Hydration Intervention for Healthy Habits

Overseen By Sarah Farthing, MS

Age: Any Age

Sex: Any

Trial Phase: Academic

Sponsor: Virginia Commonwealth University

Disqualifiers: Developmental, physical reasons, moving, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 1 Jurisdiction This treatment is already approved in other countries

Compensation: Varies

Number of Visits: Unknown

7200 Participants Needed

Trial Summary

What is the purpose of this trial?

The goal of this study is to determine the effectiveness and sustainability of a community-participatory hydration intervention over 3 years within a district that has newly installed hydration stations and is operating under a policy designed to enhance heathy hydration practices and promote equitable access to drinking water.

Will I have to stop taking my current medications?

The trial information does not specify whether participants need to stop taking their current medications.

What data supports the effectiveness of the treatment Hydration, Drinking Water, Water Intake?

Research shows that increasing water intake can help improve hydration, which is important for preventing dehydration and related health issues like constipation and urinary tract infections, especially in older adults. Additionally, a study found that interventions to improve hydration led to a significant increase in daily fluid consumption, suggesting that drinking more water can be beneficial for overall health. ^{1 2 3 4 5}

Is drinking water generally safe for humans?

Drinking water is generally safe for humans and is essential for life, helping with body functions like temperature regulation and metabolism. However, it's important to maintain a balance, as both dehydration (not enough water) and overhydration (too much water) can cause health issues. ^{6 7 8 9 10}

How does the treatment of hydration differ from other treatments for healthy habits?

Hydration as a treatment focuses on increasing water intake to improve health habits, which is unique because it emphasizes forming consistent water-drinking habits and understanding the importance of hydration. Unlike other treatments, it does not involve medication or complex interventions, but rather encourages simple lifestyle changes to maintain adequate hydration. ^{10 11 12 13 14}

Eligibility Criteria

This trial is for individuals in a district with new hydration stations and policies promoting healthy water drinking habits. It aims to assess the impact on tooth decay, weight management, and oral cancers over three years.

Inclusion Criteria

All staff in the target schools will be eligible to complete the Personnel Survey

My child eats lunch in the cafeteria and is in grades K-5.

I am a student in the 3rd grade enrolling in a study until 5th grade.

Exclusion Criteria

I am able to complete health assessments and not planning to move during the study.

None for lunchroom observations

None for staff surveys

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Hydration Intervention

4-month community participatory school-based hydration intervention including provision of refillable water bottles, social marketing, behavioral reinforcement, and education and outreach

4 months

Follow-up

Participants are monitored for effectiveness and sustainability of the hydration intervention, including assessments of water station usage, BMI, dental caries, and other secondary outcomes

up to 3 years

Treatment Details

Interventions

• Hydration

Trial Overview The study tests a community-participatory intervention focused on encouraging proper hydration among participants. The effectiveness of newly installed hydration stations and related health policies will be evaluated.

Participant Groups

Group I: Hydration Intervention Experimental Treatment 1 Intervention

4-month community participatory school-based hydration intervention that includes provision of refillable water bottles in schools with hydration stations in addition to: 1) social marketing, 2) behavioral reinforcement, and 3) education and outreach.

Group II: Control Active Control 1 Intervention

Assessment only

Who Is Running the Clinical Trial?

Virginia Commonwealth University

Lead Sponsor

Trials

732

Recruited

22,900,000+

Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

Collaborator

Trials

2,103

Recruited

2,760,000+

Findings from Research

A systematic review of 23 studies found that multicomponent strategies, such as increasing beverage choices and staff assistance, positively impacted fluid intake and reduced dehydration risk in older adults in long-term care facilities.

The implementation of the US Resident Assessment Instrument significantly decreased dehydration prevalence from 3% to 1%, highlighting the importance of structured assessments in managing hydration in this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Increasing fluid intake and reducing dehydration risk in older people living in long-term care: a systematic review. Bunn, D., Jimoh, F., Wilsher, SH., et al.[2022]

The Nutrition Now campaign is introducing an online toolkit aimed at helping nurses and support staff promote increased water consumption among hospitalized patients.

