VALIDITY OF UCHEK IPHONE APPLICATION ON ASSESSING DEHYDRATION FROM URINE SAMPLES

1Christian B. Ridings, 1J.D. Adams, 1Matthew S. Ganio, 1Brendon P. McDermott, 2Dimitris Bougatsas, 1Stavros A. Kavouras, FACSM. 1Human Performance Laboratory, Department of Health, Human Performance, and Recreation, University of Arkansas, Fayetteville, AR; 2Laboratory of Nutrition & Clinical Dietetics, Harokopio University, Athens, Greece The widespread acceptance of smartphones presents an opportunity for the development of mobile health applications and accessories. These devices can help reduce costs and improve accessibility of healthcare. PURPOSE: To determine the validity of the uChek iPhone application on measuring hydration status compared to urine refractometry and urine dipstick applicators. METHODS: Fifty-three urine samples were analyzed for urine specific gravity (USG) by a refractometer under a well-lit area. Urine strips (Multistix 10 SG Reagent Strips) were used to record USG by the Multistix label compared to an 8-color control stick, and was then analyzed by the uChek application. RESULTS: Sensitivity analysis showed that overall accuracy of USG via strips and uChek were 68 and 67.3%, respectively. Specifically, the sensitivity of a positive urine test for dehydration (USG≥1.020) was 55.6% with the strips and 51.9% with the iPhone app. The specificity for detecting hypohydrated persons was 36.4% and 31.8% for the strips and iPhone app, respectively. CONCLUSION: We concluded that the iPhone application uChek is not accurately detecting dehydration mainly due to limitations of the urine strips

WATER INTAKE AND URINARY HYDRATION BIOMARKERS IN CHILDREN

Lisa T. Jansen1, Dimitris Bougatsas2, Evan C. Johnson3, Giannis Arnaoutis2, Spiridoula Tsipouridi2, Demosthenes B. Panagiotakos2, Stavros A. Kavouras FACSM1 1 University of Arkansas, Fayetteville, AR; 2 Harokopio University, Athens, Greece; 3 University of Wyoming, Laramie, WY Guidelines for adequate water intake for children (0-18 y) are outlined by the Institute of Medicine (IOM) and the European Food Safety Authority (EFSA). While the human body safeguards against dehydration via physiological pathways, the state of active total body water conservation is manifested by excretion of small volumes of highly concentrated urine. Recent research has shown detrimental health effects in adults reporting with chronically elevated markers for total body water conservation. This suggests a potential for preventative measures for health when implementing adequate hydration habits in children. However, studies report that up to 50% of children are voluntarily hypohydrated. It is unclear if this is due to the pediatric population struggling to meet hydration guidelines or due to inadequacy of the current guidelines. PURPOSE: The aims of the study were threefold. 1) Assess fluid intake and hydration biomarkers in Greek children. 2) Determine relative risk for hypohydration in children not meeting daily water intake recommendations compared to those that do. 3) Analyze current guidelines for efficacy to meet euhydration in children. METHODS: 150 boys and girls (9-13y) recorded their fluid intake for 2 consecutive days, with 24h urine samples being collected on day 2. Fluid intake records were analyzed for total water intake from fluids (TWI-F). Urine samples were analyzed for osmolality, color, specific gravity, and volume. Urine Osmolality ≥ 800 mmol∙kg-1 H2O was defined as hypohydration. RESULTS: Water intake from fluids was 1729(1555-1905) and 1550(1406-1686)mL∙d-1 for boys and girls. Prevalence of hypohydration was 33% (44% boys, 23% girls). Children that failed to meet TWI-F recommendations demonstrated a risk that was 1.99-2.12 times higher than in those meeting recommendations (P≤0.01). Boys aged 9-13y displayed urine osmolality of 777(725-830) mmol∙kg-1 and urine specific gravity of 1.021(1.019-1.022), higher values than reported in the 9-13y girls (P≤0.015), with \u3e27% classifying as hypohydrated despite meeting fluid intake recommendations. CONCLUSION: Failure to meet TWI-F guidelines doubled risk of hypohydration in children. While 23% of Boys 9-13y reported hypohydrated despite satisfying current guidelines and therefore may require greater water intake to achieve adequate hydration avoiding hyper concentration of urine. (The study was supported by a grant by Danone Research, Palaiseau, France

