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Determining the Correlation Between Three and Seven Day Records of Fluids Consumption to Determine an Appropriate Method for Estimating the Amount and Type of Fluids Intake in Adults

1 Department of Nutritional Science, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
2 Department of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
3 Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
*Corresponding author: Mojdeh Fathi, Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran. Tel: +98-9106031053, E-mail:
Jundishapur Journal of Health Sciences. 9(1): e38233 , DOI: 10.17795/jjhs-38233
Article Type: Research Article; Received: Apr 8, 2016; Revised: May 26, 2016; Accepted: May 28, 2016; epub: Sep 26, 2016; collection: Jan 2017


Background: Different methods are used for adequate fluid intake assessment, while there is no standard method for adequate fluid intake assessment.

Objectives: The current pilot study aimed to evaluate the amount, type and frequency of fluids consumption to determine the correlation between three- and seven-day records.

Methods: This pilot cross-sectional study was done on 30 adult subjects in Ahvaz, Iran during year 2014. Demographic data were collected via a questionnaire and fluids consumption was assessed with a seven days records questionnaire. For data analyses the SPSS 16 software was used.

Results: Results of this cross-sectional study showed that the average total daily fluids consumption was 1.6 liter. Total fluids consumption for each subject on average in three and seven days was 4.5 and 11 liter, respectively. Water was the major fluid, which the participants consumed and tea was the second item. Total amount and frequency of fluids intake were not significantly different between three and seven-day records (P = 0.287), (P = 0.546).

Conclusions: This study showed that there was no significant difference between the record of seven and three days of fluids consumption in the participants and it is suggested that three-day records is useful in order to determine fluids intake.

Keywords: Fluids; Food Records; Water; Tea; Milk

1. Background

Water is the main component of our body that makes up to 60% of our body weight (1). Sources of origin of water include fluids such as water and beverages and also foods. Only a little amount of our body water is supplied from intracellular metabolic processes. Recommendation of fluid intake is different between countries, the US institute of medicine (IOM) recommended 3.7 and 2.7 liters of water intake for males and females, respectively (2). However, the European food safety authority (EFSA) recommended minimum water intake of 1 liter/1000 kcal (3). No recommendation for fluids intake has been announced for Iran. evaluation and correction of the pattern of fluid intake is important. In the recent decades in many countries fluids intake pattern has changed widely in children and adolescents (4-6); milk intake has decreased and intake of carbonated beverages, sweetened drinks and fruity drinks has increased (6, 7). Many studies showed a relationship between sweetened beverages and overweightness, obesity, metabolic and type 2 diabetes (8-10). Based on reports about fluids consumption, tea is the most popular fluid in the world after water (11). However, tea and coffee consumption is associated with more calorie intake (12).

Many studies have evaluated fluids consumption in different populations. The instrument for collecting data includes different questionnaires such as food frequency (FFQ), 24-hour recall or both FFQ and food recall, food record and biological markers (13-16). Mechanism assessment of fluids consumption is different in these studies. Also the questionnaires that were used in previous studies do not consider all types of fluids commonly consumed in populations. Because of variable types of fluids intake including industrial fluids and also different packaged fluids, as well as different volumes of fluids in communities, the actual daily intake of fluid consumption with simple FFQ or 24-hour recall has not been estimated. Crawford et al. showed that three-day food records is the best choice compared to 24-hour recall and 5-day food frequency (17).

On the other hand, long time food record for participants in some studies increased accuracy and another studies cause elaborating and so increasing risk of error (18, 19). Under reporting and over reporting of food intake in short time assessment studies has been documented (20, 21).

2. Objectives

A standard and comprehensive method for evaluating fluids consumption has not yet been designated. Therefore the present pilot study evaluated amounts, types and frequency of fluids consumption to determine correlation between three- and seven-day records. The results of this study can be used for larger studies.

