{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T09:17:28Z","timestamp":1787735848257,"version":"build-2784847793"},"reference-count":49,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:00:00Z","timestamp":1787702400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background\/Objectives: Different organizations have established fluid intake recommendations for adolescents; however, studies assessing adherence typically rely on a single reference system, limiting comparisons across populations. This study assessed beverage consumption patterns and beverage-derived energy intake among Polish adolescents and examined how adherence estimates differed when recommendations issued by the European Food Safety Authority (EFSA), the Institute of Medicine (IOM), and the Polish National Institute of Public Health\u2014National Institute of Hygiene (NIH) were applied. Methods: A cross-sectional study was conducted among 1644 secondary school students aged 14\u201318 years. Beverage consumption (mL\/day) and beverage-derived energy intake (kcal\/day) were assessed using the validated Polish Beverage Intake Questionnaire (BEVQ-PL). Adherence was defined as achieving at least 80% of the age- and sex-specific Adequate Intake (AI) from beverages, assuming that beverages provide approximately 80% of total daily water intake. Results: Water had the highest median daily intake (960 mL\/day). Males consumed significantly more water than females (1080 vs. 720 mL\/day; p = 0.037), whereas females consumed significantly more reduced-fat milk (2%), skim milk, plant-based and flavored milk beverages, 100% vegetable juice, and coffee with milk and sugar. Adherence differed according to the recommendation system, reaching 65.2% (EFSA), 50.6% (IOM), and 65.8% (NIH). Female sex was independently associated with higher adherence across all three reference systems, whereas older age was associated with lower adherence only according to the NIH criteria and overweight\/obesity only according to the IOM criteria. Conclusions: Estimated adherence to fluid intake recommendations varied substantially according to the reference system applied. These findings highlight the importance of explicitly reporting the selected reference criteria when assessing and comparing the adequacy of beverage-derived fluid intake among adolescents.<\/jats:p>","DOI":"10.3390\/nu18172784","type":"journal-article","created":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T08:11:15Z","timestamp":1787731875000},"page":"2784","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Beverage Consumption Patterns, Beverage-Derived Energy Intake, and Adherence to Fluid Intake Recommendations Among Polish Adolescents: A Cross-Sectional Study Using the BEVQ-PL Questionnaire"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2695-2491","authenticated-orcid":false,"given":"Marek","family":"Zborowski","sequence":"first","affiliation":[{"name":"The Faculty of Medicine and Health Sciences, University of Applied Sciences in Nowy S\u0105cz, Ko\u015bciuszki 2G, 33-300 Nowy S\u0105cz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0853-0685","authenticated-orcid":false,"given":"Magdalena","family":"Skotnicka","sequence":"additional","affiliation":[{"name":"Department of Commodity Science, Faculty of Health Sciences, Medical University of Gdansk, 7 Debinki Street, 80-210 Gdansk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Papaoikonomou, G., Apergi, K., and Malisova, O. (2025). Total Water Intake and Total Fluid Intake Worldwide: A Systematic Literature Review in Children and Adolescents. Beverages, 11.","DOI":"10.3390\/beverages11020046"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Zborowski, M., and Skotnicka, M. (2025). The Role of Hydration in Children and Adolescents\u2014A Theoretical Framework for Reviewing Recommendations, Models, and Empirical Studies. Nutrients, 17.","DOI":"10.3390\/nu17172841"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"257","DOI":"10.64483\/20251139","article-title":"Nutrition and Hydration Across the Lifespan: Integrating Nursing Care and Nutritional Science","volume":"1","author":"Alrashdi","year":"2024","journal-title":"Saudi J. Med. Public Health"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"20180230","DOI":"10.1515\/ijamh-2018-0230","article-title":"Hydration Status, Total Water Intake and Subjective Feelings of Adolescents Living in a Hot Environment, during a Typical School Day","volume":"33","author":"Aphamis","year":"2021","journal-title":"Int. J. Adolesc. Med. Health"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1007\/s00394-018-1869-9","article-title":"Water Intake and Hydration State in Children","volume":"58","author":"Suh","year":"2019","journal-title":"Eur. J. Nutr."