The relationship of perceptions of tap water safety with intake of sugar-sweetened beverages and plain water among US adults

AbstractObjectiveResearch is limited on whether mistrust of tap water discourages plain water intake and leads to a greater intake of sugar-sweetened beverages (SSB). The objective of the present study was to examine demographic differences in perceptions of tap water safety and determine if these perceptions are associated with intake of SSB and plain water.DesignThe study examined perceptions of tap water safety and their cross-sectional association with intake of SSB and plain water. Racial/ethnic differences in the associations of tap water perceptions with SSB and plain water intake were also examined.SettingNationally weighted data from the 2010 HealthStyles Survey (n 4184).SubjectsUS adults aged ≥18 years.ResultsOverall, 13·0 % of participants disagreed that their local tap water was safe to drink and 26·4 % of participants agreed that bottled water was safer than tap water. Both mistrust of tap water safety and favouring bottled water differed by region, age, race/ethnicity, income and education. The associations of tap water mistrust with intake of SSB and plain water were modified by race/ethnicity (P < 0·05). Non-white racial/ethnic groups who disagreed that their local tap water was safe to drink were more likely to report low intake of plain water. The odds of consuming ≥1 SSB/d among Hispanics who mistrusted their local tap water was twice that of Hispanics who did not (OR = 2·0; 95 % CI 1·2, 3·3).ConclusionsPublic health efforts to promote healthy beverages should recognize the potential impact of tap water perceptions on water and SSB intake among minority populations.

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Perceptions of drinking water safety and their associations with plain water intake among US Hispanic adults

Journal of Water and Health ◽

10.2166/wh.2019.015 ◽

2019 ◽

Vol 17 (4) ◽

pp. 587-596 ◽

Cited By ~ 1

Author(s):

Sohyun Park ◽

Stephen Onufrak ◽

Anisha Patel ◽

Joseph R. Sharkey ◽

Heidi M. Blanck

Keyword(s):

Drinking Water ◽

Water Intake ◽

Multinomial Logistic Regression ◽

Tap Water ◽

Bottled Water ◽

Plain Water ◽

Water Safety ◽

Drinking Water Safety ◽

Hispanic Adults ◽

Water Perceptions

Abstract We described sociodemographic differences in perceptions of drinking water safety and examined associations between perceptions and plain water intake. We used the 2015 Estilos survey of 1,000 US Hispanic adults conducted in both Spanish and English. Outcome was water intake. Exposures were the level of agreement about water perceptions (My tap water is safe to drink; Community tap water is safe to drink; Bottled water is safer; I would buy less bottled water if my tap water was safe). Covariates were sociodemographics, region, Hispanic heritage, and acculturation. We used chi-square tests and multinomial logistic regression to examine associations of water perceptions and intake. Overall, 24% of Hispanic adults consumed water ≤1 time/day. Although 34% disagreed their home tap water was safe to drink, and 41% disagreed their community tap water was safe to drink, 65% agreed bottled water is safer than tap water, and 69% agreed they would buy less bottled water if they knew their tap water was safe. Perceptions differed by some covariates but were not significantly associated with plain water intake. In conclusion, negative perceptions of tap water were common among US Hispanic adults, which can inform efforts to increase awareness about safe public water systems.

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Who is Replacing Sugar-Sweetened Beverages with Plain Water? Analyses of NHANES 2011–16 Data

Current Developments in Nutrition ◽

10.1093/cdn/nzaa046_057 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 557-557

Author(s):

Colin Rehm ◽

Matthieu Maillot ◽

Florent Vieux ◽

Pamela Barrios ◽

Adam Drewnowski

Keyword(s):

