Are Spanish children drinking enough and healthily? An update of the Liq.in7 cross-sectional survey in children and adolescents.

Introduction: insufficient and/or unhealthy total fluid intake (TFI), especially in the early stages of life, may have a negative impact on health. Objective: to assess the current patterns of fluid consumption in children and adolescents in Spain, including drinking occasions and locations (e.g., at home or at school), and to compare TFI with adequate intake (AI) of water from fluids as recommended by the European Food Safety Agency (EFSA). Methodology: a Spanish cross-sectional study was performed assessing TFI from all sources of fluid consumption according to drinking occasions during the day and location, using a validated liquid intake 7-day record (Liq.in7). Data collection occurred between April and May, 2018. A sample of 146 (63 % boys) children (4-9 years old) and adolescents (10-17 years old) was included. Parents reported such information when children were under 16 years. Results: a high proportion of children and adolescents did not meet EFSA-derived reference values for fluid intake (73 % and 72 %, respectively). Forty percent of children and about 50 % of adolescents consumed at least one serving of sugar-sweetened beverage (SSB) per day, while about 20 % consumed only one or less servings of water per day. Consumption during the main meals was most important for both children and adolescents (representing 50 % and 54 % of TFI, respectively), and was mainly driven by water (62 %). Consumption at home in children (70 % of TFI) was made of water (47 %). In the same way, at school, water contributed to half intake. However, adolescent girls at school drink more SSBs (41 %) than water (34 %), the former being the most consumed fluid. At other locations, adolescent boys also drink more SSBs (51 %) than either water (29 %) or milk and derivatives (10 %). Conclusion: the drinking habits of Spanish young populations are far removed from current recommendations because of a low fluid intake, specifically water, and a high proportion of SSB consumption in children and adolescents. Interventions to ensure that EFSA TFI recommendations are met are of special importance for children and adolescents, with - according to our results - a special focus on male adolescents.