The association between hydration status and body composition in healthy children and adolescents
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Priscilla Clayton
,
María Angélica Trak-Fellermeier
,
Alison Macchi
,
Rodolfo Galván
Abstract
Objectives
Children 10–20 years old in the US are currently obese, showing suboptimal hydration as 60% fail to meet the US Dietary Reference Intakes for water. Studies have shown a significant inverse association between hydration status and body composition in children, although most failed to use the Dual-X-Ray Absorptiometry Scan (DEXA), the gold standard for body composition. Limited studies used an objective marker to measure hydration, such as urine specific gravity (USG) from a 24-h urine collection. Therefore, this study aimed to examine the association between hydration status (measured from USG in a 24-h urine sample and assessed from three 24-h dietary recalls) and body fat % and lean mass (assessed from a DEXA scan) in children (10–13 years, n=34) and adolescents (18–20 years, n=34).
Methods
Body composition was measured using DEXA, total water intake (mL/d) was assessed from three 24-h dietary recalls and analyzed using the Nutrition Data System for Research (NDSR). Hydration status was objectively measured using USG via 24-h urine collection.
Results
Overall body fat % was 31.7 ± 7.31, total water intake was 1746 ± 762.0 mL/d, and USG score was 1.020 ± 0.011 uG. Linear regressions showed significance between total water intake and lean mass (B=12.2, p<0.05). Logistic regressions showed no significant association between body composition and USG and total water intake.
Conclusions
Findings showed total water intake was significantly associated with lean mass. Future research should be conducted to explore other objective markers of hydration and with a larger sample.
Funding source: National Institutes of Health
Award Identifier / Grant number: 1R01HD098589-01
Acknowledgments
We would like to thank Julia Leone from the Department of Dietetics and Nutrition, Stempel School of Public Health, at Florida International University for her contribution in the data collection.
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Research funding: This study was funded in part by the National Institutes of Health (Eunice Kennedy Shriver National Institute of Child Health and Human Development, NICHD), grant number 1R01HD098589-01.
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Author contributions: PC and CP: facilitated and conducted the study, wrote the manuscript. MATF, RG, and PC collected all questionnaires, biospecimens, and anthropometrics. CP: project oversight and was responsible for the final content of the manuscript; and all authors critically reviewed the manuscript and approved the final version.
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Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
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Informed consent: Informed consent was obtained from all individuals included in this study.
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Ethical approval: The research related to human use has complied with all the relevant national regulations, institutional polices, and in accordance with the tenets of the Helsinki Declaration and has been approved by the authors’ Institutional Review Board (IRB-22-0045).
References
1. Hales, CM, Carroll, MD, Fryar, CD, Ogden, CL. Prevalence of obesity among adults and youth: United States, 2015–2016 key findings data from the national health and nutrition examination survey; 2015. Available from: https://www.cdc.gov/nchs/data/databriefs/db288_table.pdf#1.Search in Google Scholar
2. Han, JC, Lawlor, DA, Kimm, SY. Childhood obesity – 2010: progress and challenges. Lancet 2010;375:1737. https://doi.org/10.1016/S0140-6736(10)60171-7.Search in Google Scholar
3. Güngör, NK. Overweight and obesity in children and adolescents. J Clin Res Pediatr Endocrinol 2014;6:129. https://doi.org/10.4274/JCRPE.1471.Search in Google Scholar
4. Sanyaolu, A, Okorie, C, Qi, X, Locke, J, Rehman, S. Childhood and adolescent obesity in the United States: a public health concern. Glob Pediatr Health 2019;6:1–11. https://doi.org/10.1177/2333794X19891305.Search in Google Scholar
5. Hasnain, SR, Singer, MR, Bradlee, ML, Moore, LL. Beverage intake in early childhood and change in body fat from preschool to adolescence. Child Obes 2014;10:42–9. https://doi.org/10.1089/chi.2013.0004.Search in Google Scholar
