Skip to main content
×
Home
    • Aa
    • Aa

What is the cell hydration status of healthy children in the USA? Preliminary data on urine osmolality and water intake

  • Jodi D. Stookey (a1), Bernie Brass (a1), Ava Holliday (a1) and Allen Arieff (a2)
Abstract
AbstractObjective

Hyperosmotic stress on cells limits many aspects of cell function, metabolism and health. International data suggest that schoolchildren may be at risk of hyperosmotic stress on cells because of suboptimal water intake. The present study explored the cell hydration status of two samples of children in the USA.

Design

Cross-sectional study describing the urine osmolality (an index of hyperosmotic cell shrinkage) and water intake of convenience samples from Los Angeles (LA) and New York City (NYC).

Setting

Each participant collected a urine sample at an outpatient clinic on the way to school on a weekday morning in spring 2009. Each was instructed to wake, eat, drink and do as usual before school, and complete a dietary record form describing the type and amounts of all foods and beverages consumed after waking, before giving the sample.

Subjects

The children (9–11 years) in LA (n 337) and NYC (n 211) considered themselves healthy enough to go to school on the day they gave the urine sample.

Results

Elevated urine osmolality (>800 mmol/kg) was observed in 63 % and 66 % of participants in LA and NYC, respectively. In multivariable-adjusted logistic regression models, elevated urine osmolality was associated with not reporting intake of drinking water in the morning (LA: OR = 2·1, 95 % CI 1·2, 3·5; NYC: OR = 1·8, 95 % CI 1·0, 3·5). Although over 90 % of both samples had breakfast before giving the urine sample, 75 % did not drink water.

Conclusions

Research is warranted to confirm these results and pursue their potential health implications.

    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      What is the cell hydration status of healthy children in the USA? Preliminary data on urine osmolality and water intake
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your Dropbox account. Find out more about sending content to Dropbox.

      What is the cell hydration status of healthy children in the USA? Preliminary data on urine osmolality and water intake
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your Google Drive account. Find out more about sending content to Google Drive.

