Hydration, water requirements, and energy balance from spring to summer in free-living older adults: a doubly labelled water study

The escalating effects of climate change, particularly global warming, are posing an increasing burden on human health. Older adults are particularly susceptible to the impact of extreme heat. Adequate water intake is essential to prevent dehydration in hot environments. Therefore, it is important to understand water turnover (WT) and intake. WT of older adults in hot environments remains unknown. This study aimed at investigating the seasonal effects on WT, total energy expenditure (TEE), and physical activity using doubly labeled water (DLW) and a triaxial accelerometer. A total of 26 older Japanese adult males and females aged ≥ 65 years participated in the study. WT and TEE were measured using DLW in May and August 2012. The mean values of maximum, mean, and minimum temperatures and mean humidity of the measurement days were 24 °C, 19 °C, 14 °C, and 57% in May (spring) and 35 °C, 29 °C, 25 °C, and 66% in August (summer) 2012, respectively. The mean (standard deviation, SD) age of the participants was 73.7 (5.4) years. Total body water increased significantly from 31.1 (4.6) to 31.9 (5.2) kg (+ 0.8 kg, P = 0.009) from May to August. TEE decreased significantly from 2271 (280) to 2123 (470) kcal/day (- 149 kcal/d, P = 0.036), while WT increased significantly from 2.939 (0.625) to 3.579 (0.943) L/day (+ 0.640 L/d, P < 0.001). WT increased by 640 mL/day during summer compared to that during spring, when the average temperature was 19 °C. Our findings indicate that WT increases during hot weather in older adults, reflecting seasonal adaptation.