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Objective: To study the quantity and quality of water intake from beverages among pre-schoolers and investigate associations with gender and socio-economic status (SES).Design: Kindergarten-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.Setting: Kindergartens in six European countries (Belgium, Bulgaria, Germany, Greece, Poland and Spain).Subjects: European pre-schoolers (aged 3·5-5·5 years) and their parents/caregivers (n 7051).Results: Mean 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.Conclusions: The 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. [ABSTRACT FROM AUTHOR]

Background Water balance is achieved when water intake from solid and fluid foods and drinking water meets water losses, mainly in sweat, urine and faeces. Seasonality, particularly in Mediterranean countries that have a hot summer, may affect water loss and consequently water balance. Water balance has not been estimated before on a population level and the effect of seasonality has not been evaluated. The present study aimed to compare water balance, intake and loss in summer and winter in a sample of the general population in Greece. Methods The Water Balance Questionnaire ( WBQ) was used to evaluate water balance, estimating water intake and loss in summer ( n = 480) and in winter ( n = 412) on a stratified sample of the general population in Athens, Greece. Results In winter, mean (SD) water balance was −63 (1478) mL/day−1, mean (SD)water intake was 2892 (987) mL/day−1 and mean (quartile range) water loss was 2637 (1810-3922) mL/day−1. In summer, mean (SD) water balance was −58 (2150) mL/day−1, mean (SD) water intake was 3875 (1373) mL/day−1 and mean (quartile range) water loss was 3635 (2365-5258) mL/day−1. Water balance did not differ between summer and winter ( P = 0.96); however, the data distribution was different; in summer, approximately 8% more participants were falling in the low and high water balance categories. Differences in water intake from different sources were identified ( P < 0.05). Conclusions Water balance in summer and winter was not different. However, water intake and loss were approximately 40% higher in summer than in winter. More people were falling in the low and high water balance categories in summer when comparing the distribution on water balance in winter. [ABSTRACT FROM AUTHOR]