Contributors of water intake in US children and adolescents: associations with dietary and meal characteristics--National Health and Nutrition Examination Survey 2005-2006

Abstract

Background: Little is known about the association of contributors of total water intake with dietary characteristics in US children.

Objective: We examined intakes of total water and its contributors and their associations with diet and meal reporting in children and adolescents.

Design: Dietary data for children 2-19 y of age (n = 3978) from the National Health and Nutrition Examination Survey 2005-2006 were used to compute usual intake of total water. The association of total water and its contributors with sociodemographic characteristics and dietary and meal attributes was examined by using multiple regression analysis.

Results: The adjusted mean intakes of total water in Americans aged 2-5, 6-11, and 12-19 y were 1.4, 1.6, and 2.4 L, respectively. The mean usual intake of total water was generally less than the Adequate Intake; overall, more boys reported intakes of at least the Adequate Intake. The percentage of total water intake from plain water increased with age. Plain water intake was inversely associated with the intake of beverage moisture and the energy density of foods; conversely, beverage moisture was positively associated with dietary energy, fat, and the energy density of foods. Associations of water contributors with meal patterns (number of eating occasions, reporting of breakfast or snack) were inconsistent across age groups. Nearly 80% of food moisture, >66% of beverage moisture, and ≈30% of plain water were reported with main meals.

Conclusions: Intake of total water over 24 h from different contributors varied by age. Qualitative differences in dietary intake in association with the amount of plain water and beverage moisture in the recalls were observed. American children and adolescents consumed more than two-thirds of their daily beverages with main meals.

FIGURE 1.

Adjusted mean percentages of contributors of water consumed with main meals reported in a 24-h recall by children and adolescents 2–19 y of age in the National Health and Nutrition Examination Survey (NHANES) 2005–2006. Adjusted means were obtained from multiple regression models that included sex, race-ethnicity, age group, sex-specific BMI-for-age percentile, educational level of household reference person, family income, level of physical activity, hours of screen time, day of week of dietary intake, and month of mobile examination center exam as independent variables with each water variable from main meals as a continuous dependent outcome. All regression models excluded those subjects with missing BMI, physical activity, and television and computer use data and those who reported no main meals in the recall (n = 129). All other analyses were limited to those who reported the examined water variable contributor. P values indicate the significance of the association of each independent variable (in the presence of all other variables in the model) from regression models by using the F statistic with a Satterthwaite correction for the df. The age effect was significant for total water (P = 0.001) and for beverage moisture and nutritive beverage moisture (P = 0.04).