Patterns and sociodemographic determinants of water intake by children in China: results from the first national population-based survey

Abstract

Purpose: Accurate data on water and beverage intakes are essential for assessing hydration adequacy and setting proper guidelines. The objective of this study is to identify the patterns and sociodemographic determinants of water intake and to assess the intake adequacy for children in China.

Methods: The study team recruited 41,439 children aged 6-17 years using a multi-stage cluster random sampling method. Daily water and beverage intakes were investigated with the standard questionnaires and measuring containers in face-to-face interviews. Each participant was assigned an adjustment weight to obtain a nationally representative sample. Sociodemographic factors influencing water intake were identified using multi-variable regressions. Water intake adequacy was evaluated by comparing with the recommended water intake (RWI).

Results: The mean ± standard deviation of total water intake (TWI) was 1603 ± 731 mL/day for boys and 1487 ± 661 mL/day for girls. Plain water, food moisture, and other beverages contributed 51%, 20%, and 29% of the TWI. Multi-variable analyses showed that TWI of children increased with age, in urban areas and day schools, and with parents' economic and educational levels. The majority (82%) of children had TWI not meeting the corresponding RWI, and the percentage increased with age except for 14-17-year-old boys.

Conclusions: Plain water is still the major source of daily water intake by children in China. Unfortunately, the majority of children do not have sufficient water intake, which warrants future actions and guidelines targeting adequate hydration.

Keywords: Children; China; Hydration; Plain water; Water intake; Water resource.