Rosinger Asher, Tanner Susan
Department of Anthropology,University of Georgia,250A Baldwin Hall,Athens,GA 30602,USA.
Public Health Nutr. 2015 Apr;18(6):1098-108. doi: 10.1017/S1368980014002158. Epub 2014 Oct 7.
Water is an essential nutrient overlooked in many cross-cultural studies of human nutrition. The present article describes dietary water intake patterns among forager-horticulturalist adults in lowland Bolivia, compares daily intake with international references and examines if variation in how people acquire water relates to gastrointestinal illness.
Cross-sectional observational study used survey, anthropometric and qualitative methods with Tsimane' adults selected by age and sex stratification sampling in one community.
Research occurred in one Tsimane' village in the Beni department, Bolivia with limited access to clean water. The 24 h diet and health recalls were conducted in July-August 2012 and qualitative interviews/ethnographic observation in September-October 2013.
Forty-five Tsimane' household heads (49% men) took part in the first data collection and twenty-two Tsimane' (55% men) were included in the follow-up interviews.
Men and women reported consuming 4·9 litres and 4·4 litres of water daily from all dietary sources, respectively. On average, water from foods represented 50 % of total water intake. Thirteen per cent of participants reported symptoms of gastrointestinal illness. In a logistic regression model adjusted for age, BMI, sex and raw water consumed, each percentage increase in water obtained from foods was associated with a reduced risk of gastrointestinal illness (OR=0·92; 95% CI 0·85, 0·99).
Both total water intake and percentage of water from foods were higher than averages in industrialized countries. These findings suggest that people without access to clean water may rely on water-rich foods as a dietary adaptation to reduce pathogen exposures.
水是许多人类营养跨文化研究中被忽视的一种必需营养素。本文描述了玻利维亚低地觅食-园艺成年人群的膳食水摄入模式，将每日摄入量与国际参考标准进行比较，并研究人们获取水的方式差异是否与胃肠道疾病有关。
横断面观察性研究采用了调查、人体测量和定性方法，通过年龄和性别分层抽样在一个社区选取了齐曼内成年人群。
研究在玻利维亚贝尼省的一个齐曼内村庄进行，那里获得清洁水的机会有限。2012年7月至8月进行了24小时饮食和健康回忆调查，2013年9月至10月进行了定性访谈/人种学观察。
45名头齐曼内户主（49%为男性）参与了首次数据收集，22名齐曼内人（55%为男性）纳入了随访访谈。
男性和女性报告称，所有膳食来源的每日水摄入量分别为4.9升和4.4升。平均而言，食物中的水占总水摄入量的50%。13%的参与者报告有胃肠道疾病症状。在根据年龄、体重指数、性别和饮用的生水进行调整的逻辑回归模型中，从食物中获取的水每增加一个百分点，胃肠道疾病风险就会降低（比值比=0.92；95%置信区间0.85，0.99）。
总水摄入量和食物中的水所占百分比均高于工业化国家的平均水平。这些发现表明，无法获得清洁水的人可能依赖富含水的食物作为一种饮食适应方式，以减少病原体暴露。
