Quality of diet is associated with water intake among residents in Sao Paulo, Brazil

The scope of the study was to evaluate the probability of the adequacy of water intake among residents of Sao Paulo, and to investigate if the quality of diet differs according to the adequacy of water intake. Data were extracted from the Health Survey of Sao Paulo, a cross-sectional, population-based study. Water intake (drinking water beverages and food) was evaluated using two 24-hours dietary recalls and a supplementary dietary intake questionnaire. Adequacy and classification of water intake was assessed using the corresponding Adequate Intake for sex and age of the individual. Dietary quality was evaluated using the revised Brazilian Healthy Eating Index (BHEI). The associations were tested using the Theil-Sen median test and logistic regression models. A low probability of adequate water intake was observed, and this decreased with advancing age. Except among the elderly, among whom no association was observed, a positive association between water intake and the BHEI was observed, and for the total and integral fruit components, which was maintained after confusion adjustments. Among adults, it was observed that those who ingested less water had even lower scores for saturated fats. The residents of Sao Paulo have low water intake, and the quality of diet is worse among those who drink less water.