Understanding Beverage Consumption and Excessive Fluid Intake as Cultural Practices: A Cross-Cultural Study in Spanish-Speaking Adults

Fluid intake is a key component of habitual dietary behaviour and plays an important role in health and disease prevention. Both insufficient and excessive fluid consumption have been associated with adverse health outcomes. However, beverage intake patterns and behaviours related to excessive fluid consumption remain underexplored in non-clinical populations, particularly in Spanish-speaking contexts. This study aimed to translate, culturally adapt, and apply the Beverage Intake Questionnaire-15 (BEVQ-15) in Spanish-speaking adults from Spain and Ecuador, and to describe beverage consumption patterns with a focus on behaviours potentially associated with excessive fluid intake.A two-phase cross-sectional study was conducted. The BEVQ-15 was translated and culturally adapted following established international guidelines and semantically validated in a pilot sample of university students. The adapted version (BEVQ-15P) was subsequently applied to a validation sample of adults from Spain and Ecuador. Descriptive analyses were used to characterise total fluid intake and beverage consumption patterns by sex and country. Sex-specific intake thresholds derived from the literature were applied to explore categories of potential risk for excessive fluid consumption.Semantic validation confirmed good clarity, comprehension, and cultural relevance of the Spanish BEVQ-15P. In the validation sample, mean total daily fluid intake was 3.67 ± 2.34 L/day. Men reported significantly higher fluid intake than women, largely driven by beer consumption, while the highest intake profile identified was characterised by excessive water consumption in a female participant. Beverage consumption patterns differed by sex but were broadly comparable between Spain and Ecuador. Behaviours associated with potential risk for excessive fluid intake were infrequent in this non-clinical sample.Overall, this study offers an exploratory framework to understand beverage consumption and excessive fluid intake behaviours within their social and cultural contexts, contributing to discussions on food and drink as socially embedded practices beyond purely biomedical interpretations.