3. Methods

This was a cross-sectional pilot study. Thirty adult (30 years old and above) volunteers from Ahvaz city participated in this study. The data collection consisted of a demographic questionnaire and one weekly fluids consumption record questionnaire from the study of Abdollahi et al. (2011) (22). The demographic questionnaire included questions such as age, gender, education and job, while the records questionnaire included amounts, types and frequency of fluids consumption. For easy recording, the questionnaire was designed as a booklet and we asked our subjects to keep this booklet with themselves everywhere such as restaurant and coffee shop for one week. In order to reduce the risk of error, photos of types of fluids, including water, tea, sweetened beverage (sweetened and flavored commercial beverage), milk, dough, carbonated beverage, natural fluids juice, syrups (home-made sweet drinks), green tea, nonalcoholic beer and fluid containers that are commonly consumed in Iran, was annexed in the booklet. The participants were contacted during one week. Sample selection was random by visiting the homes of the population under study and obtaining their agreement regarding participation in the study. Inclusion criteria included minimum literacy to complete the questionnaire and exclusion criteria were fasting and following a special diet. At baseline there were thirty-five volunteer participants yet at the end of the study, data from thirty were included in the analysis as five were excluded, due to failure to complete data including types and amounts of fluids consumption, completion of questionnaire in less than six days and report of total fluids consumption of less than 400 mL in three days (22). The aim of this pilot study was evaluation of the correlation between three- and seven-day records of fluids consumption. Types and amounts of fluids consumption were compared in three (including two days in the weekend) and seven days. Data was analyzed using the SPSS software. Data is presented in mean± standard deviation (SD). To study the correlation between three- and seven-day records we used the paired sample T test. P values of < 0.05 were considered significant.

4. Results

Table 1 shows distribution of subjects according to age, gender, education and employment status. Half of the participates were in the third grade of middle school to third year of high school and 23.3% had associate degrees. Seventy percent of the participants was unemployed and housekeepers and 10% were retired and the remainder was employed. Average total frequency of fluids consumption for seven and three days was 7.02 ± 2.10 and 6.80 ± 2.42, respectively and average total amount of fluids consumption for seven and three days was 1596.30 ± 567.72 and 1533.45 ± 700.58 mL, respectively. Percentage of water consumption (from total fluids) was more for seven days than three days. There was no significant difference between three and seven days regarding the frequency and also amount of fluids consumption (P = 0.287 and P = 0.546). There was no significant difference between total amount of tea, carbonate beverage, dough, natural fruit juice, syrup and beer consumption between three- and seven-day records and thus these fluids consumption was equal between three and seven days. The greatest amount of fluid consumption was water followed by tea. Mean frequency and amount of all fluids consumption is shown in Table 2.

Table 1.
Demographic Characteristics of Subjects

Table 2.
Average Amount and Frequency of Different Fluids Consumption in Subjectsa,b

5. Discussion

Many studies surveyed fluids consumption in different countries. In most of the studies, collecting data was based on FFQ, 24-hour recall and seven days records. However collecting data in these studies almost not especially for fluids consumption and questioners also included food intake. In other hand, in these studies fluids intake were not evaluated in outside mealtime and only evaluated in mealtime (13-16, 23). Drewnowski et al. evaluated fluids consumption in adults using two non-consecutive 24-hour recalls, first by mobile examination center and second by telephone. Because of different scales for obtaining the data and self-reporting error, the risk of error was probably high (24).

In the current study to evaluate fluids consumption we used a comprehensive questionnaire. To increase accuracy and decrease risk of error, we designed a booklet including images of types and amounts of all fluids consumption in Iran. Assessment of fluids consumption in previous studies was based on interviews (25). Thus, the data probably involved under and overestimations. The comprehensive questionnaire in this study included questions on where and when fluids were consumed during the day for a week and fluids intake was recorded during seven days and the participants were contacted by phone for reminders. Therefore, the current study showed all daily fluids consumption of participants during one week. Some studies used biological markers to survey adequate fluids consumption. Biological markers included urine and serum or plasma osmolality (26-28). Although these biological assessments for the evaluation of adequate fluid intake were useful yet were not complete because they do not show type and amount of each fluid. Beside evaluation of the amount of fluids intake, type of fluids consumption is also important. The world health organization (WHO) expressed that sweetened beverages consumption is a possible cause for epidemic of obesity (29). While water consumption is related to healthy diet pattern and low calorie intake (30). In some cases increased water intake was associated with weight loss and maintenance of the lost weight (31, 32). Therefore, drinking water instead of sweetened beverages consumption could be a strategic way for lower calorie intake and weight loss. Some studies suggested that non-sweetened beverages consumption, especially water, prevents kidney stone recurrent. On the other hand, carbonated and caffeinated beverages due to replacement with milk and increasing urinary calcium extraction can lead to bone fractures (33, 34). According to the increasing risk of osteoporosis in middle and older adults, this issue is important (35). Therefore, biological marker as a complement instrument with a comprehensive questionnaire to studied fluids consumption can be appreciable.

