Total fluid intake of children and adolescents: cross-sectional surveys in 13 countries worldwide

Iris Iglesia, Isabelle Guelinckx, Pilar M. De Miguel-Etayo, Esther M. González-Gil, Jordi Salas-Salvadó, Stavros A. Kavouras, Joan Gandy, Homero Martínez, Saptawati Bardosono, Morteza Abdollahi, Esmat Nasseri, Agnieszka Jarosz, Guansheng Ma, Esteban Carmuega, Isabelle Thiébaut, Luis A. Moreno

To describe total fluid intake (TFI) according to socio-demographic characteristics in children and adolescents worldwide. Data of 3611 children (4-9 years) and 8109 adolescents (10-18 years) were retrieved from 13 cross-sectional surveys (47 % males). In three countries, school classes were randomly recruited with stratified cluster sampling design. In the other countries, participants were randomly recruited based on a quota method. TFI (drinking water and beverages of all kinds) was obtained with a fluid-specific record over 7 consecutive days. Adequacy was assessed by comparing TFI to 80 % of adequate intake (AI) for total water intake set by European Food Safety Authority. Data on height, weight and socio-economic level were collected in most countries. The mean (SD) TFI ranged from [1.32 (0.68)] to [1.35 (0.71)] L/day. Non-adherence to AIs for fluids ranged from 10 % (Uruguay) to >90 % (Belgium). Females were more likely to meet the AIs for fluids than males (4-9 years: 28 %, OR 0.72, p = 0.002; 10-18 years: 20 %, OR 0.80, p = 0.001), while adolescents were less likely to meet the AI than children (OR 1.645, p < 0.001 in males and OR 1.625, p < 0.001 in females). A high proportion of children and adolescents are at risk of an inadequate fluid intake. This risk is especially high in males and adolescents when compared with females or children categories. This highlights water intake among young populations as an issue of global concern.