6. Vieux, F, Maillot, M, Rehm, CD, Barrios, P, Drewnowski, A. Trends in tap and bottled water consumption among children and adults in the United States: analyses of NHANES 2011–16 data. Nutr J 2020;19:1–14. https://doi.org/10.1186/S12937-020-0523-6.Search in Google Scholar
7. Institute of Medicine (U.S.). Panel on dietary reference intakes for electrolytes and water. In: DRI, dietary reference intakes for water, potassium, sodium, chloride, and sulfate: National Academies Press; 2004.Search in Google Scholar
8. Thornton, SN. Increased hydration can be associated with weight loss. Front Nutr 2016;3:1–8. https://doi.org/10.3389/fnut.2016.00018.Search in Google Scholar
9. Carretero-Krug, A, Úbeda, N, Velasco, C, Medina-Font, J, Laguna, TT, Varela-Moreiras, G, et al.. Hydration status, body composition, and anxiety status in aeronautical military personnel from Spain: a cross-sectional study. Mil Med Res 2021;8:1–9. https://doi.org/10.1186/S40779-021-00327-2.Search in Google Scholar
10. Armstrong, LE, Johnson, EC, Munoz, CX, Swokla, B, le Bellego, L, Jimenez, L, et al.. Hydration biomarkers and dietary fluid consumption of women. J Acad Nutr Diet 2012;112:1056–61. https://doi.org/10.1016/J.JAND.2012.03.036.Search in Google Scholar
11. González-Arellanes, R, Urquidez-Romero, R, Rodríguez-Tadeo, A, Esparza-Romero, J, Méndez-Estrada, RO, Ramírez-López, E, et al.. High hydration factor in older hispanic-American adults: possible implications for accurate body composition estimates. Nutrients 2019;11:1–10. https://doi.org/10.3390/NU11122897.Search in Google Scholar
12. Sekiguchi, Y, Benjamin, CL, Butler, CR, Morrissey, MC, Filep, EM, Stearns, RL, et al.. Relationships between WUT (body weight, urine color, and thirst level) criteria and urine indices of hydration status. Sports Health 2021;4:566–74. https://doi.org/10.1177/19417381211038494.Search in Google Scholar
13. Sekiguchi, Y, Benjamin, CL, Butler, CR, Morrissey, MC, Filep, EM, Stearns, RL, et al.. The relationship between %BML, urine color, thirst level and urine indices of hydration status. Ann Nutr Metab 2020;76:65–6. https://doi.org/10.1159/000515217.Search in Google Scholar
14. Gonçalves, A, Silva, J, Carvalho, J, Moreira, P, Padrão, P. Urinary hydration biomarkers and water sources in free-living elderly. Nutr Hosp 2016;33(3 Suppl):13–8. https://doi.org/10.20960/NH.311Search in Google Scholar
15. Chang, T, Ravi, N, Plegue, MA, Sonneville, KR, Davis, MM. Inadequate hydration, BMI, and obesity among US adults: NHANES 2009–2012. Ann Fam Med 2016;14:320–4. https://doi.org/10.1370/afm.1951.Search in Google Scholar
16. Padrão, P, Sousa, AS, Guerra, RS, Álvares, L, Santos, A, Borges, N, et al.. A cross-sectional study on the association between 24-h urine osmolality and weight status in older adults. Nutrients 2017;9:1–17. https://doi.org/10.3390/nu9111272.Search in Google Scholar
17. Maffeis, C, Tommasi, M, Tomasselli, F, Spinelli, J, Fornari, E, Scattolo, N, et al.. Fluid intake and hydration status in obese vs normal weight children. Eur J Clin Nutr 2016;70:560–5. https://doi.org/10.1038/ejcn.2015.170.Search in Google Scholar
18. Michels, N, van den Bussche, K, vande Walle, J, de Henauw, S. Belgian primary school children’s hydration status at school and its personal determinants. Eur J Nutr 2017;56:793–805. https://doi.org/10.1007/s00394-015-1126-4.Search in Google Scholar
19. García, AIL, Moráis-Moreno, C, Samaniego-Vaesken, Mde L, Puga, AM, Partearroyo, T, Varela-Moreiras, G. Influence of water intake and balance on body composition in healthy young adults from Spain. Nutrients 2019;11:1–12. https://doi.org/10.3390/NU11081923.Search in Google Scholar
20. García, AIL, Moráis-Moreno, C, Samaniego-Vaesken, Mde L, Puga, AM, Varela-Moreiras, G, Partearroyo, T. Association between hydration status and body composition in healthy adolescents from Spain. Nutrients 2019;11:1–17. https://doi.org/10.3390/NU11112692.Search in Google Scholar
21. Milla-Tobarra, M, García-Hermoso, A, Lahoz-García, N, Notario-Pacheco, B, Lucas-De La Cruz, L, Pozuelo-Carrascosa, DP, et al.. The association between water intake, body composition and cardiometabolic factors among children: the Cuenca study. Nutr Hosp 2016;33:19–26. https://doi.org/10.20960/NH.312.Search in Google Scholar
22. Raymond, CJ, Bosch, TA, Dengel, DR. Total and segmental body composition examination in collegiate football players using multifrequency BIA and DXA. Med Sci Sports Exerc 2017;49:255–6. https://doi.org/10.1249/01.mss.0000517553.34971.ba.Search in Google Scholar
