Increasing water intake in pre-school children with unhealthy drinking habits: a year-long controlled longitudinal field experiment assessing the impact of information, water affordance, and social regulation

Objective We investigated the effect of three interventions to increase the plain water consumption of children with unhealthy drinking habits, with an innovative approach combining the three layers of Installation Theory: embodied competences, affordances and social regulation. Methods 334 preschool children and their carers were allocated to three interventions: Control (control): no intervention, Information (info): online coaching sessions on water health benefits aiming at modifying embodied competences (knowledge), Information + Water Affordance (info + w): the same plus home delivery of small bottles of water. After three months, half of the info and info + w subjects were allocated to Social Regulation (+social) (on-line discussion forum) or no further intervention (-social). Intake of plain water and all other fluid types of the children were recorded by the carers 6 times over a year using an online 7-day fluid-specific dietary record.Results Over 1 year, all groups significantly increased daily water consumption by 3.0–7.8 times (+118 to +222 mL). Info + w + social and Info-social generated the highest increase in plain water intake after one year compared to baseline, by 7.8 times (+216 mL) and 6.7 times (+222 mL) respectively; both significantly exceeded the control (3.0 times, +118 mL), whilst the effect of info + w-social (5.0 times, +158 mL) and info + social (5.3 times, +198 mL) did not differ from that of control. All groups saw a decrease of sweetened beverages intake, again with info + w + social generating the largest decrease (−27%; −172 mL). No changes in other fluids or total fluid intake were observed. Conclusions Sustainable increased water consumption can be achieved in children with unhealthy drinking habits by influencing representations, changing material affordances, and providing social regulation. Combining the three provided the strongest effect as predicted by Installation Theory

Food Insecurity and Maternal Diet Influence Human Milk Composition between the Infant's Birth and 6 Months after Birth in Central-Africa

Although the World Health Organization (WHO) and UNICEF recommend that infants should be exclusively breastfed for the first 6 months of life, evidence is scarce on how the mother’s undernourishment status at delivery and maternal dietary factors influence human milk (HM) composition during the first 6 months of life in regions with high food insecurity. The maternal undernourishment status at delivery, maternal diet, and HM nutrients were assessed among 46 women and their 48 vaginally born infants in Bangui at 1, 4, 11, 18, and 25 weeks after birth through 24-h recalls and food consumption questionnaires from December 2017 to June 2019 in the context of the "Mother-to-Infant TransmIssion of microbiota in Central-Africa" (MITICA) study. High food insecurity indexes during the follow-up were significantly associated with them having lower levels of many of the human milk oligosaccharides (HMOs) that were measured and with lower levels of retinol (aß-coef = −0.2, p value = 0.04), fatty acids (aß-coef = −7.2, p value = 0.03), and amino acids (aß-coef = −2121.0, p value < 0.001). On the contrary, women from food-insecure households displayed significantly higher levels of lactose in their HM (aß-coef = 3.3, p value = 0.02). In parallel, the consumption of meat, poultry, and fish was associated with higher HM levels of many of the HMOs that were measured, total amino acids (aß-coef = 5484.4, p value < 0.001), and with lower HM levels of lactose (aß-coef = −15.6, p value = 0.01). Food insecurity and maternal diet had a meaningful effect on HM composition with a possible impact being an infant undernourishment risk. Our results plead for consistent actions on food security as an effective manner to influence the nutritional content of HM and thereby, potentially improve infant survival and healthy growth

Fecal microbiota and bile acid interactions with systemic and adipose tissue metabolism in diet-induced weight loss of obese postmenopausal women

