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Published on: May 26, 2021
A 4-d Water Intake Intervention Increases Hydration and Cognitive Flexibility among Preadolescent Children
Naiman A Khan1,2,3, Daniel R Westfall4, Alicia R Jones1
1Department of Kinesiology and Community Health, University of Illinois, Urbana, IL, USA.
Insights
Increased water intake in children improves hydration markers and enhances cognitive flexibility, particularly during task switching. This highlights the importance of adequate hydration for cognitive function in preadolescents.
Area of Science:
- Pediatric Health
- Cognitive Neuroscience
- Nutrition Science
Background:
- Hydration's impact on children's cognition is understudied, despite widespread insufficient hydration in US children.
- Preadolescents are a key demographic where hydration status may influence cognitive performance.
Purpose of the Study:
- To investigate the effects of varying water intake on hydration markers and cognitive function in children aged 9-11.
- To assess how different hydration levels impact inhibition, working memory, and cognitive flexibility.
Main Methods:
- A crossover study involving 75 children (9-11 years) with three hydration interventions: ad libitum (AL), low (0.5 L/d), and high (2.5 L/d) water intake for 4 days each.
- Cognitive tasks included modified flanker, go/no-go, and color-shape switch tasks.
- Urinary hydration indices (color, urine specific gravity (USG), osmolality) were measured via 24-h urine collection.
Main Results:
- All interventions significantly altered hydration markers, with the high intake group showing the best hydration (lowest urine color, USG, and osmolality).
- Higher hydration levels correlated with better performance on the switch task, indicating improved cognitive flexibility.
- A 34% reduction in working memory cost was observed in the high water intake group compared to the low intake group during the switch task.
Conclusions:
- Water interventions effectively improve hydration markers in children.
- Increased water intake selectively benefits cognitive flexibility and task switching abilities in preadolescents.
- Habitual hydration plays a crucial role in supporting cognitive functions like flexibility in children.
Background:
Hydration effects on cognition remain understudied in children. This is concerning since a large proportion of US children exhibit insufficient hydration.
Objective:
This study investigated the effects of water intake on urinary markers of hydration and cognition among preadolescents.
Methods:
A 3-intervention crossover design was used among 9- to 11-y-olds [n = 75 (43 males, 32 females); 58.2 ± 28.5 BMI percentile]. Participants maintained their water intake [ad libitum (AL)] or consumed high (2.5 L/d) or low (0.5 L/d) water for 4 d. The primary outcomes were performance on cognitive tasks requiring inhibition, working memory, and cognitive flexibility assessed using a modified flanker, go/no-go, and color-shape switch tasks, respectively. Secondary outcomes included urine hydration indices [i.e., color, urine specific gravity (USG), osmolality] assessed using 24-h urine collected during day 4 of each intervention. Repeated-measures ANOVAs were used to assess intervention effects.
Results:
There was a significant difference in hydration across all 3 interventions. Urine color during the low intervention [median (IQR): 6 (2)] was greater than during AL [5 (2)], and both were greater than during the high intervention [18 (0)] (all P ≤ 0.01). Similarly, osmolality [low (mean ± SD): 912 ± 199 mOsmol/kg, AL: 790 ± 257.0 mOsmol/kg, high: 260 ± 115 mOsmol/kg] and USG [low (mean ± SD): 1.023 ± 0.005, AL: 1.020 ± 0.007, high: 1.005 ± 0.004] during the low intervention were greater during AL, and both were greater than during the high intervention (all P ≤ 0.01). USG and osmolality AL values were related to switch task measures (β: 0.21 to -0.31, P < 0.05). Benefits of the high intervention were observed during the switch task, whereby participants exhibited 34% lower working memory cost relative to the low intervention. No significant changes in cognition were observed for the flanker and go/no-go tasks.
Conclusions:
The water intervention improved urinary markers of hydration and had selective benefits during task switching. Furthermore, children's cognitive flexibility selectively benefits from greater habitual hydration and water intake. This study is registered at clinicaltrials.gov as NCT02816450.
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