Daily water consumption supports a nutritious, healthful and well balanced diet and should be
recognized by the 2020 Dietary Guidelines. The studies, research articles, and other
information listed below contain data that address the healthful benefits of water
consumption, optimum hydration, and the importance of making healthy beverage choices.
I. Physiologic attributes
Cheuvront et al., Am J Clin Nutr, 2013 March; 97 (3): 455-462- Physiologic basis for
understanding quantitative dehydration assessment: https://www.ncbi.nlm.nih.gov/pubmed/23343973
Pross et al., Br J Nutr, 2013 January 28; 109(2): 313–321 – Influence of progressive
fluid restriction on mood and physiological markers of dehydration in women: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3553795/
Péronnet et al., Eur J Appl Physiol, 2012 June; 112(6): 2213–2222 –
Pharmacokinetic analysis of absorption, distribution and disappearance of ingested
water labeled with D2O in humans: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3351614/
Popkin et al., Nutr Rev, 2010 August; 68(8): 439–458. Water, hydration, and health-
II. Cognition attributes
Perry, Clinton S., et al. “Hydration status moderates the effects of drinking water on
children’s cognitive performance.” Appetite 95 (2015): 520-527.
Armstrong et al., J Nutr, 2012 Feb; 142(2):382-8 – Mild dehydration affects mood in
healthy young women http://jn.nutrition.org/content/142/2/382.long
Tang C et al., Cell Physiol Biochem, 2011; 27(6):757-68 – Hydration-sensitive gene
expression in brain: https://www.ncbi.nlm.nih.gov/pubmed/21691093
III. Chronic illness alleviation (Diabetes, kidney stones, obesity, metabolic
syndrome, cardiovascular disease)
Lemetais, Guillaume, et al. “Effect of increased water intake on plasma copeptin in
healthy adults.” European Journal of Nutrition (2017): 1-8. https://link.springer.com/article/10.1007/s00394-017-1471-6
Tasevska, Irina, et al. “Increased levels of copeptin, a surrogate marker of arginine
vasopressin, are associated with an increased risk of chronic kidney disease in a
general population.” American journal of nephrology 44.1 (2016): 22-28.
Clark, William F., et al. “Hydration and Chronic Kidney Disease Progression: A Critical
Review of the Evidence.” American journal of nephrology 43.4 (2016): 281-292.
Chang T et al., Annals of Family Medicine, July/August 2016; 14 (4):320-324-
Inadequate Hydration, BMI, and Obesity Among US Adults; NHANES 2009-2012
Duffey, Kiyah J., and Jennifer Poti. “Modeling the Effect of Replacing Sugar-
Sweetened Beverage Consumption with Water on Energy Intake, HBI Score, and
Obesity Prevalence.” Nutrients 8.7 (2016): 395.
May AL et al., Centers for Disease Control Report, 2013. Obesity — United States,
Sontrop JM et al., Am J Nephrol 2013;37:434–442 – Association between Water
Intake, Chronic Kidney Disease, and Cardiovascular Disease: A Cross-Sectional
Analysis of NHANES Data http://www.karger.com/Article/Pdf/350377
Yang Q et al. JAMA Intern Med doi:10.1001 – Added Sugar Intake and
Cardiovascular Diseases Mortality Among US Adults
World Health Organization. Obesity and Overweight. Fact sheet N°311. Updated
March 2013 Data and statistics on the population’s incidence of being overweight
and/or obese. http://www.who.int/mediacentre/factsheets/fs311/en/index.html
Finkelstein, EA et al., American Journal of Preventative Medicine, 2012;
42(6):563–570 – Obesity and Severe Obesity Forecasts Through 2030: https://www.ncbi.nlm.nih.gov/pubmed/22608371
Institute of Medicine (IOM), Washington DC: The National Academies Press,
2012— Accelerating Progress in Obesity Prevention: Solving the Weight of the
Ogden et al., NCHS Data Brief. 2012;82:1–8 — Prevalence of Obesity in the United
States: National Center for Health Statistics data on obesity in the United States
2009-2010 – https://www.ncbi.nlm.nih.gov/pubmed/22617494
