111/j.1753-4887.2012.00539.x CrossRefGoogle Scholar
  2. 2.
    Armstrong LE (2005) Hydration assessment techniques. Nutr Rev 63:S40–S54CrossRefGoogle Scholar
  3. 3.
    Bar-David Y, Urkin J, Landau D, Bar-David Z, Pilpel D (2009) Voluntary dehydration among elementary school children residing in a hot arid environment. J Hum Nutr Diet 22:455–460. doi: 10.1111/j.1365-277X.2009.00960.x CrossRefGoogle Scholar
  4. 4.
    Bellisle F, Thornton SN, Hebel P, Denizeau M, Tahiri M (2010) A study of fluid intake from beverages in a sample of healthy French children, adolescents and adults. Eur J Clin Nutr 64:350–355. doi: 10.1038/ejcn.2010.4 CrossRefGoogle Scholar
  5. 5.
    Bonnet F, Lepicard EM, Cathrin L, Letellier C, Constant F, Hawili N, Friedlander G (2012) French children start their school day with a hydration deficit. Ann Nutr Metab 60:257–263. doi: 10.1159/000337939 Google Scholar
  6. 6.
    Bornhorst C, Huybrechts I, Hebestreit A, Krogh V, De Decker A, Barba G, Moreno LA, Lissner L, Tornaritis M, Loit HM, Molnar D, Pigeot I, Idefics, the IFc (2014) Usual energy and macronutrient intakes in 2-9-year-old European children. Int J Obes (Lond) 38(Suppl 2):S115–S123. doi: 10.1038/ijo.2014.142 CrossRefGoogle Scholar
  7. 7.
    Bressona J, Goudableb J (2013) Hydratation de l’enfant et comportement dipsique. Cahiers de nutrition et de diététique 48:41–52CrossRefGoogle Scholar
  8. 8.
    Cole TJ, Bellizzi MC, Flegal KM, Dietz WH (2000) Establishing a standard definition for child overweight and obesity worldwide: international survey. Br Med J (Clin Res Ed) 320:1240–1243CrossRefGoogle Scholar
  9. 9.
    Cole TJ, Freeman JV, Preece MA (1998) British 1990 growth reference centiles for weight, height, body mass index and head circumference fitted by maximum penalized likelihood. Stat Med 17:407–429. doi: 10.1002/(SICI)1097-0258(19980228)17:4<407:AID-SIM742>3.0.CO;2-L CrossRefGoogle Scholar
  10. 10.
    D’Anci KE, Constant F, Rosenberg IH (2006) Hydration and cognitive function in children. Nutr Rev 64:457–464CrossRefGoogle Scholar
  11. 11.
    Daniels MC, Popkin BM (2010) Impact of water intake on energy intake and weight status: a systematic review. Nutr Rev 68:505–521. doi: 10.1111/j.1753-4887.2010.00311.x CrossRefGoogle Scholar
  12. 12.
    Drewnowski A, Rehm CD, Constant F (2013) Water and beverage consumption among children age 4–13y in the United States: analyses of 2005–2010 NHANES data. Nutr J 12:85. doi: 10.1186/1475-2891-12-85 CrossRefGoogle Scholar
  13. 13.
    Ebner A, Manz F (2002) Sex difference of urinary osmolality in German children. Am J Nephrol 22:352–355. doi: 10.1159/000065226 CrossRefGoogle Scholar
  14. 14.
    EFSA (2010) Scientific opinion on dietary reference values for water. European Food Safety Authority Panel on Dietetic Products, Nutrition, and Allergies. EFSA J 8:1459Google Scholar
  15. 15.
    Fadda R, Rapinett G, Grathwohl D, Parisi M, Fanari R, Calo CM, Schmitt J (2012) Effects of drinking supplementary water at school on cognitive performance in children. Appetite 59:730–737. doi: 10.1016/j.appet.2012.07.005 CrossRefGoogle Scholar
  16. 16.
    Gandy J (2012) First findings of the United Kingdom fluid intake study. Nutrition today 47Google Scholar
  17. 17.
    Huybrechts I, De Backer G, De Bacquer D, Maes L, De Henauw S (2009) Relative validity and reproducibility of a food-frequency questionnaire for estimating food intakes among flemish preschoolers. Int J Environ Res Public Health 6:382–399. doi: 10.3390/ijerph6010382 CrossRefGoogle Scholar
  18. 18.
    Huybrechts I, Vereecken C, De Bacquer D, Vandevijvere S, Van Oyen H, Maes L, Vanhauwaert E, Temme L, De Backer G, De Henauw S (2010) Reproducibility and validity of a diet quality index for children assessed using a FFQ. Br J Nutr 104:135–144. doi: 10.1017/S0007114510000231 CrossRefGoogle Scholar
  19. 19.
