WATER AND ELECTROLYTES REQUIREMENTS

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WATER

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 WATER NEED

• Water makes up most of our body

• The water ratio in our body changes in
accordance with ratios of the fat free mass
and fat mass in the body. The more the fat
free mass, the more the water.
• Water ratio is high in athletes and low in
the elders (less fat free mass)
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 FUNCTIONS AND METABOLISM

• Solvent for solutes in cells

• Intermediate substance for all chemical
reactions
• Chemicals in metabolic reactions
• Structural component in creating a shape
of a cell
• Essential for digestion, absorption and
excretion 4
 FUNCTIONS AND METABOLISM

• Plays an important role in structure and

functions of circulatory system
• Intermediate substance in transporting
nutrients and all other substances in our body
• Maintain the physical and chemical balance
state of intracellular and extracellular fluid
• Maintain body temperature
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 WATER IS ESSENTIAL FOR LIFE
• Losing water at: 1% body mass => affects
thermoregulation ability, feeling thirsty
• Losing water at: 2% body mass => feeling more
thirsty
• Losing water at: 3% => mouth dry
• Losing water at: 4% => working productivity
lowers 20-30%
• Losing water at: 5% => lower concentration,
headache, sleepiness
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 FUNCTIONS AND METABOLISM
• Sweating: 1l of water helps alleviate/reduce
heat equal to 600Kcal
• Losing 10% of water in the body leads to
serious disorder
• Losing 20% of water in the body might be
deathly
• People can live 10 days without water,
children can live up to 5 days (while can live
several weeks without food)
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 WATER DISTRIBUTION IN THE
BODY
• Water in intracellular fluid (2/3 water amount in our body,
50% body mass)
• Water in extracellular fluid (1/3 the water amount in our body
or about 20% of body mass) including water in plasma/huyet
tuong, lymphatic fluid/bach huyet, cerebrospinal fluid/nao
tuy, secretion fluid, intercellular fluid/gian bao
• Intercellular fluid is often in gel form and links with capillary
holes
• Excessive accumulation of intercellular fluid =>
hydropsy/phu

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 WATER DISTRIBUTION IN THE
BODY
• In different conditions, water distribution
might be different but the total water is
constant

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 WATER BALANCE
• Homeostasis/can bang noi moi regulation from
the digestive tract, kidney, brain helps keep the
water amount in our body relatively constant, the
water amount taken in every day is equal to the
water amount discharged
• Water taken in is regulated by thirst
• Thirst is regulated by nerve cells and hormones in
brain when osmotic pressure of plasma increases
or intravascular/long mach volume decreases
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 WATER INTAKE

Water: Drinking/eating foods ml/day

Drink 1100 – 1400
Eat foods 800 - 1000
Water from transformation 300
(oxidation of food)
Total 2200 – 2700 (about 2500)

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 WATER INTAKE
• Water is absorbed quickly due to free
movement through the cell membrane
under facilitated diffusion
• Water movements is controlled by osmotic
pressure created by the ions in bodily
fluids
• When a person cannot drink water, water
is transferred as NaCl, glucose solution,
blood or serum 12
 WATER INTAKE

• Water poisoning: increase water intake,

increase intracellular fluid
• Water poisoning leads to brain cells
edema/phu→ nausea, vomiting, headache,
convulsion/co giat, retina edema, eyesight
asthenopia/mo/suy yeu and death

