Will Fluoridated Water Affect my Child’s IQ?

To know what fluoride is and why our water is fluoridated, check out our last Fact Friday post here. Today’s post reviews the current research on whether drinking fluoridated water will affect a child’s IQ.

A recent Canadian study looked at the association between consumption of fluoride by pregnant women and their child’s IQ. From 601 mother-child pairs in six cities, they looked at how much fluoride the mothers consumed, how much was in their urine, and then tested the child’s IQ at age three [1]. To simplify, what they found was a slight decrease in IQ when the mother’s urine had a bit more fluoride a. This was only the case for boys, not girls. However the child’s IQ (regardless of sex) slightly decreased when the mother’s daily fluoride intake was higher b.   

So does this mean I should avoid fluoride while pregnant?

In the realm of research, we investigate to add to our knowledge. While this study presents that there is a potential association, we cannot prove that it is definitely true or that there is a risk with just one study. 

This study has some limitations: 

  1. Some key measurements were off – fluoride intake did not match urinary fluoride, i.e. we don’t know exactly how much fluoride the mothers were consuming to make a conclusion. 
  2. The decrease in IQ only affected the boys it is very unclear why fluoride consumption would not affect girl’s IQ as it did in the boys, although similar studies did not find a difference in sex as they did. 
  3. Previous studies had fluoride levels way above acceptable limits in Canada – these studies took place in regions where water fluoride concentrations are well above the guideline (1.5mg/L) [2]c.  
  4. High fluoride in 3 urine samples ≠ exposure to baby three urinary samples from the mother do not reflect the overall exposure of fluoride to the fetus over the whole pregnancy. 
  5. They did not take into account different ways of intaking fluoride: As mentioned, fluoride is present in toothpaste, mouthwash, some bottled water, and food i.e. measurements were off. 

Conclusion:

Though we can’t make conclusions based on one study, we can continually review what level of fluoridation is best for us. Based on years of research, we know that drinking optimally fluoridated tap water in Canada is safe, improves oral health and is better for the environment than bottled water!

a Results: With an increase of 1mg/L of maternal urinary fluoride they found an associated decrease of 4.49 points in their child’s IQ, but only when the child was a boy, and not in girls.

b When mother’s daily fluoride intake increased by 1 mg, they found an associated decrease of 3.66 points in their child’s IQ (regardless of sex).

c The researchers try to back up their results by quoting studies that have observed a similar association. But these studies took place in regions where water fluoride concentrations are well above the guideline of 1.5mg/L (the highest acceptable amount in Canada), while the study conducted in Mexico did not report a concrete fluoride value at all [3]. 

Please be aware that these are general guidelines. Nutrition and intake varies by age, sex, height, activity, being pregnant or breastfeeding, and medical conditions. For more information or to sit with one of our dietitians for an individualised nutrition counselling session, please contact us at amananutrition@gmail.com or visit our Contact Us page to book your first appointment.

Until next time,

Almas-Sadaf Shaikh, PMDip, RD


References:

[1] Green R, Lanphear B, Hornung R, et al. Association Between Maternal Fluoride Exposure During Pregnancy and IQ Scores in Offspring in Canada. JAMA Pediatr. Published online August 19, 2019. doi:10.1001/jamapediatrics.2019.1729.

[2] Health Canada (2017). Fluoride and Oral Health. [online] Available at: https://www.canada.ca/en/health-canada/services/healthy-living/your-health/environment/fluorides-human-health.html

[3] Bashash, M., Thomas, D., Hu, H., Angeles Martinez-Mier, E., Sanchez, B. N., Basu, N., … & Liu, Y. (2017). Prenatal fluoride exposure and cognitive outcomes in children at 4 and 6–12 years of age in Mexico. Environmental health perspectives, 125(9), 097017.

Fluoride: Friend or Foe?

What is fluoride? Is it safe? Why is our water fluoridated? Find out in today’s Fact Friday. 

What is fluoride? 

