Total water intake guidelines are sufficient for optimal hydration in United States adults

Purpose Recent studies suggest that 24-h urine osmolality (UOsm) for optimal water intake should be maintained < 500 mmol center dot kg(-1). The purpose of this study was to determine the total water intake (TWI) requirement for healthy adults to maintain optimal hydration as indicated by 24-h urine osmolality < 500 mmol center dot kg(-1). Methods Twenty-four-hour UOsm was assessed in 49 men and 50 women residing in the United States (age: 41 +/- 14 y, body mass index: 26.3 +/- 5.2 kg center dot m(-2)). TWI was assessed from 7-day water turnover, using a dilution of deuterium oxide, corrected for metabolic water production. The diagnostic accuracy of TWI to identify UOsm < 500 mmol center dot kg(-1) was evaluated using receiver operating characteristic (ROC) analysis in men and women separately. Results Twenty-four-hour UOsm was 482 +/- 229 and 346 +/- 182 mmol center dot kg(-1) and TWI was 3.57 +/- 1.10 L center dot d(-1) and 3.20 +/- 1.27 L center dot d(-1) in men and women, respectively. ROC analysis for TWI detecting 24-h UOsm < 500 mmol center dot kg(-1) in men yielded an area under the curve (AUC) of 77.4% with sensitivity, specificity, and threshold values of 83.3%, 64.5%, and 3.39 L center dot d(-1), respectively. The AUC was 82.4% in women with sensitivity, specificity, and threshold values of 85.7%, 72.1%, and 2.61 L center dot d(-1). Conclusion Considering threshold values in men and women of 3.4 L center dot d(-1) and 2.6 L center dot d(-1), respectively, maintaining TWI in line with National Academy of Medicine guidelines of 3.7 L center dot d(-1) in men and 2.7 L center dot d(-1) in women should be sufficient for most individuals in the United States to maintain 24-h UOsm < 500 mmol center dot kg(-1).

Automated summary

The purpose of this study was to determine the total water intake requirement for healthy adults to maintain optimal hydration, and it suggests that following the National Academy of Medicine guidelines should be sufficient for most individuals in the United States to maintain 24-h urine osmolality < 500 mmol center dot kg(-1).