Over half of the adult population in Europe, Asia and Latin America fail to meet adequate water intake guidelines as advised by the European Food Safety Authority (EFSA; 2.5 and 2 litres/day for men and women, respectively coming from both food and drinks). Increasing epidemiological evidence suggests that chronic low fluid intake may be associated with an increased risk of cardiovascular, metabolic, and renal diseases. The association between chronic low fluid intake and increased morbidity risk may be underpinned by elevations in key water-regulating hormones, such as arginine vasopressin (AVP) and its surrogate copeptin, which influence glucose regulation and renal function. For example, AVP stimulates the hypothalamic-pituitary adrenal (HPA) axis to release the stress hormone cortisol with potentially far-reaching effects on metabolism, immunity and inflammation. Prospective cohort studies have demonstrated that exaggerated cortisol responses to acute stress are associated with poor health outcomes. A recent cross-sectional study (NCT05491122) from our group found that individuals with a low habitual fluid intake experienced greater cortisol reactivity to acute stress than those with a high habitual intake. The findings of this study may provide a potential explanation for why poor hydration and low fluid intake have negative effects on long-term health. We now aim to explore whether altering fluid intake influences cortisol reactivity to acute stress.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
BASIC_SCIENCE
Masking
NONE
Enrollment
192
7-day intervention where the intake of drinking water will either be maintained at habitual level, increased (if habitually low) or decreased (if habitually high). The TFI prescriptions during the intervention are derived from the mean TFI of habitually low and habitually high drinkers from a sex, age and country matched population. Specifically, habitually low drinkers will be permitted a TFI of 3.5 L/day for men and 3.3 L/day for women and habitually high drinkers will be permitted a TFI of 1.3 L/day. Participants will be instructed to maintain their usual intake of other beverages i.e., tea/coffee to achieve their target TFI.
Liverpool John Moores University
Liverpool, United Kingdom
RECRUITINGSalivary cortisol reactivity to acute psychosocial stress
Changes in the concentration of salivary free cortisol throughout the psychosocial stress test. Cortisol will be measured in stimulated saliva samples and analysed by ELISA. Delta changes (increase/decrease) in cortisol response will also be calculated.
Time frame: Assessed during the main trial (day 8 of the intervention period). Saliva samples will be taken pre (-30 and -5 minutes) and post (+0, +10, +20, +30, +45 and +60 minutes) stress test.
Plasma copeptin
Plasma copeptin will be analysed by ELISA and compared cross-sectionally between intervention conditions.
Time frame: Copeptin will be assessed using a single blood sample taken on the morning of the main trial (day 8 of intervention period).
Urine osmolality (UOsm)
The concentration of osmotic solutes present in the urine, measured using a freezing point depression osmometer.
Time frame: Late-afternoon urine samples will be collected on days 6 and 7 of the verification and intervention periods. Spot urine samples will be collected on the morning and afternoon visits of the main trial (day 8 of the intervention period).
Urine colour
Urine colour, a common marker used for assessing hydration status, will be assessed using a urine colour chart that has been developed to assess urine concentration in healthy humans.
Time frame: Late-afternoon urine samples will be collected on days 6 and 7 of the verification and intervention periods. Spot urine samples will be collected on the morning and afternoon visits of the main trial (day 8 of the intervention period).
Plasma osmolality
A marker of intracellular osmolality, measured using a freezing point depression osmometer. Plasma will be derived from venous blood.
Time frame: A venous blood sample will be taken on the morning of the main trial (day 8 of the intervention period).
Sleep duration
Total sleep time (minutes) will be measured using accelerometery-based movement data recorded using a wrist-worn actigraph.
Time frame: Verification period: an actigraph will be worn continuously from day 5 until the end of the verification period. Intervention period: an actigraph will be worn continuously from day 5 until the stress test on day 8.
Sleep efficiency
Sleep efficiency will be calculated using the following equation: (total sleep time/total time in bed) \* 100.
Time frame: Verification period: an actigraph will be worn continuously from day 5 until the end of the verification period. Intervention period: an actigraph will be worn continuously from day 5 until the stress test on day 8.
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