Plain water consumption in relation to energy intake and diet quality among US adults, 2005–2012
An and McCaffrey JHND Early View
The present study examined plain water consumption in relation to energy intake and diet quality among US adults.
A nationally representative sample of 18 311 adults aged ≥18 years, from the National Health and Nutrition Examination Survey 2005–2012, was analysed. The first-difference estimator approach addressed confounding bias from time-invariant unobservables (e.g. eating habits, taste preferences) by using within-individual variations in diet and plain water consumption between two nonconsecutive 24-h dietary recalls.
One percentage point increase in the proportion of daily plain water in total dietary water consumption was associated with a reduction in mean (95% confidence interval) daily total energy intake of 8.58 (7.87–9.29) kcal, energy intake from sugar-sweetened beverages of 1.43 (1.27–1.59) kcal, energy intake from discretionary foods of 0.88 (0.44–1.32) kcal, total fat intake of 0.21 (0.17–0.25) g, saturated fat intake of 0.07 (0.06–0.09) g, sugar intake of 0.74 (0.67–0.82) g, sodium intake of 9.80 (8.20–11.39) mg and cholesterol intake of 0.88 (0.64–1.13) g. The effects of plain water intake on diet were similar across race/ethnicity, education attainment, income level and body weight status, whereas they were larger among males and young/middle-aged adults than among females and older adults, respectively. Daily overall diet quality measured by the Healthy Eating Index-2010 was not found to be associated with the proportion of daily plain water in total dietary water consumption.
Promoting plain water intake could be a useful public health strategy for reducing energy and targeted nutrient consumption in US adults, which warrants confirmation in future controlled interventions.