The present study indicated that mean of the amount of fluids consumption was 11 and 4.5 liters in seven and three days, respectively. The WHO recommended daily amount of fluids intake of 2.2 liters for females and 2.9 liters for males (36). In this study, the mean daily fluids intake was 1.6 liters. This study indicated that mean daily fluids intake in Ahvaz citizen was less than the WHO recommendations. Despite the importance of drinking water and fluids on human health, there is still no consensus about the amount of daily water intake. The mean daily fluids intake for one study from Tehran city was reported as 1.9 liters, while for England and China this was 2.33 and 1.76 liters, respectively (11, 18, 22). The current study indicated that the percentage of the amount of water intake from total fluids consumption in one day was 7.4% according to the three-day report, and 15.6% in one week. The American panel of beverages consumption guide (2006), according to energy and nutrients content, recommended the ranking of a variety of fluids for above six-year olds, in the following order, drinking water then tea and coffee, skim and low fat milk, soy milk, non-caloric sweetened beverages, fruit and vegetable juice and whole milk (37). In the present study, the pattern of fluid consumption was somewhat similar to this recommendation (water, tea, natural fruit juice, milk, green tea, soda, dough, carbonated beverages, non-alcoholic beer and sweetened beverages).

The purpose of the current pilot study was to evaluate the correlation between three- and seven-day records of fluids consumption. This study showed there was no significant difference between these records. This study showed that for evaluation of fluids consumption, we can use a three-day record as well.


This study was financially supported by a grant from Ahvaz Jundishapur University of Medical Sciences (AJUMS). The authors express their thanks to all participants of this study.


Funding/Support: This study was financially supported by a grant from Ahvaz Jundishapur University of Medical Sciences (AJUMS).


