Total Daily Fluid Intake Research Articles

Fluid intake behavior in women with refractory overactive bladder undergoing third line therapy.

Fluid intake has been shown to be related to urinary symptoms, but no studies to date have investigated the effect of fluid intake on urinary symptoms in women with refractory overactive bladder (OAB). As this group of women are considered to have a possible unique pathophysiologic mechanism of OAB, we investigated the relationship between fluid intake, fluid intake behavior, and urinary symptoms in women with refractory OAB. A prospective cross-sectional study of women with refractory OAB was conducted by assessing the relationship between fluid intake and lower urinary tract symptoms (LUTS) in women undergoing third line OAB therapies. Fluid intake and behavior were measured by the questionnaire based voiding diaryand urinary symptoms were measured by the International Consultation on Incontinence Questionnaire for Female Lower Urinary Tract Symptoms (ICIQ-FLUTS). The relationship between fluid intake and symptom severity was assessed using Spearman's rankcorrelation and χ2 tests. Of the 126 individuals undergoing third line therapy for OAB, 60 (48%) underwent intradetrusor onabotulinumtoxinA injection (BTX) injection, 42 (33%) peripheral tibial nerve stimulation,and 24 (19%) sacral neuromodulation.The mean total daily fluid intake was 2567.0 ± SD 1292.4 mL and did not differ significantly across treatment groups. Total fluid intake was weakly correlated with worse filling-type LUTS (r = 0.241, p = 0.007), and there was no relationship between LUTS and caffeinated fluid intake. Half (52%) of the subjects reported current fluid restricting behavior to control urinary symptoms, but this behavior was not correlated with LUTS severity (all p > 0.05). Patients that currently use tobacco have greater LUTS (current = 25.8 ± SD 9.5, former = 14.8 ± SD 6.1, never = 15.0 ± SD 6.1; p < 0.001). BMI was also positively correlated with worse incontinence symptoms (r = 0.351, p < 0.001). Fluid intake along with other lifestyle factors, including tobacco use and weight, are minimally related to the symptomatology seen in women with refractory OAB. Further studies are needed to assess if behaviors change during treatment with third line therapies, and if these behavioral changes may affect treatment response.

Water, mineral, and blood acid-base balance in calves with naturally occurring diarrhea receiving two alternative oral rehydration solutions or a placebo

Quantifying the water and mineral losses in feces is essential to determine the optimal composition of oral rehydration solutions (ORS) for diarrheic animals. In a randomized complete block design, this study evaluated water, mineral, and blood acid-base balance of calves with naturally occurring diarrhea receiving ORS or a placebo. On d 0, 45 calves (age: 18 ± 3.2 d; mean ± SD) were selected based on the presence of visual signs of diarrhea, such as dirty tail or wet feces, along with clinical symptoms evaluated by measuring the skin turgor and the degree of enophthalmos. On d 1, calves were divided into blocks of 3 animals based on blood base excess (BE) measured at 0900 h, and within each block, calves were randomly assigned to 1 of 3 treatments (15 calves per treatment) including (1) a hypertonic ORS (HYPER; Na+ = 110 mmol/L; 370 mOsm/kg; strong ion difference [SID] = 60 mEq/L), (2) a hypotonic ORS with low Na+ (HYPO; Na+ = 77 mmol/L; 278 mOsm/kg; SID = 71 mEq/L), and (3) a placebo consisting of lukewarm water with 5 g/L of whey powder (CON). Milk replacer (MR) was fed through teat buckets twice daily at 0630 h and 1700 h in 2 equally sized meals of 2.5 L from d 1 to 3 and of 3.0 L on d 4 and 5. Treatments consisting of 2.0 L lukewarm solutions were administered between milk meals from d 1 to 3 at 1200 h and 2030 h through teat buckets. Refusals of MR and treatments were recorded daily, and blood samples were collected from the jugular vein once daily at arrival in the afternoon of d 0 and at 0900 h from d 1 to 5 after arrival. Urine and feces were collected quantitatively over a 48-h period from 1200 h on d 1 to 1200 h on d 3, and a representative sample of each 24-h period was stored. In addition, the volume of extracellular fluid was evaluated on d 2 by postprandial sampling over a 4-h period relative to the injection of sodium thiosulfate at 1300 h. Total daily fluid intake (MR, treatment, and water) from d 1 to 3 was greater in HYPER (LSM ± SEM; 8.9 ± 0.36 L/d) and HYPO (7.8 ± 0.34 L/d) than in CON (6.6 ± 0.34 L/d). This resulted in a greater water balance (water intake - fluid output in urine and feces) in calves receiving ORS (59.6 ± 6.28 g/kg BW per 24 h vs. 39.6 ± 6.08 g/kg BW per 24 h). Fecal Na+ losses were greater in HYPER than in the other treatments (81 ± 12.0 mg/kg BW per 24 h vs. 24 ± 11.8 mg/kg BW per 24 h). Blood pH was higher in HYPO (7.41 ± 0.016) than CON (7.35 ± 0.016) over the 5 monitoring days, whereas HYPER (7.37 ± 0.017) did not differ with other treatments. In this experimental model, diarrheic calves were likely unable to absorb the high Na+ load from HYPER, resulting in greater Na+ losses in feces, which might have impaired the alkalinizing capacity of HYPER. In contrast, HYPO significantly sustained blood acid-base balance compared with CON, whereas HYPER did not. This suggests that low tonicity ORS with a high SID are more suitable for diarrheic calves.