23. Palacios, C, Trak-Fellermeier, MA, Pérez, CM, Huffman, F, Suarez, YH, Bursac, Z, et al.. Effect of soluble corn fiber supplementation for 1 year on bone metabolism in children, the MetA-bone trial: rationale and design. Contemp Clin Trials 2020;95:106061. https://doi.org/10.1016/J.CCT.2020.106061.Search in Google Scholar
24. Growth Charts. Individual growth charts. Available from: https://www.cdc.gov/growthcharts/charts.htm [Accessed 4 May 2022].Search in Google Scholar
25. National Center for Health Statistics. Anthropometry procedures manual. Atlanta, GA: Centers for Disease Control and Prevention; 2017.Search in Google Scholar
26. Craig, CL, Marshall, AL, Sjöström, M, Bauman, AE, Booth, ML, Ainsworth, BE, et al.. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc 2003;35:1381–95. https://doi.org/10.1249/01.MSS.0000078924.61453.FB.Search in Google Scholar
27. National Oceanic and Atmospheric, Administration. Climate. Available from: https://www.weather.gov/wrh/Climate?wfo=mfl [Accessed 28 Jan 2023].Search in Google Scholar
28. Barreira, TV, Tseh, W. The effects of acute water ingestion on body composition analyses via dual-energy X-ray absorptiometry. Clin Nutr 2020;12:3836–8. https://doi.org/10.1016/j.clnu.2020.03.037.Search in Google Scholar
29. Wang, B, Tang, C, Wang, H, Zhou, W, Chen, Y, Zhou, Y, et al.. Influence of body mass index status on urinary creatinine and specific gravity for epidemiological study of children. Eur J Pediatr 2015;174:1481–9. https://doi.org/10.1007/s00431-015-2558-9.Search in Google Scholar
30. Sawka, MN, Burke, LM, Eichner, ER, Maughan, RJ, Montain, SJ, Stachenfeld, NS, et al.. American College of Sports Medicine position stand. Exercise and fluid replacement. Med Sci Sports Exerc 2007;39:377–90. https://doi.org/10.1249/MSS.0B013E31802CA597.Search in Google Scholar
31. Grimes, CA, Wright, JD, Liu, K, Nowson, CA, Loria, CM. Dietary sodium intake is associated with total fluid and sugar-sweetened beverage consumption in US children and adolescents aged 2–18 y: NHANES 2005–2008. Am J Clin Nutr 2013;98:189–96. https://doi.org/10.3945/AJCN.112.051508.Search in Google Scholar
32. Grimes, CA, Riddell, LJ, Campbell, KJ, Nowson, CA. Dietary salt intake, sugar-sweetened beverage consumption, and obesity risk. Pediatrics 2013;131:14–21. https://doi.org/10.1542/PEDS.2012-1628Search in Google Scholar
33. Kozioł-Kozakowska, A, Piórecka, B, Suder, A, Jagielski, P. Body composition and a school day hydration state among polish children-A cross-sectional study. Int J Environ Res Publ Health 2020;17:1–12. https://doi.org/10.3390/IJERPH17197181.Search in Google Scholar
34. Gutiérrez-Marín, D, Luque, V, Ferré, N, Fewtrell, MS, Williams, JE, Wells, JCK. ARTICLE Body composition, energy expenditure and physical activity Associations of age and body mass index with hydration and density of fat-free mass from 4 to 22 years. Eur J Clin Nutr 2019;73:1422–30. https://doi.org/10.1038/s41430-019-0447-4.Search in Google Scholar
35. García, AIL, Samaniego-Vaesken, MDL, Partearroyo, T, Varela-Moreiras, G. Adaptation and validation of the hydration status questionnaire in a Spanish adolescent-young population: a cross sectional study. Nutrients 2019;11:1–14. https://doi.org/10.3390/nu11030565.Search in Google Scholar
36. Shypailo, RJ, Wong, WW. Fat and fat-free mass index references in children and young adults: assessments along racial and ethnic lines. Am J Clin Nutr 2020;112:566–75. https://doi.org/10.1093/AJCN/NQAA128.Search in Google Scholar
37. Weber, DR, Moore, RH, Leonard, MB, Zemel, BS. Fat and lean BMI reference curves in children and adolescents and their utility in identifying excess adiposity compared with BMI and percentage body fat. Am J Clin Nutr. 2013;98:49. https://doi.org/10.3945/AJCN.112.053611.Search in Google Scholar
38. Baron, S, Courbebaisse, M, Lepicard, EM, Friedlander, G. Assessment of hydration status in a large population. Br J Nutr 2015;113:147–58. https://doi.org/10.1017/S0007114514003213.Search in Google Scholar
39. Imran, S, Eva, G, Christopher, S, Flynn, E, Henner, D. Is specific gravity a good estimate of urine osmolality? J Clin Lab Anal 2010;24:426. https://doi.org/10.1002/JCLA.20424.Search in Google Scholar
40. Chadha, V, Garg, U, Alon, US. Measurement of urinary concentration: a critical appraisal of methodologies. Pediatr Nephrol. 2001;16:374–82. https://doi.org/10.1007/s004670000551.Search in Google Scholar
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- Clinical spectrum, imaging characteristics, and treatment outcomes of pediatric adrenocortical tumors: a 24-year experience from Western India
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