You may have heard of this element way back in science class. Well fluoride is a mineral, and it is found in food, water, air, soil, and also found in toothpaste and mouthwash [1]. 

Why is water fluoridated in Canada? 

Water has been fluoridated in Canada for over 70 years to prevent our teeth from decaying [2]. Registered Dental Hygienist Zohra Chhiboo explains that “fluoride helps in remineralization, desensitization and prevention of decay for teeth. Fluoridated water to an optimal level, is beneficial for children and adults as it’s a natural, safe and effective way to give exposure to these benefits”. The provincial ministry of environment regulates how much fluoride is in our water [3]. 

*Note: Speak to a dental professional for more information on fluoride and your dental health!*

Is bottled water a better choice? 

As mentioned, water that has optimal amounts of fluoride is shown to improve oral health and prevent cavities. But not all bottled water has fluoride. Therefore, try drinking more tap water or use it when cooking. (It’s also much better for the environment! Yes, climate change is real).

Are there any side effects from drinking fluoridated water?  

There are two known side effects of having too much fluoride: dental fluorosis and skeletal fluorosis. The first condition only happens when you’ve had too much fluoride as a child (for ex. accidentally swallowing toothpaste), and as a result, your adult teeth have white or brown spots [3]. Skeletal fluorosis happens when you’ve had excessive amounts of fluoride daily, for a long time, and causes bones and joints to become hard [1]. 

Fortunately in Canada, the levels of fluoride in our water and other products are regulated and limited to be kept low [1]. And therefore some of these conditions become more and more rare. 

What about if I’m pregnant or breastfeeding? 

Health Canada states that other than fluorosis there aren’t any health conditions associated with fluoride, and that it is safe to have while pregnant or breastfeeding [1]. They do suggest to check if your infant formula has fluoride in case you add drinking water to it that has more than the guideline (1.5mg/L). In these infant formulas, they recommend using water with less fluoride.

Stay tuned for our upcoming post where we will review current research on whether drinking fluoridated water will affect a child’s IQ!

Conclusion:

Based on years of research, we know that drinking optimally fluoridated tap water in Canada is safe, improves oral health and is better for the environment than bottled water! So grab that reusable water bottle and fill it with some fresh tap water!

Please be aware that these are general guidelines. Nutrition and intake varies by age, sex, height, activity, being pregnant or breastfeeding, and medical conditions. For more information or to sit with one of our dietitians for an individualised nutrition counselling session, please contact us at amananutrition@gmail.com or visit ourContact Us page to book your first appointment.

Until next time,

Almas-Sadaf Shaikh, PMDip, RD

References:

[1]  Health Canada (2017). Fluoride and Oral Health. [online] Available at: https://www.canada.ca/en/health-canada/services/healthy-living/your-health/environment/fluorides-human-health.html

[2] City of Toronto. (2019). Dental & Oral Health Services. [online] Available at: https://www.toronto.ca/community-people/health-wellness-care/health-programs-advice/dental-and-oral-health-services/?accordion=fluoride-and-drinking-water

[3] Unlock Food (2018). Facts on Fluoride. [online] Available at: https://www.unlockfood.ca/en/Articles/Dental-health/Fluoride-Facts.aspx

[4] Public Health Agency of Canada and Health Canada (2018). Fact sheet – Community water fluoridation. [online] Available at: https://www.canada.ca/en/services/health/publications/healthy-living/fluoride-factsheet.html

The Wonders of Water

Did you know that your body is mostly made up of water? There’s a reason for that!

Water is used for:

  • Digestion
  • Removing wastes
  • Transporting nutrients
  • Metabolism 
  • Regulating your body temperature and blood pressure
  • Helping to keep your skin, joints, and organs healthy [1]

Do I really need 8 cups a day? 

  • Healthy adults generally require up to 9-12 cups of fluid a day (depending on your sex, age, activity level, and even the weather) [1]. 
  • Note: Fluid is not just water, but can be food and drinks that contain water such as milk, tea, soup, etc. 

