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Total and drinking water intake and risk of all-cause and cardiovascular mortality: a systematic review and dose-response meta-analysis of prospective cohort studies
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  • Maryam Majdi,
  • Fatemeh Hosseini,
  • Sina Naghshi,
  • kurosh djafarian,
  • Sakineh Shab-Bidar
Maryam Majdi
Tehran University of Medical Sciences
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Fatemeh Hosseini
Tehran University of Medical Sciences
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Sina Naghshi
Tehran University of Medical Sciences
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kurosh djafarian
Tehran University of Medical Sciences
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Sakineh Shab-Bidar
Tehran University of Medical Sciences
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Abstract

Background: Understanding the association between water consumption and mortality is important for guiding consumers and prioritizing dietary guidelines to reduce the risk. Therefore, in the current study, we conducted a systematic review and dose-response meta-analysis of prospective cohort studies to summarize the association between total water and drinking intake and risk of mortality from all causes and CVD. Method: A comprehensive search was performed on PubMed/Medline, Scopus, and ISI Web of Science up to February 2020. The random effects model was used to calculate pooled effect size (EFs) and 95% confidence interval. Result: Seven prospective cohort studies with a total of 116816 reporting 14754 cases of all-cause mortality and 7611 of CVD mortality, were included in the present meta-analysis. No significant association was found between drinking water intake and all-cause mortality (EFs: 0.82; 95% CI: 0.63-1.08, P=0.65) and CVD mortality (EFs: 0.82; 95% CI: 0.63-1.08, P= 0.16). Total water intake was not associated with all-cause mortality (EFs: 0.95; 95% CI: 0.83-1.09, P=0.47). However, indicating a significant inverse association between total water intake and risk of CVD mortality (EFs: 0.84; 95% CI: 0.77-0.93, P<0.001). Linear dose-response meta-analysis revealed a significant inverse association between total water intake and all-cause mortality by an additional one cup per day (Pooled ES: 0.98; 95% CI: 0.97-0.99, P= 0.001). Furthermore, each additional cup of total water intake per day was associated with a 3% lower risk of death from CVD (Pooled ES: 0.97; 95% CI: 0.96-0.98, P<0.001). Conclusion: High consumption of total water is associated with a lower risk of CVD mortality. However total water intake was not associated with an increased risk of all-cause mortality.

Peer review status:UNDER REVIEW

03 Nov 2020Submitted to International Journal of Clinical Practice
12 Nov 2020Submission Checks Completed
12 Nov 2020Assigned to Editor
16 Nov 2020Reviewer(s) Assigned
01 Dec 2020Review(s) Completed, Editorial Evaluation Pending
08 Jan 20211st Revision Received
06 Feb 2021Submission Checks Completed
06 Feb 2021Assigned to Editor
23 Apr 2021Reviewer(s) Assigned