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Total water intake guidelines are sufficient for optimal hydration in United States adults

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Abstract

Purpose

Recent studies suggest that 24-h urine osmolality (UOsm) for optimal water intake should be maintained < 500 mmol·kg−1. The purpose of this study was to determine the total water intake (TWI) requirement for healthy adults to maintain optimal hydration as indicated by 24-h urine osmolality < 500 mmol·kg−1.

Methods

Twenty-four-hour UOsm was assessed in 49 men and 50 women residing in the United States (age: 41 ± 14 y, body mass index: 26.3 ± 5.2 kg·m−2). TWI was assessed from 7-day water turnover, using a dilution of deuterium oxide, corrected for metabolic water production. The diagnostic accuracy of TWI to identify UOsm < 500 mmol·kg−1 was evaluated using receiver operating characteristic (ROC) analysis in men and women separately.

Results

Twenty-four-hour UOsm was 482 ± 229 and 346 ± 182 mmol·kg−1 and TWI was 3.57 ± 1.10 L·d−1 and 3.20 ± 1.27 L·d−1 in men and women, respectively. ROC analysis for TWI detecting 24-h UOsm < 500 mmol·kg−1 in men yielded an area under the curve (AUC) of 77.4% with sensitivity, specificity, and threshold values of 83.3%, 64.5%, and 3.39 L·d−1, respectively. The AUC was 82.4% in women with sensitivity, specificity, and threshold values of 85.7%, 72.1%, and 2.61 L·d−1.

Conclusion

Considering threshold values in men and women of 3.4 L·d−1 and 2.6 L·d−1, respectively, maintaining TWI in line with National Academy of Medicine guidelines of 3.7 L·d−1 in men and 2.7 L·d−1 in women should be sufficient for most individuals in the United States to maintain 24-h UOsm < 500 mmol·kg−1.

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Acknowledgements

The authors would like to thank Catalina Capitan, LynnDee Summers, Zachary Lewis, Tom Vidal, Ryan Peters, Berkley Vaughan, Lauren Smith, Ainsley Huffman, Mickey Hammer, and Rebecca Mishler for their help during data collection. This study was funded by Danone Research.

Author information

Authors and Affiliations

  1. Department of Kinesiology and Public Health, California Polytechnic State University, San Luis Obispo, CA, USA

    Adam D. Seal

  2. Hydration Science Lab, Arizona State University, College of Health Solutions, Phoenix, AZ, USA

    Abigail T. Colburn & Stavros A. Kavouras

  3. Human Integrated Physiology Laboratory, University of Wyoming, Laramie, WY, USA

    Evan C. Johnson

  4. École de Kinésiologie et des Sciences de l’Activité Physique, University of Montreal, Montreal, QC, Canada

    François Péronnet

  5. Department of Dietetics and Nutrition, University of Arkansas for Medical Sciences, Little Rock, AR, USA

    Lisa T. Jansen

  6. Department of Health and Human Performance, College of Charleston, Charleston, SC, USA

    J. D. Adams

  7. Section of Sports Medicine and Biology of Physical Activity, School of Physical Education and Sport Science, University of Athens, Athens, Greece

    Costas N. Bardis

  8. Danone Research, Palaiseau, France

    Isabelle Guelinckx & Erica T. Perrier

Authors
  1. Adam D. Seal
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  10. Stavros A. Kavouras
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Contributions

All authors contributed to the study’s conception and design. Material preparation, data collection, and analysis were performed by EJ, LJ, JDA, CB, AS, and AC. The first draft of the manuscript was written by AS and AC and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript. SK was the principal investigator and had primary responsibility for the final content.

Corresponding author

Correspondence to Stavros A. Kavouras.

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Conflicts of interest

ADS has served as a scientific consultant for Gatorade Sports Science Institute. IG and ETP were employees of Danone Research, France at the time of analysis. SAK is a scientific consultant for Hyduro Inc. and has served as a scientific consultant for Standard Process, Quest Diagnostics, and Danone Research. He also has active grants with Danone Research and Standard Process. ECJ has previously received research grants from Danone Research.

Ethical approval

This protocol was approved by the University’s institutional review board and biosafety committee and was therefore performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Consent to participate

All persons gave their informed consent prior to their inclusion in the study.

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Seal, A.D., Colburn, A.T., Johnson, E.C. et al. Total water intake guidelines are sufficient for optimal hydration in United States adults. Eur J Nutr 62, 221–226 (2023). https://doi.org/10.1007/s00394-022-02972-2

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  • DOI: https://doi.org/10.1007/s00394-022-02972-2

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