Microbiota and bile acids in the gastrointestinal tract profoundly alter systemic metabolic processes. In obese subjects, gradual weight loss ameliorates adipose tissue inflammation and related systemic changes. We assessed how rapid weight loss due to a very low calorie diet (VLCD) affects the fecal microbiome and fecal bile acid composition, and their interactions with the plasma metabolome and subcutaneous adipose tissue inflammation in obesity. We performed a prospective cohort study of VLCD-induced weight loss of 10% in ten grades 2-3 obese postmenopausal women in a metabolic unit. Baseline and post weight loss evaluation included fasting plasma analyzed by mass spectrometry, adipose tissue transcription by RNA sequencing, stool 16S rRNA sequencing for fecal microbiota, fecal bile acids by mass spectrometry, and urinary metabolic phenotyping by H-NMR spectroscopy. Outcome measures included mixed model correlations between changes in fecal microbiota and bile acid composition with changes in plasma metabolite and adipose tissue gene expression pathways. Alterations in the urinary metabolic phenotype following VLCD-induced weight loss were consistent with starvation ketosis, protein sparing, and disruptions to the functional status of the gut microbiota. We show that the core microbiome was preserved during VLCD-induced weight loss, but with changes in several groups of bacterial taxa with functional implications. UniFrac analysis showed overall parallel shifts in community structure, corresponding to reduced abundance of the genus Roseburia and increased Christensenellaceae;g__ (unknown genus). Imputed microbial functions showed changes in fat and carbohydrate metabolism. A significant fall in fecal total bile acid concentration and reduced deconjugation and 7-α-dihydroxylation were accompanied by significant changes in several bacterial taxa. Individual bile acids in feces correlated with amino acid, purine, and lipid metabolic pathways in plasma. Furthermore, several fecal bile acids and bacterial species correlated with altered gene expression pathways in adipose tissue. VLCD dietary intervention in obese women changed the composition of several fecal microbial populations while preserving the core fecal microbiome. Changes in individual microbial taxa and their functions correlated with variations in the plasma metabolome, fecal bile acid composition, and adipose tissue transcriptome

Effect of increased water intake on plasma copeptin in healthy adults

Purpose: Inter-individual variation in median plasma copeptin is associated with incident type 2 diabetes mellitus, progression of chronic kidney disease, and cardiovascular events. In this study, we examined whether 24-h urine osmolality was associated with plasma copeptin and whether increasing daily water intake could impact circulating plasma copeptin. Methods: This trial was a prospective study conducted at a single investigating center. Eighty-two healthy adults (age 23.6 ± 2.9 years, BMI 22.2 ± 1.5 kg/m2, 50% female) were stratified based upon habitual daily fluid intake volumes: arm A (50–80% of EFSA dietary reference values), arm B (81–120%), and arm C (121–200%). Following a baseline visit, arms A and B increased their water intake to match arm C for a period of 6 consecutive weeks. Results: At baseline, plasma copeptin was positively and significantly associated with 24-h urine osmolality (p = 0.002) and 24-h urine specific gravity (p = 0.003) but not with plasma osmolality (p = 0.18), 24-h urine creatinine (p = 0.09), and total fluid intake (p = 0.52). Over the 6-week follow-up, copeptin decreased significantly from 5.18 (3.3;7.4) to 3.90 (2.7;5.7) pmol/L (p = 0.012), while urine osmolality and urine specific gravity decreased from 591 ± 206 to 364 ± 117 mOsm/kg (p < 0.001) and from 1.016 ± 0.005 to 1.010 ± 0.004 (p < 0.001), respectively. Conclusions: At baseline, circulating levels of copeptin were positively associated with 24-h urine concentration in healthy young subjects with various fluid intakes. Moreover, this study shows, for the first time, that increased water intake over 6 weeks results in an attenuation of circulating copeptin. Clinical Trial Registration Number: NCT02044679

Drivers and barriers of water intake in preschool children in a one-year longitudinal field study in Poland

