Racial/Ethnic and Socioeconomic Disparities in Hydration Status Among US Adults and the Role of Tap Water and Other Beverage Intake

Abstract

Objectives: To evaluate whether differences in tap water and other beverage intake explain differences in inadequate hydration among US adults by race/ethnicity and income.

Methods: We estimated the prevalence of inadequate hydration (urine osmolality ≥ 800 mOsm/kg) by race/ethnicity and income of 8258 participants aged 20 to 74 years in the 2009 to 2012 National Health and Nutrition Examination Survey. Using multivariable regression models, we estimated associations between demographic variables, tap water intake, and inadequate hydration.

Results: The prevalence of inadequate hydration among US adults was 29.5%. Non-Hispanic Blacks (adjusted odds ratio [AOR] = 1.44; 95% confidence interval [CI] = 1.17, 1.76) and Hispanics (AOR = 1.42; 95% CI = 1.21, 1.67) had a higher risk of inadequate hydration than did non-Hispanic Whites. Lower-income adults had a higher risk of inadequate hydration than did higher-income adults (AOR = 1.23; 95% CI = 1.04, 1.45). Differences in tap water intake partially attenuated racial/ethnic differences in hydration status. Differences in total beverage and other fluid intake further attenuated sociodemographic disparities.

Conclusions: Racial/ethnic and socioeconomic disparities in inadequate hydration among US adults are related to differences in tap water and other beverage intake. Policy action is needed to ensure equitable access to healthy beverages.

Figures

FIGURE 1—

Weighted % of Participants Who Drank Any of Each Beverage Type in the Past 24 Hours, by Race/Ethnicity: National Health and Nutrition Examination Survey, United States, 2009–2012 Note. Sample size was n = 8258. *Significantly different from non-Hispanic White persons (P  ≤ .001). P value is from logistic regression models comparing likelihood of consuming any of each beverage type for non-Hispanic Black, Hispanic, and other race groups to non-Hispanic White persons, accounting for complex sampling design and adjusted for age category (20–39, 40–59, 60–74, and ≥ 75 y), gender (male or female), number of chronic conditions, blood pressure medication use (yes or no), time of day of urine sample (morning vs afternoon or evening), body mass index (kg/m2), whether participant met moderate to vigorous physical activity recommendations of ≥ 150 min/wk (yes or no), sodium consumption (in quartiles), and protein consumption (in quartiles).