Current Status Water Intake Of Children And Adolescents In Four Cities Of China

[objective]Water, the essential substance of all life, is an important integral part of the human body, and plays an important function in life activities. Water requirements are mainly affected by age, ambient temperature, physical activity and other factors. Drinking less or more will take disadvantages to health. Because of children and adolescents is a critical period of growth and development, dehydration have impact on their health and leaning. To describe total drinking water and its influence factors of children and adolescents in four cities of China, and to provide timely, accurate and reliable information for establishing adequate water intake for children and adolescents and evaluation relevant policies in China, we carried out the survey in four cities of China in September to October,2011.[Methods]A total of5868school students from four cities,Beijing, Shanghai, Guangzhou and Chengdu were selected, using multi-stage random sampling method. Total drinking water included plain water and beverages.The information of amounts and types of daily drinking water was recorded by subjects for seven consecutive days using a quantitative measurement. Using questionnaire to understand the general information of students’ families, physical activity, the knowledge of drinking water and behavior of the students and their parents. Height and weight were measured by uniform training investigators.[Results]The average daily total drinking water of subjects wasl089ml, with significant difference among four cities(F=114.28, P<0.0001), the highest in Beijing (1165ml) and Guangzhou (1185ml), followed by Shanghai (1126ml), Chengdu (866ml) at least. Total drinking water in boys (1157ml) was significantly higher than girls (1026ml,x2=78.89, P<0.0001), and significantly higher in urban (1185ml)than rural (991ml, x2=194.38, P<0.0001).The difference among different ages was statistically significant (F=66.32, P<0.0001), with descending order in high school student (1185ml), secondary school students (1141ml)and primary school students(l000ml). The difference was statistically significant among different nutritional status (F=31.29, P<0.0001), in which the amount of obese students was the highest (1270ml), followed by overweight students (1202ml), and both of them were higher than normal (1067ml) and underweight students (1010ml).The average daily consumption of plain water of subjects was744ml (68.3%), the difference was statistically significant (F=113.74, P<0.0001) among four cities, with descending order, Guangzhou869ml, Beijing818ml, Shanghai702ml, and Chengdu573ml.The amount of plain water in boys (809ml) was significantly higher than girls (683ml,x2=91.76, P<0.0001).Urban (792ml) was significantly higher than in rural (695ml,x2=37.06, P<0.0001). The difference among different age groups were statistically significant (F=55.23, P<0.0001), in which high school students (829ml) drinking the most, primary students(672ml) drinking the least. Obese students (894ml) drinking the most, followed by overweight students (830ml), while higher than normal (726ml) and underweight students (681ml), the difference was statistically significant (F=25.11, P<0.0001).The average daily consumption of beverages was345ml (31.7%) with descending order in four cities, Shanghai (424ml), Beijing (347ml), Guangzhou (316ml), Chengdu (293ml), the difference was statistically significant (F=58.94, P <0.0001). The consumption of beverages in urban areas (394ml) was higher than in rural areas (296ml,x2=209.72, P<0.0001), but no significant difference between boys (348ml) and girls (342ml).The difference among different age groups was statistically significant (F=8.37, P=0.0002), the consumption of beverages of high school students (356ml) and middle school students (360ml) were higher than primary school students (328ml). Obesity students(376ml) and overweight students (371ml) drank the most, underweight students (329ml) drank the least, the difference was statistically significant (F=4.26, P=0.0052).The difference among various types of beverages was statistically significant (F=9946.12, P<0.0001).The highest consumption of milk and derivatives was in Shanghai (225ml). All kinds of beverages consumed in boys were significantly higher than girls, and urban higher than rural.The average daily number of drinking acts was4.7times. The average drinking water per act was239ml,the consumption of plain water per act was231ml,and beverages per act was237ml.Among three periods a day, the amount of drinking water in the morning (420ml)was the most, followed by afternoon (341ml),and the least in the evening (327ml), the difference was statistically significant (F=325.23, P<0.0001). The distribution trend of plain water in three time periods was the same as total drinking water, but beverages in the morning drank the most, followed by the evening, afternoon the least.The average daily drinking water in meal time was316ml,while non-mealtime was773ml, the difference was statistically significant (S=7,622,772, P <0.0001).Both plain water and beverages in non-meal time were higher than meal time.(plain water:S=7884427, P<0.0001,beverages:S=15,551,117, P <0.0001).There was no significant difference between plain water and beverage; but plain water in non-meal time was significantly higher than beverages (x2=4163.55, P<0.0001).The amount of total drinking water in weekday (1102ml) was significantly higher than weekend (1062ml S=-1319377, P<0.0001).The consumption of plain water (767ml) in weekday was significantly higher than weekend(691ml),while beverages was the opposite(weekday:336ml,weekend:370ml).The difference among different levels of physical activity of the total drinking water was statistically significant (F=10.62, P<0.0001). The amount of total fluid intake in high level (1134ml) was higher than medium level (1059ml) and low level (1075ml), plain water among three level were no significant difference, but the trend in beverage was the same as the total drinking water.81.4%of children and adolescents considered they should drink plain water in their daily life, while73.5%of them choose beverage as the most favorite drink.59.8%of them drank water when they felt thirsty.[Conclusion]The average daily total fluid intake of children and adolescents in China is less than the recommendation of EFSA and the United States. Major of fluid intake comes from drinking water. The influence factors of fluid intake include city, gender, urban and rural, age, time period, nutritional status and physical activity levels.The knowledge of drinking water of children and adolescents in four cities is not comprehensive enough.