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Water Supplementation Reduces Copeptin and Plasma Glucose in Adults With High Copeptin: The H2O Metabolism Pilot Study.
Enhörning, S, Brunkwall, L, Tasevska, I, Ericson, U, Persson Tholin, J, Persson, M, Lemetais, G, Vanhaecke, T, Dolci, A, Perrier, ET, et al
The Journal of clinical endocrinology and metabolism. 2019;(6):1917-1925
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Abstract
OBJECTIVE Because elevated copeptin, a marker of vasopressin, is linked to low water intake and high diabetes risk, we tested the effect of water supplementation on copeptin and fasting glucose. DESIGN, SETTING, AND PARTICIPANTS Thirty-one healthy adults with high copeptin (>10.7 pmol · L-1 in men and >6.1 pmol·L-1 in women) identified in a population-based survey from 2013 to 2015 and with a current 24-hour urine osmolality of >600 mOsm · kg-1 were included. INTERVENTION Addition of 1.5 L water daily on top of habitual fluid intake for 6 weeks. MAIN OUTCOME MEASURE Pre- and postintervention fasting plasma copeptin concentrations. RESULTS Reported mean water intake increased from 0.43 to 1.35 L · d-1 (P < 0.001), with no other observed changes in diet. Median (interquartile range) urine osmolality was reduced from 879 (705, 996) to 384 (319, 502) mOsm · kg-1 (P < 0.001); urine volume increased from 1.06 (0.90, 1.20) to 2.27 (1.52, 2.67) L · d-1 (P < 0.001); and baseline copeptin decreased from 12.9 (7.4, 21.9) pmol · L-1 to 7.8 (4.6;11.3) pmol · L-1 (P < 0.001). Water supplementation reduced fasting plasma glucose from a mean (SD) of 5.94 (0.44) to 5.74 (0.51) (P = 0.04). The water-associated reduction of both fasting copeptin and glucose concentration in plasma was most pronounced in participants in the top tertile of baseline copeptin. CONCLUSIONS Water supplementation in persons with habitually low water consumption and high copeptin levels is effective in lowering copeptin. It appears a safe and promising intervention with the potential of lowering fasting plasma glucose and thus reducing diabetes risk. Further investigations are warranted to support these findings.
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Unaware of the amount consumed: Systematic error in estimating food- and drink intake.
Lasschuijt, MP, Camps, G, Koopman, Y, Smeets, PAM
Physiology & behavior. 2019;:112591
Abstract
BACKGROUND Our current food environment promotes overconsumption due to the overrepresentation of foods that have a high calorie density and can be easily consumed. These food characteristics lead to limited oro-sensory exposure, which may lead to overconsumption due to insufficient perception of the amount consumed. Better perception of the amount eaten and thus a better ability to estimate intake may help control actual food intake through prolonged inter-meal interval and smaller meal sizes. OBJECTIVE The aim of this study was to determine whether food form, flavor and portion size influence the error in estimated intake (EiE). METHOD Participants (n = 72) were recruited at a science festival where the study was also performed. The experiment had a 2 × 2 × 3 design with a reference condition. Experimental conditions differed in food form (liquid vs. solid stimuli), taste category (savory vs. sweet) and portion size (small, medium, large). Water was used as a reference condition. RESULTS Participants overestimated the amount consumed of all stimuli. The overestimation was ten times greater for solid compared to liquid products (104 ± 12 vs 12 ± 9% overestimation) and was more pronounced for sweet (75 ± 9%) than for savory products (41 ± 12%). There was a trend for larger EiE% of smaller portions. No differences were found among the differently flavored liquids including the water reference. CONCLUSION People overestimate the amount they consume of solid and sweet products more than that of liquid and savory products. This overestimation may be due to overvaluation of the oro-sensory stimulation when visual cues and intake effort are controlled for or because of learned associations. However, the uncontrolled setting of the experiment should be taken into account when drawing conclusions. Future research may replicate the study in a more controlled setting and should determine whether the overestimation of sweet solid product intake also leads to lower intake at a subsequent meal.
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[How to improve hydration and fluid intake in institutionalized older people? A scientific literature review].
