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ObjectiveTo examine the association of water intake with risk of mortality from CVD.DesignProspective cohort study.Setting/SubjectsA total of 22 939 men and 35 362 women aged 40–79 years enrolled in the Japan Collaborative Cohort (JACC) Study with available data regarding water intake from foods and beverages. The underlying causes of death were determined based on the International Classification of Diseases.ResultsDuring the median 19·1 years of follow-up, 1637 men and 1707 women died from CVD. There was an inverse trend between high water intake and risk of CVD in both sexes. Compared with participants in the lowest quintile of water intake, the multivariable-adjusted hazard ratios (95 % CI) for mortality from total CVD in the highest quintile of water intake were 0·88 (0·72, 1·07; P for trend=0·03) in men and 0·79 (0·66, 0·95; P for trend=0·10) in women. Those for CHD were 0·81 (0·54, 1·21; P for trend=0·06) in men and 0·60 (0·39, 0·93; P for trend=0·20) in women. Reduced risk of mortality from ischaemic stroke was also observed among women in the highest water intake quintile: 0·70 (0·47, 0·99; P for trend=0·19). There was no association between water intake and mortality from haemorrhagic stroke in either sex.ConclusionsHigher intake of fluids from foods and beverages was associated with reduced risk of cardiovascular mortality in both sexes and reduced risk of ischaemic stroke in women in Japan.

The European Food Safety Authority’s 2010 scientific opinion on dietary reference values for total water intakes was partly based on observed intakes in population groups. Large variability was observed, and it is unlikely that these differences can be explained by differences in climate, activity level and/or culture. This suggests that there are uncertainties in the methodologies used to assess water intake from food and fluids, including all types of beverages. To determine current methods for recording and reporting total water, beverages and fluid intakes, twenty-one European countries were surveyed using an electronic questionnaire. In total, twelve countries responded and ten completed surveys were summarised. Countries reported that their survey was representative of the population in terms of age and socio-economic status. However, a variety of methods were used – that is, repeated 24-h recalls, estimated food diaries and FFQ. None of the methods were validated to assess water and fluid intakes. The methods used to record liquid foods – for example, soup and diluted drinks – were inconsistent. Clarity and consistency on definitions of categories of beverages to facilitate comparisons between countries are needed. Recommendations for a unified approach to surveying and quantifying intake of water from fluids and foods are proposed.

ObjectiveTo examine the consumption of plain water among children in France and compare total water intakes with guidelines issued by the European Food Safety Authority (EFSA).DesignNationally representative data were used to assess food, beverage and water consumption by sex, age group (4–8 years, 9–13 years), income-to-poverty ratio, eating occasion and location. Beverages were classified into nine groups: water (tap or bottled), milk, 100 % fruit juice, sodas, fruit drinks, hot beverages, sports drinks and flavoured waters. Total water volume in relation to energy intake (litres/kcal) was also examined.SettingINCA 2 study (Étude Individuelle Nationale des Consommations Alimentaires 2006–2007).SubjectsFrench children (n 835) aged 4–13 years.ResultsTotal water intakes were accounted for by plain water (34 %), beverages (26 %) and food moisture (40 %). Plain water could be tap (18 %) or bottled (16 %). Older children drank more plain water than did younger children and boys drank more plain water than did girls. No socio-economic gradient for plain water consumption was observed. About 90 % of children did not meet the EFSA water intake recommendations. The daily water shortfall ranged from 367 to 594 ml/d. Water-to-energy ratio was 0·75–0·77 litres/1000 kcal (4184 kJ). Children drank milk at breakfast and plain water during lunch and dinner. Caloric beverages provided 10 % of dietary energy; consumption patterns varied by eating location.ConclusionsTotal water intakes among young children in France were below EFSA-recommended levels. Analyses of beverage consumption patterns by eating occasion and location can help identify ways to increase water consumption among children.

ObjectiveTo study the quantity and quality of water intake from beverages among pre-schoolers and investigate associations with gender and socio-economic status (SES).DesignKindergarten-based cross-sectional survey within the large-scale European ToyBox-study. A standardized protocol was used and parents/caregivers filled in sociodemographic data and a semi-quantitative FFQ.SettingKindergartens in six European countries (Belgium, Bulgaria, Germany, Greece, Poland and Spain).SubjectsEuropean pre-schoolers (aged 3·5–5·5 years) and their parents/caregivers (n 7051).ResultsMean water intake was 1051 ml/d; plain water, 547 ml/d; plain milk, 241 ml/d; other fruit juice, 104 ml/d; pure fruit juice, 59 ml/d; soft drinks, 55 ml/d; tea, 45 ml/d; sugared and chocolate milk, 37 ml/d; smoothies, 15 ml/d; and light soft drinks, 6 ml/d. Boys had a higher water intake than girls due to a higher consumption of plain water, but more importantly to the consumption of beverages of less quality. Lower-SES pre-schoolers scored better on quantity than high-SES pre-schoolers, but as a consequence of consumption of sugared beverages. Nevertheless, the associations differed by country.ConclusionsThe water intake from beverages did not meet the European Food Safety Authority standard of 1280 ml/d; especially in Western European countries water intake from beverages was low. The most important water sources were plain water, milk and fruit juices. Interventions aiming at a proper and sufficient water intake should focus on both quantity and quality. Messages about water and water sources should be clear for everyone and interventions should be sufficiently tailored.

Taking on the challenge of motivating users to drink water regularly, we designed a smart water bottle that can track water intake behavior and inform users about this behavior through ambient feedback. We then conducted two studies to explore the bottle's feedback design from the perspective of users and designers. First, we conducted semi-structured interviews with 10 prospective users and found that they would like to receive personalized, precise, gamified and reminding feedback. Second, we conducted a design workshop with 13 professional designers to explore the range of visualizations that can be used to give feedback. Analyzing these visualizations, we identified three reminder types (augmenting, restoring and balancing) and six visualization styles grouped according to three dimensions of ambient displays (representation fidelity, notification level, aesthetic emphasis). In this paper, we first explain our water bottle concept along with existing solutions. Then, we report the results of these studies. Finally, we discuss the potential implications of the results for our own work as well as for designing ambient displays aimed at supporting users' water intake tracking practices., NA