},{"key":"ref_6","unstructured":"(2011). EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA) Scientific Opinion on the Substantiation of Health Claims Related to Water and Maintenance of Normal Physical and Cognitive Functions (ID 1102, 1209, 1294, 1331), Maintenance of Normal Thermoregulation (ID 1208) and \u201cBasic Requirement of All Living Things\u201d (ID 1207) Pursuant to Article 13(1) of Regulation (EC) No 1924\/2006. EFS2, 9, 2075."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1007\/s00394-018-1740-z","article-title":"Fluid Intake of Children, Adolescents and Adults in Indonesia: Results of the 2016 Liq.In7 National Cross-Sectional Survey","volume":"57","author":"Laksmi","year":"2018","journal-title":"Eur. J. Nutr."},{"key":"ref_8","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_9","doi-asserted-by":"crossref","first-page":"101643","DOI":"10.1016\/j.tjnut.2026.101643","article-title":"Hydration and Water Intake among Children and Parents","volume":"156","author":"Seal","year":"2026","journal-title":"J. Nutr."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1007\/s00394-015-0955-5","article-title":"Intake of Water and Beverages of Children and Adolescents in 13 Countries","volume":"54","author":"Guelinckx","year":"2015","journal-title":"Eur. J. Nutr."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"490","DOI":"10.4162\/nrp.2020.14.5.490","article-title":"Fluid Intake, Hydration Status and Its Association with Cognitive Function among Adolescents in Petaling Perdana, Selangor, Malaysia","volume":"14","author":"Tung","year":"2020","journal-title":"Nutr. Res. Pract."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1007\/s00394-018-1745-7","article-title":"Challenges in the Assessment of Total Fluid Intake in Children and Adolescents: A Discussion Paper","volume":"57","author":"Warren","year":"2018","journal-title":"Eur. J. Nutr."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Apergi, K., Styliaras, G.D., Tsirogiannis, G., Beligiannis, G.N., and Malisova, O. (2025). A Scoping Review of AI-Driven mHealth Systems for Precision Hydration: Integrating Food and Beverage Water Content for Personalized Recommendations. MTI, 9.","DOI":"10.3390\/mti9110112"},{"key":"ref_14","unstructured":"EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA) (2010). Scientific Opinion on Dietary Reference Values for Water, European Food Safety Authority."},{"key":"ref_15","unstructured":"Institute of Medicine (2005). Dietary Reference Intakes for Water, Potassium, Sodium, Chloride, and Sulfate, National Academies Press."},{"key":"ref_16","unstructured":"Rychlik, E., Sto\u015b, K., Wo\u017aniak, A., and Mojska, H. (2024). Nutrition Standards for the Polish Population\u20132024."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1007\/s00394-015-0946-6","article-title":"Total Fluid Intake of Children and Adolescents: Cross-Sectional Surveys in 13 Countries Worldwide","volume":"54","author":"Iglesia","year":"2015","journal-title":"Eur. J. Nutr."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"G\u0142\u0105bska, D., Skolmowska, D., and Guzek, D. (2026). Beverage Intake Patterns in a National Sample of Polish Adolescents: PLACE-19 Study. Nutrients, 18.","DOI":"10.3390\/nu18091384"},{"key":"ref_19","first-page":"138","article-title":"Cultural Adaptation and Preliminary Validation of the Polish Version of the Beverage Intake Questionnaire (BEVQ-PL) among Adolescents","volume":"33","author":"Zborowski","year":"2026","journal-title":"\u017bywno\u015b\u0107. Nauka Technol. Jako\u015b\u0107"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1016\/j.jclinepi.2007.11.008","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: Guidelines for Reporting Observational Studies","volume":"61","author":"Altman","year":"2008","journal-title":"J. Clin. Epidemiol."},{"key":"ref_21","unstructured":"Cochran, W.G. (1977). Sampling Techniques, John Wiley & Sons. [3rd ed.]