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    Hydration status, drug interactions, and determinants in a Spanish elderly population: a pilot study. Puga A M,Partearroyo T,Varela-Moreiras G Journal of physiology and biochemistry Proper hydration is essential to maintain optimal health and well-being at all stages of life, especially for the elderly. Side effects of certain drugs that affect hydration status may compromise the health of the ancients, who also constitute the most vulnerable group. No studies have been carried out, to our knowledge, at the intersection of drugs and hydration status. Our study aimed to evaluate the effects of chronic use of certain drugs (diuretics, corticoids and metformin) in the hydration status of the elderly. Results were obtained from a cross-sectional study with 96 volunteers (65-93 years) selected based on their pharmacological treatment. It included a validated food and drink frequency questionnaire and water removal, dehydration signs and symptoms assessment and urine analysis. All data were analysed by age and sex. Water balance decreased with advanced age, especially in men's group. Results were confirmed by means of the evaluation of dehydration signs and symptoms and colorimetric and chemical analysis of urine. Correlations between consumption of corticoids and hydration status were found, with different signs depending on the administration route (Rho = 0.522 and Rho = - 0,522 for oral and pulmonary corticoids, respectively). Furthermore, correlations between diuretics (Rho = - 0.343, p < 0.05) and metformin (Rho = - 0.802, p < 0.01) consumption and different urine markers were determined. In conclusion, the predominant dehydration state of the volunteers of the study is affected by drugs consumption and their route of administration. Hence, there is an urgent need for monitorization of hydration status based on drugs consumption. 10.1007/s13105-017-0585-x
    Assessing a Tool for Self-Monitoring Hydration Using Urine Color in Pregnant and Breastfeeding Women: A Cross-Sectional, Online Survey. Rigaud Marion,Sevalho Corçao Camila,Perrier Erica T,Boesen-Mariani Sabine Annals of nutrition & metabolism BACKGROUND:Pregnant and breastfeeding women experience great changes in their total body water content and water dynamics. To support the accretion of total body water during pregnancy and compensate for the water lost through breast milk during breastfeeding, increased adequate intakes (AI) for total water have been established by various health authorities. Despite this widespread advice, several studies suggest that pregnant and breastfeeding women do not meet the AI for total water, suggesting the need to raise women's awareness on the importance of adequate water intake, particularly during pregnancy and breastfeeding, as well as to provide them with a simple means of monitoring their hydration on a day-to-day basis. A urine color (UC) scale recently has been validated for hydration monitoring in pregnant and breastfeeding women. SUMMARY:We sought to develop a version of a tool based on the UC scale, using only images or illustrations, which could be understood by users of various nationalities and spoken languages. Pregnant and breastfeeding women (n = 1,275) from Brazil, Mexico, and Poland were shown 3 versions of the tool. Understanding, appreciation, simplicity and intent to use were evaluated using a questionnaire consisting of 26 items. Key Messages: Among the 3 versions tested, one tool emerged as the most highly understood (88% spontaneous understanding) and was highly appreciated by users (mean [SD]: 8.40 [2.20] out of 10). There were no differences between countries. Furthermore, 83% reported being very likely to use the tool daily. These results suggest that a simple tool based on the UC scale will help pregnant and breastfeeding women meet the AI for total water. 10.1159/000463000
    Cross-cultural adaptation and validation of questionnaire for knowledge, attitudes, and behavioral intentions in Italian nurses with regard to provision of artificial nutrition and hydration to patients terminally ill with cancer. Albanesi Beatrice,Marchetti Anna,Facchinetti Gabriella,Clari Marco,Dellafiore Federica,Piervisani Loredana,Lusignani Maura,De Marinis Maria Grazia,Piredda Michela Nutrition (Burbank, Los Angeles County, Calif.) OBJECTIVES:Decision-making on artificial nutrition and hydration for patients terminally ill with cancer can be influenced by nurses' knowledge, attitudes, and behavioral intentions. A comprehensive 57-item questionnaire including six sections on the knowledge, attitudes, and behavioral intentions in providing artificial nutrition and hydration to patients terminally ill with cancer has been developed and used in Taiwan. However, the questionnaire needs further psychometric testing and adaptation for other cultures. This study aimed to cross-culturally adapt the questionnaire within the Italian cultural context and test its psychometric properties. METHODS:The questionnaire was translated into Italian and cross-culturally adapted per the recommendations by Beaton. A panel of 10 experts assessed content validity. A multicenter cross-sectional study was conducted with 411 nurses to test its psychometric properties. Dimensionality and construct validity were assessed through exploratory and confirmatory factor analyses. Reliability was estimated by composite ω and traditional methods, such as the Kuder Richardson formula-20 and Cronbach's α coefficients. RESULTS:The overall content validity index was 0.85. A confirmatory factor analysis was conducted for the knowledge section and the four attitudes sections. A preliminary analysis for the behavioral intentions section yielded non acceptable results. The internal consistency of the scales was adequate (range, 0.64-0.93). CONCLUSIONS:This study constituted a notable advancement in the psychometric testing of the tool, and provides evidence that the Italian version of the questionnaire has acceptable psychometric characteristics for the sections on knowledge and attitudes. 10.1016/j.nut.2019.110655
