Water Intake and Hydration Indices in Healthy European Adults: The European Hydration Research Study (EHRS).
Normative values and confidence intervals for the hydration indices of women do not exist. Also, few publications have precisely described the fluid types and volumes that women consume. This investigation computed seven numerical reference categories for widely used hydration biomarkers (eg, serum and urine osmolality) and the dietary fluid preferences of self-reported healthy, active women. Participants (n=32; age 20±1 years; body mass 59.6±8.5 kg; body mass index [calculated as kg/m(2)] 21.1±2.4) were counseled in the methods to record daily food and fluid intake on 2 consecutive days. To reduce day-to-day body water fluctuations, participants were tested only during the placebo phase of the oral contraceptive pill pack. Euhydration was represented by the following ranges: serum osmolality=293 to 294 mOsm/kg; mean 24-hour total fluid intake=2,109 to 2,506 mL/24 hours; mean 24-hour total beverage intake=1,300 to 1,831 mL/24 hours; urine volume=951 to 1,239 mL/24 hours; urine specific gravity=1.016 to 1.020; urine osmolality=549 to 705 mOsm/kg; and urine color=5. However, only 3% of women experienced a urine specific gravity <1.005, and only 6% exhibited a urine color of 1 or 2. Water (representing 45.3% and 47.9% of 24-hour total fluid intake), tea, milk, coffee, and fruit juice were consumed in largest volumes. In conclusion, these data provide objective normative values for hyperhydration, euhydration, and dehydration that can be used by registered dietitians and clinicians to counsel women about their hydration status.