Drinking Water ◽

Family Income ◽

Tap Water ◽

The United States ◽

Bottled Water ◽

Plain Water ◽

Lower Income ◽

Sugar Sweetened Beverages ◽

Sweetened Beverages ◽

Hispanic White

Abstract Objectives In the United States, replacing sugar-sweetened beverages (SSB) with plain drinking water is recommended via by numerous public health agencies and non-governmental organizations. While declines in SSB consumption in the US are well-documented, it is not clear if consumers are replacing SSBs with other beverages, namely plain drinking water. Methods Beverage consumption data for 7453 children (4–18y) and 15,263 adults (≥19y) came from two 24 h dietary recalls in three most recent cycles of the National Health and Nutrition Examination Survey (NHANES 2011–2016). Consumption trends for water intakes (in mL/d) from SSBs and from drinking water were analyzed by gender, age group, family income, and race/ethnicity. Results Mean water intakes from SSBs declined from 322 mL/d to 262 mL/d (p-trend = 0.002) on average, whereas plain drinking water increased from 1011 mL/d to 1144 mL/d (p-trend = 0.0108). Statistically significant reductions in SSBs were observed only among men (-18%), younger participants (-26% in 4–8, -22% in 9–13, -33% in 14–19 and -30% in 20–30), those with lower incomes (family income-to-poverty ratio < 2.0), non-Hispanic whites and non-Hispanic black participants (p-trend < 0.05 for each). Within these population sub-groups, only non-Hispanic white participants, those with a family income to poverty ratio of 1–1.99, but not < 1.0, and children aged < 14y had a corresponding increase in plain water consumption. When examining types of water, non-Hispanic white participants replaced SSBs with tap water as opposed to bottled water, and the lower income group replaced SSBs with bottled water, as opposed to tap water. Conclusions The expected replacement of SSBs with plain drinking water was not uniformly observed across socio-demographic group. Only non-Hispanic Whites and lower income groups replaced SSB with water, whereas teenagers (14–19y) and non-Hispanic black participants did not. Understanding how and if specific population sub-groups are replacing a declining food/beverage category with another category has important population health implications. Funding Sources Analyses of publicly available federal NHANES databases were sponsored by PepsiCo Inc. and conducted by MS-Nutrition. The views expressed in this abstract are those of the authors and do not necessarily reflect the position or policy of PepsiCo, Inc.

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Factors Related to Water Filter Use for Drinking Tap Water at Home and Its Association with Consuming Plain Water and Sugar-Sweetened Beverages Among US Adults

Current Developments in Nutrition ◽

10.1093/cdn/nzaa061_100 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 1472-1472

Author(s):

Sohyun Park ◽

Stephen Onufrak ◽

Angie Cradock ◽

Christina Hecht ◽

Anisha Patel ◽

...

Keyword(s):

Weight Status ◽

Tap Water ◽

Bottled Water ◽

Plain Water ◽

Limited Information ◽

Sugar Sweetened Beverages ◽

Lower Odds ◽

Water Filter ◽

Sweetened Beverages ◽

At Home

Abstract Objectives Drinking plain water, especially as a substitute for sugar-sweetened beverages (SSB), may improve diet and prevent chronic disease. There is limited information on how water filter use impacts intake of beverages. We explored factors associated with water filter use for drinking tap water at home and examined its association with consuming plain water and SSB. Methods We used the 2018 SummerStyles data for 4042 US adults (≥18 y). For a first model, outcome was water filter use (yes vs. no or do not drink tap water at home). For a second model, outcomes were intake of plain water (tap and bottled water) and SSB (regular soda, fruit drinks, sports/energy drinks, sweetened coffee/tea drinks), and exposure was water filter use. Covariates included sociodemographics, weight status, Census regions, and ownership status of living quarters. Four multivariable logistic regressions were used to estimate adjusted odds ratios (AOR) for consuming tap water, bottled water, or total plain water >3 cups/d (vs. ≤3 cups) and SSB ≥ 1 time/d (vs. <1 time) by water filter use. Results Overall, 36% of adults reported using a filter for drinking tap water at home and 14% did not drink tap water at home. Factors significantly associated with lower odds of using a water filter were being non-Hispanic (NH) black (AOR = 0.72, vs. NH white), lower education (AOR = 0.61 for ≤ high school; AOR = 0.69 for some college, vs. college graduate), not married (AOR = 0.78 vs. married/domestic partnership) and lower household income (AOR = 0.70 for <$35,000 vs. ≥$100,000). After adjusting for covariates, using a water filter was significantly associated with higher odds for drinking >3 cups/d of tap water (AOR = 1.33) and lower odds for consuming SSB ≥ 1 time/d (AOR = 0.76). Not drinking tap water at home was significantly associated with lower odds for drinking >3 cups/d of tap water (AOR = 0.39) and higher odds of drinking >3 cups/d bottled water (AOR = 3.46). Conclusions Using a filter for drinking home tap water was associated with higher tap water intake and lower SSB intake among US adults. Yet, water filter use was lower among Black adults and those with lower income and education compared to other groups. While filters can improve tap water quality and healthful beverage habits, some may reduce fluoride content and their cost and proper use should be considered. Funding Sources Solely for author's time from their institutions.

