Water and The Electrolytes By Jennifer Turley and Joan Thompson © 2016 Cengage Presentation Overview • • • • • • • Water and minerals in the body Water functions & importance Fluid compartments Intake needs & sources Output & loss Dehydration & intoxication The electrolytes: Na, K, & Cl Minerals in the Body • Minerals are inorganic elements that are naturally found in earth. • Major (>5 gm in reference body) & Trace • Major minerals = electrolytes (sodium, potassium, and chloride) • Major minerals in bone = calcium, phosphorus, and magnesium • Major mineral in protein = sulfur • Trace minerals = iron, copper, iodine, manganese, fluoride, chromium, molybdenum, selenium, zinc, & cobalt Water & Minerals in the Body • Needed in mg or µg amounts (depending on the nutrient) & based on age, gender, and conditions of pregnancy and lactation. • Inadequate/deficient intake → deficiency signs/symptoms over time. • Excess (>UL) intake → toxicity signs/symptoms over time. • Some foods or food groups provide a good source of some minerals and not others. • In general, eat a wide variety of foods from each of the food groups & drink fluids to meet mineral and water needs. Water: Chemical Form • Water is an inorganic compound composed of two hydrogen atoms and one oxygen atom. • It is abbreviated chemically as H2O. Functions of Water in the Body • • • • • A medium for chemical reactions Participates in energy formation Regulates nutrients & waste products Helps regulate body temperature Lubricants & cushions – joints, eyes, spinal cord, etc. • Maintains blood volume Fluid Compartments Extracellular 25% interstitial 8% blood/plasma Fluid Balance: Intake Needs • Adult DRI: ♂ 3.7 liters/day ♀ 2.7 liters/day There is no UL for water • Another recommend level is 1 ml/Calorie ♂ : 2900 Calories = 2.9 Liters (12 C) ♀: 2200 Calories = 2.2 Liters (9 C) These may not be optimal fluid intake levels. Strenuous physical activity & heat stress greatly increase water needs. Fluid Turnover Without Perspiration 4% Adults 15% Infants Fluid Sources and Losses (in liters) Importance of Water Moments without oxygen Days without water Weeks without food ~ 60% of total body weight is water Fluid Balance: Input & Output • Optimal fluid intake and output leads to normal skin integrity, body weight, urine volume and urine color. • Enough fluid should be taken in to produce a clear urine output every 2 hours while awake. • With insufficient intake and obligatory output, dehydration results. Adverse Effects of Dehydration % Loss Severity Symptoms 1-2 Mild Thirst, fatigue, weakness, loss of appetite 3-4 Moderate Impaired performance, dry mouth, urine reduction, impatience, apathy 5-6 Moderate Headache, irritability, sleepiness, increased respiration 7-10 Severe Dizziness, muscle spasm, imbalance, delirium, collapse How to Become Dehydrated • • • • • Intake of caffeine Intake of alcohol Diuretic medications Sweating Heat exposure Effects of Dehydration on Health Chronic Mild Dehydration is linked to: • Increased Risk – Urinary tract infection & stones, constipation, hypertension, heart disease, kidney dysfunction, hyperglycemia with diabetes, and possibly colon and bladder cancer and bronchopulmonary disorders. Water Intoxication • Rare, usually from forced water intake, • Serious life threatening consequences. • Associated with low blood levels of sodium (hyponatremia) – – – – CNS edema lung congestion muscle weakness Maximum renal clearance (urinary output) ~700 ml (24 ounces) -1000 ml per hour. • With heavy exercise, replace both water and electrolytes. Sources of Water for the Body 100% Water, diet soda 90-99% Nonfat milk, berries, watermelon, celery, lettuce 80-89% Fruit juice, yogurt, apples, oranges, grapes, carrots 70-79% Shrimp, banana, corn, potato, cottage cheese 60-69% Cooked pasta, legumes, salmon, chicken, ice cream 50-59% Ground beef, hot dog <50% Crackers, cereals, pretzels, nuts, butter, margarine, oils The Electrolytes • Electrolytes are salts that dissolve in water & dissociate into charged particles called ions. – Sodium: Na+ – Potassium: K+ – Chloride: Cl- • Electrolytes function in Fluid/Water balance & acid-base balance (excessive vomiting can cause alkalosis). Water Follows Electrolytes Fluid and Electrolytes • Drinking water & eating regular foods restores fluid & electrolyte balance. • With excessive sweating, bleeding, vomiting, or diarrhea special drinks may be used to restore electrolytes. Sodium Deficiency & Toxicity Food Sources: Salt, sea salt, soy sauce, processed foods, MSG. Deficiency Adequacy Toxicity (<66% of DRI) DRI: 1500 mg/day (>UL) Approx. <990 mg/day DRV: 2400 mg >2,300 mg/day Cardio-Vascular: hyponatremia, cardiac failure Central Nervous System: mental apathy, weakness GI System: loss of appetite Neuro-Musccular: muscle cramping, skeletal muscle cell injury Other: renal failure Normal ECF balance and volume, plasma osmolarity and volume, pH balance, and the membrane potential of cells Cardio-Vascular: increased blood pressure with increased risk for heart attack and stroke Other: fluid retention (edema) Adult deficient, adequate, toxic values Food Processing and Sodium Adult DRI: 1,500 mg/day Chloride Deficiency & Toxicity Food Sources: Salt (~2700 mg/tsp), salt substitute (~2600 mg/tsp), sea salt, soy sauce, processed foods with salt, seaweed, rye, tomatoes, lettuce, celery, and olives. Deficiency Adequacy Toxicity (<66% of DRI) DRI: 2,300 mg/day (>UL) Approx. <1520 mg/day (3,800 mg NaCl) >3,500 mg/day RDI: 3,400 mg (5,800 mg NaCl) Bone & tooth: growth failure in children Central Nervous System: mental apathy GI System: loss of appetite Neuro-Musccular: muscle cramps Normal ECF balance and volume and plasma osmolarity and volume. Hydrochloric acid production Cardio-Vascular: in combination with sodium, increased blood pressure with increased risk for heart attack and stroke Quantitative data unavailable for graphical analysis Potassium Deficiency & Toxicity Food Sources: All whole foods like meats, milk, fruit, vegetables, grains, and legumes, as well as, salt substitute Deficiency Adequacy Toxicity (<66% of DRI) DRI: 4,700 mg/day (UL is Not Established) Approx. <990 mg/day DRV: 3,500 mg Bone & tooth: bone turnover Cardio-Vascular: hypokalemia, cardiac arrhythmia, increased blood pressure with increased risk for heart attack and stroke Neuro-Musccular: muscle weakness Other: glucose intolerance, risk of kidney stones Normal ICF volume and function, nerve transmission, muscle contraction, and vascular tone, blunts the rise in blood pressure from excess sodium, and decreases kidney stone reoccurrence In renal (kidney) failure only. Cardio-Vascular: hyperkalemia, cardiac arrest Neuro-Musccular: muscle tetany Potassium in Whole Foods Adult DRI: 4,700 mg/day Some Summary Points • Adequate fluid intake is important for health and optimal functioning. • Dehydration has negative health effects. • Fluid intake should support producing a clear urine every 2 hours while awake. • The electrolytes function to regulate fluid & acid-base balance. References for this presentation are the same as those for this topic found in module 5 of the textbook