Hydration patterns and beverage consumption among a sample of institutionalized senior adults in Portugal

Water plays an important role in different body functions, being fundamental for cells, tissues, and organs. It is also directly related to various processes, from maintaining body temperature to eliminating compounds. With age the feeling of thirst decreases, which can lead to inadequate consumption of water causing dehydration in the senior population. This dehydration can have consequences on the clinical status of this population, enhancing its clinical decline. The primary objective of the present study was to evaluate the daily consumption of liquid from beverages in institutionalized individuals in a senior adult residence in the Lisbon area. A cross-sectional observational quantitative study views. An adapted version of a specific fluid-validated questionnaire was used to assess the consumption of different beverages and total daily fluid intake. It was observed that institutionalized individuals did not consume enough total fluid intake to meet the European recommendations appropriate for their sex and age group. Nevertheless, individuals receiving artificial nutrition achieve a daily consumption of 1.5 liters of water.

Fluid Intake And Prevalence Of Nocturia In Geriatric Populations

Nocturia is common among older adults. One treatment strategy is to reduce evening fluid intake. However, this recommendation could put older adults with nocturia at higher risk for not meeting daily water recommendations. PURPOSE: To determine if there is a relationship between total daily fluid intake and nocturia symptoms in a geriatric population (> 65 y). The study will assess 1) if lower daily fluid intake is associated with symptoms of nocturia, 2) if certain beverages are related to higher rates of nocturia, and 3) compare incidence rates of meeting sex-specific daily water recommendations between those with and those without nocturia. METHODS: Participants [n = 76 (52 female), 167 ± 10 cm, 74 ± 16 kg, 73 ± 6 y] were recruited to complete a survey electronically via Research Electronic Data Capture (REDCap) as part of a pilot study. Recruitment was done in conjunction with the University of Washington. The survey included the Sleep Quality Questionnaire, and Hydration Questionnaire (BEVQ-15). Total daily fluid volume was calculated by summing together the fluid intake for each beverage based off frequency of intake and the amount consumed during each intake. Participants were grouped into severe nocturia (HIGH; n = 26) if they selected “three or more times a week,” moderate nocturia (MOD; n = 25) if they reported “once or twice a week” or “less than once a week,” or no nocturia (NO; n = 25) if they selected “not during the past month” in relation to urination frequency at night during the past month. RESULTS: Of 116 surveys started, 76 were completed. No significant difference in average daily fluid intake was found between NO (1467.73 ± 155.85 mL/day), MOD (1507.07 ± 155.85 mL/day), and HIGH (1525.40 ± 152.90 mL/day) groups (F [2,73] =0.036, p = 0.965). Only five participants met daily water recommendations (NO, n = 1; MOD, n = 3; HIGH, n = 1). There was a notable, but non-significant relationship between nocturia symptoms and any alcohol consumption (NO 33% yes, MOD 28% yes, HIGH 12% yes, p = 0.14). CONCLUSION: It does not appear that older adults with nocturia reduce fluid intake to a greater degree than those without nocturia. Overall, the incidence of underhydration in this sample was below recommendations.

Fluid Intake in the First Week of Life and the Duration of Hemodynamically Significant Patent Ductus Arteriosus in Extremely Preterm Infants.

