Does the provision of cooled filtered water in secondary school cafeterias increase water drinking and decrease the purchase of soft drinks?

Loughridge, J.L. and Barratt, J. (2005) Journal of Human Nutrition & Dietetics, 18 (4); 281-6.

Secondary school students often do not drink enough water to prevent dehydration and promote learning, good health and well being. Drinking water for a large number of school students is mainly obtained from the cold-water tap in the school toilets. School toilets are not the ideal environment for obtaining drinking water. Other factors leading to poor fluid intake include: nonrecognition of the thirst signal, warm school tap water, no cups available and warm unattractive jugged tap water in school dining halls. Soft drinks high in sugar or artificially sweetened are often more appealing than the tap water alternative. This study was undertaken to see if the free provision of cooled filtered water in school cafeterias and the promotion of the benefits of water consumption would increase water drinking and decrease the purchase of soft drinking. Students' views of drinking water provision were also explored.

Three secondary schools were selected from the most deprived areas in North Tyneside, UK . Two of the schools were chosen for the water cooler intervention (water = W) which was sited in their cafeterias. Students from one of these schools were also educated about the health benefits of drinking water and how to access it (promotion = P). Promotion of drinking water benefits including posters, verbal school assembly information, sports personalities attending assemblies, water promotion lessons and promotional pencils and water bottles. The third school was the control school (C) and did not receive any intervention. In the month before the intervention the sales of soft drinks and existing water provision (i.e. jug and cup, bottled water on sale) were measured in the three schools. The intervention was carried out over a month. Water uptake was quantified during the intervention period and post-intervention (two months) in the two intervention schools. Sales of soft drinks and other water provision continued to be measured in all three schools during the intervention and post-intervention periods. Focus group work was undertaken in the control school's council on perceptions of water consumption.

The average volume of water drunk by the students in the W + P school was greater than that drunk in both the W school and the C school ( P =0.05). The volume of soft drink purchased in all three schools over the study period remained fairly static. The focus groups found that students viewed their existing water provision as poor and would like to have many water machines strategically located around their school. There were also comments about being aware of symptoms of dehydration and the unpalatable warm water.

This study showed that secondary students increased their water consumption after active promotion of water drinking. It is recommended that this pilot study be repeated with a more intensive intervention promoting the drinking of water in school involving a whole school approach. Measuring of water consumption for at least a year after the initial intervention should occur to allow for seasonal influences. Caterers worried about lost of revenue from reduced sales of soft drinks may conclude from this study that provision of free, cooled water will attract students to the dinning room to purchase meals and snacks.