1-in-5 US Kids Drink No Water During a Given Day

Troy Brown, RN

April 22, 2019

One fifth of US children and young adults said they drank no water on a given day and that they consumed almost twice as many calories from sugar-sweetened beverages (SSBs) as those who drank water, new data show.

"It was surprising that 1-in-5 children and young adults did not consume any plain water on a given day since water is the healthiest drink people can consume, [and] is critical for physiological and cognitive health," Asher Y. Rosinger, PhD, MPH, assistant professor of biobehavioral health and anthropology, Pennsylvania State University, University Park, told Medscape Medical News.

Rosinger and colleagues published their findings online today in JAMA Pediatrics.

The researchers analyzed data from 8400 children and young adults included in the 2011 to 2016 cross-sectional survey waves of the National Health and Nutrition Examination Survey (NHANES) and who had complete valid dietary and covariate data. Of those, 51.1% were male and 48.9% were female. The mean age was 10.6 years.

"Number of total kilocalories and percentage of total energy intake from SSBs varied by water intake status within all age and racial/ethnic groups," the researchers note.

On a given day, 79.9% of participants said they drank plain water. Drinking no water in a day was associated with intake of 92.9 kcal (P < .001) and 4.5% (P < .001) more calories from SSBs among those aged 2 to 19 years, after adjustment for sociodemographic variables.

"Clinicians should know that kids [who] did not consume any plain water (from tap or bottled water) consumed almost twice as many calories and percent of total calories from sugary drinks than kids [who] consumed water. And for the sample overall that translated to nearly 100 extra calories on a given day," Rosinger said.

Interactions of water consumption status with race/ethnicity and age were statistically significant but not for sex or federal income to poverty ratio.

Caloric intake from SSBs was significantly higher among non-Hispanic white (237.4 vs 114.9 kcal), non-Hispanic black (218.1 vs 124.9 kcal), and Hispanic children (176.1 vs 115.3 kcal) who reported no water intake compared with those who reported water intake.

Caloric intake from SSBs was also significantly higher among those who did not drink water vs those who did in all age categories (2 - 5 years, 92.8 vs 46.4 kcal; 6-11 years, 183.3 vs 95.4 kcal; 12-19 years, 288.4 vs 155.4 kcal; all P < .001).

"Kids should drink water every day. When they don't drink water, they are more likely to consume more sugary drinks and that's when they're likely getting more than 10% of their daily calories from these beverages. Sugar-sweetened beverage consumption has been linked to many negative health conditions, such as weight gain, dental caries, and type 2 diabetes" Rosinger explained.

The authors caution that causality cannot be inferred from the results as NHANES is cross-sectional in nature.

Rosinger concluded, "It's important to note that in parts of the US, some people may not trust their water due to lead or other contamination. Water insecurity is a growing problem in the US, so we need to keep that in mind as [an] important context, especially when it comes to parents who may be giving their kids soda or juice because they distrust the water. Therefore, it's critical to ensure that everyone has access to safe, clean water."

The authors have disclosed no relevant financial relationships.

JAMA Pediatrics. Published online April 22, 2019. Abstract

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