This study aimed to determine the association between daily fluid intake and the duration of hemodynamically significant patent ductus arteriosus (hsPDA). This is a retrospective cohort study of extremely preterm infants (<29 weeks) admitted in the Neonatal Intensive Care Unit of the Advent Health for Children from January 2013 to March 2016, if hsPDA was diagnosed in first week of life and serial echocardiograms were available. Diagnosis of hsPDA was based on a scoring system and its duration was estimated from serial echocardiograms. Cohort was divided into two groups based on duration of hsPDA (<1week, group A and ≥1 week, group B). Daily fluid intake was categorized as prescribed and actual. Prescribed volume was ordered by clinicians based on birth weight, not including trophic feeds, intravenous (IV) boluses or transfusions, etc. Actual intake was calculated by the electronic medical records based on daily weights and included all enteral or parenteral fluids. Multivariate analysis was performed to determine an association between total daily fluid intake over the first week of life and the duration of hsPDA. Two groups were compared to observe the difference between prescribed and actual daily fluid intakes. We enrolled 50 infants in group A and 76 in group B. Infants in group B were of significantly lower gestation and required prolonged ventilation and hospitalization. An association between higher fluid intake in the first 2 days of life and prolonged duration of hsPDA was confirmed by multivariate analysis. Actual fluid intake was significantly higher than prescribed total fluid intake in first 4 days of life for infants in both groups. In extremely preterm infants, higher fluid intake in first 2 days of life is associated with prolonged duration of hsPDA. Actual daily fluid intake can be significantly higher than prescribed daily fluids due to daily weight changes and additional fluid administration. · In preterm infants, actual daily fluid intake may be higher than prescribed volume.. · Higher daily fluid intake in first week of life is associated with prolonged duration of PDA.. · PDA scoring system can be helpful for objective assessment of PDA in preterm infants..

Fluid Intake in the First Week of Life and the Duration of Hemodynamically Significant Patent Ductus Arteriosus in Extremely Preterm Infants

This study aimed to determine the association between daily fluid intake and the duration of hemodynamically significant patent ductus arteriosus (hsPDA). This is a retrospective cohort study of extremely preterm infants (<29 weeks) admitted in the Neonatal Intensive Care Unit of the Advent Health for Children from January 2013 to March 2016, if hsPDA was diagnosed in first week of life and serial echocardiograms were available. Diagnosis of hsPDA was based on a scoring system and its duration was estimated from serial echocardiograms. Cohort was divided into two groups based on duration of hsPDA (<1week, group A and ≥1 week, group B). Daily fluid intake was categorized as prescribed and actual. Prescribed volume was ordered by clinicians based on birth weight, not including trophic feeds, intravenous (IV) boluses or transfusions, etc. Actual intake was calculated by the electronic medical records based on daily weights and included all enteral or parenteral fluids. Multivariate analysis was performed to determine an association between total daily fluid intake over the first week of life and the duration of hsPDA. Two groups were compared to observe the difference between prescribed and actual daily fluid intakes. We enrolled 50 infants in group A and 76 in group B. Infants in group B were of significantly lower gestation and required prolonged ventilation and hospitalization. An association between higher fluid intake in the first 2 days of life and prolonged duration of hsPDA was confirmed by multivariate analysis. Actual fluid intake was significantly higher than prescribed total fluid intake in first 4 days of life for infants in both groups. In extremely preterm infants, higher fluid intake in first 2 days of life is associated with prolonged duration of hsPDA. Actual daily fluid intake can be significantly higher than prescribed daily fluids due to daily weight changes and additional fluid administration. · In preterm infants, actual daily fluid intake may be higher than prescribed volume.. · Higher daily fluid intake in first week of life is associated with prolonged duration of PDA.. · PDA scoring system can be helpful for objective assessment of PDA in preterm infants..

Improving Drinking and Micturition Habits in Preschool Children: An Educational Project

Introduction: Children worldwide often do not drink enough. However, sufficient fluids are essential for physical and cognitive health. A regular and adequate supply of fluids also supports bladder maturation in the context of acquiring urinary continence. We investigated whether training preschool children and their caretakers improves drinking and micturition habits. Methods: This field study in a pre-post design was conducted in 6 kindergartens in the district of Garmisch-Partenkirchen from October 2018 to February 2019. An intervention group (IG) received a 3-day training on drinking and micturition habits and was compared to a control group (CG) without any training. Caretakers (IG + CG) were instructed about drinking and voiding management, too. Behavioral changes were identified by questionnaires. To analyze the long-term effect, group interviews were performed with the IG 3 months after training. The training was evaluated on different levels. Results: After training, the estimated total daily fluid intake in the IG (1,160 mL) significantly exceeded that of CG (830 mL) (p = 0.015). In the IG, fluid intake until 12:00 a.m. increased (p = 0.001), children took more time for voiding (p = 0.029), and urgency decreased (p = 0.008). Children (IG + CG) used leg support to enable pelvic floor relaxation more often both at home (p = 0.026) and in kindergarten (p = 0.047). Nocturnal enuresis was reduced by approximately 46% in the IG (p = 0.485). Group interviews in the IG showed a considerable learning effect. Conclusion: The present study could demonstrate an increased intake of fluids and significant changes in micturition behavior in the IG. So far, this is the first educational project in Germany addressing drinking and voiding management. Our results suggest that a training of preschool children and their caretakers is feasible and effective. Further nationwide research will be needed to confirm our results and assess the need for prevention in these areas.

