Encouraging children to drink more water and increasing their access to it at school may help prevent unhealthy weight gain, according to a new study in California elementary schools.
Water is a healthier drink than sugar-sweetened beverages, which are known to increase overweight and obesity. Researchers conducted a trial of the Water First program among 1,249 fourth graders at low-income schools in California’s Bay area. Nine schools installed water stations and engaged students with schoolwide promotions and both in-class and at-home lessons about the benefits of drinking water. Nine other schools served as a control group.
Authors reported their findings in “Effectiveness of a School Drinking Water Promotion and Access Program for Overweight Prevention,” (Patel AI, et al. Pediatrics. Aug. 7, 2023).
At seven months, there was no significant difference in the percentage of students deemed overweight from either group. At 15 months, overweight prevalence in the control group increased 3.7 points from 47.7% at baseline to 51.4%. The prevalence of overweight in the intervention group increased just 0.5 points from 49.5% to 50%.
“Despite the small effects of school-based obesity prevention programs like Water First, they have the potential to impact large numbers of children at a lower cost than more intensive clinical interventions,” authors wrote.
While the Water First program had a positive impact on overweight, it did not appear to change obesity rates. Authors said, “more intensive clinical interventions, and more comprehensive prevention efforts targeting the home environment may be needed to improve the weight status of students who already have obesity or severe obesity.”
As a secondary analysis, researchers observed water consumption at school. They found the intervention group had larger increases in water intake at lunch and recess at seven months compared to the control group, but increases were not sustained at 15 months. They noted the water promotions in the study lasted only six months and called for continued encouragement.
At baseline and seven months, families were asked about children’s food and beverage consumption in the past 24 hours. Total calories and sugar-sweetened beverage calories in the intervention group stayed about the same.
Author Anisha I. Patel, M.D., M.S.P.H., M.S.H.S., professor of pediatrics at Stanford University, said she was not surprised the study found no overall calorie difference because there were only two food recalls for each student. She said the data showed the intervention “helped some children but not others.”
Authors concluded Water First “holds promise for preventing overweight in children.” In a video abstract with the study, they encouraged continued promotion of water in schools.
“Educating and enabling kids to practice simple, healthy habits such as drinking water at school can impact their health,” they said, “helping to prevent unhealthy weight gain and the chronic diseases that come with it.”