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Perceptions of Tap Water and School Water Fountains and Association With Intake of Plain Water and Sugar-Sweetened Beverages

Journal of School Health ◽

10.1111/josh.12138 ◽

2014 ◽

Vol 84 (3) ◽

pp. 195-204 ◽

Cited By ~ 31

Author(s):

Stephen J. Onufrak ◽

Sohyun Park ◽

Joseph R. Sharkey ◽

Caitlin Merlo ◽

Wesley R. Dean ◽

...

Keyword(s):

Tap Water ◽

Plain Water ◽

Sugar Sweetened Beverages ◽

Sweetened Beverages

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Acquisition of Bottled Water Among US Households

Current Developments in Nutrition ◽

10.1093/cdn/nzaa061_096 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 1468-1468

Author(s):

Stephen Onufrak ◽

Jennifer Chevinsky ◽

Angie Cradock ◽

Mary Kathryn Poole ◽

Sohyun Park

Keyword(s):

Linear Models ◽

Tap Water ◽

Caloric Intake ◽

Bottled Water ◽

Plain Water ◽

Food Record ◽

Chi Square ◽

Bar Code ◽

Race Ethnicity ◽

Per Capita

Abstract Objectives While drinking plain water instead of sugar-sweetened beverages (SSB) may improve diet and prevent diseases, bottled water is more costly than tap water and typically does not contain fluoride for oral health benefits. We explored bottled water acquisition among US households and its relationship with SSB acquisition. Methods We used data from the USDA Food Acquisition and Purchasing Survey, which collected 7 days of data on all foods purchased or obtained for free in a nationally representative sample of 4826 households during 2012. Data were collected using food record books and bar code scanners. We assessed the prevalence of acquiring bottled water to bring home and for immediate consumption away from home, volume of water acquired, money spent on water, and the association of water acquisition with SSB acquisition. Differences in prevalence according to race/ethnicity, Census region, education level, rural status, and income/SNAP status were assessed using Chi-square tests. Adjusted linear models were used to assess the association of acquiring water for home or away from home with per-capita household total SSB calories acquired. Results A quarter (24.6%) of households acquired any bottled water during the study week with 16.2% acquiring water for home and 11.1% away from home. Prevalence of acquiring any bottled water differed by region and race/ethnicity and was highest among households in the South and West (each 26.8%) and among Hispanic households (35.2%). Among those that acquired each type, households spent $4.13 acquiring 14.1 liters of water for home, while households spent $1.65 acquiring 2.0 liters for away from home. In regression models, households that acquired bottled water for home had greater per capita SSB calorie acquisition than households that did not (adjusted mean: 1203 vs. 734 kcal/week; P = 0.0005); acquiring water for away from home was not associated with greater per capita SSB calorie acquisition (adjusted means: 931 vs. 1005 kcal; P = 0.34). Conclusions One quarter of US households acquire bottled water though acquisition differs according to demographic factors. Although plain water can reduce caloric intake when substituted for SSB, findings suggest that households that acquire bottled water for home also acquire more SSB calories than households that do not. Funding Sources Solely for authors time from their institutions.