    Validation of beverage intake methods vs. hydration biomarkers; a short review. Nissensohn Mariela,Ruano Cristina,Serra-Majem Lluis Nutricion hospitalaria INTRODUCTION:Fluid intake is difficult to monitor. Biomarkers of beverage intake are able to assess dietary intake/hydration status without the bias of self-reported dietary intake errors and also the intra-individual variability. Various markers have been proposed to assess hydration, however, to date; there is a lack of universally accepted biomarker that reflects changes of hydration status in response to changes in beverage intake. AIM:We conduct a review to find out the questionnaires of beverage intake available in the scientific literature to assess beverage intake and hydration status and their validation against hydration biomarkers. METHODS:A scientific literature search was conducted. Only two articles were selected, in which, two different beverage intake questionnaires designed to capture the usual beverage intake were validated against Urine Specific Gravidity biomarker (Usg). RESULTS:Water balance questionnaire (WBQ) reported no correlations in the first study and the Beverage Intake Questionnaire (BEVQ), a quantitative Food frequency questionnaire (FFQ) in the second study, also found a negative correlation. FFQ appears to measure better beverage intake than WBQ when compared with biomarkers. However, the WBQ seems to be a more complete method to evaluate the hydration balance of a given population. CONCLUSIONS:Further research is needed to understand the meaning of the different correlations between intake estimates and biomarkers of beverage in distinct population groups and environments. 10.3305/nutr hosp.v28in06.6886
    Drinking patterns and hydration biomarkers among young adults with different levels of habitual total drinking fluids intake in Baoding, Hebei Province, China: a cross-sectional study. Zhang Jianfen,Zhang Na,Wang Yan,Liang Shuxin,Liu Shufang,Du Songming,Xu Yifan,He Hairong,Cai Hao,Ma Guansheng BMC public health BACKGROUND:The purposes were to investigate the drinking patterns and hydration biomarkers among young adults with different levels of habitual total drinking fluids intake. METHODS:A cross-sectional study was conducted among 159 young adults aged 18-23 years in Baoding, China. Total drinking fluids and water from food were assessed by 7-day 24-h fluid intake questionnaire and duplicate portion method, respectively. The osmolality and electrolyte concentrations of the 24 h urine and fasting blood samples were tested. Differences in LD (low drinker), LD, LD and HD (high drinker) groups, stratified according to the quartiles of total drinking fluids, were compared using one-way ANOVA, Kruskal-Wallis H test and chi-square test. RESULTS:A total of 156 participants (80 males and 76 females) completed the study. HD group had greater amounts of TWI (Total Water Intake), water from food, higher and lower contributions of total drinking fluids and water from food to TWI, respectively, than LD, LD and LD groups (p < 0.05). Participants in HD group had higher amounts of water and water from dishes than participants in LD, LD and LD groups (p < 0.05). No significant differences were found in the contributions of different fluids to total drinking fluids within the four groups (p > 0.05). The osmolality of urine was 59-143 mOsm/kg higher in LD than that in LD, LD and HD group (p < 0.05). The percentage of participants in optimal hydration status increased from 12.8% in LD group to 56.4% in HD group (p < 0.05). HD and LD groups had 386~793 higher volumes of urine than that of LD and LD groups (p < 0.05). Differences were found in the concentrations of electrolytes among the four groups (p < 0.05). No significant differences were found in the plasma biomarkers (p > 0.05), with the exception of higher concentration of Mg in LD and HD groups than that in LD and LD groups (p < 0.05). CONCLUSIONS:Participants with higher total drinking fluids had better drinking pattern and hydration status. Interventions should be undertaken to advise adults to have adequate total drinking fluids, in order to keep in optimal hydration status. TRIAL REGISTRATION:The registration number was ChiCTR-ROC-17010320, which was registered on the Chinese clinical trial registry. 10.1186/s12889-020-08558-z
    Validated questionnaire to assess the hydration status in a healthy adult Spanish population: a cross sectional study. Laja García Ana Isabel,Samaniego Vaesken María de Lourdes,Partearroyo Teresa,Varela Moreiras Gregorio Nutricion hospitalaria Introduction:Introduction: adequate hydration status is crucial in most physiological functions; conversely, its assessment is hindered by the limited availability of research tools. Objective: to develop and validate a novel questionnaire that evaluates the hydration status of a healthy adult Spanish population. Method: a novel questionnaire was designed and validated relying on biochemical parameters related to blood, urine, and body water content. The study involved 39 healthy subjects aged between 18 and 39 years. Food and beverage consumption were assessed by the novel questionnaire and through a three-day dietary record. Physical activity was assessed using both: accelerometers and the Short International Physical Activity Questionnaire (IPAQ). Validity was determined by correlation of the aforementioned parameters with the water balance and water intake obtained by the novel questionnaire. The questionnaire was administered twice over the course of 28 days to evaluate its reliability. Results: water balance and total water intake were correlated with specific gravity, and urine color. Water intake obtained by the novel questionnaire was correlated with water intake results from the three-day dietary record. Intraclass correlation coefficient indicated moderate concordance between both recordings, and the Cronbach's alpha revealed high consistency. Finally, the Bland and Altman method indicated that the limits of agreement were acceptable to reveal the reliability of the estimated measures. Conclusions: the questionnaire designed is a new valid and reliable screening tool to estimate hydration status of adult populations in dietary and nutritional assessment. 10.20960/nh.02533