      What is the cell hydration status of healthy children in the USA? Preliminary data on urine osmolality and water intake
      Available formats
      ×
Copyright
Corresponding author
*Corresponding author: Email jstookey@chori.org
References
Hide All
1.Lang F, Busch GL, Ritter M et al. (1998) Functional significance of cell volume regulatory mechanisms. Physiol Rev 78, 247306.
2.Andrew RD & MacVicar BA (1994) Imaging cell volume changes and neuronal excitation in the hippocampal slice. Neuroscience 62, 371383.
3.Eilers H & Schumacher MA (2005) Mechanosensitivity of primary afferent nociceptors in the pain pathway. In Mechanosensitivity in Tissues and Cells, pp. 357–370 [A Kamkin and I Kiseleva, editors]. Moscow: Academia; available at http://www.ncbi.nlm.nih.gov/books/NBK7514/
4.Le Bihan D (2007) The ‘wet mind’: water and functional neuroimaging. Phys Med Biol 52, R57R90.
5.Krause EG, deKloet AD, Flak JN et al. (2011) Hydration state controls stress responsiveness and social behavior. J Neurosci 31, 54705476.
6.Yancey PH, Clark ME, Hand SC et al. (1982) Living with water stress: evolution of osmolyte systems. Science 217, 12141222.
7.Haussinger D (2008) Osmosensing and osmosignaling in the liver. Wien Med Wochenschr 158, 549552.
8.Hernanz-Schulman M, Vanholder R, Waterloos MA et al. (2000) Effect of radiographic contrast agents on leukocyte metabolic response. Pediatr Radiol 30, 361368.
9.Lancaster MG & Allison F (1966) Studies on the pathogenesis of acute inflammation. VII. The influence of osmolality upon the phagocytic and clumping activity by human leukocytes. Am J Pathol 49, 11851200.
10.Berneis K, Ninnis R, Haussinger D et al. (1999) Effects of hyper- and hypoosmolality on whole body protein and glucose kinetics in humans. Am J Physiol 276, E188E195.
11.Brown CM, Barberini L, Dulloo AG et al. (2005) Cardiovascular responses to water drinking: does osmolality play a role? Am J Physiol Regul Integr Comp Physiol 289, R1687R1692.
12.Capra NF & Ro JY (2004) Human and animal experimental models of acute and chronic muscle pain: intramuscular algesic injection. Pain 110, 37.
13.Judelson DA, Maresh CM, Yamamoto LM et al. (2008) Effect of hydration state on resistance exercise-induced endocrine markers of anabolism, catabolism, and metabolism. J Appl Physiol 105, 816824.
14.Lyall V, Heck GL, DeSimone JA et al. (1999) Effects of osmolarity on taste receptor cell size and function. Am J Physiol 277, C800C813.
15.Pasantes-Morales H & Tuz K (2006) Volume changes in neurons: hyperexcitability and neuronal death. Contrib Nephrol 152, 221240.
16.Schliess F & Haussinger D (2003) Cell volume and insulin signaling. Int Rev Cytol 225, 187228.
17.McKenzie MA, Greenleaf JE, Looft-Wilson R et al. (1999) Leucocytosis, thrombocytosis, and plasma osmolality during rest and exercise: an hypothesis. J Physiol Pharmacol 50, 259273.
18.Cheung SS & McLellan TM (1998) Heat acclimation, aerobic fitness, and hydration effects on tolerance during uncompensable heat stress. J Appl Physiol 84, 17311739.
19.Ainslie PN, Campbell IT, Frayn KN et al. (2002) Energy balance, metabolism, hydration, and performance during strenuous hill walking: the effect of age. J Appl Physiol 93, 714723.
20.Sawka MN (1992) Physiological consequences of hypohydration: exercise performance and thermoregulation. Med Sci Sports Exerc 24, 657670.
21.Silnik M (1998) Practical management of diabetic ketoacidosis in childhood and adolescence. Paediatr Suppl 425, 6366.
22.Trachtman H (1992) Cell volume regulation: a review of cerebral adaptive mechanisms and implications for clinical treatment of osmolal disturbances. Pediatr Nephrol 6, 104112.
23.Vercellino M, Bezante GP & Balbi M (2009) Contrast medium induced nephropathy: new insights into prevention and risk management. Cardiovasc Hematol Agents Med Chem 7, 166180.
24.Pier GB (2002) CFTR mutations and host susceptibility to Pseudomonas aeruginosa lung infection. Curr Opin Microbiol 5, 8186.
25.Kuroda T, Harada T, Tsutsumi H et al. (1997) Hypernatremic suppression of neutrophils. Burns 23, 338340.
26.Platt OS (1982) Exercise-induced hemolysis in sickle cell anemia: shear sensitivity and erythrocyte dehydration. Blood 59, 10551060.
27.Tripette J, Loko G, Samb A et al. (2010) Effects of hydration and dehydration on blood rheology in sickle cell trait carriers during exercise. Am J Physiol Heart Circ Physiol 299, H908H914.
28.El-Mougi M, Hendawi A, Koura H et al. (1996) Efficacy of standard glucose-based and reduced osmolarity maltodextrin-based oral rehydration solutions: effect of sugar malabsorption. Bull World Health Organ 74, 471477.
29.Hahn S, Kim Y & Garner P (2001) Reduced osmolarity oral rehydration solution for treating dehydration due to diarrhoea in children: systematic review. BMJ 323, 8185.
30.Arora SK (2011) Hypernatremic disorders in the intensive care unit. J Intensive Care Med (Epublication ahead of print version).
31.Alshayeb HM, Showkat A, Babar F et al. (2011) Severe hypernatremia correction rate and mortality in hospitalized patients. Am J Med Sci 341, 356360.
32.Stookey JD, Pieper CF & Cohen HJ (2004) Hypertonic hyperglycemia progresses to diabetes faster than normotonic hyperglycemia. Eur J Epidemiol 19, 935944.
33.Stookey JD, Purser JL, Pieper CF et al. (2004) Plasma hypertonicity: another marker of frailty? J Am Geriatr Soc 52, 13131320.
34.Kroke A, Manz F, Kersting M et al. (2004) The DONALD Study. History, current status and future perspectives. Eur J Nutr 43, 4554.
35.Star RA (1990) Southwestern internal medicine conference: Hyperosmolar states. Am J Med Sci 300, 402412.
36.Manz F & Wentz A (2003) 24-h hydration status: parameters, epidemiology and recommendations. Eur J Clin Nutr 57, Suppl. 2, S10S18.
37.JrEdelmann CM , Barnett HL, Stark H et al. (1967) A standardized test of renal concentrating capacity in children. Am J Dis Child 114, 639644.
38.Manz F, Wentz A & Sichert-Hellert W (2002) The most essential nutrient: defining the adequate intake of water. J Pediatr 141, 587592.
