Research Article
Qualitative and/or Quantitative Drinking Water Recommendations for Pediatric Obesity Treatment
| Jodi D Stookey1*, Rigoberto Del Toro1, Janice Hamer1, Alma Medina1, Annie Higa2, Vivian Ng2, Lydia Tinajero-Deck3 and Lourdes Juarez3 | |
| 1Children’s Hospital Oakland Research Institute, Oakland, CA, USA | |
| 2Pediatric Clinical Research Center, Oakland, CA, USA | |
| 3Healthy Hearts Program for Weight Management, Children’s Hospital & Research Center, Oakland, CA, USA | |
| Corresponding Author : | Jodi Dunmeyer Stookey Children’s Hospital Oakland Research Institute 5700 Martin Luther King Jr. Way, Oakland, California 94609, USA Tel: (415) 312-0237 Fax: (415) 753-9805 E-mail: jstookey@chori.org |
| Received August 04, 2014; Accepted October 04, 2014; Published October 11, 2014 | |
| Citation: Stookey JD, Del Toro R, Hamer J, Medina A, Higa A, et al. (2014) Qualitative and/or Quantitative Drinking Water Recommendations for Pediatric Obesity Treatment. J Obes Weight Loss Ther 4:232. doi:10.4172/2165-7904.1000232 | |
| Copyright: © 2014 Stookey JD, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. | |
Abstract
Objective: The qualitative recommendation to ‘drink water instead of caloric beverages’ may facilitate pediatric obesity treatment by lowering total energy intake. The quantitative recommendation to ‘drink enough water to dilute urine’ might further facilitate weight loss by increasing fat oxidation via cell hydration-mediated changes in insulin. Methods: This 8 week randomized intervention tested whether both Qualitative-plus-Quantitative (QQ) drinking water recommendations result in more weight loss than the Qualitative recommendation alone (Q) in 25 children (9-12 y) with body mass index at or above the 85th percentile, given a reduced glycemic diet and usual physical activity. Random urine osmolality, saliva insulin, and body weight were assessed weekly. Mixed models explored if insulin mediated an effect of urine osmolality on weight loss. Results: In intention-to-treat analyses, QQ and Q participants did not differ significantly with respect to level of urine osmolality, saliva insulin, or weight loss. Only 4 out of 16 QQ participants complied with instruction to drink enough water to dilute urine, however. In completers analyses, the compliant QQ participants, who diluted urine osmolality from 910 ± 161 mmol/kg at baseline to below 500 mmol/kg over time (8 week mean ± SE: 450 ± 67 mmol/ kg), had significantly lower saliva insulin over time (8 week mean ± SE: 13 ± 8 pmol/l vs. 22 ± 4 pmol/l) and greater weight loss (mean ± SE: -3.3 ± 0.7kg vs. -2.0 ± 0.5 kg) than compliant Q participants (7 out of 9 participants) who maintained elevated urine osmolality over time (8- week mean ± SE: 888 ± 41 mmol/kg). Urine osmolality below 500 mmol/kg was significantly associated with weight loss. Change in saliva insulin partially explained the association. Conclusions: QQ recommendations may increase weight loss for those able to dilute urine. Work is warranted to pursue cell hydration effects of drinking water for pediatric obesity treatment.