This initiative is designed to improve patient hydration, which is crucial for recovery and overall health in hospital settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Drink to good health. [2016]

Behavioral interventions significantly improved hydration in acutely unwell or institutionalized older adults, with participants consuming an average of 300.93 mL more fluid per day compared to usual care groups, based on a meta-analysis of 19 studies involving 978 participants.

Environmental, multifaceted, and nutritional interventions showed mixed results, highlighting the need for high-quality studies that use validated methods to assess hydration effectiveness in this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Interventions to Improve Hydration in Older Adults: A Systematic Review and Meta-Analysis. Bruno, C., Collier, A., Holyday, M., et al.[2021]

A quality improvement project at a Veterans Administration Hospital successfully increased hydration among geriatric psychiatry patients by implementing strategies like flavored water, larger cups, and increased nurse prompting, resulting in an average daily fluid intake increase of 700 mL, far exceeding the goal of 125 mL.

The interventions not only improved hydration in geriatric patients but also had positive effects on non-geriatric psychiatry in-patients, highlighting the broader applicability of the hydration strategies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

An Innovative Approach to Adequate Oral Hydration in an Inpatient Geriatric Psychiatry Unit. Smith, M., Velasco, R., John, S., et al.[2019]

In a study of 9,528 adults from the NHANES survey, those who were inadequately hydrated had significantly higher body mass indexes (BMIs) and were more likely to be classified as obese compared to those who were adequately hydrated.

The research suggests a strong link between hydration levels and weight status, indicating that improving hydration could be an important factor in weight management strategies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Inadequate Hydration, BMI, and Obesity Among US Adults: NHANES 2009-2012. Chang, T., Ravi, N., Plegue, MA., et al.[2022]

A study of 36 middle-aged male cyclists during a 164-km cycling event showed that regardless of their hydration status before the event, all groups experienced similar body mass loss and exercise times, indicating that hydration status may not significantly impact performance in this context.

Most cyclists recognized that dehydration negatively affects performance, but they relied more on personal experience and thirst cues rather than scientific recommendations for hydration, suggesting a need for individualized drinking plans tailored to their experiences during exercise.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Factors Associated with Pre-Event Hydration Status and Drinking Behavior of Middle-Aged Cyclists. Yates, BA., Ellis, LA., Butts, CL., et al.[2019]

Adequate hydration is crucial for health, but current dietary recommendations for water intake are often overlooked and lack strong scientific backing, leading to reliance on estimates from healthy populations.

Clinical studies indicate that both dehydration and overhydration can have negative health effects, yet there is a scarcity of robust research on hydration status measurement and its implications for physical and cognitive performance.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[The importance of water consumption in health and disease prevention: the current situation]. Salas Salvadó, J., Maraver Eizaguirre, F., Rodríguez-Mañas, L., et al.[2022]

A study of 3,397 US adults found that 7% reported no daily water consumption, and factors like age (55+), low fruit and vegetable intake, lack of exercise, and not actively trying to lose weight were linked to lower water intake.

Understanding these characteristics can help target interventions to encourage higher water consumption, which is important for hydration and weight management.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Behaviors and attitudes associated with low drinking water intake among US adults, Food Attitudes and Behaviors Survey, 2007. Goodman, AB., Blanck, HM., Sherry, B., et al.[2023]

The study highlights significant methodological issues in hydration research, including how to select appropriate samples and methods for evaluating hydration status and water intake.

Understanding hydration should be approached as a daily routine influenced by factors like gender, age, physical activity, and environment, emphasizing the need for well-designed studies to accurately assess hydration.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Hydration: certain basic aspects for developing technical and scientific parameters into the nutrition knowledge Perales-García, A., Estévez-Martínez, I., Urrialde, R.[2018]

In a study of 74 physically active elderly individuals in Portugal, less than 10% were found to be at risk of dehydration, indicating that most participants maintained adequate hydration status.