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 WATER DISCHARGE
Through eyes/eye tear Normal Hot weather Long
weather exercise
Recognizable
Through urine 1400ml 1200ml 500ml
Through waste 100ml 100ml 100ml
material/feces
Unrecognizable
Through sweating 100ml 1400ml 5000ml
Vaporize through skin 350ml 350ml 350ml
Through breathing 350ml 350ml 650ml
Total 2300ml 3400ml 6600ml
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 WATER DISCHARGE
• Mostly through kidneys
• Substances that cause higher excretion
includes alcohol and caffeine
• Height, low humidity, high temperature
increase unrecognizable dehydration through
lungs and recognizable through sweat
• Exercise in high temperature and low
humidity also lose water
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 WATER DISCHARGE
• Water in digestive tracts: 7-9 liters of digestive fluid is fully
absorbed at small intestine and colon/dai trang
• This water amount is twice as much (as) the water in blood, if
a person has diarrhea, he will lose a lot of water that affects
health seriously, especially children and elders
• Losing water through diarrhea causes death to thousands of
children in developing countries. The solution is ORS (oral
rehydration solution)
• Other water losing cases: vomiting, bleeding, burnt, drain,
diuretic/loi tieu 16
 WATER DISCHARGE
• When the fluid lost is much more than the fluid intake, the
kidneys will compensate by condensing urine, increase re-
absorption to meet hormone ADH (antidiuretic hormone:
regulates and balances the amount of water in your blood)
• However, the kidneys can only condense maximum 1400
mOsm/L (milliosmole: unit of osmotic concentration)
• Condensing ability of elders decreases => easier to lose
water and increase Natrium in blood
• Dehydration symptoms: headache, tiredness, losing appetite,
dry mouth, heart beating fast,… 17
 WATER TAKEN IN AND
DISCHARGED DAILY OF ADULTS
Drink/Eat in (ml/day) Discharged (ml/day)
Drink 1100 – 1400 Urine 1200 – 1500
Eat food 800 – 1000 Intestinal tract 100 – 200

Water 300 Breathing 400

(oxidation food) Sweating 500 – 600

Total 2200 -2700 2200 – 2700

~2500 ~2500

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 RECOMMENDED WATER INTAKE
FOR KIDS
• Kidneys’ working ability is not fully developed
• Can’t say they’re thirsty or ask for water so they don’t get water
=> Water demand : 150ml/kg/day
(Breast milk: 80% is water => Infants < 6 months old taking breast
milk don’t need water supply)

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 RECOMMENDED WATER INTAKE FOR OLDER AGE
Estimation method Water intake (ml/kg)

Teenagers (10 – 18 years old) 40

19 – 30 years old, heavy physical activity 40
19 – 55 years old, moderate physical activity 35
Grownups ≥ 55 years old 30

According to weight Water intake (ml/kg)

Children 1 – 10 kg 100
Children 11 – 20 kg 1000ml + 50 ml/kg for each 10kg increase
Children ≥ 21 kg 1500ml + 20ml/kg for each 20kg increase
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RECOMMENDED WATER INTAKE
FOR OLDER AGE
❑ Recommended water intake according to
energy supplied (by food):
▪ 1ml/1kcal for grownups/adults
▪ 1.5ml/kcal for teenagers

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 WATER DEMANDS

• For normal people, thirst helps us drink

enough water for the body
• For children, athletes with high intense
activities, severely sick people, and the
elders, they need to actively supply water
without only depending on thirst.

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 WATER DEMANDS
❑ The body doesn’t store water => the water lost
throughout the day must be compensated by water taken
in
❑ Water demands:
▪ 1ml/kcal for grownups and 1,5ml/kcal for children
▪ 35ml/kg for grownups, 50 – 60ml/kg for children
and 150ml/kg for kids
▪ 2 – 2.5 liter or 8 cups a day (250ml per cup)
▪ Pregnant women need more 600 – 700ml/day
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NATRIUM/SODIUM

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 NATRIUM DEMANDS

• Natrium/sodium with potassium and

Chlorine are essential nutrients that must
be included in daily diets
• Rarely missed out on diets
• High chance of over-consuming of
Natrium

