DOI QR코드

DOI QR Code

Fluid intake, hydration status and its association with cognitive function among adolescents in Petaling Perdana, Selangor, Malaysia

  • Tung, Serene En Hui (Department of Food Science and Nutrition, UCSI University Kuala Lumpur Campus) ;
  • Ch'ng, Yi Zhang (Department of Food Science and Nutrition, UCSI University Kuala Lumpur Campus) ;
  • Karnan, Thaneswary V (Department of Food Science and Nutrition, UCSI University Kuala Lumpur Campus) ;
  • Chong, Pei Nee (Department of Food Science and Nutrition, UCSI University Kuala Lumpur Campus) ;
  • Zubaidah, Jamil Osman (Division of Psychology, Cyberjaya University College of Medical Sciences) ;
  • Chin, Yit Siew (Department of Nutrition and Dietetics, Universiti Putra Malaysia)
  • Received : 2019.06.17
  • Accepted : 2020.02.03
  • Published : 2020.10.01

Abstract

BACKGROUND/OBJECTIVES: A cross-sectional study was undertaken to evaluate fluid intake and hydration status in association with cognitive function among 230 adolescents (10-14 years of age) in Petaling Perdana, Selangor, Malaysia. SUBJECTS/METHODS: Urine color was used to measure hydration status, while fluid intake was assessed using the 15-item beverage intake questionnaire. Cognitive function was assessed using the Wechsler Intelligence Scale for Children, Fourth Edition. RESULTS: More than half of the adolescents were mildly or moderately dehydrated (59.6%) and only one-third (33.0%) were well hydrated. Among the daily fluid types, intakes of soft drinks (r = -0.180; P = 0.006), sweetened tea (r = -0.184; P = 0.005) and total sugar-sweetened beverages (SSBs) (r = -0.199; P = 0.002) were negatively correlated with cognitive function. In terms of hydration status, cognitive function score was significantly higher (F-ratio = 4.102; P = 0.018) among hydrated adolescents (100.38 ± 12.01) than in dehydrated (92.00 ± 13.63) counterparts. Hierarchical multiple linear regression analysis, after adjusting for socio-demographic factors, showed that soft drinks (β = -0.009; P < 0.05) and sweetened tea (β = -0.019; P < 0.05) negatively predicted cognitive function (ΔR2 = 0.044). When further control for sources of fluid, hydration status (β = -2.839; P < 0.05) was shown to negatively predict cognitive function (ΔR2 = 0.021). The above variables contributed 20.1% of the variance in cognitive function. CONCLUSIONS: The results highlight the links between fluid intake (soft drinks, sweetened tea, total SSBs) and hydration status with cognitive function in adolescents. Interventions aimed at decreasing the consumption of SSBs and increasing hydration status through healthy fluid choices, such as water, could improve cognitive performance in adolescents.