39.Uttley WS, Paxton J & Thistlethwaite D (1972) Urinary concentrating ability and growth failure in urinary tract disorders. Arch Dis Child 47, 436441.
40.Bar-David Y, Urkin J & Kozminsky E (2005) The effect of voluntary dehydration on cognitive functions of elementary school children. Acta Paediatr 94, 16671673.
41.Bar-David Y, Urkin J, Landau D et al. (2009) Voluntary dehydration among elementary school children residing in a hot arid environment. J Hum Nutr Diet 22, 455460.
42.Philip M, Chaimovitz C, Singer A et al. (1993) Urine osmolality in nursery school children in a hot climate. Isr J Med Sci 29, 104106.
43.Van Hoeck K, Bael A, Lax H et al. (2007) Circadian variation of voided volume in normal school-age children. Eur J Pediatr 166, 579584.
44.Nose H, Mack GW, Shi XR et al. (1988) Role of osmolality and plasma volume during rehydration in humans. J Appl Physiol 65, 325331.
45.Merson SJ, Maughan RJ & Shirreffs SM (2008) Rehydration with drinks differing in sodium concentration and recovery from moderate exercise-induced hypohydration in man. Eur J Appl Physiol 103, 585594.
46.Bar David Y, Landau D, Bar David Z et al. (1998) Urine osmolality among elementary school children living in a hot climate: implications for dehydration. Ambul Child Health 4, 393397.
47.Bar-Or O (2001) Nutritional considerations for the child athlete. Can J Appl Physiol 26, Suppl., S186S191.
48.D'Anci KE, Constant F & Rosenberg IH (2006) Hydration and cognitive function in children. Nutr Rev 64, 457464.
49.Stahl A, Kroke A, Bolzenius K et al. (2007) Relation between hydration status in children and their dietary profile – results from the DONALD study. Eur J Clin Nutr 61, 13861392.
50.Kant AK & Graubard BI (2010) Contributors of water intake in US children and adolescents: associations with dietary and meal characteristics – National Health and Nutrition Examination Survey 2005–2006. Am J Clin Nutr 92, 887896.
51. Chriqui JF, Schneider L, Chaloupka FJ et al. (2009) Local Wellness Policies: Assessing School District Strategies for Improving Children's Health. http://www.rwjf.org/files/research/20090728bridgingthegapfull.pdf (accessed October 2011).
52.Patel AI, Bogart LM, Uyeda KE et al. (2010) Perceptions about availability and adequacy of drinking water in a large California school district. Prev Chronic Dis 7, A39.
53.Institute of Medicine (2004) Dietary Reference Intakes for Water, Potassium, Sodium, Chloride, and Sulfate. Washington, DC: The National Academies Press.
54.Bond L, Clements J, Bertalli N et al. (2006) A comparison of self-reported puberty using the Pubertal Development Scale and the Sexual Maturation Scale in a school-based epidemiologic survey. J Adolesc 29, 709720.
55.Petersen AC, Crockett L, Richards M et al. (1988) A self-report measure of pubertal status: reliability, validity and initial norms. J Youth Adolesc 17, 117133.
56.Shirtcliff EA, Dahl RE & Pollak SD (2009) Pubertal development: correspondence between hormonal and physical development. Child Dev 80, 327337.
57.Ikeda Y, Tanaka I, Oki Y et al. (1993) Testosterone normalizes plasma vasopressin response to osmotic stimuli in men with hypogonadism. Endocr J 40, 387392.
58.Stachenfeld NS (2008) Sex hormone effects on body fluid regulation. Exerc Sport Sci Rev 36, 152159.
59.Weston AT, Petosa R & Pate RR (1997) Validation of an instrument for measurement of physical activity in youth. Med Sci Sports Exerc 29, 138143.
60.Welk GJ, Dzewaltowski DA & Hill JL (2004) Comparison of the computerized ACTIVITYGRAM instrument and the previous day physical activity recall for assessing physical activity in children. Res Q Exerc Sport 75, 370380.
61.Friis-Hansen B (1982) Water – the major nutrient. Acta Paediatr Scand Suppl 299, 1116.
62.Guenther PM, Kott PS & Carriquiry AL (1997) Development of an approach for estimating usual nutrient intake distributions at the population level. J Nutr 127, 11061112.
63.Mettler S, Rusch C & Colombani PC (2006) Osmolality and pH of sport and other drinks available in Switzerland. Schweizerische Zeitschrift fur Sportmedizin und Sporttraumatologie 54, 9295.
64.Arieff AI, Guisado R & Lazarowitz VC (1977) Pathophysiology of Hyperosmolar States. Disturbances in Body Fluid Osmolality. Bethesda, MD: American Physiological Society.
65.Schmitt F, Bresson JL, Beressi N et al. (2003) Influence of plasma amino acid level on vasopressin secretion. Diab Metab 29, 352361.
66.Seifert J, Harmon J & DeClercq P (2006) Protein added to a sports drink improves fluid retention. Int J Sport Nutr Exerc Metab 16, 420429.
67.Shirreffs SM, Aragon-Vargas LF, Keil M et al. (2007) Rehydration after exercise in the heat: a comparison of 4 commonly used drinks. Int J Sport Nutr Exerc Metab 17, 244258.
68.Shirreffs SM, Watson P & Maughan RJ (2007) Milk as an effective post-exercise rehydration drink. Br J Nutr 98, 173180.
69.Vist GE & Maughan RJ (1994) Gastric emptying of ingested solutions in man: effect of beverage glucose concentration. Med Sci Sports Exerc 26, 12691273.
70.Vaisman N, Voet H, Akivis A et al. (1996) Effect of breakfast timing on the cognitive functions of elementary school students. Arch Pediatr Adolesc Med 150, 10891092.
71.Moritz ML (2008) Urine sodium composition in ambulatory healthy children: hypotonic or isotonic? Pediatr Nephrol 23, 955957.
72.Alfieri RR & Petronini PG (2007) Hyperosmotic stress response: comparison with other cellular stresses. Pflugers Arch 454, 173185.
73.O'Neill WC (1999) Physiological significance of volume-regulatory transporters. Am J Physiol 276, C995C1011.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Public Health Nutrition
  • ISSN: 1368-9800
  • EISSN: 1475-2727
  • URL: /core/journals/public-health-nutrition
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords:

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 23
Total number of PDF views: 165 *
Loading metrics...

Abstract views

Total abstract views: 1009 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 22nd October 2017. This data will be updated every 24 hours.