The positive effect of the pH and volume of fluid intake on kidney stones in adult men

PurposeThe purpose of this study is to investigate the relationship between pH of water or other daily fluid intake and risk of kidney stones in adult men.Design/methodology/approachThis case–control study included 120 adult men with kidney stones and 240 healthy controls matched by age. Participants were selected from the Urmia Imam Khomeini Educational Hospital in the northwest of Iran by the available sampling method between 2017 and 2018. The mean total daily fluid intake of the subjects over the past one year period was collected using a validated 139-item Food Frequency Questionnaire, and the pH of drinking water samples consumed over the past six months was determined using an electrochemical pH meter. Information on physical activity level and socio-demographic characteristics of all participants was collected.FindingsThe mean pH of daily water consumption was 7.1 ± 250.3 and 7.4%± 250.3 in case and control groups, respectively. In multivariate logistic regression analysis after adjusting for the covariates 25 a significant relationship was detected between the pH of drinking water (not for other fluid intake26) and kidney stone disease (OR = 0.15, CI 0.06–0.4, P > 1. Moreover, no association was found between the volume of total fluid intake and risk of kidney stones.Originality/valueThese findings support potential protective effects of drinking water intake with higher pH level on preventing kidney stones.

Fluid Intake and Urinary Symptoms in Patients with Multiple Sclerosis.

The relationship between fluid intake and lower urinary tract symptoms in individuals with neurogenic bladder is unknown. We investigated the association between fluid intake and urinary symptoms in patients with multiple sclerosis. A prospective cross-sectional study of patients with multiple sclerosis presenting to the neurology office was conducted. Fluid intake and lower urinary tract symptoms were assessed by the questionnaire based voiding diary and the American Urological Association Symptom Score, respectively. The relationship between fluid intake and lower urinary tract symptoms was assessed using univariate and multivariate analyses. Among 200 individuals with multiple sclerosis the mean total daily fluid intake was 2,489 ml (SD 1,883) and did not differ according to severity (ie mild, moderate, severe) of lower urinary tract symptoms (F=0.30, p=0.74). Fluid restricting behavior to control urinary symptoms was reported by 47% of subjects. Subjects who reported fluid restricting were more likely to have worse urinary symptoms (OR 1.95, 95% CI 1.53-2.47, p <0.01). After accounting for fluid restricting behavior on multivariate analysis, there was a minimal relationship between caffeinated fluid intake and lower urinary tract symptom severity (OR 1.00, 95% CI 1.00-1.01, p=0.01), and there was no relationship between total fluid intake and lower urinary tract symptom severity (OR 1.00, 95% CI 1.00-1.00, p=0.07). Caffeinated fluid intake has a minimal effect on lower urinary tract symptoms in patients with multiple sclerosis. On average, patients with multiple sclerosis do not hydrate excessively and a considerable proportion restrict fluid intake to control urinary symptoms. Fluid intake may not contribute considerably to lower urinary tract symptoms in patients with multiple sclerosis.

Impact of Clinical, Laboratory and Fluid Therapy Variables on Hospital Length of Stay for Children with Acute Pancreatitis.

PurposeThere have been many efforts to develop generalizable severity markers in children with acute pancreatitis (AP). Expert opinion panels have developed consensus guidelines on management but it is unclear if these are sufficient or valid. Our study aims to assess the effect of clinical and laboratory variables, in addition to treatment modality on hospital length of stay (LOS) as a proxy variable for severity in pediatric patients admitted with AP.MethodsWe conducted a retrospective chart review of patients between ages of 0–18 years, who were admitted with AP at 2 institutions between 2013–2018, John R. Oishei Children's Hospital (Buffalo, NY, USA) and Medical University of South Carolina Children's Hospital (Charleston, SC, USA). We constructed three linear regression models to analyze the effect of clinical signs of organ dysfunction, laboratory markers and fluid intake on hospital LOS.ResultsNinety-two patients were included in the study. The mean age was 12 years (range, 7.6–17.4 years), 55% were females, and median LOS was 3 days. The most frequent cause of AP was idiopathic. Our study showed that elevated blood urea nitrogen (BUN) on admission (p<0.005), tachycardia that lasted for ≥48 hours (p<0.001) and need for fluid resuscitation were associated with increase LOS. Total daily fluid intake above maintenance did not have a significant effect on the primary outcome (p=0.49).ConclusionElevated serum BUN on admission, persistent tachycardia and need for fluid resuscitation were associated with increase LOS in pediatric AP. Daily total fluid intake above recommended maintenance did not reduce LOS.