    Kant AK, Graubard BI, Atchison EA (2009) Intakes of plain water, moisture in foods and beverages, and total water in the adult US population–nutritional, meal pattern, and body weight correlates: National Health and Nutrition Examination Surveys 1999–2006. Am J Clin Nutr 90:655–663. doi: 10.3945/ajcn.2009.27749 CrossRefGoogle Scholar
  20. 20.
    Katz AI, Massry S, Agmon J, Toor M (1965) Concentration and dilution of urine in permanent inhabitants of hot regions. Isr J Med Sci 1:968–978Google Scholar
  21. 21.
    Manz F, Wentz A (2003) 24-h hydration status: parameters, epidemiology and recommendations. Eur J Clin Nutr 57(Suppl 2):S10–S18. doi: 10.1038/sj.ejcn.1601896 CrossRefGoogle Scholar
  22. 22.
    Masento NA, Golightly M, Field DT, Butler LT, van Reekum CM (2014) Effects of hydration status on cognitive performance and mood. Br J Nutr 111:1841–1852. doi: 10.1017/S0007114513004455 CrossRefGoogle Scholar
  23. 23.
    Mikkila V, Rasanen L, Raitakari OT, Pietinen P, Viikari J (2005) Consistent dietary patterns identified from childhood to adulthood: the cardiovascular risk in Young Finns Study. Br J Nutr 93:923–931CrossRefGoogle Scholar
  24. 24.
    Moreno L, Iglesia-Altaba I, Santaliestra-Pasias A (2013) Fluid intake of european children and adolescents. Nutr Today 48(4):s25–s30CrossRefGoogle Scholar
  25. 25.
    Perrier E, Rondeau P, Poupin M, Le Bellego L, Armstrong LE, Lang F, Stookey J, Tack I, Vergne S, Klein A (2013) Relation between urinary hydration biomarkers and total fluid intake in healthy adults. Eur J Clin Nutr 67:939–943. doi: 10.1038/ejcn.2013.93 CrossRefGoogle Scholar
  26. 26.
    Popkin BM, D’Anci KE, Rosenberg IH (2010) Water, hydration, and health. Nutr Rev 68:439–458. doi: 10.1111/j.1753-4887.2010.00304.x CrossRefGoogle Scholar
  27. 27.
    Powers JS, Buchowski M, Wang L, Otoo-Boameh A (2012) Total body water in elderly adults–assessing hydration status by bioelectrical impedance analysis vs urine osmolality. J Am Geriatr Soc 60:388–390. doi: 10.1111/j.1532-5415.2011.03814.x CrossRefGoogle Scholar
  28. 28.
    Sichert-Hellert W, Kersting M, Manz F (2001) Fifteen year trends in water intake in German children and adolescents: results of the DONALD Study: Dortmund Nutritional and Anthropometric Longitudinally Designed Study. Acta Paediatr 90:732–737CrossRefGoogle Scholar
  29. 29.
    Stahl A, Kroke A, Bolzenius K, Manz F (2007) Relation between hydration status in children and their dietary profile—results from the DONALD study. Eur J Clin Nutr 61:1386–1392. doi: 10.1038/sj.ejcn.1602663 CrossRefGoogle Scholar
  30. 30.
    Stookey JD, Brass B, Holliday A, Arieff A (2012) What is the cell hydration status of healthy children in the USA? Preliminary data on urine osmolality and water intake. Public Health Nutr 15:2148–2156. doi: 10.1017/S1368980011003648 CrossRefGoogle Scholar
  31. 31.
    Tiffin R, Salois M (2012) Inequalities in diet and nutrition. Proc Nutr Soc 71:105–111. doi: 10.1017/S0029665111003284 CrossRefGoogle Scholar
  32. 32.
    Unesco (2010) International Standard Classification of Education. Available at: http://www.uis.unesco.org
  33. 33.
    VIGeZ (2006) De actieve voedingsdriehoek: een praktische voedings—en beweeggids (The active Food Pyramid: A practical guide to diet and physical activity). Vlaams Instituut voor Gezondheidspromotie en Ziektepreventie (VIGeZ), BrusselsGoogle Scholar
  34. 34.
    Wells JC, Williams JE, Chomtho S, Darch T, Grijalva-Eternod C, Kennedy K, Haroun D, Wilson C, Cole TJ, Fewtrell MS (2010) Pediatric reference data for lean tissue properties: density and hydration from age 5 to 20 y. Am J Clin Nutr 91:610–618. doi: 10.3945/ajcn.2009.28428 CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  1. 1.Department of Public Health, Faculty of Medicine and Health SciencesGhent UniversityGhentBelgium
  2. 2.Department of Pediatric Nephrology/UrologyUniversity Hospital GhentGhentBelgium
  3. 3.Department of Health Sciences, VesaliusUniversity College GhentGhentBelgium

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