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NATRIUM’S ROLES IN OUR BODY
❑ Na is a main electrolyte that helps:
▪ Regulate the osmotic pressure and balance the
body fluid
▪ Maintain the balance between acid and base
▪ Electrophysiological/dien sinh ly actions in
muscles and nerves
▪ With K, Cl, Na is essential for the active
transportation of metabolites through membranes
like glucose metabolism and metabolism of ion
Na in cells
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 NATRIUM’S ROLES IN OUR BODY
• Is absorbed almost 100% through digestive tract
• Mainly excreted through urinary tract => Na balance
• In hot, humid atmosphere: less excreted through
urine and waste material/feces
• High intensity activity: Na excreted through sweats
is much higher, but mostly is compensated through
eating => doesn’t need to change the diet/eating habit
or use special supplements
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 NATRIUM DEMANDS
❑ Na+ and Cl- are the main components of salts
❑ Na+ in animal-based foods > plant-based foods
❑ Minimum Na demand: 200 – 500mg/day
❑ Recommended Na intake:
▪ 600mg Na (1,5g salt)/day
▪ Diets: <2g Na (5g salt)/day

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LACK AND EXCESSIVE AMOUNT OF
NATRIUM
❑ Lack of Na:
▪ Lack of Na is rarely seen in healthy people
▪ Low Na in blood when losing excessive amount
of Na because of diarrhea, vomiting, sweating,
kidney disorder
❑ Excess of Na:
▪ Hypertension
▪ Cardiovascular diseases, especially strokes,
coronary diseases
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 NATRIUM IN FOOD

• Natural sources: milk, meat, sea food

• Processed food: bread, cookies, processed
meat, snack,…
• Additives: fish sauce, soy sauce,…

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POTASSIUM

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 POTASSIUM

• K is an essential nutrient for maintaining

total body fluid
• K is the main cation in the body fluid =>
electrolytes balanced
• Plasma concentration: 3.5 – 5.2 mmol/L

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 FUNCTIONS
• Electrolytes balance
• Balance between acid and base, and cellular activities
• Extremely important for the activities of connective system and
cardiac/heart muscles
• Act as a muscle relaxant
• Plays a role in transporting nerve impulses and maintaining normal
blood pressure
• Specific role in enzymatic reactions like protein and glycogen
synthesis
• Transform glucose => reserve glycogen and Nitrogen in muscular
proteins 33
 POTASSIUM DEMANDS

• Increasing Kali in a diet => lower systole/tam

thu and diastole/tam truong blood pressure in
adults
• Higher K in diets is related to lower chance of
strokes
• Adequate intake: 2000 – 2500mg K/day
• Diet goal: >3500mg

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 LACK AND EXCESSIVE AMOUNT OF POTASSIUM
❑ Lack of K:
▪ Rare
▪ Losing K due to vomiting, chronic digestive diseases, diuretic usage
▪ Chronic diseases and metabolic disorder
▪ Serious lack of K might lead to arrhythmia/roi loan nhip tim and death
❑ Excessive amount of K:
▪ Over-consuming of K when kidneys’ functions are normal is not
poisonous
▪ When kidneys’ functions are poor, increase K in blood and slower
heartbeats, might lead to heart stopping beating
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 K DISCHARGE

• Mostly excreted through urinary tract

• Over sweating due to exercises: K is lost
considerably through sweating, but quickly
restored
• Mainly compensated through food,
supplements or specially formulated
products are not necessary
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 SOURCES OF K

• From many unprocessed food

• Especially vegetables, fruits
• Processed foods lower K content
• Diets that consume lots of processed food
and less fresh vegetables, fruits are usually
lack of K

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CLORINE

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 CLORINE DEMANDS (CLORIDE, Cl)

• Distributed throughout the body as Cl-

• High content in cerebrospinal/nao tuy fluids,
stomach juice/chat tiet
• With Na, K, Cl helps maintaining the water
balance, regulate the homeostatic pressure and
acid-base balance
• Maintain blood pH
• Component of gastric juice/dich vi
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 CLORINE DEMANDS (CLORIDE, Cl)
• Excessive loss through vomiting, long and continuous
over-sweating, chronic digestive inflammation, kidney
failure
• High content Cl in blood when the body is dehydrated
• Diets are usually excessive with Cl (due to overeating
salt)
• Demand (equivalent to Na)
• Adequate intake: 900mg Cl/day
• Diet goal: <2900mg 40