Estimates of fluid intake, urine output and hydration-levels in women from Somaliland: a cross-sectional study

J Nutr Sci. 2021 Aug 20:10:e66. doi: 10.1017/jns.2021.54. eCollection 2021.

Abstract

The study objective was to measure fluid intake and associations with background characteristics and hydration biomarkers in healthy, free-living, non-pregnant women aged 15-69 years from Hargeisa city. We also wanted to estimate the proportion of euhydrated participants and corresponding biomarker cut-off values. Data from 136 women, collected through diaries and questionnaires, 24h urine samples and anthropometric measurements, were obtained with a cross-sectional, purposeful sampling from fifty-two school and health clusters, representing approximately 2250 women. The mean (95 % CI) 24 h total fluid intake (TFI) for all women was 2⋅04 (1⋅88, 2⋅20) litres. In multivariate regression with weight, age, parity and a chronic health problem, only weight remained a predictor (P 0.034, B 0.0156 (l/kg)). Pure water, Somali tea and juice from powder and syrup represented 49⋅3, 24⋅6 and 11⋅7 % of TFI throughout the year, respectively. Mean (95 % CI) 24 h urine volume (Uvol) was 1⋅28 (1⋅17, 1⋅39) litres. TFI correlated strongly with 24 h urine units (r 0.67) and Uvol (r 0.59). Approximately 40 % of the women showed inadequate hydration, using a threshold of urine specific gravity (Usg) of 1⋅013 and urine colour (Ucol) of 4. Five percent had Usg > 1⋅020 and concomitant Ucol > 6, indicating dehydration. TFI lower cut-offs for euhydrated, non-breast-feeding women were 1⋅77 litres and for breast-feeding, 2⋅13 litres. Euhydration cut-off for Uvol was 0⋅95 litre, equalling 9⋅2 urine units. With the knowledge of adverse health effects of habitual hypohydration, Somaliland women should be encouraged to a higher fluid intake.

Keywords: 24-h urine volume; BFQ, beverage frequency questionnaire; Beverages; Dehydration; MCH, mother–child health clinics; PWI, plain water intake; Somaliland; TFI, total fluid intake; TWI, total water intake; Total fluid intake; Ucol, urine colour; Uosm, urine osmolality; Urine colour; Usg, urine specific gravity; Uvol, urine volume; Women.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Biomarkers / urine
  • Cross-Sectional Studies
  • Dehydration* / epidemiology
  • Drinking*
  • Female
  • Humans
  • Middle Aged
  • Osmolar Concentration
  • Somalia / epidemiology
  • Water-Electrolyte Balance
  • Young Adult

Substances

  • Biomarkers