Fluid intake patterns of adults: results of six Liq.In7 national cross-sectional surveys

AbstractDietary patterns provide valuable information for the development of public health policies. Despite increasing interest in the role of fluids in health and disease there are limited data on drinking patterns in adults. The aim of this analysis was to identify and characterize patterns of fluid intake in adults in cross-sectional surveys in China, Indonesia, Argentina, Brazil, Mexico and Uruguay.Data on fluid intake volume and type amongst 8159 adults (46% male) were collected using a validated 7-day fluid specific record (Liq.In7). A cluster analysis (partitioning around k-medoids algorithm) was used to identify relatively distinct clusters of subjects based on eight fluid types (water, milk and its derivatives, hot beverages (HB), sugar sweetened beverages (SSB), 100% fruit juices, artificial/non-nutritive sweetened beverages, alcoholic beverages, other beverages). Subjects were categorized according to total daily fluid intake as low (&lt; 1500 mL/d), medium (&gt; 1500- &lt; 3000mL/d), high (&gt; 3000mL- &lt; 4000mL/d) or very high (&gt; 4000mL/d). The clusters were characterized according to country of residence, socio-demographics and lifestyle factors.The eight interpretable clusters identified were: (1) low drinkers – SSB (n = 2450), (2) low drinkers – HB (n = 1589), (3) medium drinkers - water (n = 1306), (4) medium drinkers – HB and SSB (n = 892), (5) medium drinkers - SSB (n = 262), (6) high drinkers – water (n = 817), (7) high drinkers – water &amp; SSB (n = 313) and (8) very high drinkers – water (n = 530). Country of residence was the dominant characteristic in all clusters. In cluster #1 34% of subjects were resident in Mexico (v test 21), 43% of cluster #2 lived in China (v test 21.4). 47% of cluster #4 lived in Argentina (v test 24.2) with 30% living in Uruguay (v test 19.7), (v test 8). Cluster #3 was characterized by residence in Indonesia (v test 23.6) as were clusters #6 (v test 28.5), cluster #7 (v test 8.2) and cluster #8 (v test 24.5). To a lesser extent cluster #7 (high drinkers – water &amp; SSB) was characterised by residence in Mexico (v test 3.6). In cluster #5, 51% and 30% lived in Mexico and Argentina, respectively; with 60% of this cluster being male.Fluid intake patterns (clusters) varied according to the different countries. This information highlights the need to tailor interventions aimed at improving fluid intake behaviour and health to the specific adult populations.

Central Diabetes Insipidus and Chemotherapy: Use of a Continuous Arginine Vasopressin Infusion for Fluid and Sodium Balance

Central diabetes insipidus can occur in the setting of primary or metastatic tumors that disrupt the hypothalamic-pituitary axis. Usual treatment consists of water intake to replace ongoing fluid losses and desmopressin administration aimed at decreasing the urine output to enable maintenance of eunatremia without polyuria. Marked derangement in plasma sodium concentration can occur when high-volume intravenous fluid administration is required during chemotherapy to prevent nephrotoxicity, particularly if obligate fluid intake exceeds the total daily fluid intake necessary to maintain eunatremia. We developed a protocol for a rapidly titratable low-dose continuous intravenous arginine vasopressin infusion to maintain eunatremia in patients with central diabetes insipidus during periods of obligate fluid intake. We successfully maintained eunatremia in 2 patients with central nervous system lymphoma who underwent several cycles of obligate intravenous fluid administration with 5% dextrose in 0.45% sodium chloride for chemotherapy. Obligate fluid administration can result in dangerous and severe fluctuations in plasma sodium concentration in patients with central diabetes insipidus receiving conventional desmopressin therapy. The use of a rapidly titratable low-dose continuous vasopressin infusion successfully maintained eunatremia in this setting. This protocol can be replicated to prevent the wide and potentially dangerous fluctuations in plasma sodium concentration that can occur in patients with central diabetes insipidus who require high-volume intravenous fluid administration. This protocol has not been assessed among patients with impaired renal function and, thus, may not be generalizable to this population. (AACE Clinical Case Rep. 2018;4:e487-e492).

Synergetic Effects of Prenatal and Postnatal High Sucrose Intake on Glucose Tolerance and Hepatic Insulin Resistance in Rat Offspring.