Masot, O, Iglesias Millán, A, Nuin, C, Miranda, J, Lavedán, A, Botigué, T
Nutricion hospitalaria. 2018;(6):1441-1449
Abstract
BACKGROUND residents are vulnerable to suffer of dehydration due to physiological changes and the physical and cognitive limitations. AIM: to handle this situation, it has been decided to evaluate the interventions which are carried out for the management of dehydration and low fluid intake in older people living in nursing homes. METHODS the revised scientific literature review methodology of PRISMA was applied. An electronic database search was performed in PubMed, Scopus, CINAHL and other sources databases. The literature search was carried out between October 2016 and January 2017. Out of a total of 3,379 articles extracted, eleven studies were selected for analysis. In addition, their quality was assessed through Cochrane and the Newcastle-Ottawa Scale. RESULTS the risk of bias in the studies was mostly medium. Regarding the results, the interventions were classified according to whether they were invasive or non-invasive. Invasive interventions were intravenous and/or subcutaneous fluid therapy. Their effectiveness was related to the clinical improvement of dehydration. However, local reactions appeared. Non-invasive interventions focused on the individualized assistance, the stimulation to drink more and the consideration of the preferences of each resident, producing an increase in fluid intake and an improvement in analytical parameters. CONCLUSIONS given the peculiarities of the institutionalized elderly population, both types of intervention have been shown to have a positive effect on improving hydration. Nonetheless, non-invasive interventions have confirmed to be more efficient given their simplicity of application and cause fewer adverse effects.
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Energy, macronutrient and water intake during a mountain ultramarathon event: The influence of distance.
Martinez, S, Aguilo, A, Rodas, L, Lozano, L, Moreno, C, Tauler, P
Journal of sports sciences. 2018;(3):333-339
Abstract
Adequate dietary strategies are essential for the successful participation in ultra-endurance races. The aim of this study was to evaluate and compare the energy and water intakes of participants during three different mountain ultra-endurance runs. The study took place at the "Ultra Mallorca Serra de Tramuntana" (Mallorca, Spain), an ultra-endurance mountain event with runners participating either in a 44-km (Marathon, n = 51), a 67-km (Trail, n = 109) or a 112-km (Ultra, n = 53) run competition. Participants in the study answered a questionnaire focused on the nutritional intake within an hour after finishing the competition. Mean energy intake during the competitions was 183 kcal · h¯1, with an average carbohydrate intake of 31 g · h¯1 (52.1% of participants consumed less than 30 g · h¯1). No significant differences between competitions were found in these parameters. However, a higher percentage of energy from lipids in participants in the Trail and the Ultra was found (P = 0.034). Furthermore, significant differences were observed in water intake per hour of competition (P = 0.039), with the lowest value for the intake during the Ultra competition. In conclusion, the majority of the participants in the study present low carbohydrate intakes. However, fluid intake seems to be adequate. Different distances did not significantly influence the participants' nutritional strategies.
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Drinking water with consumption of a jelly filled doughnut has a time dependent effect on the postprandial blood glucose level in healthy young individuals.
Bipat, R, Toelsie, JR
Clinical nutrition ESPEN. 2018;:20-23
Abstract
An elevated postprandial glucose (PPG) level in plasma or blood is a risk factor for chronic disorders like obesity, diabetes mellitus type II and related cardiovascular conditions. Therefore, it is important to identify mechanisms that increase the value of postprandial glucose PPG levels. Hence in the present study we investigated the time dependent effect of drinking water during a meal on the level of PPG. Thirty-five volunteers were randomly assigned to five groups. Group A was given a jelly filled doughnut and group B, C, D and E had a similar doughnut in combination with a bottle of water along with the doughnut, thirty minutes before, thirty minutes after, and a second doughnut with water thirty minutes after the first one, respectively. Glucose was measured in capillary blood at intervals of 30 min up to 150 min (reg # FMeW 725B/17). PPG versus fasting glucose (Means ± SD, mmol/L) was for group A 5.4 ± 0.6 vs 4.6 ± 0.4, B 7.2 ± 0.7 vs 4.9 ± 0.4, C 5.5 ± 0.7 vs 4.4 ± 0.3, D 5.5 ± 0.6 vs 4.6 ± 0.3 and E 5.7 ± 0.5 vs 4.7 ± 0.2. The increase in group B was significantly higher than in all other groups (ANOVA, Dunnet's posttest). These results show that drinking water with consumption of a jelly-filled doughnut increases the postprandial blood glucose levels significantly compared to no drinking at all or thirty minutes before or after the consumption. It is therefore advisable that we should reconsider our eating and drinking habits to lower the PPG and consequently reduce the risks of abovementioned chronic disorders. Further assessment is necessary to evaluate this in more detail.
