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HIGHER WATER INTAKE AND BETTER HYDRATION STATE IS ASSOCIATED WITH LOWER RISK OF INSULIN RESISTANCE IN HEALTHY ADULTS: NHANES 2009-2012

Abstract

Hyun-Gyu Suh1, Marie-Rachelle Narcisse1, Evan C. Johnson2, Lisa T. Jansen1, & Stavros A. Kavouras1, FACSM 1University of Arkansas, Fayetteville, Arkansas; 2University of Wyoming, Laramie, Wyoming

Preliminary data suggest that low water intake is associated with the risk of developing diabetes, while most of U.S. adults do not meet the requirements for daily water intake. PURPOSE: To study the effect of high water intake on glucose regulation in healthy adults. METHODS: 2,233 participants from 2009-10 & 2011-12 National Health and Nutrition Examination Survey were selected to examine the association between water intake and hydration state with insulin resistance in healthy individuals (females: 48.3%, age: 44±1 y, BMI: 27.5±0.2 kg∙m-2) in the US. RESULTS: Insulin resistance was assessed by homeostasis model assessment of insulin resistance (HOMA-IR) and data were divided into tertiles (≤1.77, 1.78-3.45, and >3.45). Hydration status was assessed by urine osmolality (621±7 mmol∙kg-1) and urine flow rate (0.96±0.03 ml∙min-1). Plain water (1,203±35 mL) and total water intake (TWI; 3,190±43 mL) was assessed from a 24 h dietary recall. Urine osmolality was highest in the upper HOMA tertile (679±9 mmol∙kg-1) compared to lowest tertile (583±1 mmol∙kg-1, P<0.001), while urine flow rate was highest in the lowest HOMA-IR tertile (1.03±0.04 ml∙min-1) compared to upper tertile (0.92±0.03 ml∙min-1, P=0.001). Multinomial logistic regression showed healthy adults who consumed more plain water (≥859 mL) were half as likely to be in the upper HOMA-IR tertile, compared with their peers who consumed less (≤207 mL, OR=0.50; 0.34-0.73), after adjusting for age, gender, BMI, waist circumference, race/ethnicity, education, and physical activity. Similarly, adults with higher levels of daily TWI (≥2,657 mL) had significantly lesser odds (42%) of being in the upper HOMA tertile, compared to adults with a lower level of TFI (1,598 mL, OR=0.58; 0.38-0.90). CONCLUSION: Higher plain water (≥859 mL) and total water intake (≥2,657 mL), as well as better hydration state were associated with lower insulin resistance.

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