High sucrose intake during pregnancy is linked to type 2 diabetes mellitus and altered insulin resistance. This study attempts to ascertain whether prenatal high sucrose intake (20% sucrose) alleviates the detrimental effects of high postnatal sugar consumption in the offspring, and the molecular mechanisms are investigated using a rat model. High prenatal sucrose exposure increases the body weight of the offspring at 1-3 weeks of age. Exposure to both prenatal and postnatal high sucrose increases glucose tolerance in the 4-month-old adult offspring compared with offspring receiving other treatments. Postnatal high sucrose exposure suppresses food intake but increases the total daily caloric and fluid intake. Both fasting blood glucose and plasma triglyceride levels are increased, but the fasting insulin level is unaffected. Prenatal high sucrose intake enlarges pancreatic islet area; however, prenatal-plus-postnatal high sucrose exposure induces smaller pancreatic islets. IRS-1(S612) protein phosphorylation is significantly increased, and the GSK-3β (S9) phosphorylation level is reduced. Both prenatal and prenatal-plus-postnatal high sucrose exposure substantially affect biological functions related to insulin homeostasis. IRS-1(S612) protein phosphorylation appears to be a part of the molecular mechanism underlying these effects. These results add to the understanding of how high sucrose intake contributes to insulin resistance and diabetes pathogenesis and how postnatal nutrition and lifestyle may mitigate detrimental prenatal exposures.

A Nutrition Recovery Station Following Recreational Exercise Improves Fruit Consumption but Does Not Influence Fluid Recovery.

Immediate postexercise access to fruit/fluid via a recovery "station" is a common feature of mass participation sporting events. Yet little evidence exists examining their impact on subsequent dietary intake. The aim of this study was to determine if access to fruit/water/sports drinks within a recovery station significantly alters dietary and fluid intakes in the immediate postexercise period and influences hydration status the next morning. 127 (79 males) healthy participants (M ± SD, age = 22.5 ± 3.5y, body mass (BM) = 73 ± 13kg) completed two self-paced morning 10km runs separated by 1 week. Immediately following the first run, participants were randomly assigned to enter (or not) the recovery station for 30min. All participants completed the alternate recovery option the following week. Participants recorded BM before and after exercise and measured Urine Specific Gravity (USG) before running and again the following morning. For both trial days, participants also completed 24h food and fluid records via a food diary that included photographs. Paired-sample t tests were used to assess differences in hydration and dietary outcome variables (Recovery vs. No Recovery). No difference in preexercise USG or BM change from exercise were observed between treatments (p's > .05). Attending the recovery zone resulted in a greater total daily fluid (Recovery = 3.37 ± 1.46L, No Recovery = 3.16 ± 1.32L, p = .009) and fruit intake (Recovery = 2.37 ± 1.76 servings, No Recovery = 1.55 ± 1.61 servings, p > .001), but had no influence on daily total energy (Recovery = 10.15 ± 4.2MJ, No Recovery = 10.15 ± 3.9MJ), or macronutrient intakes (p > .05). Next morning USG values were not different between treatments (Recovery = 1.018 ± 0.007, No Recovery = 1.019 ± 0.009, p > .05). Recovery stations provide an opportunity to modify dietary intake which promote positive lifestyle behaviors in recreational athletes.

Hydration, Fluid Intake, and Related Urine Biomarkers among Male College Students in Cangzhou, China: A Cross-Sectional Study-Applications for Assessing Fluid Intake and Adequate Water Intake.

The objectives of this study were to assess the associations between fluid intake and urine biomarkers and to determine daily total fluid intake for assessing hydration status for male college students. A total of 68 male college students aged 18–25 years recruited from Cangzhou, China completed a 7-day cross-sectional study. From day 1 to day 7; all subjects were asked to complete a self-administered 7-day 24-h fluid intake record. The foods eaten by subjects were weighed and 24-h urine was collected for three consecutive days on the last three consecutive days. On the sixth day, urine osmolality, specific gravity (USG), pH, and concentrations of potassium, sodium, and chloride was determined. Subjects were divided into optimal hydration, middle hydration, and hypohydration groups according to their 24-h urine osmolality. Strong relationships were found between daily total fluid intake and 24-h urine biomarkers, especially for 24-h urine volume (r = 0.76; p < 0.0001) and osmolality (r = 0.76; p < 0.0001). The percentage of the variances in daily total fluid intake (R2) explained by PLS (partial least squares) model with seven urinary biomarkers was 68.9%; two urine biomarkers—24-h urine volume and osmolality—were identified as possible key predictors. The daily total fluid intake for assessing optimal hydration was 2582 mL, while the daily total fluid intake for assessing hypohydration was 2502 mL. Differences in fluid intake and urine biomarkers were found among male college students with different hydration status. A strong relationship existed between urine biomarkers and fluid intake. A PLS model identified that key variables for assessing daily total fluid intake were 24-h urine volume and osmolality. It was feasibility to use total fluid intake to judge hydration status.

