Given the rapid increase in the prevalence of overweight, obesity, and type 2 diabetes across the world, it is now essential that public health authorities and healthcare providers impart evidence-based guidance and advice to the general public, to prevent overweight- and obesity-related healthcare costs and societal burdens from escalating. The importance of fluid intake has been overlooked in campaigns and guidelines and also in the clinical setting. The question “what do you drink” is often omitted.
The Expert Working Group Meeting performed an overview of studies related to hydration-related problems and proposed recommendations for healthy hydration.1 The Expert Working Group calls for better hydration practices to be more widely adopted, specifically for all management guidelines regarding prevention and management of overweight and obesity. Furthermore, all national “food pyramids” and “portion plates” should demonstrate what drinks should be consumed as part of a healthy balanced diet.
Expert Working Group Consensus recommendations for providing healthy-hydration advice are summarized. It is essential to increase healthcare provider education and public awareness of the following: (a) the importance of drinking ample safe water within the context of a healthy, balanced diet and (b) the detrimental effects of overconsumption of sugar-sweetened beverages and nonnutritive sweeteners on long-term health.
A. To achieve this goal and to ensure adoption by the general public, increasing awareness of the current obesity epidemic is paramount, both at a national and a regional level. Revise current dietary guidelines to include evidence-based advice on healthy hydration within the context of dietary and lifestyle modifications.
B. Revise national nutrition guidelines to emphasize the importance of water as a macronutrient and to include it within the food pyramid as recently performed.
C. Newly revised guidelines should be simple, effective, and include easy-to-remember targets for each group of individuals. For example, guidelines should advise normal adults to drink approximately 2 L of water per day.
Recommendations about healthy eating and regular exercise practice must be associated to hydration guidelines.
D. Water intake should be emphasized during physical activity, during sweating, and when living in hot and cold environments.
E. Conduct new research to identify the daily water needs of specific groups (eg, pregnant and lactating women, elderly individuals). Longitudinal studies should also be extended to different populations (different countries, different socioeconomic levels and different age groups) to optimize hydration procedures.
1. Armstrong LE, Barquera S, Duhamel JF, et al. Recommendations for healthier hydration-Addressing the public health issues of obesity and type 2 diabetes. Clin Obes. 2012; 2 (5–6): 115–124.