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Drinking Water in the United States: Implications of Water Safety, Access, and Consumption

Annual Review of Nutrition ◽

10.1146/annurev-nutr-122319-035707 ◽

2020 ◽

Vol 40 (1) ◽

pp. 345-373

Author(s):

Anisha I. Patel ◽

Christina E. Hecht ◽

Angie Cradock ◽

Marc A. Edwards ◽

Lorrene D. Ritchie

Keyword(s):

United States ◽

Drinking Water ◽

Water Intake ◽

The United States ◽

Water Safety ◽

Environmental Interventions ◽

High Profile ◽

Sweetened Beverages ◽

Race Ethnicity ◽

The Life Course

Recent water quality crises in the United States, and recognition of the health importance of drinking water in lieu of sugar-sweetened beverages, have raised interest in water safety, access, and consumption. This review uses a socioecological lens to examine these topics across the life course. We review water intakes in the United States relative to requirements, including variation by age and race/ethnicity. We describe US regulations that seek to ensure that drinking water is safe to consume for most Americans and discuss strategies to reduce drinking water exposure to lead, a high-profile regulated drinking water contaminant. We discuss programs, policies, and environmental interventions that foster effective drinking water access, a concept that encompasses key elements needed to improve water intake. We conclude with recommendations for research, policies, regulations, and practices needed to ensure optimal water intake by all in the United States and elsewhere.

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Tap Water Consumption and Perceptions in United States Latinx Adults

Nutrients ◽

10.3390/nu13092999 ◽

2021 ◽

Vol 13 (9) ◽

pp. 2999

Author(s):

Abigail T. Colburn ◽

Stavros A. Kavouras

Keyword(s):

Water Intake ◽

Eating Behaviors ◽

Tap Water ◽

Hydration Status ◽

Plain Water ◽

Institute Of Medicine ◽

Sources Of Information ◽

Water Safety ◽

Water Insecurity ◽

White Adults

Insufficient water intake is associated with adverse health outcomes, including chronic disease prevalence and mortality. Adherence to Institute of Medicine total water intake (TWI) recommendations has been low in recent decades, and TWI has been consistently lower in Latinx adults compared with non-Hispanic (NH) white adults. While overall plain water intake is similar between Latinx and NH white adults, Latinx adults consistently consume significantly more bottled water and less tap water. The purpose of this review is to identify factors that may contribute to low water intake and low tap water intake, particularly in Latinx adults. The decision to drink water is complex and is influenced by a myriad of factors including context, environment, eating behaviors, geography, and beverage attributes. Plain water preferences appear to be related, in part, to perceptions of tap water safety as Latinx adults are significantly more likely to perceive their tap water as unsafe compared to NH white adults. Although recent investigations have not consistently or comprehensively evaluated the same factors, we have compiled their findings to describe the complex, interrelated determinants of tap water safety perceptions in Latinx adults. The present review proposes that perceptions are influenced by water insecurity, demographics, prior experiences, organoleptic (sensory) perceptions and availability and sources of information. Existing interventions designed to improve TWI primarily focus on improving access to water and/or educating individuals on the importance of hydration. However, this may not be sufficient in Latinx populations where water is not trusted. Future work should comprehensively assess these factors in Latinx samples and include validated plain water intake, TWI, and hydration status measures. A greater understanding of these relationships could inform interventions to improve TWI and hydration status in Latinx adults.

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Racial/ethnic and immigrant differences in early childhood diet quality

Public Health Nutrition ◽

10.1017/s1368980013001183 ◽

2013 ◽

Vol 17 (6) ◽

pp. 1308-1317 ◽

Cited By ~ 18

Author(s):

Marieke LA de Hoog ◽

Ken P Kleinman ◽

Matthew W Gillman ◽

Tanja GM Vrijkotte ◽

Manon van Eijsden ◽

...

Keyword(s):

