ehi key tips on hydration volume 1

Key Tips on Hydration (Volume 1)

Hydration needs for different life stages

Index

• Key Tips on Hydration for infants and children.

• Key Tips on Hydration for adolescents and adults.

• Key Tips on Hydration for elderly people.

• Key Tips on Hydration for pregnant and breastfeeding women.

for infants and children

KEY TIPSON HYDRATION

The hydration needs of children are not that different to those of adults. However, infants and children are more susceptible to dehydration than adults. According to the Panel on Dietetic Products, Nutrition and Allergies from the European Food Safety Authority (EFSA)1 2010, the values for total water intake shown in the adjacent table are those recommended for infants and children under conditions of moderate environmental temperature and moderate physical activity levels.

Age range Daily adequate water intake1

Infants

0-6 months680 mL/day or 100-190 mL/kg/day. From human milk/

infant formula.

6-12 months0.8-1.0 L/day. From human

milk/infant formula and complementary foods and

beverages.

1-2 years 1.1-1.2 L/day

Children

2-3 years 1.3 L/day

4-8 years 1.6 L/day

• Compared to children and adults, infants have a higher total body water content. In newborns the total body water content can be as much as 75% and this decreases to 50-60% by the time they reach adulthood.

• Infants and children need water not only to replace the losses via respiration, sweating and urine, but also for growth.

• Instances of diarrhoea and vomiting are frequent in infants and young children and both can lead to dehydration if water losses are not replaced .

• Infants cannot easily communicate their needs and active children can be so involved in what they are doing that they forget to drink, so it is important for those caring for them to be alert to the possibility of dehydration especially during hot weather or during periods of illness.

it is important to remember that:

The Panel on Dietetic Products, Nutrition and Allergies from the European Food Safety Authority (EFSA)* issued reference intakes for water in 2010. These are defined as total water intake, which is water from beverages (including drinking water) and from food moisture. It is normally assumed that the contribution of food to total dietary water intake is 20 to 30%, while 70 to 80% is provided by beverages. This relationship is not fixed and depends on the type of beverage and on the choice of foods.

For HeaLtHcare ProFessionaL distribution onLy

KEY TIPS ON HYDRATION

how to ensure proper hydration of infants and childreninfants

During breastfeeding healthy infants can maintain adequate hydration status while exclusively breastfed without additional water, even in very hot weather.

Additional water intake may be needed from 0 to 6 months when an infant formula is used, or from 6 to 12 months when formula or other weaning food with higher energy and nutrient density is used.

children

These are practical tips to keep active children hydrated, especially in hot environments:

• Have children drink before heading out to play and call them in frequently for drinks.

• To avoid overheating, encourage regular breaks in the shade when the sun is hot.

• Keep drinks cool whenever possible and offer beverages that your child enjoys. All beverages, including water, milk, juice, soft-drinks, and other fluids, can help meet a child’s hydration needs..

• Remember that many foods have a high water content and contribute to total fluid intake. Fruits, vegetables, and some other foods are high in water content.

There is some evidence that providing drinks to children can help them to perform better in standardised tests of concentration, short term memory and other essential elements of the learning process. Hydration needs should therefore also be considered when children are at school.

70-80%from beverages (all types, not just plain water)1,2

20-30%typically comes from food and

It is calculated that ofthe total water consumed…

However, this may vary greatlydepending of the diet that an individualchooses.1,2

to know more about the sources of water, please visit us at:http://www.europeanhydrationinstitute.org/nutrition_and_beverages.html

1. efsa panel on dietetic products, nutrition, and allergies (nda); scientific opinion on dietary reference values for water. efsa Journal 2010; 8(3):1459. available online: http://www.efsa.europa.eu/en/efsajournal/pub/1459.htm

2. manz f, Johner sa, wentz a, boeing h, remer t. water balance throughout the adult lifespan in a German population. br J nutr 2011; 1-9 [epub ahead of print]

for adolescents and adults


the body requires water to survive and function properly. Humans cannot live without drinking for more than a few days – depending on weather, activity levels and other factors- whereas other nutrients may be neglected for weeks or months. although commonly it is treated rather trivially, no other nutrient is more essential or is needed in such large amounts.

Water requirements vary between individuals and according to diet, environmental conditions, activity levels and a range of other factors. as a reference, the adjacent table shows the values for total water intake for each age group, as issued by the Panel on dietetic Products, nutrition and allergies from the european food safety authority (efsa)1 on 2010.

