Is increased water consumption among older adults associated with improvements in glucose homeostasis?


Obesity and impaired glucose homeostasis in older adults place these individuals at risk for diabetes. Dehydration, glucose homeostasis, and insulin resistance are related; while aging and dehydration are associated with decreased glucose tolerance, weight loss can improve glycemia. For older adults following hypocaloric diets, additional water consumption may lead to greater weight loss. Further more, research suggests an association between insulin resistance and the body water retention hormone, arginine vasopressin (AVP). Analysis of the association between plasma copeptin (an AVP derivative) and fasting glucose, insulin, and homeostasis model assessment of insulin resistance (HOMA-IR) may provide further insight into the relationship between dehydration and diabetes risk. Our objective was to investigate the possibility that increased water consumption among older adults (n = 29, BMI = 31 ± 1 kg/m2, age = 62 ± 1 years) could improve glucose homeostasis beyond that observed with weight loss, as well as associations between plasma copeptin and diabetes risk. This retrospective analysis utilized data from a previous investigation, in which obese/overweight older adults were assigned to one of two groups: 1) Water: consume 500 ml of water prior to three daily meals over a 12-week hypocaloric diet intervention, or 2) Non-water: hypocaloric diet alone. In the present analysis, fasting plasma glucose and insulin, HOMA-IR, and plasma copeptin were evaluated, and compared to urinary specific gravity (USG), drinking water consumption, and body weight. Analyses performed using group assignment, volume of drinking water consumed or among a subgroup pair-matched for weight loss and sex did not reveal significant differences between groups. However in the full sample, plasma insulin concentration was associated with USG (r = 0.512, P < 0.01) and copeptin (r = 0.389, P < 0.05), and HOMA-IR was associated with USG (r = 0.530, P < 0.01) at week 12. Improvements in fasting insulin for water group participants (-8.5 +/-4 pmol/L) were also detected. Associations between hydration and insulin resistance support the need for future investigations addressing hydration status and diabetes risk.

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Clark, A. , Parker, E. , Savla, J. , Davy, K. and Davy, B. (2013) Is increased water consumption among older adults associated with improvements in glucose homeostasis?. Open Journal of Preventive Medicine, 3, 363-367. doi: 10.4236/ojpm.2013.35049.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] CDC (2011) National Diabetes Fact Sheet: National estimates and general information on diabetes and prediabetes in the United States. US Department of Health and Human Services, Centers for Disease Control and Prevention.
[2] Eikenberg, J.D. and Davy, B.M. (2013) Prediabetes: A prevalent and treatable, but often unrecognized, clinical condition. Journal of the Academy of Nutrition and Dietetics, 113, 213-218.
[3] Roussel, R.F.L., Bouby, N., Balkau, B., Lantieri, O., Alhenc-Gelas, F., Marre, M. and Bankir, L. (2011) Low water intake and risk for new-onset hyperglycemia American Diabetes Association. Diabetes Care, 34, 2551-2554.
[4] Tate, D.F., Turner-McGrievy, G., Lyons, E., Stevens, J., Erickson, K., Polzien, K., et al. (2012) Replacing caloric beverages with water or diet beverages for weight loss in adults: main results of the Choose Healthy Options Consciously Everyday (CHOICE) randomized clinical trial. The American Journal of Clinical Nutrition, 95, 555-563.
[5] Colman, E., Katzel, L.I., Rogus, E., Coon, P., Muller, D. and Goldberg, A.P. (1995) Weight loss reduces abdominal fat and improves insulin action in middle-aged and older men with impaired glucose tolerance. Metabolism, 44, 1502-1508.
[6] Tuomilehto, J., Lindstrom, J., Eriksson, J.G., Valle, T.T., Hamalainen, H., Ilanne-Parikka, P., et al. (2001) Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. The New England Journal of Medicine, 344, 1343-1350.
[7] Knowler, W.C., Barrett-Connor, E., Fowler, S.E., Hamman, R.F., Lachin, J.M., Walker, E.A., et al. (2002) Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. The New England Journal of Medicine, 346, 393-403.
[8] (2005) Dietary reference intakes for water, potassium, sodium, cholride, and sulfate: Chapter 4 water. The National Academies Press, Washington, D.C.
[9] Stipanuk, M. and Caudill, M. (2013) Biochemical, physiological, and molecular aspects of human nutrition. 3rd Edition, Elsevier,
[10] Stookey, J.D. (2005) High prevalence of plasma hypertonicity among community-dwelling older adults: Results from NHANES III. Journal of the American Dietetic Association, 105, 1231-1239.
[11] Popkin, B.M. (2010) Patterns of beverage use across the lifecycle. Physiology & Behavior, 100, 4-9.
[12] US Department of Agriculture (2011) What we eat in america, national health and nutrition examination survey 2005-2008, drinking water intake in the US. Dietary Data Brief No. 7.
[13] Enhorning, S., Wang, T.J., Nilsson, P.M., Almgren, P., Hedblad, B., Berglund, G., et al. (2010) Plasma copeptin and the risk of diabetes mellitus. Circulation, 121, 2102-2108.
[14] Balanescu, S., Kopp, P., Gaskill, M.B., Morgenthaler, N.G., Schindler, C. and Rutishauser, J. (2011) Correlation of plasma copeptin and vasopressin concentrations in hypo-, iso-, and hyperosmolar States. The Journal of Clinical Endocrinology & Metabolism, 96, 1046-1052.
[15] Morgenthaler, N.G., Struck, J., Alonso, C. and Bergmann, A. (2006) Assay for the measurement of copeptin, a stable peptide derived from the precursor of vasopressin. Clinical Chemistry, 52, 112-119.
[16] Saleem, U., Khaleghi, M., Morgenthaler, N.G., Bergmann, A., Struck, J., Mosley, T.H., Jr., et al. (2009) Plasma carboxy-terminal provasopressin (copeptin): A novel marker of insulin resistance and metabolic syndrome. The Journal of Clinical Endocrinology & Metabolism, 94, 2558-2564.
[17] Meijer, E., Bakker, S.J., de Jong, P.E., Homan van der Heide, J.J., van Son, W.J., Struck, J., et al. (2009) Copeptin, a surrogate marker of vasopressin, is associated with accelerated renal function decline in renal transplant recipients. Transplantation, 88, 561-567.
[18] Davy, B.M., Dennis, E.A., Dengo, A.L., Wilson, K.L. and Davy, K.P. (2008) Water consumption reduces energy intake at a breakfast meal in obese older adults. Journal of the American Dietetic Association, 108, 1236-1239.
[19] Dennis, E.A., Dengo, A.L., Comber, D.L., Flack, K.D., Savla, J., Davy, K.P., et al. (2010) Water consumption increases weight loss during a hypocaloric diet intervention in middle-aged and older adults. Obesity, 18, 300-307.
[20] Bonora, E., Formentini, G., Calcaterra, F., Lombardi, S., Marini, F., Zenari, L., et al. (2002) HOMA-estimated insulin resistance is an independent predictor of cardiovascular disease in type 2 diabetic subjects: Prospective data from the Verona Diabetes Complications Study. Diabetes Care, 25, 1135-1141.
[21] Bhandari, S.S., Loke, I., Davies, J.E., Squire, I.B., Struck, J. and Ng, L.L. (2009) Gender and renal function influence plasma levels of copeptin in healthy individuals. Clinical Science (Lond), 116, 257-263.
[22] Morgenthaler, N.G., Struck, J., Jochberger, S. and Dunser, M.W. (2008) Copeptin: Clinical use of a new biomarker. Trends in Endocrinology & Metabolism, 19, 43-49.

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