Background Many children consume too little water and too many sugar-sweetened beverages (SSBs), with potential negative consequences for health. Sustainably increasing water intake is therefore relevant, however challenging. Objective Explore drivers of and barriers to water intake during a one-year field study aiming to increase plain water consumption using Installation Theory in Polish preschool children. Method Caregivers of children (3–6 yrs) completed questionnaires on the child's preference for water and SSBs, water drinking habit strength (Self-Report Habit Index, range 1 (low)-5 (high habit)), and barriers to drinking water, at baseline and after one year. Children were first allocated to one of three interventions: CONTROL: no intervention; INFO: online coaching sessions on water health benefits (3 weeks); INFO + W: similar coaching sessions and home water delivery (3 weeks). After 3 months, half of INFO and INFO + W subjects were exposed to an online discussion forum (3 weeks) (+ SOCIAL); the other half received no further intervention (-SOCIAL). Results 334 children (age: 4.4 ± 1.2 yrs; 50% female) completed the study. At baseline,72% attended kindergarten, among which 48% had access to water during the day. Drinking water during class was not allowed for 41%. The proportion of children who liked or loved water increased from 28% at baseline to 67% after one year. Conversely, that of children who liked or loved SSBs decreased from 58% at baseline to 45% after one year. The increase in preference for water was greater in groups who initially received INFO + W compared to CONTROL (p = 0.004). The mean drinking water habit score increased from 2.3 at baseline to 3.0 across all groups with a larger increase in INFO + W + SOCIAL (+ 28%) compared to CONTROL (+ 16%) (p = 0.001). At baseline, the strongest barriers to drinking water were (1) Drinking large amounts of other beverages (72%), (2) A preference for other beverages such as SSBs (71%), (3) Not being aware that they should drink more water (61%), and (4) Not being used to drinking water or water having no taste (both 55%).Most barriers strongly decreased over the course of the study with no specific effect of the interventions. Conclusion An intervention aiming to increase water in pre-school children was able to modulate the preference for water, habit to drink water, and barriers to drinking water in preschool children with unhealthy drinking habits. Providing information and facilitating access to water were the most important contributors to improving healthy hydration habits

Food Insecurity and Maternal Diet Influence Human Milk Composition between the Infant&rsquo;s Birth and 6 Months after Birth in Central-Africa

Although the World Health Organization (WHO) and UNICEF recommend that infants should be exclusively breastfed for the first 6 months of life, evidence is scarce on how the mother&rsquo;s undernourishment status at delivery and maternal dietary factors influence human milk (HM) composition during the first 6 months of life in regions with high food insecurity. The maternal undernourishment status at delivery, maternal diet, and HM nutrients were assessed among 46 women and their 48 vaginally born infants in Bangui at 1, 4, 11, 18, and 25 weeks after birth through 24-h recalls and food consumption questionnaires from December 2017 to June 2019 in the context of the "Mother-to-Infant TransmIssion of microbiota in Central-Africa" (MITICA) study. High food insecurity indexes during the follow-up were significantly associated with them having lower levels of many of the human milk oligosaccharides (HMOs) that were measured and with lower levels of retinol (a&szlig;-coef = &minus;0.2, p value = 0.04), fatty acids (a&szlig;-coef = &minus;7.2, p value = 0.03), and amino acids (a&szlig;-coef = &minus;2121.0, p value &lt; 0.001). On the contrary, women from food-insecure households displayed significantly higher levels of lactose in their HM (a&szlig;-coef = 3.3, p value = 0.02). In parallel, the consumption of meat, poultry, and fish was associated with higher HM levels of many of the HMOs that were measured, total amino acids (a&szlig;-coef = 5484.4, p value &lt; 0.001), and with lower HM levels of lactose (a&szlig;-coef = &minus;15.6, p value = 0.01). Food insecurity and maternal diet had a meaningful effect on HM composition with a possible impact being an infant undernourishment risk. Our results plead for consistent actions on food security as an effective manner to influence the nutritional content of HM and thereby, potentially improve infant survival and healthy growth

Hydration for health hypothesis : a narrative review of supporting evidence

Purpose: An increasing body of evidence suggests that excreting a generous volume of diluted urine is associated with short- and long-term beneficial health effects, especially for kidney and metabolic function. However, water intake and hydration remain under-investigated and optimal hydration is poorly and inconsistently defined. This review tests the hypothesis that optimal chronic water intake positively impacts various aspects of health and proposes an evidence-based definition of optimal hydration. Methods: Search strategy included PubMed and Google Scholar using relevant keywords for each health outcome, complemented by manual search of article reference lists and the expertise of relevant practitioners for each area studied. Results: The available literature suggest the effects of increased water intake on health may be direct, due to increased urine flow or urine dilution, or indirect, mediated by a reduction in osmotically -stimulated vasopressin (AVP). Urine flow affects the formation of kidney stones and recurrence of urinary tract infection, while increased circulating AVP is implicated in metabolic disease, chronic kidney disease, and autosomal dominant polycystic kidney disease. Conclusion: In order to ensure optimal hydration, it is proposed that optimal total water intake should approach 2.5 to 3.5 L day−1 to allow for the daily excretion of 2 to 3 L of dilute (< 500 mOsm kg−1) urine. Simple urinary markers of hydration such as urine color or void frequency may be used to monitor and adjust intake