Age range Daily adequate water intake1

Adolescents (Males / Females)

9-13 years 2.1 L/day / 1.9 L/day

14-18 years 2.5 L/day / 2.0 L/day

Adults (Males / Females)*

›19 years 2.5 L/day/ 2.0 L/day

* some groups are at a higher risk of dehydration (elderly people) or are special cases that need higher quantities of water (pregnant and lactating women). Please read our special advice for these groups at: http://www.europeanhydrationinstitute.org/elderly_people.html andhttp://www.europeanhydrationinstitute.org/pregnancy_a_lactation.html

That the amount of water that is deemed adequate includes not only water from drinking water, but also beverages of all kinds and from food moisture.

That the reference values included in this recommendation only apply to conditions of moderate environmental temperature and moderate physical activity levels.

That thirst appears in the middle-stage of dehydration so it’s better to drink on a regular basis.

To know more about the water requirements of your body, please visit us at:http://www.europeanhydrationinstitute.org/hydration_needs.html

IT Is ImporTanT To Take InTo accounT...

are you aware of how much waTer you need?



type of beverage / food Water contentnon-alcoholic beverages*water, tea, coffee, light refreshments, sports drinks, soft drinks, lemonade, vegetable juice 90% to 100%

milk, fruit juice, juice beverages 85% to 90%

soupsIncluding consommé and creams made with milk, etc. 80% to 95%

Fruits and vegetablesstrawberry, melon, grapefruit, grape, peach, pear, orange, apple, cucumber, lettuce, celery, tomato, pumpkin, broccoli, onion, carrot 80% to 95%

Banana, potato, corn 70% to 80%

dairy productsfresh whole milk 87 to 90%

yoghurt 75% to 85%

Ice creams 60% to 65%

cheese 40% to 60%

cerealsrice (boiled) 65% to 70%

pasta (spaghetti, macaroni, noodles) 75% to 85%**

Bread, cookies 30% to 40%

Breakfast cereals (ready to eat) 2% to 5%

Meat, Fish, eggsfish and seafood 65% to 80%

eggs (scrambled, fried, poached), omelette, egg substitute 65% to 75%

Beef, chicken, lamb, pig, veal 40% to 65%

cured meat, bacon 15% to 40%

adapted from: Holland B. et al (1991) Mccance and Widdowson. the composition of foods 5th ed. the royal society of chemistry cambridge, uK.* softer alcoholic beverages such as beer may have an important cultural weight in some countries. Beer and wine contain 85% to 95% of water whereas distilled alcoholic drinks typically contain only 57% - 70% water.**note that these values are approximations only and values will depend on source of the food, cooking method, etc. for example pasta cooked “al dente” (Italian style) will have a slightly lower water content than shown here** and is between 50 and 60%. there are many good online databases that will give food composition values for a much wider range of foods.

1. efsa Panel on dietetic Products, nutrition, and allergies (nda); scientific opinion on dietary reference values for water. efsa Journal 2010; 8(3):1459. available online: “http://www.efsa.europa.eu/en/efsajournal/pub/1459.htm”www.efsa.europa.eu/en/efsajournal/pub/1459.htm2. Manz f, Johner sa, Wentz a, Boeing H, remer t. Water balance throughout the adult lifespan in a German population. Br J nutr 2011; 1-9 [epub ahead of print]

where can I geT The waTer from?


The following are the average water contents of different kinds of non-alcoholic beverages and foods,which may give you an idea of the water intake you get according to your own food choices.



However, this may vary greatlydepending of the diet that an individualchooses.1,2

for ELDErLY PEoPLE


• People usually drink in response to thirst, but by the age of 60, if people only drink when they are thirsty, they may not get as much water as they need.

• Renal concentrating capacity generally declines with the age, leading to an increased loss of water via urine.

• Diminished appetite and poor food choices may lead to a reduction of fluid intake from food.

• Some older adults may suffer from poor memory, immobility, or illness which may affect fluid intake. In addition, certain medications can also block the thirst mechanism.

• Dehydration can cause serious problems in older adults. Elderly people are at greatest risk of dehydration and its potentially life-threatening consequences: People aged between 85-99 years are 6 times more likely to be hospitalised for dehydration than those aged 65-69 years.

• Chronic dehydration constitutes a serious problem and is associated with an increased risk of falls, urinary tract infections, dental disease, bronchopulmonary disorders, kidney stones, constipation, and impaired cognitive function.

SPEciaL conSiDErationS for thE ELDErLY

arE You awarE of thEir incrEaSED riSk of DEhYDration?

2 L for women

2.5 L for menunder conditions of moderate environmentaltemperature and moderate physical activity levels.But age-related changes can lead to an increased risk ofdehydration with consequent effects on health and wellness.

The EFSA adult recommendations for the daily intake of water from all sources*(water, beverages and food) do not fall with age



how to EnSurE ProPEr hYDration in thE ELDErLY

These are practical tips to help keep elderly people well hydrated

• a hydration programme should include advice on drinking, offering fluids at mealtime and in between meals. fluids should be readily available and physically accessible both day and night.

