{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T21:11:09Z","timestamp":1770844269404,"version":"3.50.1"},"reference-count":48,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2025,3,21]],"date-time":"2025-03-21T00:00:00Z","timestamp":1742515200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"World Vision International","award":["2023-11, 2024-09"],"award-info":[{"award-number":["2023-11, 2024-09"]}]},{"DOI":"10.13039\/501100004476","name":"Chinese Center For Disease Control and Prevention","doi-asserted-by":"publisher","award":["2023-11, 2024-09"],"award-info":[{"award-number":["2023-11, 2024-09"]}],"id":[{"id":"10.13039\/501100004476","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background and Objectives: Maintaining an appropriate hydration status is crucial for promoting health. Children, who are in the process of growth and development, are at a higher risk of insufficient water intake and dehydration. This study aimed to compare water intake among children with different levels of dietary sodium intake, and explore the relationship between hydration status, and dietary sodium intake and water intake. Methods: In this cross-sectional survey, 155 students in grades 4\u20136 from a primary school in Binyang County, Nanning, Guangxi, were recruited. Water intake from fluid was assessed using a validated 7-Day 24 h Fluid Intake Survey Questionnaire (days 1\u20137). Food intake was recorded and weighed using the duplicate diet method on days 5, 6, and 7. The water content in food was determined using the direct drying method, and dietary sodium intake was measured using inductively coupled plasma-optical emission spectrometry (ICP-OES). Urine osmolality was measured at two time points (morning and before afternoon classes) on days 5, 6, and 7 to assess hydration status. Results: A total of 155 participants (87 boys and 68 girls) completed the study, with a completion rate of 100%. The average dietary sodium intake, total water intake (TWI), water intake from fluid, and water intake from food were 1647 mg, 2039 mL, 956 mL, and 1175 mL, respectively. Among the participants, 19.4% exceeded the recommended sodium intake (2000 mg\/day), 41.9% did not meet the adequate daily water intake from fluid, and 63.2% did not meet the adequate daily total water intake. When participants were divided into quartiles based on dietary sodium intake, significant differences were observed in water intake from fluid (p = 0.031) and food (p &lt; 0.001). The water intake from fluid among participants in the HS1 (982 mL) and HS2 groups (997 mL) was higher than that among participants in LS2 (759 mL). Water intake from food increased progressively with increasing sodium intake (851 mL, 1075 mL, 1224 mL, and 1550 mL). Urine osmolality was associated with meeting the daily adequate water intake from fluid (p = 0.006), but not with exceeding the sodium intake standard (p = 0.787). There was no interaction between meeting the daily adequate water intake from fluid and exceeding the sodium intake standard (p = 0.413). Conclusions: Insufficient water intake was common among children. Children with a higher dietary sodium intake had a higher water intake from fluid and food. Urine osmolality was closely related to daily water intake from fluid, but not to sodium intake.<\/jats:p>","DOI":"10.3390\/nu17071099","type":"journal-article","created":{"date-parts":[[2025,3,21]],"date-time":"2025-03-21T04:58:38Z","timestamp":1742533118000},"page":"1099","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Association Between Increased Dietary Sodium Intake and Higher Water Intake from Fluid and Food in Children"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-9485-1671","authenticated-orcid":false,"given":"Yi","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Nutrition and Food Hygiene, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing 100191, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8668-1828","authenticated-orcid":false,"given":"Yongye","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Food Hygiene, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing 100191, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuai","family":"Cheng","sequence":"additional","affiliation":[{"name":"National Center for Rural Water Supply Technical Guidance, Chinese Center for Disease Control and Prevention, Beijing 102200, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yunting","family":"Xia","sequence":"additional","affiliation":[{"name":"National