« Make healthy hydration the new norm »

Iglesia I. et al. 2021

Are Spanish children drinking enough and healthily? An update of the Liq.In7 cross-sectional survey in children and adolescents

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Insufficient and unhealthy total fluid intake (TFI), especially in early stages of life, may have negative health impact.


To assess current patterns of fluids consumption in children and adolescents in Spain; including drinking occasions and locations (e.g., at home and at school) and to compare TFI with the adequate intake (AI) of water from fluids recommended by the European Food Safety agency (EFSA).


A Spanish cross-sectional study assessing TFI from all sources of fluid consumption according to occasions of the day and location, using a validated liquid intake 7-day record (Liq.in7) was performed. Data collection occurred between April and May 2018. A sample of 146 (63% boys) children (4-9 years old) and adolescents (10-17 years old) was included. Parents reported such information in case children were under 16 years.


A high proportion of children and adolescents did not meet EFSA-derived reference values for fluid intake (73% and 72%, respectively). Forty percent of children and about 50% of adolescents consumed at least one serving of sugar-sweetened beverage (SSB) per day, while about 20% consumed only one or less serving of water per day. Consumption during main meals was the most important for both children and adolescents (representing 50% and 54% of TFI, respectively) and was mainly driven by water (62%). The consumption at home in children (70% of TFI), was made of water (47%). In the same way, at school, water was contributing to half of the intake. However, adolescents’ girls at school drink more SSB (41%) than water (34%), being the highest consumed fluid. At other locations, adolescents’ boys, also drink more SSB (51%) than either water (29%) or milk and derivatives (10%). 


Drinking habits of Spanish young populations are far away from current recommendations because a low fluid intake, specifically water, and a high proportion of SSB consumption in children and adolescents. Interventions assuring achieving EFSA TFI recommendations are of special importance for children and adolescents, with, according our results, a special focus in male adolescents.

A word from our expert, Clémentine Morin, France

"Childhood is an important period to adopt healthy drinking habits that will persist into adulthood and which will lead to long-term impact on cognitive and physical performances. Nevertheless, to encourage change, a deep understanding of fluid intake patterns including how fluid consumption may differ throughout the day is key. This study highlights the large number of children and adolescents in Spain who don’t drink adequate fluid amount and 50% of them drinking SSB in a daily basis. Moreover, low intake outside meals and at school, especially water, might be a window of opportunity to drive change in fluid intake patterns in children and adolescents."

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