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Liberal fluid fasting: impact on gastric pH and residual volume in healthy children undergoing general anaesthesia for elective surgery.
Schmidt, AR, Buehler, KP, Both, C, Wiener, R, Klaghofer, R, Hersberger, M, Weiss, M, Schmitz, A
British journal of anaesthesia. 2018;(3):647-655
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Abstract
BACKGROUND The paediatric preoperative fasting time of 2 h for clear fluids, as suggested by guidelines, is often exceeded. Shorter preoperative fasting has been proposed to avoid potential outcomes such as dehydration, ketoacidosis, reduced arterial blood pressure, and patient discomfort. The aim of this study was to investigate whether liberal clear fluid intake until premedication significantly reduces actual fasting time and impacts gastric pH and residual volume. METHODS Children (1-16 yr old, ASA I or II) undergoing elective procedures with general anaesthesia requiring tracheal intubation were randomised for clear fluid intake until premedication with midazolam (liberal) or 2 h fluid fasting (standard). Actual fasting times were recorded. Gastric content was sampled after tracheal intubation with an orogastric tube to determine gastric pH and residual volume. Data are presented as median [interquartile range]. RESULTS We included 162 children aged 1.1-16 yr; gastric pH was determined in 138 patients. Patients' characteristics were similar in the two groups. The liberal fasting group had significantly shorter fasting times (48 [18.5-77.5] vs 234 [223.5-458.5] min; P<0.001). No significant difference was observed regarding gastric pH (1.6 [1.5-1.8] vs 1.6 [1.4-1.7]; P=0.237) or residual volume (0.38 [0.1-1.1] vs 0.43 [0.13-0.73] ml kg-1; P=0.535). Twelve patients (15%) in the liberal group (median fluid fasting 32 min) vs one patient (1%) had gastric residual volumes >2 ml kg-1 (P=0.001). CONCLUSION Fluid intake until premedication allows for significantly shorter fasting times. Elevated gastric residual volumes may occur more often in patients with fasting times of 30 min or shorter. CLINICAL TRIAL REGISTRATION NCT02603094.
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Effect of Fluid Intake on Hydration Status and Skin Barrier Characteristics in Geriatric Patients: An Explorative Study.
Akdeniz, M, Boeing, H, Müller-Werdan, U, Aykac, V, Steffen, A, Schell, M, Blume-Peytavi, U, Kottner, J
Skin pharmacology and physiology. 2018;(3):155-162
Abstract
BACKGROUND/AIM: Inadequate fluid intake is assumed to be a trigger of water-loss dehydration, which is a major health risk in aged and geriatric populations. Thus, there is a need to search for easy to use diagnostic tests to identify dehydration. Our overall aim was to investigate whether skin barrier parameters could be used for predicting fluid intake and/or hydration status in geriatric patients. METHODS An explorative observational comparative study was conducted in a geriatric hospital including patients aged 65 years and older. We measured 3-day fluid intake, skin barrier parameters, Overall Dry Skin Score, serum osmolality, cognitive and functional health, and medications. RESULTS Forty patients were included (mean age 78.45 years and 65% women) with a mean fluid intake of 1,747 mL/day. 20% of the patients were dehydrated and 22.5% had an impending dehydration according to serum osmolality. Multivariate analysis suggested that skin surface pH and epidermal hydration at the face were associated with fluid intake. Serum osmolality was associated with epidermal hydration at the leg and skin surface pH at the face. Fluid intake was not correlated with serum osmolality. Diuretics were associated with high serum osmolality. CONCLUSIONS Approximately half of the patients were diagnosed as being dehydrated according to osmolality, which is the current reference standard. However, there was no association with fluid intake, questioning the clinical relevance of this measure. Results indicate that single skin barrier parameters are poor markers for fluid intake or osmolality. Epidermal hydration might play a role but most probably in combination with other tests.
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Is it Safe to Reduce Water Intake in the Overactive Bladder Population? A Systematic Review.