Beverage Intake Assessment Questionnaire: Relative Validity and Repeatability in a Spanish Population with Metabolic Syndrome from the PREDIMED-PLUS Study

We assess the repeatability and relative validity of a Spanish beverage intake questionnaire for assessing water intake from beverages. The present analysis was performed within the framework of the PREDIMED-PLUS trial. The study participants were adults (aged 55–75) with a BMI ≥27 and <40 kg/m2, and at least three components of Metabolic Syndrome (MetS). A trained dietitian completed the questionnaire. Participants provided 24-h urine samples, and the volume and urine osmolality were recorded. The repeatability of the baseline measurement at 6 and 1 year was examined by paired Student’s t-test comparisons. A total of 160 participants were included in the analysis. The Bland–Altman analysis showed relatively good agreement between total daily fluid intake assessed using the fluid-specific questionnaire, and urine osmolality and 24-h volume with parameter estimates of −0.65 and 0.22, respectively (R2 = 0.20; p < 0.001). In the repeatability test, no significant differences were found between neither type of beverage nor total daily fluid intake at 6 months and 1-year assessment, compared to baseline. The proposed fluid-specific assessment questionnaire designed to assess the consumption of water and other beverages in Spanish adult individuals was found to be relatively valid with good repeatability.

Urine colour change as an indicator of change in daily water intake: a quantitative analysis.

PurposeUrine colour (UCol) is simple to measure, differs between low-volume and high-volume drinkers, and is responsive to changes in daily total fluid intake (TFI). However, to date, no study has quantified the relationship between a change in TFI and the resultant change in UCol. This analysis aimed to determine the change in TFI needed to adjust 24-h UCol by 2 shades on an 8-colour scale, and to evaluate whether starting UCol altered the relationship between the change in TFI and change in UCol.MethodsWe performed a pooled analysis on data from 238 healthy American and European adults (50 % male; age, 28 (sd 6) years; BMI 22.9 (sd 2.6) kg/m2), and evaluated the change in TFI, urine volume (UVol), and specific gravity (USG) associated with a change in UCol of 2 shades.ResultsThe mean [95 % CI] change in TFI and UVol associated with a decrease in UCol by 2 shades (lighter) was 1110 [914;1306] and 1011 [851;1172] mL/day, respectively, while increasing UCol by 2 shades (darker) required a reduction in TFI and UVol of −1114 [−885;−1343] and −977 [−787;−1166] mL/day. The change in UCol was accompanied by changes in USG (lighter urine: −.008 [−.007;−.010]; darker urine: +.008 [.006;.009]). Starting UCol did not significantly impact the TFI change required to modify UCol by 2 shades.ConclusionsOur results suggest a quantifiable relationship between a change in daily TFI and the resultant change in UCol, providing individuals with a practical means for evaluating and adjusting hydration behaviours.

Plasma concentration of N-terminal pro-atrial and N-terminal pro-brain natriuretic peptides and fluid balance in children with bronchiolitis.

The aim of this study was to evaluate the plasma levels of N-Terminal pro-brain natriuretic peptide (N-BNP), N-Terminal pro-atrial natriuretic peptide (N-ANP) and antidiuretic hormone (ADH) over time and their relationship to clinical indicators in hospitalized children with bronchiolitis. Prospective crossover clinical investigation. Hospitalized children in a university-affiliated hospital. Twenty-seven children (birth to 24 mo) with first episode of bronchiolitis and 34 age-matched healthy controls. Daily blood samples up to five consecutive days were obtained for N-BNP, N-ANP and ADH in the bronchiolitis group and on the initial blood draw in the control group. Daily total fluid intake, net fluid balance and clinical bronchiolitis severity levels were recorded. N-BNP and N-ANP levels were measured by enzyme-linked immunosorbent assay. ADH levels were measured by a double antibody technique. The mean age (months ± SD) in the bronchiolitis group was 4.2 ± 5.9 mo and 12.0 ± 6.1 mo in the control group; 51.9% of bronchiolitis patients were positive for respiratory syncytial virus (RSV). In patients with bronchiolitis on admission, plasma N-BNP measurements (mean ± SD) were elevated (996.0 ± 570.2 fmol/mL) compared to controls (552.7 ± 264.7 fmol/mL P < 0.005). Serum N-ANP levels were also initially elevated (3,889 ± 1,769.7 fmol/mL) compared to controls (2,173 ± 912 fmol/mL P < 0.005). The serum levels of N-BNP and N-ANP remained significantly elevated from day 2 through day 5. Similarly, ADH levels were significantly higher on admission in the bronchiolitis group (10 ± 7.49 pg/mL) vs. the control group (5.8 ± 5.5 pg/mL P < 0.05), but quickly decreased from day 2 through day 5. N-BNP, N-ANP and ADH concentrations were elevated in hospitalized children with bronchiolitis at admission. Based on our observation, judicious fluid management is indicated in children hospitalized with bronchiolitis.