References

  1. D'Anci KE, Constant F, Rosenberg IH. Hydration and cognitive function in children. Nutr Rev 2006;64:457-64.
  2. Muckelbauer R, Barbosa CL, Mittag T, Burkhardt K, Mikelaishvili N, Muller-Nordhorn J. Association between water consumption and body weight outcomes in children and adolescents: a systematic review. Obesity (Silver Spring) 2014;22:2462-75.
  3. Iglesia I, Guelinckx I, De Miguel-Etayo PM, Gonzalez-Gil EM, Salas-Salvado J, Kavouras SA, Gandy J, Martinez H, Bardosono S, Abdollahi M, Nasseri E, Jarosz A, Ma G, Carmuega E, Thiebaut I, Moreno LA. Total fluid intake of children and adolescents: cross-sectional surveys in 13 countries worldwide. Eur J Nutr 2015;54 Suppl 2:57-67. https://doi.org/10.1007/s00394-015-0946-6
  4. Kenney EL, Long MW, Cradock AL, Gortmaker SL. Prevalence of inadequate hydration among US children and disparities by gender and race/ethnicity: National Health and Nutrition Examination Survey, 2009-2012. Am J Public Health 2015;105:e113-8.
  5. Masento NA, Golightly M, Field DT, Butler LT, van Reekum CM. Effects of hydration status on cognitive performance and mood. Br J Nutr 2014;111:1841-52.
  6. Fadda R, Rapinett G, Grathwohl D, Parisi M, Fanari R, Calo CM, Schmitt J. Effects of drinking supplementary water at school on cognitive performance in children. Appetite 2012;59:730-7.
  7. Fuchs T, Luhrmann P, Simpson F, Dohnke B. Fluid intake and cognitive performance: should schoolchildren drink during lessons? J Sch Health 2016;86:407-13.
  8. Kempton MJ, Ettinger U, Foster R, Williams SC, Calvert GA, Hampshire A, Zelaya FO, O'Gorman RL, McMorris T, Owen AM, Smith MS. Dehydration affects brain structure and function in healthy adolescents. Hum Brain Mapp 2011;32:71-9.
  9. Loh DA, Moy FM, Zaharan NL, Jalaludin MY, Mohamed Z. Sugar-sweetened beverage intake and its associations with cardiometabolic risks among adolescents. Pediatr Obes 2017;12:e1-5. https://doi.org/10.1111/ijpo.12108
  10. Ha K, Chung S, Lee HS, Kim CI, Joung H, Paik HY, Song Y. Association of dietary sugars and sugar-sweetened beverage intake with obesity in Korean children and adolescents. Nutrients 2016;8:31.
  11. Luger M, Lafontan M, Bes-Rastrollo M, Winzer E, Yumuk V, Farpour-Lambert N. Sugar-sweetened beverages and weight gain in children and adults: a systematic review from 2013 to 2015 and a comparison with previous studies. Obes Facts 2017;10:674-93.
  12. Hu FB. Resolved: there is sufficient scientific evidence that decreasing sugar-sweetened beverage consumption will reduce the prevalence of obesity and obesity-related diseases. Obes Rev 2013;14:606-19.
  13. Reichelt AC, Killcross S, Hambly LD, Morris MJ, Westbrook RF. Impact of adolescent sucrose access on cognitive control, recognition memory, and parvalbumin immunoreactivity. Learn Mem 2015;22:215-24.
  14. Wolraich ML, Wilson DB, White JW. The effect of sugar on behavior or cognition in children. A meta-analysis. JAMA 1995;274:1617-21.
  15. Kaur S, Tung S, Maykanathan D, Lim YY. The association of the hydration status and parental knowledge on fluid consumption with children's weight status in Malaysia. Sri Lanka J Child Health 2017;46:222-9.
  16. Hedrick VE, Comber DL, Estabrooks PA, Savla J, Davy BM. The beverage intake questionnaire: determining initial validity and reliability. J Am Diet Assoc 2010;110:1227-32.
  17. Jan Mohamed JM, Loy SL, Mohd Taib MN, Karim NA, Tan SY, Appukutty M, Razak NA, Thielecke F, Hopkins S, Ong MK, Ning C, Tee ES. Characteristics associated with the consumption of malted drinks among Malaysian primary school children: findings from the MyBreakfast study. BMC Public Health 2015;15:1322.