Center for Rural Water Supply Technical Guidance, Chinese Center for Disease Control and Prevention, Beijing 102200, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6530-6711","authenticated-orcid":false,"given":"Hongxing","family":"Li","sequence":"additional","affiliation":[{"name":"National Center for Rural Water Supply Technical Guidance, Chinese Center for Disease Control and Prevention, Beijing 102200, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiangping","family":"Huang","sequence":"additional","affiliation":[{"name":"Institute of Environmental Hygiene and Endemic Disease Control, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luxi","family":"Xu","sequence":"additional","affiliation":[{"name":"Institute of Environmental Hygiene and Endemic Disease Control, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7713-5980","authenticated-orcid":false,"given":"Na","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Food Hygiene, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing 100191, China"},{"name":"Laboratory of Toxicological Research and Risk Assessment for Food Safety, Peking University, 38 Xue Yuan Road, Haidian District, Beijing 100191, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,21]]},"reference":[{"key":"ref_1","unstructured":"Chinese Nutrition Society (2022). The Chinese Dietary Guidelines (2022), People\u2019s Medical Publishing House."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Zhang, J., Ma, G., Du, S., Liu, S., and Zhang, N. (2021). Effects of water restriction and supplementation on cognitive performances and mood among young adults in Baoding, China: A randomized controlled trial (RCT). Nutrients, 13.","DOI":"10.3390\/nu13103645"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Schlader, Z.J., Hostler, D., Parker, M.D., Pryor, R.R., Lohr, J.W., Johnson, B.D., and Chapman, C.L. (2019). The potential for renal injury elicited by physical work in the heat. Nutrients, 11.","DOI":"10.3390\/nu11092087"},{"key":"ref_4","first-page":"337","article-title":"Hydration status and health","volume":"53","author":"Ma","year":"2019","journal-title":"Chin. J. Prev. Med."},{"key":"ref_5","unstructured":"Jiang, Z. (2013). Clinical Water and Electrolytes Balance, People\u2019s Medical Publishing House. [3rd ed.]."},{"key":"ref_6","unstructured":"Chinese Nutrition Society (2022). Dietary Guidelines for Chinese School-Aged Children (2022), People\u2019s Medical Publishing House."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"3035","DOI":"10.1017\/S1368980019000715","article-title":"Assessing the relationship between water and nutrition knowledge and beverage consumption habits in children","volume":"22","author":"Irwin","year":"2019","journal-title":"Public Health Nutr."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"841","DOI":"10.1260\/1747-9541.10.5.841","article-title":"Thirst for Drink Knowledge: How Singaporean Youth Athletes Measure up in an Exercise Hydration Knowledge Questionnaire","volume":"10","author":"Chia","year":"2015","journal-title":"Int. J. Sports Sci. Coach."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"776","DOI":"10.1016\/j.appet.2009.02.010","article-title":"Should children drink more water? The effects of drinking water on cognition in children","volume":"52","author":"Edmonds","year":"2009","journal-title":"Appetite"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1111\/j.1365-2214.2006.00721.x","article-title":"A study of the association between children\u2019s access to drinking water in primary schools and their fluid intake: Can water be \u2019cool\u2019 in school?","volume":"33","author":"Kaushik","year":"2007","journal-title":"Child Care Health Dev."},{"key":"ref_11","first-page":"250","article-title":"Analysis of daily drinking frequency and amount of water in adults from four cities of china in summer","volume":"35","author":"Wang","year":"2013","journal-title":"Acta Nutr. Sin."},{"key":"ref_12","first-page":"1163","article-title":"Fluid intake in Spanish children and adolescents; a cross-sectional study","volume":"29","author":"Iglesia","year":"2014","journal-title":"Nutr. Hosp. Organo Of. Soc. Espa\u00f1ola Nutr. Parenter. Enter."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1007\/s00394-015-0952-8","article-title":"Intake of water and different beverages in adults across 13 countries","volume":"54","author":"Guelinckx","year":"2015","journal-title":"Eur. J. Nutr."