Total fluid intake and its determinants: cross-sectional surveys among adults in 13 countries worldwide.

Purpose To evaluate the total fluid intake from drinking water and beverages in adult populations from different countries and assess the percentage of individuals complying with the European Food Safety Agency (EFSA) adequate intake (AI) of water from fluids.MethodsA total of 16,276 adults (7580 men and 8696 women) aged between 18 and 70 years (mean age 39.8 years) were randomly recruited from 13 different countries from three continents. Information about the total daily fluid intake (sum of drinking water and beverages) was collected using a 24-h fluid-specific record over seven consecutive days.ResultsImportant differences in total fluid intake between countries were found; however, few differences between men and women were reported in most of the countries. Less than 50 % of the women and approximately 60 % of the men do not comply with the EFSA AI of water from fluids. Women were more than twice as likely as men to meet these AI (OR 2.15; 95 % CI 2.02–2.29). The odds of meeting the AI of water from fluids were lower in individuals over 50 years (OR 0.88; 95 % CI 0.80–0.96). Nine percent of the total population consumed less than half of the AI, 40.5 % between 50 and 100 %, and 50.5 % more than the AI.ConclusionsThere were considerable differences in total fluid intake between countries but not between genders. Only 40 % of men and 60 % of women comply with the EFSA AI of water from fluids. Men and elderly individuals had an increased risk of not complying with this reference value.

Equivalence of Spot and Twenty Four Hour Urine Osmolality in Young Adults

Urinary biomarkers of hydration can discriminate euhydration from hypohydration and are responsive to changes in daily total water intake. However, urine concentration is subject to daily fluctuation and circadian variation has been reported. Given the time and burden associated with 24 hour urine collections, establishing a time-frame during which spot urine concentration is equivalent to the 24 hour value would have utility for researchers, coaches, clinicians and individuals seeking to monitor hydration. PURPOSE: To determine the equivalence of multiple daytime spot urine osmolalities (UOsm_Spot) to the 24 hour sample (UOsm_24). METHODS: During three consecutive days, 82 adults (50% women; age 23.6 ± 2.9 years; BMI 22.2 ± 1.5 kg·m−2) recorded all ad libitum food and fluid intake and avoided physical activity that would result in substantial sweat loss. On the third day, subjects collected each void in a separate collection container over a full 24 hour period. The time of each void was recorded. UOsm was measured on each sample individually and on the 24 hour pool. Equivalence was set as ±100 mOsm·kg−1 from the 24 hour value, and was evaluated using the two one-sided test (TOST) method with α = 0.05. RESULTS: Mean total daily fluid intake (TFI) was 1830 ± 648 (range: 687 - 4350) ml·day−1, and mean UOsm_24 was 567 ± 214 (range: 149 - 1029) mOsm·kg−1. UOsm_Spot from samples produced between 14:00 and 20:00 were equivalent to UOsm_24, while UOsm_Spot between 10:00-12:00 and 12:00-14:00 was not equivalent. Samples between 10:00-12:00 and 12:00-14:00 tended to overestimate UOsm_24; the mean [95% CI] difference between UOsm_24 and UOsm_Spot was 83 [12;154] between 10:00-12:00; and 107 [58;157] between 12:00-14:00. From 14:00-16:00; 16:00-18:00; and 18:00-20:00, the mean [95% CI] differences between UOsm_24 and UOsm_Spot were −25 [−72;22]; 29 [−35;92]; and 12 [−41;66], respectively. CONCLUSION: Urine osmolality measured in voids produced between 14:00 and 20:00 was equivalent to 24 hour urine osmolality, while spot samples taken earlier in the day tended to overestimate 24 hour urine osmolality. This finding has practical utility for individuals, coaches, clinicians and researchers interested in evaluating 24 hour hydration without the burdens inherent in collecting 24 hour urine samples.