Water intake and markers of hydration are related to cardiometabolic risk biomarkers in community-dwelling older adults: a cross-sectional analysis

Authors: JACQUES, PAUL - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; ROGERS, GAIL - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; STOOKEY, JODI - Arizona State University; PERRIER, ERICA - Danone Institute International

Submitted to: Journal of Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 6/22/2021
Publication Date: 8/12/2021
Citation: Jacques, P.F., Rogers, G., Stookey, J.D., Perrier, E.T. 2021. Water intake and markers of hydration are related to cardiometabolic risk biomarkers in community-dwelling older adults: a cross-sectional analysis. Journal of Nutrition. 151(10):3205-3213. https://doi.org/10.1093/jn/nxab233.
DOI: https://doi.org/10.1093/jn/nxab233

Interpretive Summary: The role of water and hydration in physical performance has been well-described in young adults and, on the other end of the age spectrum, it is well-known that rates of dehydration in older adults are high and frequently lead to hospitalization. In contrast, we know little about the possible consequences of chronic underhydration, especially in community-dwelling older adults. There is growing evidence that links underhydration due to habitual low daily water intake to higher cardiometabolic risk in younger and middle-aged adults, but this evidence is limited in older adults. To address this gap in our knowledge, we examined the relationship between water intake and markers of hydration status and cardiometabolic health in 2238 in community-dwelling older adults, on average age 70 years old, and showed a consistent pattern between low water consumption and urinary markers of underhydration and dyslipidemia. This adds to the growing evidence from younger individuals that inadequate water intake and underhydration may lead to higher cardiometabolic risk.

Technical Abstract: Background: Emerging evidence links underhydration and habitual low water intake to higher cardiometabolic risk, but evidence is limited in community-dwelling older adults. Objectives: The objective is to examine if higher water intake and better hydration are associated with better cardiometabolic health. Methods:This cross-sectional analysis using general linear models included 2238 participants from the Framingham Heart Study Second Generation and First Generation Omni cohorts with an estimated glomerular filtration rate >30 mL.min-1.1.73 m-2 and a valid FFQ for assessment of water intake. Of these participants, 2219 had fasting spot urinary creatinine data and 950 had 24-h urine creatinine data to assess hydration. Cardiometabolic risk factors included fasting glucose, triglycerides (TGs), total cholesterol (TC), HDL cholesterol, and calculated LDL cholesterol; glycated hemoglobin (HbA1c); C-reactive protein (CRP); and systolic (SBP) and diastolic (DBP) blood pressure. Results: The combined cohorts were on average aged 70 y; 55% were women. Mean (95% CI) daily total water intakes were 2098 (2048, 2150) mL for men and 2109 (2063, 2156) mL for women. Total daily water, beverage (including plain water), and plain water intakes demonstrated significant positive trends with HDL cholesterol (P < 0.01). TG concentrations were significantly lower among the highest plain water consumers (P < 0.05). The 24-h urine concentration, as measured by creatinine, was positively associated with LDL cholesterol and TG concentrations ( P < 0.01) and inversely associated with HDL cholesterol concentrations (P < 0.002). Neither water intake nor urine concentration was associated with glucose or HbA1c (P > 0.05). Conclusions: Our findings of a consistent pattern between circulating lipid concentrations and different water sources and hydration markers support an association between hydration and lipid metabolism in older adults and add to the growing evidence that inadequate water intake and underhydration may lead to higher cardiometabolic risk.