Wood, LN, Markowitz, MA, Parameshwar, PS, Hannemann, AJ, Ogawa, SL, Anger, JT, Eilber, KS
The Journal of urology. 2018;(2):375-381
Abstract
PURPOSE Overactive bladder imposes a significant socioeconomic burden on the health care system. It is a commonly held belief that increased fluid intake (8 glasses of water per day) is beneficial for health. However, increased fluid intake exacerbates overactive bladder symptoms. Thus, it is imperative that clinicians appropriately educate patients for whom increased water intake may be detrimental (women with overactive bladder), in contrast to patients with comorbidities that necessitate increased water intake (nephrolithiasis). We systematically reviewed the literature to determine the potential health advantages of increased water intake and identify specific subpopulations that need increased hydration. MATERIALS AND METHODS We systematically reviewed published articles from 1972 through 2017 on PubMed® and the Cochrane Library. The data were reviewed independently by 2 individuals. Studies were included if they explored water intake in relation to the risk of a particular disease. RESULTS Level 1 evidence supported increased fluid intake in patients with nephrolithiasis. There was no available evidence to support increased fluid intake in patients with cardiovascular disease, constipation, venous thromboembolism, headaches, cognitive function or bladder cancer. Dehydration may exacerbate some conditions, specifically chronic constipation and headache intensity. Increased fluid intake may have a role in preventing stroke recurrence but not in preventing primary stroke. CONCLUSIONS The available reviewed literature suggests no benefit to drinking 8 glasses of water per day in patients without nephrolithiasis. Also, excess fluid intake can exacerbate symptoms of overactive bladder.
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Just add water: Effects of added gastric distention by water on gastric emptying and satiety related brain activity.
Camps, G, Veit, R, Mars, M, de Graaf, C, Smeets, PA
Appetite. 2018;:195-202
Abstract
BACKGROUND Gastric distention contributes to meal termination. There is little research on the neural correlates of gastric distention by food. To date, neural measures have not been obtained concurrently with measurements of gastric distention. OBJECTIVES 1) To study how offering a small versus a large water load following a standardized nutrient load affects gastric distention over time. 2) To assess associations between satiety experiences and brain activity and the degree of gastric distention. METHOD 19 healthy males (age 22.2 ± 2.5 y, BMI 21.8 ± 1.5 kg/m2) participated in a randomized crossover study with two treatments: ingestion of a 500-kcal 150-mL liquid meal shake followed by a low (LV, 50 mL) or a high volume (HV, 350 mL) water load. At baseline and three times after ingestion satiety was scored, MRI scans were made to determine total gastric content volume (TGV) and functional MRI scans were made to measure cerebral blood flow (CBF). RESULTS TGV was significantly higher for HV compared to LV at all time points (p < 0.001) with relative differences between HV and LV of 292 ± 37 mL after ingestion, 182 ± 83 mL at t = 15 min and 62 ± 57 mL at t = 35 min. Hunger decreased (p = 0.023) and fullness increased (p = 0.030) significantly more for HV compared to LV. Ingestion increased CBF in the inferior frontal gyrus and the anterior insula, but there were no differences between treatments. There were no significant correlations between appetite ratings and CBF values. CONCLUSION Performing concurrent gastric MRI and CBF measurements can be used to investigate neural correlates of gastric distention. Increased distention did not induce significantly greater brain activation. Future research should further examine the role of the inferior frontal gyrus in satiety.
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Under What Conditions do Water-Intervention Studies Significantly Improve Child Body Weight?
Stookey, JD
Annals of nutrition & metabolism. 2017;:62-67
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Abstract
There are particular conditions that may optimize the effects of drinking-water interventions on body weight change and risk of obesity. Strategic planning to create and sustain conditions for optimal effects of drinking water may maximize the impact of school-based interventions to reduce childhood obesity. This paper proposes questions about the target population, type of diet and activity level that will be maintained during the intervention, and planned intervention message(s). The proposed questions are motivated by conditions associated with significant effects of drinking water in randomized controlled trials. They are discussed in relation to conditions underlying the recently successful school-based drinking-water intervention in New York City. If conditions allow, school-based drinking-water interventions have the potential to efficiently benefit millions of children worldwide, who are at risk of becoming obese.