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Senterre, C., Dramaix, M., and Thi\u00e9baut, I. (2014). Fluid intake survey among schoolchildren in Belgium. BMC Public Health, 14.","DOI":"10.1186\/1471-2458-14-651"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Jomaa, L., Hwalla, N., Constant, F., Naja, F., and Nasreddine, L. (2016). Water and beverage consumption among children aged 4\u201313 years in Lebanon: Findings from a national cross-sectional study. Nutrients, 8.","DOI":"10.3390\/nu8090554"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1186\/s12970-015-0080-0","article-title":"Hydration status and fluid intake of urban, underprivileged South African male adolescent soccer players during training","volume":"12","author":"Gordon","year":"2015","journal-title":"J. Int. Soc. Sports Nutr."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"189","DOI":"10.3945\/ajcn.112.051508","article-title":"Dietary sodium intake is associated with total fluid and sugar-sweetened beverage consumption in US children and adolescents aged 2\u201318 y: NHANES 2005\u20132008","volume":"98","author":"Grimes","year":"2013","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1161\/HYPERTENSIONAHA.107.100990","article-title":"Salt Intake Is Related to Soft Drink Consumption in Children and Adolescents","volume":"51","author":"He","year":"2008","journal-title":"Hypertension"},{"key":"ref_19","first-page":"605","article-title":"The effect of dietary sodium and protein on urine volume and water intake","volume":"101","author":"Luft","year":"1983","journal-title":"J. Lab. Clin. Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1932","DOI":"10.1172\/JCI88530","article-title":"Increased salt consumption induces body water conservation and decreases fluid intake","volume":"127","author":"Rakova","year":"2017","journal-title":"J. Clin. Investig."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"112725","DOI":"10.1016\/j.physbeh.2019.112725","article-title":"Hydration status affects thirst and salt preference but not energy intake or postprandial ghrelin in healthy adults: A randomised crossover trial","volume":"212","author":"Carroll","year":"2019","journal-title":"Physiol. Behav."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1016\/j.clnu.2011.08.014","article-title":"24h-Sodium excretion and hydration status in children and adolescents\u2014Results of the DONALD Study","volume":"31","author":"Alexy","year":"2012","journal-title":"Clin. Nutr."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Zhang, N., Du, S., Tang, Z., Zheng, M., Yan, R., Zhu, Y., and Ma, G. (2017). Hydration, Fluid Intake, and Related Urine Biomarkers among Male College Students in Cangzhou, China: A Cross-Sectional Study-Applications for Assessing Fluid Intake and Adequate Water Intake. Int. J. Environ. Res. Public Health, 14.","DOI":"10.3390\/ijerph14050513"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Zhang, J., Zhang, N., Liu, S., Du, S., and Ma, G. (2022). Young Adults with Higher Salt Intake Have Inferior Hydration Status: A Cross-Sectional Study. Nutrients, 14.","DOI":"10.3390\/nu14020287"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Zhang, J., Zhang, N., Du, S., He, H., Xu, Y., Cai, H., Guo, X., and Ma, G. (2018). The Effects of Hydration Status on Cognitive Performances among Young Adults in Hebei, China: A Randomized Controlled Trial (RCT). Int. J. Environ. Res. Public Health, 15.","DOI":"10.3390\/ijerph15071477"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"S105","DOI":"10.1111\/j.1753-4887.2012.00520.x","article-title":"Fluid intake of adults in four Chinese cities","volume":"70","author":"Ma","year":"2012","journal-title":"Nutr. Rev."},{"key":"ref_27","first-page":"210","article-title":"Water intake of primary and middle school students in four cities of China","volume":"47","author":"Du","year":"2013","journal-title":"Zhonghua Yu Fang Yi Xue Za Zhi"},{"key":"ref_28","unstructured":"(2016). Determination of Moisture in Foods (Standard No. GB 5009.3-2016)."},{"key":"ref_29","unstructured":"(2016). Determination of Multielement in Foods (Standard No. GB 5009.268-2016)."},{"key":"ref_30","unstructured":"National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention (2018). China Food Composition, Peking University Medicine Press. [6th ed.]."},{"key":"ref_31","unstructured":"National Institutes for Food and Drug Control (2019). China Standard Practice for Drug Testing, China Medical Science and Technology Press."