• carers should be familiar with dietary changes so that appropriate hydration recommendations can be made.

• Environmental temperatures inside should be moderate. in hot environments, it is recommended that intake of liquids be increased by 250 mL for each degree centigrade over 37ºc.

• Strong (distilled) alcoholic beverages may provoke dehydration and are not recommended.

• Many types of foods contain a substantial amount of water. if an older person finds it difficult to increase the amount of fluid drunk, increasing the intake of foods, such as soups or fruit and vegetables, which typically contain 80-90 per cent water, can help to maintain an adequate water intake as well as being good sources of essential nutrients.

• Varying flavours and even colours can improve palatability of beverages offered and can help facilitate adequate hydration.


* Source: EfSa Panel on Dietetic Products, nutrition, and allergies (nDa); Scientific opinion on Dietary reference values for water. EfSa Journal 2010; 8(3):1459. available online: http://www.efsa.europa.eu/en/efsajournal/pub/1459.htm

The Panel on Dietetic Products, Nutrition and Allergies from the European Food Safety Authority (EFSA)* issued reference intakes for water in 2010. These are defined as total water intake, which is water from beverages (including drinking water) and from food moisture. It is normally assumed that the contribution of food to total dietary water intake is 20 to 30%, while 70 to 80% is provided by beverages. This relationship is not fixed and depends on the type of beverage and on the choice of foods.

for PrEgnant andbrEastfEEding womEn


• Pregnancy Increased water needs in pregnancy arise because of the weight gained (typically 10-15 kg), the higher energy intake, the increase in blood volume, the formation of amniotic fluid and because of increased water output which can occur as a result of morning sickness.

Meeting water needs through diet may be more difficult in pregnant than in non pregnant women because of food aversions and/or avoidance of fluid intake when morning sickness appears. It follows that pregnant women may be more vulnerable to dehydration.

• Breastfedbabies take in an average of about 750 mL of milk per day (600-900 mL) between the ages of 1 and 6 months. Breastfeeding mothers therefore lose significant amounts of fluid during nursing and need to increase their fluid intake to compensate.

Mild dehydration does not affect milk supply, but moderate to severe dehydration may have an effect, including changing the composition of the milk and decreasing the amount of milk produced. Dehydration will also add to feelings of tiredness at what can be a very stressful time.

ForHeaLtHcareProFessionaLdistriBution onLy

Water neeDs Increase DurIng pregnancy anD BreastfeeDIng:

Water IntaKe recOMMenDatIOnthe european food safety authority (efsa)1 has made the following recommendations for adequate intakes of water for pregnant and breastfeeding women:

Status EFSA Recommendation Daily adequate intake of water from all sources

PregnantAn additional water intake of 300 mL on top of the 2 L per day adequate intake recommended for non-pregnant women.

2.3 L

BreastfeedingAn additional 600 – 700 mL per day on top of the 2 L per day adequate intake recommended for non-breastfeeding women.

2.7 L



1. Efsa Panel on dietetic Products, nutrition, and allergies (nda); scientific opinion on dietary reference values for water. Efsa Journal 2010; 8(3):1459. available online: http://www.efsa.europa.eu/en/efsajournal/pub/1459.htm2. manz f, Johner sa, wentz a, boeing H, remer t. water balance throughout the adult lifespan in a german population. br J nutr 2011; 1-9 [Epub ahead of print]

What tO DrInK?good choices include water (mineral or tap), fruit juices, herbal teas, soft drinks, and decaffeinated tea and coffee.




However, this may vary greatlydepending of the diet that an individual chooses.1,2

hOW tO ensure prOperhyDratIOn WhILst pregnantOr BreastfeeDIngDrink plenty of fluids:

• During pregnancy hydration plays an essential role since an adequate supply of water is essential for meeting the water needs of your body and of the baby (water represents 94% of the baby’s weight at the end of the first trimester). Water is also needed for the renewal of amniotic fluid, the baby’s living environment. not drinking enough water can lead to constipation and then to haemorrhoids which are a common complication during pregnancy.

• proper hydration during breastfeeding ensures milk supply. It is always good practice to have a beverage nearby whilst breastfeeding.

• When choosing food and beverages it is important to take into account that small amounts of food or beverages can pass to the baby via the breast milk. Drinks containing caffeine can affect your baby and may keep them awake. While your baby is young, drink caffeinated drinks occasionally rather than every day. caffeine occurs naturally in many foods and drinks, including coffee, tea and chocolate. It’s also added to some soft drinks and energy drinks, and to some cold and flu remedies.

http://www.europeanhydrationinstitute.org/

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