Abstract
BACKGROUND: Adequate water intake is essential for maintaining health, particularly in children and adolescents. In the context of global warming, the likelihood of experiencing more frequent and intense heatwaves increases, posing a serious threat to regions already grappling with water scarcity. Therefore, we aim to explore the exposure-response relationship between ambient temperature and daily total fluid intake (TFI) among Chinese children and adolescents and to forecast their fluid consumption patterns up to the year 2099 in China, considering different climate change scenarios. METHODS: Utilizing data from a 2011 cross-sectional survey of 3713 students (51.98% female) aged 7 to 18 in Beijing, Shanghai, and Guangzhou, this study employs generalized linear mixed models to analyze the association between temperature and fluid intake. Projections of future fluid consumption are made under the Shared Socioeconomic Pathways (SSP) 126, SSP370, and SSP585 scenarios, reflecting a range of possible climate futures. RESULTS: Our results show a nearly linear relationship between temperature and fluid consumption. For every 1 °C increase, average daily TFI rises by 24 mL (95% CI: 21-27 mL), and plain water intake (PWI) increases by 12 mL (95% CI: 9-14 mL). The daily TFI ranges from 961 mL at 17 °C to 1298 mL at 31 °C. Future projections under different SSP scenarios indicate a substantial increase in fluid intake by the year 2099. CONCLUSIONS: These findings reveal a positive association between ambient temperature and fluid intake with projected increases in hydration needs under future warming scenarios. They highlight important public health implications in the context of climate change and emphasize the need for updated hydration guidelines to protect child health in a warming world.