A FLUID CONSUMPTION PATTERN BASED ON PLAIN WATER AND MILK IS ASSOCIATED WITH BETTER HYDRATION

Adam D. Seal1, Dimitris Bougatsas2, Giannis Arnaoutis2, Demosthenes B. Panagiotakos2, Evan C. Johnson3, Jeanne H. Bottin4, Spiridoula Tsipouridi2, Stavros A. Kavouras1, FACSM 1University of Arkansas, Fayetteville, AR; 2Harokopio University, Athens, Greece; 3University of Wyoming, Laramie, WY; 4Danone Research, Palaiseau, France Children consume various fluids in order to cover daily water needs. However, the contribution of different beverage categories to hydration is unclear. PURPOSE: To examine whether various fluid intake patterns are associated with hydration, as indicated by urine osmolality. METHODS: Two hundred and ten healthy Greek children (height: 1.49±0.13 m, weight: 43.4±12.6 kg, body fat: 25.2±7.8%), 105 girls and 105 boys, were asked to collect their urine for 24 hours while conducting normal daily activities. For two consecutive days they were instructed to record their fluid consumption using a provided fluid diary including type, amount, and time of fluid consumed. A trained nutritionist evaluated total water intake and categorized beverages into 6 drinking groups. Urine samples were analyzed for color, specific gravity, and osmolality. Factor analysis with the Principal Components method was applied to extract dietary patterns from 6 drinks or drinking groups. Linear regression analysis evaluated the associations between the extracted dietary patterns and hydration levels deriving from 24h urine osmolality. RESULTS: Component 1 was mainly characterized by consumption of milk and fresh juice but not packaged juice, component 2 by regular soda and other drinks but not water, component 3 by fresh juice and other drinks, component 4 by packaged juice but not regular soda, component 5 by water and milk and component 6 by fresh juice. Component 2 was positively correlated with high urine osmolality (P\u3c0.001), whereas Component 5 was negatively correlated with urine osmolality (P\u3c0.001). CONCLUSION: A fluid consumption pattern that features water and milk was associated with better hydration. Contrastingly, a drinking pattern featuring regular soda and other drinks but not water was associated with inadequate hydration. Grant Funding: Danone Research, 91767 Palaiseau, Franc

Physical activity level improves the predictive accuracy of cardiovascular disease risk score: The ATTICA study (2002–2012)

Background: Although physical activity (PA) has long been associated with cardiovascular disease (CVD), assessment of PA status has never been used as a part of CVD risk prediction tools. The aim of the present work was to examine whether the inclusion of PA status in a CVD risk model improves its predictive accuracy. Methods: Data from the 10-year follow-up (2002–2012) of the n = 2020 participants (aged 18–89 years) of the ATTICA prospective study were used to test the research hypothesis. The HellenicSCORE (that incorporates age, sex, smoking, total cholesterol, and systolic blood pressure levels) was calculated to estimate the baseline 10-year CVD risk; assessment of PA status was based on the International Physical Activity Questionnaire. The estimated CVD risk was tested against the observed 10-year incidence (i.e., development of acute coronary syndromes, stroke, or other CVD according to the World Health Organization [WHO]-International Classification of Diseases [ICD]-10 criteria). Changes in the predictive ability of the nested CVD risk model that contained the HellenicSCORE plus PA assessment were evaluated using Harrell’s C and net reclassification index. Results: Both HellenicSCORE and PA status were predictors of future CVD events (P < 0.05). However, the estimating classification bias of the model that included only the HellenicSCORE was significantly reduced when PA assessment was included (Harrel’s C = 0.012, P = 0.032); this reduction remained significant even when adjusted for diabetes mellitus and dietary habits (P < 0.05). Conclusions: CVD risk scores seem to be more accurate by incorporating individuals’ PA status; thus, may be more effective tools in primary prevention by efficiently allocating CVD candidates. © 2016 International Journal of Preventive Medicine