  18. National Coordinating Committee on Food and Nutrition (NCCFN), Ministry of Health Malaysia. RNI: recommended nutrient intakes for Malaysia [Internet]. Putrajaya: Ministry of Health Malaysia; 2017 [cited 2019 May 10]. Available from: http://nutrition.moh.gov.my.
  19. Armstrong LE, Soto JA, Hacker FJ JrCasa DJ, Kavouras SA, Maresh CM. Urinary indices during dehydration, exercise, and rehydration. Int J Sport Nutr 1998;8:345-55.
  20. Sattler JM. Resource Guide to Accompany Assessment of Children: Cognitive Foundations. 5th ed. San Diego: J.M. Sattler; 2008. p.35-6.
  21. National Coordinating Committee on Food and Nutrition (NCCFN), Ministry of Health Malaysia. Recommended Nutrient Intakes for Malaysia: a Report of the Technical Working Group on Nutritional Guidelines. Putrajaya: Ministry of Health Malaysia; 2005.
  22. Laksmi PW, Morin C, Gandy J, Moreno LA, Kavouras SA, Martinez H, Salas-Salvado J, Guelinckx I. Fluid intake of children, adolescents and adults in Indonesia: results of the 2016 Liq.In7 national cross-sectional survey. Eur J Nutr 2018;57:89-100.
  23. Martinez H, Morin C, Gandy J, Carmuega E, Arredondo JL, Pimentel C, Moreno LA, Kavouras SA, Salas-Salvado J, Guelinckx I. Fluid intake of Latin American adults: results of four 2016 Liq.In7 national cross-sectional surveys. Eur J Nutr 2018;57:65-75.
  24. Moreno LA, Iglesia-Altaba I, Santaliestra-Pasias AM. Fluid intake of European children and adolescents. Nutr Today 2013;48:S25-30.
  25. Gouda Z, Zarea M, El-Hennawy U, Viltard M, Lepicard E, Hawili N, Constant F. Hydration deficit in 9- to 11-year-old Egyptian children. Glob Pediatr Health 2015;2:2333794X15611786.
  26. Guelinckx I, Iglesia I, Bottin JH, De Miguel-Etayo P, Gonzalez-Gil EM, Salas-Salvado J, Kavouras SA, Gandy J, Martinez H, Bardosono S, Abdollahi M, Nasseri E, Jarosz A, Ma G, Carmuega E, Thiebaut I, Moreno LA. Intake of water and beverages of children and adolescents in 13 countries. Eur J Nutr 2015;54 Suppl 2:69-79. https://doi.org/10.1007/s00394-015-0955-5
  27. Ames SL, Kisbu-Sakarya Y, Reynolds KD, Boyle S, Cappelli C, Cox MG, Dust M, Grenard JL, Mackinnon DP, Stacy AW. Inhibitory control effects in adolescent binge eating and consumption of sugar-sweetened beverages and snacks. Appetite 2014;81:180-92.
  28. Cohen JF, Rifas-Shiman SL, Young J, Oken E. Associations of prenatal and child sugar intake with child cognition. Am J Prev Med 2018;54:727-35.
  29. Murray AM, Barzilay JI, Lovato JF, Williamson JD, Miller ME, Marcovina S, Launer LJ; Action to Control Cardiovascular Risk in Diabetes Memory in Diabetes (ACCORD-MIND) Substudy Investigators. Biomarkers of renal function and cognitive impairment in patients with diabetes. Diabetes Care 2011;34:1827-32.
  30. Messier C. Impact of impaired glucose tolerance and type 2 diabetes on cognitive aging. Neurobiol Aging 2005;26 Suppl 1:26-30. https://doi.org/10.1016/j.neurobiolaging.2005.09.014
  31. Warnberg J, Gomez-Martinez S, Romeo J, Diaz LE, Marcos A. Nutrition, inflammation, and cognitive function. Ann N Y Acad Sci 2009;1153:164-75.
  32. Wilson MM, Morley JE. Impaired cognitive function and mental performance in mild dehydration. Eur J Clin Nutr 2003;57 Suppl 2:S24-9. https://doi.org/10.1038/sj.ejcn.1601898
  33. Maughan RJ, Shirreffs SM, Watson P. Exercise, heat, hydration and the brain. J Am Coll Nutr 2007;26:604S-612S.
  34. de Bruin EJ, van Run C, Staaks J, Meijer AM. Effects of sleep manipulation on cognitive functioning of adolescents: a systematic review. Sleep Med Rev 2017;32:45-57.
  35. Sibley BA, Etnier JL. The relationship between physical activity and cognition in children: a meta-analysis. Pediatr Exerc Sci 2003;15:243-56.
  36. Liang J, Matheson BE, Kaye WH, Boutelle KN. Neurocognitive correlates of obesity and obesity-related behaviors in children and adolescents. Int J Obes (Lond) 2014;38:494-506.