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"EFSA Panel on Dietetic Products, Nutrition, and Allergies (NDA) (2010). Scientific Opinion on Dietary Reference Values for water. EFSA J., 8, 1459.","DOI":"10.2903\/j.efsa.2010.1459"},{"key":"ref_33","unstructured":"Chinese Nutrition Society (2023). Dietary Reference Intakes for China, People\u2019s Medical Publishing House."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Li, Y., Sun, Y., Li, X., Dong, L., Cheng, F., Luo, R., Wang, C., Song, J., He, F.J., and MacGregor, G.A. (2021). Sodium and potassium excretion of schoolchildren and relationship with their family excretion in China. Nutrients, 13.","DOI":"10.3390\/nu13082864"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Ding, G., Wen, C., Chen, Y., Vinturache, A., and Zhang, Y. (2025). Dietary sodium intake among youth. Pediatr. Res.","DOI":"10.1038\/s41390-025-03836-1"},{"key":"ref_36","first-page":"1734","article-title":"Status and related factors on the drinking behavior among primary and secondary students in China rural middle and western regions in 2019","volume":"56","author":"Bi","year":"2022","journal-title":"Chin. J. Prev. Med."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1038\/ejcn.2009.111","article-title":"Water as an essential nutrient: The physiological basis of hydration","volume":"64","author":"Constant","year":"2010","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Trinies, V., Chard, A.N., Mateo, T., and Freeman, M.C. (2016). Effects of water provision and hydration on cognitive function among primary-school pupils in Zambia: A randomized trial. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0150071"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1016\/j.appet.2015.08.006","article-title":"Hydration status moderates the effects of drinking water on children\u2019s cognitive performance","volume":"95","author":"Perry","year":"2015","journal-title":"Appetite"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Guelinckx, I., Tavoularis, G., K\u00f6nig, J., Morin, C., Gharbi, H., and Gandy, J. (2016). Contribution of water from food and fluids to total water intake: Analysis of a French and UK population surveys. Nutrients, 8.","DOI":"10.3390\/nu8100630"},{"key":"ref_41","first-page":"1249","article-title":"Secular trends in dietary sodium and potassium intakes in Chinese population, 2000\u20132015","volume":"33","author":"Li","year":"2017","journal-title":"Chin. J. Public Health"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1165","DOI":"10.1017\/S000711452000032X","article-title":"Sources of dietary sodium and implications for a statewide salt reduction initiative in Victoria, Australia","volume":"123","author":"Bolton","year":"2020","journal-title":"Br. J. Nutr."},{"key":"ref_43","first-page":"175","article-title":"Survey on Sanitary Knowledge, Attitude and Practice (KAP) of Drinking-water in Community Residents","volume":"6","author":"Tan","year":"2016","journal-title":"J. Environ. Hyg."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"723","DOI":"10.1161\/HYPERTENSIONAHA.119.13932","article-title":"Effects of Sodium Reduction on Energy, Metabolism, Weight, Thirst, and Urine Volume","volume":"75","author":"Juraschek","year":"2020","journal-title":"Hypertension"},{"key":"ref_45","unstructured":"Tinghuai, W. (2018). Physiology, People\u2019s Medical Publishing House."},{"key":"ref_46","first-page":"1289","article-title":"Associations of water drinking and voiding behaviors with health","volume":"40","author":"Zhang","year":"2019","journal-title":"Chin. J. Sch. Health"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1007\/s00394-022-02972-2","article-title":"Total water intake guidelines are sufficient for optimal hydration in United States adults","volume":"62","author":"Seal","year":"2023","journal-title":"Eur. J. Nutr."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1038\/s41581-024-00817-1","article-title":"Long-term health outcomes associated with hydration status","volume":"20","author":"Dmitrieva","year":"2024","journal-title":"Nat. Rev. Nephrol."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/17\/7\/1099\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:57:39Z","timestamp":1760029059000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/17\/7\/1099"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,21]]},"references-count":48,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2025,4]]}},"alternative-id":["nu17071099"],"URL":"https:\/\/doi.org\/10.3390\/nu17071099","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,21]]}}}