Fast Food ◽

Negative Binomial ◽

Saturated Fat ◽

Sociodemographic Factors ◽

Snack Food ◽

Hispanic Children ◽

Sugar Sweetened Beverages ◽

Explanatory Role ◽

Sweetened Beverages ◽

Racial Ethnic

AbstractObjectiveTo assess racial/ethnic differences in the diet in young children and the explanatory role of maternal BMI, immigrant status and perception of child's weight.DesignAmong white, black and Hispanic 3-year-olds, we used negative binomial and linear regression to examine associations of race/ethnicity with foods and nutrients assessed by a validated FFQ.SettingProject Viva, Boston (MA), USA.SubjectsChildren aged 3 years (n 898).ResultsMean age was 38·3 (sd 2·8) months; 464 (52 %) were boys and 127 mothers (14 %) were immigrants. After adjustment for sociodemographic factors, black and Hispanic children (v. white) had a higher intake of sugar-sweetened beverages (rate ratio (RR) = 2·59 (95 % CI 1·95, 3·48) and RR = 1·59 (95 % CI 1·07, 2·47), respectively) and lower intakes of skimmed/1 % milk (RR = 0·42 (95 % CI 0·33, 0·53) and RR = 0·43 (95 % CI 0·31, 0·61), respectively) and trans-fat (−0·10 (95 % CI −0·18, −0·03) % of energy and −0·15 (95 % CI −0·26, −0·04) % of energy, respectively). Among Hispanics only, a lower intake of snack food (RR = 0·83 (95 % CI 0·72, 0·98)) was found and among blacks only, a higher intake of fast food (RR = 1·28 (95 % CI 1·05, 1·55)) and lower intakes of saturated fat (−0·86 (95 % CI −1·48, −0·23) % of energy), dietary fibre (0·85 (95 % CI 0·08, 1·62) g/d) and Ca (−120 (95 % CI −175, −65) mg/d) were found. Being born outside the USA was associated with more healthful nutrient intakes and less fast food.ConclusionsThree-year-old black and Hispanic (v. white) children ate more sugar-sweetened beverages and less low-fat dairy. Total energy intake was substantially higher in Hispanic children. Snack food (Hispanic children) and fat intakes (black children) tended to be lower. Children of immigrants ate less fast food and bad fats and more fibre.

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Disparities in plain, tap and bottled water consumption among US adults: National Health and Nutrition Examination Survey (NHANES) 2007–2014

Public Health Nutrition ◽

10.1017/s1368980017004050 ◽

2018 ◽

Vol 21 (8) ◽

pp. 1455-1464 ◽

Cited By ~ 25

Author(s):

Asher Y Rosinger ◽

Kirsten A Herrick ◽

Amber Y Wutich ◽

Jonathan S Yoder ◽

Cynthia L Ogden

Keyword(s):

National Health ◽

Water Consumption ◽

Tap Water ◽

Bottled Water ◽

Plain Water ◽

Nutrition Examination Survey ◽

Linear Regression Models ◽

Cross Sectional ◽

Dietary Recall ◽

Health And Nutrition

AbstractObjectiveDifferences in bottled v. tap water intake may provide insights into health disparities, like risk of dental caries and inadequate hydration. We examined differences in plain, tap and bottled water consumption among US adults by sociodemographic characteristics.DesignCross-sectional analysis. We used 24 h dietary recall data to test differences in percentage consuming the water sources and mean intake between groups using Wald tests and multiple logistic and linear regression models.SettingNational Health and Nutrition Examination Survey (NHANES), 2007–2014.SubjectsA nationally representative sample of 20 676 adults aged ≥20 years.ResultsIn 2011–2014, 81·4 (se 0·6) % of adults drank plain water (sum of tap and bottled), 55·2 (se 1·4) % drank tap water and 33·4 (se 1·4) % drank bottled water on a given day. Adjusting for covariates, non-Hispanic (NH) Black and Hispanic adults had 0·44 (95 % CI 0·37, 0·53) and 0·55 (95 % CI 0·45, 0·66) times the odds of consuming tap water, and consumed B=−330 (se 45) ml and B=−180 (se 45) ml less tap water than NH White adults, respectively. NH Black, Hispanic and adults born outside the fifty US states or Washington, DC had 2·20 (95 % CI 1·79, 2·69), 2·37 (95 % CI 1·91, 2·94) and 1·46 (95 % CI 1·19, 1·79) times the odds of consuming bottled water than their NH White and US-born counterparts. In 2007–2010, water filtration was associated with higher odds of drinking plain and tap water.ConclusionsWhile most US adults consumed plain water, the source (i.e. tap or bottled) and amount differed by race/Hispanic origin, nativity status and education. Water filters may increase tap water consumption.

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