Strengthening Policy Coherence to Link Healthy Hydration with Water Security in the United States

Water security ensures the availability, accessibility, and acceptability of safe water for drinking, hygiene, and other purposes for individuals and communities to meet daily and future needs. An estimated 2.2 million Americans experience water insecurity linked to poor diet quality and adverse health outcomes. This perspective article summarizes the scientific evidence about water security and healthy hydration to understand the opportunities and challenges for government agencies to strengthen the links and policy coherence across both areas for the population. We focus on the United States context because of the complex policy landscape of government agencies with different regulatory oversight for promoting healthy hydration and water security, and a weakly regulated yet growing multibillion-dollar bottled water, functional beverage, and hydration supplement industry marketed to Americans. First, we describe healthy hydration recommendations and United States fluid intake trends across the lifespan. Second, we examine the evolving industry that produces and markets hydration products, including bottled water, soft drinks, nonalcoholic functional beverages, and dietary supplements. Third, we discuss the United States government agencies that have regulatory oversight to protect and educate the public to ensure the safety of bottled water and publicly supplied drinking water and enforce policies requiring that businesses use truthful advertising and marketing claims for functional beverages and supplements. We offer recommendations for United States government agencies and other stakeholders to strengthen policy coherence and improve coordination of guidelines and legislation to ensure affordable, healthy hydration and water security for all Americans.