."},{"key":"ref_22","unstructured":"(2026, June 25). GUS-Bank Danych Lokalnych, Available online: https:\/\/bdl.stat.gov.pl\/BDL\/dane\/podgrup\/temat."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1037\/a0037416","article-title":"Combating Unmeasured Confounding in Cross-Sectional Studies: Evaluating Instrumental-Variable and Heckman Selection Models","volume":"19","author":"DeMaris","year":"2014","journal-title":"Psychol. Methods"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Kulaga, Z., Litwin, M., Tkaczyk, M., R\u00f3\u017cd\u017cy\u0144ska, A., Barwicka, K., Grajda, A., \u015awi\u0105der, A., Gurzkowska, B., Napieralska, E., and Pan, H. (2010). The Height-, Weight-, and BMI-for-Age of Polish School-Aged Children and Adolescents Relative to International and Local Growth References. BMC Public Health, 10.","DOI":"10.1186\/1471-2458-10-109"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1016\/j.jand.2012.01.023","article-title":"Development of a Brief Questionnaire to Assess Habitual Beverage Intake (BEVQ-15): Sugar-Sweetened Beverages and Total Beverage Energy Intake","volume":"112","author":"Hedrick","year":"2012","journal-title":"J. Acad. Nutr. Diet."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1111\/jhn.12749","article-title":"Update of the BEVQ-15, a Beverage Intake Questionnaire for Habitual Beverage Intake for Adults: Determining Comparative Validity and Reproducibility","volume":"33","author":"Fausnacht","year":"2020","journal-title":"J. Human. Nutr. Diet."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1007\/s00394-015-0944-8","article-title":"Water Intake: Validity of Population Assessment and Recommendations","volume":"54","author":"Gandy","year":"2015","journal-title":"Eur. J. Nutr."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1017\/S0007114516002336","article-title":"Recording of Fluid, Beverage and Water Intakes at the Population Level in Europe","volume":"116","author":"Gandy","year":"2016","journal-title":"Br. J. Nutr."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"27","DOI":"10.20960\/nh.313","article-title":"Comparison of Beverage Consumption in Adult Populations from Three Different Countries: Do the International Reference Values Allow Establishing the Adequacy of Water and Beverage Intakes?","volume":"33","author":"Nissensohn","year":"2016","journal-title":"Nutr. Hosp."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"5021","DOI":"10.1007\/s00431-024-05736-8","article-title":"Reference Data for Body Composition Parameters in Normal-Weight Polish Adolescents: Results from the Population-Based ADOPOLNOR Study","volume":"183","author":"Kaczmarek","year":"2024","journal-title":"Eur. J. Pediatr."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"108567","DOI":"10.1016\/j.appet.2026.108567","article-title":"Healthy Beverages in a Sugary World: Dutch Adolescents\u2019 Perspectives on Water and Other Healthy Beverages; a Qualitative Multi-Method Study","volume":"224","author":"Pepping","year":"2026","journal-title":"Appetite"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1038\/ejcn.2011.166","article-title":"Beverage Consumption among European Adolescents in the HELENA Study","volume":"66","author":"Duffey","year":"2012","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"104","DOI":"10.26444\/aaem\/195313","article-title":"Hydration Status, Frequency of Consumption of Water-Rich Foods, and Anthropometric Measurements in 10\u201312-Year-Old Polish Schoolchildren","volume":"32","author":"Gutkowska","year":"2025","journal-title":"Ann. Agric. Environ. Med."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Kostecka, J., Jackowska, I., Chabros, I., Kostecka-Jarecka, J., Kawecka, P., and Kostecka, M. (2024). Beverage Consumption and Factors Influencing the Choice of Beverages among Polish Children Aged 11\u201313 Years in 2018\u20132023. Nutrients, 16.","DOI":"10.3390\/nu16111625"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1143","DOI":"10.1017\/S136898001500066X","article-title":"Focus on Sugar-Sweetened Beverages","volume":"18","author":"Caballero","year":"2015","journal-title":"Public Health Nutr."