People at risk: 

Certain groups of people are at higher risk of becoming dehydrated:

  • The elderly
  • Young children and infants
  • Athletes
  • People who work outdoors

Indicators of dehydration:

Your body loses fluids during exercise and in hot conditions through sweat, so it’s important to replenish/restore these losses by drinking water throughout the day. Indicators that your body is already dehydrated and needs water include: 

  • Feeling thirsty
  • Dark urine
  • Not urinating very much
  • Feeling dizzy
  • Delirium (mostly in the elderly)
  • Dry skin and lips

Can sugar-sweetened beverages (like juice, pop, and chocolate milk) give me the fluid I need?

Sugary drinks definitely do contain water, but the amount of sugar (and in the case of pop, the acid too) makes water the best choice to stay hydrated. Limiting sugar in your diet has lots of positive effects on your health, and avoiding pop (even diet ones!) can save your teeth from erosion.

Will caffeine make me dehydrated?

Try to limit your caffeine intake to less than 3 cups a day (400mg of caffeine/day) [4]. This is the amount that research has shown that does not cause your body to be dehydrated or make more urine (especially if you drink caffeine regularly).

Tips to stay hydrated:

  • Keep a reusable water bottle handy
  • Have a cup of water when you wake up and go to bed
  • Add fun flavours to your water like cucumber, herbs, lemon, etc
  • Have a glass of water with meals
  • Drink one glass of water with medication
  • Drink when you feel thirsty
  • Track your intake with apps

Be sure to check out our Recipes for fun infused water ideas to help you stay hydrated!

*Please be aware that these are general guidelines. Nutrition and intake varies by age, sex, height, activity, being pregnant or breastfeeding, and medical conditions. For more information or to sit with one of our dietitians for an individualised nutrition counselling session, please contact us at amananutrition@gmail.com or visit our Contact Us page to book your first appointment.

Until next time,

Almas-Sadaf Shaikh, PMDip, RD & Huda Amareh, MAHN, RD

References:

[1] Dietitians of Canada (2014). Guidelines for drinking fluids to stay hydrated [online] Available at: https://www.dietitians.ca/getattachment/becace49-3bad-4754-ac94-f31c3f04fed0/FACTSHEET-Guidelines-for-staying-hydrated.pdf.aspx [Accessed 28 Apr. 2019].
[2] Canadian Association of Nephrology Dietitians. (2008). Essential guide for renal dietitians (2nd ed.). [Accessed 1 Aug. 2019].
[3] Health Link BC (2015). Healthy Eating Guidelines for Prevention of Recurrent Kidney Stones. Available at: https://www.healthlinkbc.ca/hlbc/files/healthyeating/pdf/eating-guidelines-for-kidney-stones.pdf [Accessed 1 Aug. 2019]. 
[4] Dietitians of Canada (2013). What is caffeine? Is it bad for my health?. [online] Available at: https://www.dietitians.ca/Downloads/Factsheets/What-is-caffeine.aspx [Accessed 2 May 2019].

Cool Cucumber Lemon!

Cucumber and Lemon battle it out in this refreshing flavoured water drink!

You will need:

  • ½ cucumber, sliced
  • ½ lemon, sliced
  • 1L (4 cups) tap water

Directions

  1. Combine lemon and cucumber in a pitcher.
  2. Pour in tap water and cover before placing in the fridge for 3-4 hours, allowing for flavours to blend.

Serve cold and enjoy!

Orange Mango Mayhem!

Ever wondered what happens when you mix orange and mango in water? You’re about to find out!

Put aside:

  • 1 cm (about ½ inch) of ginger
  • 1 small orange, sliced
  • ½ cup of mango chunks
  • 1.5L (6 cups) tap water

Directions

  1. Place ginger, water, orange, and mango into a large pitcher and lightly mix with a spoon to have the flavour infuse a bit better.
  2. Cover and place in the fridge for 3-4 hours. Serve cold or with crushed ice.