  • 1. Hall JE. Guyton and Hall textbook of medical physiology. Amsterdam, Netherlands: Elsevier Health Sciences; 2010.
  • 2. NAP.. Electrolytes IoMPoDRIf, Water. DRI, dietary reference intakes for water, potassium, sodium, chloride, and sulfate. U. S.: National Academy Press; 2005.
  • 3. Panel E, Nda A. Scientific Opinion on Dietary Reference Values for water. EFSA J. 2010;8:2-3.
  • 4. Bowman SA. Beverage choices of young females: changes and impact on nutrient intakes. J Am Diet Assoc. 2002;102(9):1234-9. [PubMed]
  • 5. Nielsen SJ, Siega-Riz AM, Popkin BM. Trends in food locations and sources among adolescents and young adults. Prev Med. 2002;35(2):107-13. [PubMed]
  • 6. Rampersaud GC, Bailey LB, Kauwell GP. National survey beverage consumption data for children and adolescents indicate the need to encourage a shift toward more nutritive beverages. J Am Diet Assoc. 2003;103(1):97-100. [DOI] [PubMed]
  • 7. Ballew C, Kuester S, Gillespie C. Beverage choices affect adequacy of children's nutrient intakes. Arch Pediatr Adolesc Med. 2000;154(11):1148-52. [PubMed]
  • 8. Mattes RD, Popkin BM. Nonnutritive sweetener consumption in humans: effects on appetite and food intake and their putative mechanisms. Am J Clin Nutr. 2009;89(1):1-14. [DOI] [PubMed]
  • 9. Hu FB, Malik VS. Sugar-sweetened beverages and risk of obesity and type 2 diabetes: epidemiologic evidence. Physiol Behav. 2010;100(1):47-54. [DOI] [PubMed]
  • 10. Malik VS, Hu FB. Sweeteners and Risk of Obesity and Type 2 Diabetes: The Role of Sugar-Sweetened Beverages. Curr Diab Rep. 2012. [DOI] [PubMed]
  • 11. Gibson S, Shirreffs SM. Beverage consumption habits "24/7" among British adults: association with total water intake and energy intake. Nutr J. 2013;12:9. [DOI] [PubMed]
  • 12. Ng SW, Ni Mhurchu C, Jebb SA, Popkin BM. Patterns and trends of beverage consumption among children and adults in Great Britain, 1986-2009. Br J Nutr. 2012;108(3):536-51. [DOI] [PubMed]
  • 13. Le Bellego L, Jean C, Jiménez L, Magnani C, Tang W, Boutrolle I. Understanding Fluid Consumption Patterns to Improve Healthy Hydration. Nutrition Today. 2010;45(Supplement):22-6. [DOI]
  • 14. Han E, Powell LM. Consumption patterns of sugar-sweetened beverages in the United States. J Acad Nutr Diet. 2013;113(1):43-53. [DOI] [PubMed]
  • 15. Vergne S. Methodological Aspects of Fluid Intake Records and Surveys. Nutrition Today. 2012;47:S7-S10. [DOI]
  • 16. Sawaya AL, Tucker K, Tsay R, Willett W, Saltzman E, Dallal GE, et al. Evaluation of four methods for determining energy intake in young and older women: comparison with doubly labeled water measurements of total energy expenditure. Am J Clin Nutr. 1996;63(4):491-9. [PubMed]
  • 17. Crawford PB, Obarzanek E, Morrison J, Sabry ZI. Comparative advantage of 3-day food records over 24-hour recall and 5-day food frequency validated by observation of 9- and 10-year-old girls. J America Dietetic Ass. 1994;94(6):626-30. [DOI]
  • 18. Rothausen BW, Matthiessen J, Groth MV, Brockhoff PB, Andersen LF, Trolle E. Comparison of estimated energy intake from 2×24-hour recalls and a seven-day food record with objective measurements of energy expenditure in children. Food Nutrition Res. 2012;56 [DOI]
  • 19. Jain M, Howe GR, Johnson KC, Miller AB. Evaluation of a diet history questionnaire for epidemiologic studies. Am J Epidemiol. 1980;111(2):212-9. [PubMed]
  • 20. Pfrimer K, Vilela M, Resende CM, Scagliusi FB, Marchini JS, Lima NK, et al. Under-reporting of food intake and body fatness in independent older people: a doubly labelled water study. Age Ageing. 2015;44(1):103-8. [DOI] [PubMed]
  • 21. Poslusna K, Ruprich J, de Vries JH, Jakubikova M, van't Veer P. Misreporting of energy and micronutrient intake estimated by food records and 24 hour recalls, control and adjustment methods in practice. Br J Nutr. 2009;101 Suppl 2:S73-85. [DOI] [PubMed]
  • 22. Abdollahi M, Naseri E, Bondarianzadeh D, Mohammadpour B, Houshiar-rad A. Types and amounts of fluids consumed by the adult population of Tehran, 2011. Iran J Nutrition Sci Food Techno. 2013;8(1):71-80.
  • 23. Nissensohn M, Ruano C, Serra-Majem L. Validation of beverage intake methods vs. hydration biomarkers; a short review. Nutr Hosp. 2013;28(6):1815-9. [DOI] [PubMed]
  • 24. Drewnowski A, Rehm CD, Constant F. Water and beverage consumption among adults in the United States: cross-sectional study using data from NHANES 2005-2010. BMC Public Health. 2013;13:1068. [DOI] [PubMed]
  • 25. Nielsen SJ, Popkin BM. Changes in beverage intake between 1977 and 2001. Am J Prev Med. 2004;27(3):205-10. [DOI] [PubMed]
  • 26. Agostoni CV, Bresson JL, Fairweather-Tait S. Scientific opinion on dietary reference values for water. EFSA J. 2010;8(3)
  • 27. Armstrong LE. Assessing hydration status: the elusive gold standard. J America College Nutrition. 2007;26(sup5):575S-84S.
  • 28. Perrier E, Vergne S, Klein A, Poupin M, Rondeau P, Le Bellego L, et al. Hydration biomarkers in free-living adults with different levels of habitual fluid consumption. Br J Nutr. 2013;109(9):1678-87. [DOI] [PubMed]
  • 29. Who J, Consultation FAO. Diet, nutrition and the prevention of chronic diseases. World Health Organ Tech Rep Ser. 2003;916(i-viii)
  • 30. Popkin BM, Barclay DV, Nielsen SJ. Water and food consumption patterns of U.S. adults from 1999 to 2001. Obes Res. 2005;13(12):2146-52. [DOI] [PubMed]
  • 31. Dennis EA, Dengo AL, Comber DL, Flack KD, Savla J, Davy KP, et al. Water consumption increases weight loss during a hypocaloric diet intervention in middle-aged and older adults. Obesity (Silver Spring). 2010;18(2):300-7. [DOI] [PubMed]
  • 32. Akers JD, Cornett RA, Savla JS, Davy KP, Davy BM. Daily self-monitoring of body weight, step count, fruit/vegetable intake, and water consumption: a feasible and effective long-term weight loss maintenance approach. J Acad Nutr Diet. 2012;112(5):685-692 e2. [DOI] [PubMed]
  • 33. Heaney RP, Rafferty K. Carbonated beverages and urinary calcium excretion. Am J Clin Nutr. 2001;74(3):343-7. [PubMed]
  • 34. Wyshak G. Teenaged girls, carbonated beverage consumption, and bone fractures. Arch Pediatr Adolesc Med. 2000;154(6):610-3. [PubMed]
  • 35. Borghi L, Meschi T, Schianchi T, Briganti A, Guerra A, Allegri F, et al. Urine volume: stone risk factor and preventive measure. Nephron. 1999;81 Suppl 1:31-7. [PubMed]
  • 36. Howard G, Bartram J. Domestic water quantity, service level, and health. Geneva: World Health Organization; 2003.
  • 37. Popkin BM, Armstrong LE, Bray GM, Caballero B, Frei B, Willett WC. A new proposed guidance system for beverage consumption in the United States. Am J Clin Nutr. 2006;83(3):529-42. [PubMed]

