Water Drinking recommendations are less common and detailed than food recommendations in patients of Diabetes as of now .Dr.KJ Joshipura from Peurto Rico and associates have depicted an association between drinking bottled water and prediabetes/diabetes by presenting a study at late Poster breaking session at American Diabetic Association meeting 2018 in Orlando, Florida.
Dietary recommendations for healthy adults include activity, adequate hydration (males: 125 ounces/day, females: 91 ounces/day) from drinking water, other beverages, and water contained in food. Bottled water sales in the U.S. exceeded 11.7 billion gallons in 2015 (36.5 gallons per capita). Low water intake, as well as some chemicals in water sources, are associated with hyperglycemia. Limitation of the study are that the association between drinking water sources and hyperglycemia/diabetes has not been studied.
In a cohort of overweight/obese Puerto Ricans, the researchers evaluated the association between water sources (bottled compared to tap water and filtered compared to tap water and prediabetes/diabetes. In 2014-2016, 1023 participants reported their primary source of water as bottled (52%), filtered (25%) and tap(23%); diabetes status was assessed using ADA criteria for fasting and 2-hour post-load glucose, and HbA1c.
Logistic regression models controlled for age, gender waist circumference, smoking, alcohol intake, physical activity, and hypertension. The researchers found that Bottled water consumers (compared to tap water) had higher prediabetes (OR=1.43), and diabetes (OR=1.93).
Further controlling for the amount of water, sugar-sweetened beverages, or canned food and drinks did not change the associations but controlling for education or income strengthened the association with diabetes. The results were stronger when restricted to San Juan city residents (43%): prediabetes (OR=1.68), and diabetes(OR=4.05). It was also observed that filtered water users had somewhat higher prediabetes/diabetes (OR=1.38) compared to tap water users.
The researchers concluded that the results suggest that drinking bottled water may be associated with a higher prevalence of diabetes compared to tap water, potentially mediated by endocrine disruptors in plastic bottles. The researchers could not determine time sequence or causality, given the cross-sectional analyses.