Access to Drinking Water, Sugar-Sweetened Beverage and Water Intake, and Abdominal Obesity in Puerto Rican Adults

Abstract

ObjectivesTo examine associations between access to drinking water, beverage intake, and abdominal obesity among adults in Puerto Rico (PR).MethodsCross-sectional data from 856 adults (30–75 y) of the Puerto Rico Observational Study of Psychosocial, Environmental, and Chronic Disease Trends (PROSPECT) were used. Participants indicated the type of drinking water most used at home and preference factors (e.g., availability, appearance, cost, and taste). Sugar-sweetened beverages (SSBs) and water intake was assessed with a food frequency questionnaire. Interviewers measured waist circumference; abdominal obesity was defined as >102 cm in men and >88 cm in women. Multivariable linear regression models were used to test the associations between type and preference factors for water and SSBs intake. Multivariable logistic regression models were used to test the association between SSBs and water intake and abdominal obesity. Substitution analysis of water for SSBs was also performed.ResultsMost participants (61%) reported drinking bottled water, while 27% chose filtered tap water and 11% chose unfiltered tap water. Most participants (82%) did not think their tap water was clean or safe, while 63% disliked its taste. Participants that preferred bottled water to unfiltered tap water had higher water intake (mean ± SE: 7.54 ± 0.17 vs. 6.55 ± 0.41 servings/d). Water intake was lower in participants that reported cost (6.66 ± 0.23 vs. 7.76 ± 0.16 servings/d), appearance (6.67 ± 0.22 vs. 7.80 ± 0.17 servings/d), and availability (6.57 ± 0.20 vs. 8.06 ± 0.18 servings/d) as preference factors, compared to their counterparts. Taste or safety were not associated with water intake. SSBs or water intake were not associated with abdominal obesity. Substituting one serving of water for one serving of SSBs was associated with lower odds of abdominal obesity (OR = 0.89; 95% CI: 0.79, 0.98), with a significant association for substituting soda (OR = 0.83; 95% CI: 0.74, 0.93) and no association for substituting juice.ConclusionsMost adults in PR disliked their tap water's cleanliness, safety, taste, and appearance. Measures to provide affordable, safe, and appealing drinking water may facilitate its intake, and its use as a substitute for SSBs, notably soda, may prevent abdominal obesity in PR adults.Funding SourcesNIH.