Food contributed nearly half of the total water intake (47% for women and 48% for men), highlighting the importance of water-rich foods and non-alcoholic beverages in hydration strategies, especially for men who had a significantly higher intake of alcoholic beverages.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Urinary hydration biomarkers and water sources in free-living elderly. Gonçalves, A., Silva, J., Moreira, P., et al.[2018]

A study involving 92 college students found that drinking 1,600 mL of water per day improved mood and cognitive performance compared to drinking 800 mL, suggesting that higher fluid intake can enhance vigor and memory.

The optimal fluid intake behavior identified was consuming 200 mL of water 8 times a day, which was associated with better cognitive scores and lower mood disturbance, indicating that both the amount and frequency of water intake are important for mental well-being.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Influence of Fluid Intake Behavior on Cognition and Mood among College Students in Baoding, China. He, H., Zhang, JF., Zhang, N., et al.[2021]

The average adult man needs at least 2,900 mL and the average adult woman at least 2,200 mL of fluids daily to stay well-hydrated, with solid foods contributing significantly to this intake.

Chronic mild dehydration can impair physiological functions and is linked to various health issues, including urinary stone disease and certain cancers, highlighting the importance of monitoring fluid intake for overall health.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Water: an essential but overlooked nutrient. Kleiner, SM.[2013]

Water is essential for human health, and its intake is crucial for preventing nutrition-related diseases, especially as people increasingly consume caloric beverages instead of plain water.

There is a significant lack of comprehensive studies on total fluid intake and hydration status in populations, highlighting the need for more long-term research and controlled trials to better understand water requirements and their impact on health.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Water, hydration, and health. Popkin, BM., D'Anci, KE., Rosenberg, IH.[2022]

A study involving 60 participants revealed that many people have inconsistent water drinking habits, often only drinking in specific situations, which can lead to underhydration when those situations change.

Participants generally lacked knowledge about the importance of hydration and effective strategies to increase water intake, indicating a need for educational interventions to promote better hydration habits.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

"I know it's just pouring it from the tap, but it's not easy": Motivational processes that underlie water drinking. Rodger, A., Wehbe, LH., Papies, EK.[2021]

References

1. United States pubmed.ncbi.nlm.nih.gov

Increasing fluid intake and reducing dehydration risk in older people living in long-term care: a systematic review. [2022]

2. England pubmed.ncbi.nlm.nih.gov

Drink to good health. [2016]

3. Switzerland pubmed.ncbi.nlm.nih.gov

Interventions to Improve Hydration in Older Adults: A Systematic Review and Meta-Analysis. [2021]

4. United States pubmed.ncbi.nlm.nih.gov

An Innovative Approach to Adequate Oral Hydration in an Inpatient Geriatric Psychiatry Unit. [2019]

5. United States pubmed.ncbi.nlm.nih.gov

Inadequate Hydration, BMI, and Obesity Among US Adults: NHANES 2009-2012. [2022]

6. France pubmed.ncbi.nlm.nih.gov

Factors Associated with Pre-Event Hydration Status and Drinking Behavior of Middle-Aged Cyclists. [2019]

7. Spain pubmed.ncbi.nlm.nih.gov

[The importance of water consumption in health and disease prevention: the current situation]. [2022]

8. United States pubmed.ncbi.nlm.nih.gov

Behaviors and attitudes associated with low drinking water intake among US adults, Food Attitudes and Behaviors Survey, 2007. [2023]

9. Spain pubmed.ncbi.nlm.nih.gov

Hydration: certain basic aspects for developing technical and scientific parameters into the nutrition knowledge [2018]

10. Spain pubmed.ncbi.nlm.nih.gov

Urinary hydration biomarkers and water sources in free-living elderly. [2018]

11. Switzerland pubmed.ncbi.nlm.nih.gov

The Influence of Fluid Intake Behavior on Cognition and Mood among College Students in Baoding, China. [2021]

12. United States pubmed.ncbi.nlm.nih.gov

Water: an essential but overlooked nutrient. [2013]

13. United States pubmed.ncbi.nlm.nih.gov

Water, hydration, and health. [2022]

14. England pubmed.ncbi.nlm.nih.gov

"I know it's just pouring it from the tap, but it's not easy": Motivational processes that underlie water drinking. [2021]