Lotan et al., BJU Int, 2012 Dec; 110(11 Pt C):E1060-7– Primary prevention of
nephrolithiasis is cost-effective for a national healthcare system – https://www.ncbi.nlm.nih.gov/pubmed/22686216
Strippoli et al., Nephrology (Carlton), 2011 Mar;16(3):326-34 – Fluid and nutrient
intake and risk of chronic kidney disease – https://www.ncbi.nlm.nih.gov/pubmed/21342326
de La Guéronnière et al., Arch Ital Urol Androl, 2011;83(1):43-50 – Increasing daily
water intake decreases the kidney stone risk, measured by an indicator, the
Crystallization Risk Index – https://www.ncbi.nlm.nih.gov/pubmed/21585170
Roussel et al., Diabetes Care, 2011 December; 34(12): 2551–2554 (American
Diabetes Association) – Low water intake and risk for new-onset hyperglycemia – https://www.ncbi.nlm.nih.gov/pubmed/21994426
Clark et al., Clin J Am Soc Nephrol, 2011; 6: 2634 –2641 – Urine volume and change
in estimated GFR in a community-based Cohort study – https://www.ncbi.nlm.nih.gov/pubmed/21885793
Daudon et al., Ann Urol, 2005; 39:209-31 – Epidemiology of nephrolithiasis in
France – (article in French) http://urofrance.org/fileadmin/documents/data/PU/2008/00180012/08003874/main.pdf – Abstract: https://www.ncbi.nlm.nih.gov/pubmed/16425740
Schulze et al., JAMA, 2004 Aug 25; 292(8):927-34 —Sugar-sweetened beverages,
weight gain, and incidence of type 2 diabetes in young and middle-aged women
Yoo et al., Am J Clin Nutr, 2004 Oct; 80(4):841-8— Comparison of dietary intakes
associated with metabolic syndrome risk factors in young adults: the Bogalusa Heart
Study – http://ajcn.nutrition.org/content/80/4/841.full
Stamatelou et al., Kidney Int, 2003 May; 63(5):1817-23—Time trends in reported
prevalence of kidney stones in the United States: 1976-1994. – http://www.sciencedirect.com/science/article/pii/S0085253815490726
IV. Children and adolescents
Yu, Ching-Jung, et al. “Sugar-sweetened beverage consumption is adversely
associated with childhood attention deficit/hyperactivity disorder.” International
Journal of Environmental Research and Public Health 13.7 (2016): 678.
Alman, Breanna L., et al. “Associations between Maternal Water Consumption and
Birth Defects in the National Birth Defects Prevention Study (2000–2005).” Birth
Defects Research Part A: Clinical and Molecular Teratology (2016).
Steinberger, Julia, et al. “Cardiovascular health promotion in children: Challenges
and opportunities for 2020 and beyond: a scientific statement from the American
Heart Association.” Circulation 134.12 (2016): e236-e255.”
Feferbaum et al., BMC Public Health, 2012 Nov 20; 12:1005 – Fluid intake patterns:
an epidemiological study among children and adolescents in Brazil – https://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-12-1005
Kavouras et al., cand J Med Sci Sports, 2012 Oct; 22(5):684-9 – Educational
intervention on water intake improves hydration status and enhances exercise
performance in athletic youth – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3468721/
V. Recommendation on daily water consumption
Armstrong, Lawrence E. “Hydration Conference Spans Many Research
Areas.” Annals of Nutrition and Metabolism 70.Suppl. 1 (2017): 1-3.
Grimes, Carley A., Ewa A. Szymlek-Gay, and Theresa A. Nicklas. “Beverage
Consumption among US Children Aged 0–24 Months: National Health and Nutrition
Examination Survey (NHANES).” Nutrients 9.3 (2017): 264.
An, R., & McCaffrey, J. (2016). Plain water consumption in relation to energy intake
and diet quality among US adults, 2005–2012. Journal of Human Nutrition and
Dietetics, 29(5), 624-632.
Gazan, Rozenn, et al. “Drinking Water Intake Is Associated with Higher Diet Quality
among French Adults.” Nutrients 8.11 (2016): 689.
A, Herrick K. Daily CDC intake among U.S. men and women, 2009–2012. NCHS data
brief, no 242. Hyattsville, MD: National Center for Health Statistics. 2016.
