Department of Public Health, Erasmus University Medical Center, Wytemaweg 80, 3015, CN, Rotterdam, The Netherlands.
Nestlé Waters MT, Issy-les-Moulineaux, France.
Int J Behav Nutr Phys Act. 2019 Aug 13;16(1):64. doi: 10.1186/s12966-019-0827-0.
Water is recommended as the main beverage for daily fluid intake. Previous systematic reviews have studied the consumption of sugar-sweetened beverages (SSBs) among children, but none have focused on water consumption. Insight into factors that are associated with children's water intake is needed to inform the development of interventions aimed at the promotion of water consumption. The objective of this review was therefore to summarize the current evidence on factors associated with water consumption among children aged 2 to 12 years.
A systematic literature search in seven electronic databases was conducted in May, 2018 and retrieved 17,850 unique records. Two additional studies were identified by hand-searching references of included articles. Studies were selected if they had a cross-sectional or longitudinal study design, focused on children aged 2-12 years and published in an English language peer-reviewed journal. Participants from clinical populations, studies that included data of < 10 participants and non-human studies were excluded.
A total of 63 articles met inclusion criteria and were included in the analysis. We identified 76 factors that were investigated in these studies; 17/76 were investigated in a longitudinal study. There was evidence of positive associations between water consumption and child's self-efficacy, parental education level, parental self-efficacy, use of feeding practices such as restriction or encouraging healthy eating and study year. Evidence was inconsistent (< 60% of studies reported an association) for child's age, sex, BMI, consumption of SSBs and ethnic background of the parent. There was no evidence (≤33% of studies reported an association) of associations between consumption of milk or juice, parental emotional-, modelling- or instrumental feeding practices, eating school lunch or outside temperature and water consumption. The remaining 54 factors were investigated in fewer than three studies.
There is some evidence for an association between potentially modifiable parental and child-related factors and water consumption. However, most factors identified in this review were only studied by one or two studies and most studies were cross-sectional. More longitudinal research is necessary to investigate environmental, parental and child-related factors associated with water consumption that are currently under-studied and could further inform intervention strategies.
PROSPERO ID# CRD42018093362 , registered May 22, 2018.
水被推荐作为日常液体摄入的主要饮料。先前的系统评价已经研究了儿童中含糖饮料（SSB）的消费情况，但没有一项专门研究水的消费情况。需要深入了解与儿童水摄入量相关的因素，为旨在促进水消费的干预措施的制定提供信息。因此，本综述的目的是总结目前关于 2 至 12 岁儿童水摄入相关因素的证据。
2018 年 5 月，我们在七个电子数据库中进行了系统文献检索，检索到 17850 个独特的记录。通过手动搜索纳入文章的参考文献，又确定了另外两项研究。如果研究具有横断面或纵向研究设计，专注于 2-12 岁儿童，且发表在英语同行评审期刊上，则将其纳入研究。排除临床人群参与者、纳入数据<10 名参与者的研究以及非人类研究。
共有 63 篇文章符合纳入标准，并纳入分析。我们确定了 76 个在这些研究中被调查的因素；其中 17/76 个因素在纵向研究中被调查。水的摄入量与儿童的自我效能感、父母的教育水平、父母的自我效能感、使用限制或鼓励健康饮食等喂养行为之间存在正相关的证据。儿童年龄、性别、BMI、SSB 的摄入以及父母的种族背景与水摄入之间的关联证据不一致（<60%的研究报告有相关性）。摄入牛奶或果汁、父母的情感、示范或工具喂养行为、在学校吃午餐或外部温度与水摄入之间没有关联的证据（≤33%的研究报告有相关性）。其余 54 个因素在不到 3 项研究中被调查。
有一些证据表明，一些潜在可改变的父母和儿童相关因素与水的摄入有关。然而，本综述中确定的大多数因素仅由一项或两项研究研究过，而且大多数研究都是横断面研究。需要更多的纵向研究来调查目前研究不足且可以进一步为干预策略提供信息的与水摄入相关的环境、父母和儿童相关因素。
PROSPERO 注册号#CRD42018093362 ，注册于 2018 年 5 月 22 日。
