Nutrients, Vol. 14, Pages 5150: The Severity of Obesity Promotes Greater Dehydration in Children: Preliminary Results

Alexy et al. (2012) [14]Children and adolescents (4–18 years old)GermanyCross-sectional study, 2003–2009Three-day nutrition diary of weighed foods and nutrientsHydration state based on 24-hour sodium excretion Salt excretion increased with age but remained constant during the studyBonnet et al. (2012) [15]Children (9–11 years old)FranceCross-sectional study, 2010Food diary of breakfastWater intake and hydration status at breakfastMore than a third of the children had high urine osmolality (801 and 1000 mmol kg−1) and total water intake was inversely correlated with high urine osmolalityBougatsas et al. (2018) [16]Children (8–14 years old)GreeceCross-sectional study 2013Fluid intake from two days Assessment of fluid consumption and hydration levelDrinking water and milk was correlated with better hydration status, whereas drinking regular soda and other drinks was associated with worse hydration (p  =  0.001)Kavouras et al. (2016) [17]Children (8–14 years old)GreeceCross-sectional study, 2012–2013Color of urine Assessment of urine color The traditional urine color score scale is a good method for assessing children’s hydration; the average 24-hour urine color was 3 and the average 24-hour urine osmolality was 686 mmol kg−1Kavouras et al. (2017) [18]Children (9–13 years old)GreeceCross-sectional study, 2012–2013Food diary of fluid intake from 2 dayAssessment of daily water intake and biomarkers of hydration Insufficient water intake from fluids was associated with lower levels of hydration in childrenKozioł-Kozakowska at al. [19]Children (7–15 years old)PolandCross-sectional, 2018Urine osmolality during a school dayHydration stateIn all, 53% of the children were insufficiently hydrated, and 16.3% of them had urine osmolality > 1000 mOsm/kgH2O, which indicates severe dehydrationMaffeis et al. (2016) [20]Children (7–11 years old)ItalyCross-sectional studyThree-day nutrition diary of weighed foods and fluidAssessment of fluid intake and level of hydration in obese children vs. normal weightObese children were less hydrated compared to normal-weight children and drink less when considering body mass indexMichels et al. (2017) [21]School children (7–13 years old)BelgiumCross-sectional study, 2014Food frequency questionnaire FFQ for children Assessment of children’s hydration at school and its predictorsThe children had a high risk of dehydration (school urine osmolality of 888 mmol kg−1); however, this was not due to the quality of the diet.Padrão et al. (2016) [22]Children (7–11 years old)PortugalCross-sectional study, 2014Twenty-four-hour dietary interview Assessment of diet and biomarkers of hydrationMore than half of the children had too low hydration levels; higher water intake was associated with better hydration levelsStahl et al. (2007) [23]Children (4–11 years old)GermanyCross-sectional study, 2007 Three-day nutrition diary of weighed foods Assessment of the relationship between hydration and dietChildren who were properly hydrated had a higher total water intake with the diet and lower energy density of the diet, compared with children with lower hydration levelsStookey et al. (2012) [8]Children (9–11 years old)USACross-sectional study, 2009Food diary for breakfastsAssessment of hydration and intake of water Elevated urinary os-molarity (>800 mmol kg−1) was associated with lower water intake in the morning

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