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Kim, Y.S., and Kim, H.J. (2024). Health-Related Behaviors and Perceived Health Status According to Water and Sugar-Sweetened Beverage Intake in Korean Adolescents. Nutrients, 16.","DOI":"10.3390\/nu16173038"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"e14660","DOI":"10.1111\/nmo.14660","article-title":"The Role of Gastric Function in Control of Food Intake (and Body Weight) in Relation to Obesity, as Well as Pharmacological and Surgical Interventions","volume":"36","author":"Camilleri","year":"2024","journal-title":"Neurogastroenterol. Motil."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1186\/s12576-024-00904-9","article-title":"Satiety: A Gut\u2013Brain\u2013Relationship","volume":"74","author":"Barakat","year":"2024","journal-title":"J. Physiol. Sci."},{"key":"ref_39","first-page":"e947124","article-title":"Regulatory Efforts and Health Implications of Energy Drink Consumption by Minors in Poland","volume":"31","author":"Gujski","year":"2025","journal-title":"Med. Sci. Monit."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Mularczyk-Tomczewska, P., Lewandowska, A., Kami\u0144ska, A., Ga\u0142ecka, M., Atroszko, P.A., Baran, T., Koweszko, T., and Silczuk, A. (2025). Patterns of Energy Drink Use, Risk Perception, and Regulatory Attitudes in the Adult Polish Population: Results of a Cross-Sectional Survey. Nutrients, 17.","DOI":"10.3390\/nu17091458"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"44","DOI":"10.5604\/01.3001.0054.1825","article-title":"Eating Habits of Polish Children","volume":"34","author":"Mikowska","year":"2023","journal-title":"J. Kinesiol. Exerc. Sci."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"230354","DOI":"10.5888\/pcd21.230354","article-title":"Factors Associated with Sugar-Sweetened Beverage Intake Among Young Children\u2013United States, 2021","volume":"21","author":"Grap","year":"2024","journal-title":"Prev. Chronic Dis."},{"key":"ref_43","first-page":"e079234","article-title":"Intake of Sugar Sweetened Beverages among Children and Adolescents in 185 Countries between 1990 and 2018: Population Based Study","volume":"386","author":"Micha","year":"2024","journal-title":"BMJ"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1016\/j.puhe.2023.08.024","article-title":"Consumption of Energy Drinks by Children and Young People: A Systematic Review Examining Evidence of Physical Effects and Consumer Attitudes","volume":"227","author":"Ajibo","year":"2024","journal-title":"Public Health"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1038\/s41432-024-01103-6","article-title":"Effectiveness of School-Based Approaches for Reduction of Sugar and Sugar-Sweetened Beverages in Children: A Systematic Review and Meta-Analysis","volume":"26","author":"Malhotra","year":"2025","journal-title":"Evid. Based Dent."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1093\/nutrit\/nux061","article-title":"Effectiveness of Behavioral Interventions to Reduce the Intake of Sugar-Sweetened Beverages in Children and Adolescents: A Systematic Review and Meta-Analysis","volume":"76","author":"Jomaa","year":"2018","journal-title":"Nutr. Rev."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1038\/s41574-021-00627-6","article-title":"The Role of Sugar-Sweetened Beverages in the Global Epidemics of Obesity and Chronic Diseases","volume":"18","author":"Malik","year":"2022","journal-title":"Nat. Rev. Endocrinol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"e20190282","DOI":"10.1542\/peds.2019-0282","article-title":"Public Policies to Reduce Sugary Drink Consumption in Children and Adolescents","volume":"143","author":"Muth","year":"2019","journal-title":"Pediatrics"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1350","DOI":"10.1111\/obr.12580","article-title":"Interventions to Reduce Consumption of Sugar-sweetened Beverages or Increase Water Intake: Evidence from a Systematic Review and Meta-analysis","volume":"18","author":"Evans","year":"2017","journal-title":"Obes. Rev."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/18\/17\/2784\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T08:17:32Z","timestamp":1787732252000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/18\/17\/2784"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,26]]},"references-count":49,"journal-issue":{"issue":"17","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["nu18172784"],"URL":"https:\/\/doi.org\/10.3390\/nu18172784","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,26]]}}}