Table 1.

Demographic Characteristics of Subjects

Gender, No. (%)
Males 7 (23.3)
Females 23 (76.7)
Age, mean ± SD 42.7 ± 1.17
Educational Status, No. (%)
Primary 3 (10)
Third grade middle school to third year of high school 15 (50)
Associate degree 7 (23.3)
Bachelor of science and higher 5 (16.7)
Job Status, No. (%)
Employed 6 (20)
Unemployed 21 (70)
Retired 3 (10)

Table 2.

Average Amount and Frequency of Different Fluids Consumption in Subjectsa,b

Fluids Type Average Frequency of Fluid Consumption in Seven-Day Records, Mean ± SD Average Frequency of Fluid Consumption in Three-Day Records, Mean ± SD Correlation of the Frequency of Fluid Consumption Between Seven- and Three-Day Records, P value Average Amount of Fluid Consumption in Seven-Day Records, mL, Mean ± SD Average Amount of Fluid Consumption in Three-Day Records, mL, Mean ± SD Correlation of the Amount of Fluid Consumption Between Seven and Three Days Records, P value
Water 3.6 ± 2.14 3.21 ± 1.80 0.000 931.77 ± 604.50 773.11 ± 441.38 0.026
Tea 2.51 ± 1.44 2.25 ± .97 0.034 773.11 ± 441.38 399.65 ± 232.37 0.653
Sweetened Beverage 0.48 ± 0.41 0.69 ± 0.52 0.004 106.87 ± 97.88 174.09 ± 145.05 0.001
Milk 0.60 ± 0.39 0.74 ± 0.38 0.081 136.96 ± 83.30 185.64 ± 39.100 0.006
Dough 0.38 ± 0.16 0.50 ± 0.23 0.131 102.76 ± 45.04 126 ± 45.10 0.898
Carbonated Beverages 0.28 ± 0.07 0.44 ± 0.17 0.541 102.76 ± 45.04 93.88 ± 41.76 0.462
Natural Fluid Juice 0.71 ± 0.46 0.77 ± 0.50 0.000 167.14 ± 89.33 187.77 ± 120.75 0.073
Syrup 0.25 ± 0.16 0.40 ± 0.14 1.000 55.45 ± 22.37 93.83 ± 28.34 0.874
Green Tea 0.57 ± 0.40 0.66 ± 0.47 0.000 36.25 ± 16.77 86.11 ± 47.79 0.00
Nonalcoholic beer 0.40 ± 0.23 0.60 ± 0.27 0.196 98.57 ± 79.02 143 ± 94.57 0.112
Total 7.02 ± 2.10 6.80 ± 2.42 0.287 1596.30 ± 567.72 1533.45 ± 700.58 0.546
a Values are expressed as mean ± Standard Deviation (SD).
b P value of paired sample T test was used for statistical analysis. P< 0.05 was considered significant