Drenowski A et al., BMC Public Health 2013, 13:1068 – Water and beverage
consumption among adults in the United States: cross-sectional study using data
from NHANES 2005–2010. http://www.biomedcentral.com/content/pdf/1471-2458-
National Cancer Institute, Applied Research Program Web site. Sources of Calories
from Added Sugars among the US Population, 2005–06.
Piernas et al., Am J Clin Nutr, 2013 March; 97 (3): 604-611 – Does diet-beverage
intake affect dietary consumption patterns? Results from the Choose Healthy
Options Consciously Everyday (CHOICE) randomized clinical trial – http://ajcn.nutrition.org/content/97/3/604.full
2013 Australian Dietary Guidelines, Reference number: N55, ISBN: 1864965754 –
Guidelines include scientific evidence to provide information on the types and
amounts of foods, food groups and dietary patterns that aim to promote health and
wellbeing, reduce the risk of diet-related conditions, reduce the risk of chronic
U.S. Department of Agriculture and U.S. Department of Health and Human
Services – 2010 Dietary Guidelines for Americans www.dietaryguidelines.gov
USDA 2013 MyPlate Campus Toolkit. MyPlate on Campus Toolkit was designed by
the USDA especially for young adults attending universities and colleges. This toolkit
helps students to communicate the Dietary Guidelines messages supporting the
“MyPlate” symbol to student bodies.
USDA 2012 Nutrition Education Series, Make Better beverage Choices. MyPlate
Nutrition Education Series Tips for beverage choices.
West E, The Food Republic, 2011 June; www.foodrepublic.com “Food Pyramids of
The World: 10 nutrition guideline charts from around the globe.” – http://www.foodrepublic.com/2011/06/07/food-pyramids-of-the-world/
European Food Safety Authority (EFSA), EFSA Journal, 2010; 8(3):1459. Scientific
Opinion on Dietary Reference Values for water
European Food Information Council (EUFIC), EUFIC Review, 2009. Food-Based
Dietary Guidelines in Europe. http://www.eufic.org/article/en/expid/food-based-
Institute of Medicine (IOM), National Academies Press, Copyright 2005, ISBN 0-
309-53049- 0 (PDF). Dietary Reference Intakes for Water, Potassium, Sodium,
Chloride, and Sulfate. https://www.nal.usda.gov/sites/default/files/fnic_uploads/water_full_report.pdf
Howard G, Bartram J. World Health Organization (WHO), Geneva, Switzerland
Domestic water quantity, service level and health
Kleiner et al, J Am Diet Assoc, 1999 Feb; 99(2):200-6 Water: an essential but
overlooked nutrient. https://www.ncbi.nlm.nih.gov/pubmed/9972188
VI. Hydration Biomarkers
Kavouras, S. A., et al. “Water intake and urinary hydration biomarkers in
children.” European journal of clinical nutrition (2016).
Perrier et al., Br J Nutr, 2013 May;109(9):1678-87— Relation between urinary
hydration biomarkers and total fluid intake in healthy adults – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3778844/
Armstrong et al., J Acad Nutr Diet, 2012 Jul; 112(7):1056-61 – Hydration biomarkers
and dietary fluid consumption of women – http://www.h4hinitiative.com/system/files/science/files/etap-armstrong.pdf
Armstrong et al., Nutr Rev, 2005 Jun;63(6 Pt 2):S40-54— Hydration Assessment
Techniques – https://www.ncbi.nlm.nih.gov/pubmed/16028571
Nicolaïdis et al., Ann Nutr Aliment, 1976; 30(2-3):349- 68—Physiology of water
VII. Hydration and Aging
Pross, N., 2017. Effects of Dehydration on Brain Functioning: A Life-Span Perspective. Annals of Nutrition and Metabolism, 70(Suppl. 1), pp.30-36.
Mentes, J., 2006. Oral Hydration in Older Adults: Greater awareness is needed in preventing, recognizing, and treating dehydration. AJN The American Journal of Nursing, 106(6), pp.40-49.
Hydration for Health Initiative, Hydration in the aging: A Review of Current Knowledge (2017) available at: http://www.h4hinitiative.com/