UNIT 1

WATER
B.Sc.. Nursing
Dt. Swaichchha Basnet

Water is essential to sustain life, and a satisfactory (adequate, safe, and accessible) supply must be
available to all. Improving access to safe drinking water can result in tangible benefits to health. Water is
largest constituent of the body. A 10% loss of body water is serious hazard & death is likely to follow a
20% loss. Water is the solvent of life. Because of its high polarity, water is called the universal solvent. A
solvent is a substance that dissolves, breaks apart, another substance (known as solute).

FUNCTIONS:
On a biological level, water’s role as a solvent helps cells transport and use substances like oxygen or
nutrients. Water-based solutions like blood help carry molecules to the necessary locations. Thus, water’s
role as a solvent facilitates the transport of molecules like oxygen for respiration and has a major impact
on the ability of drugs to reach their targets in the body. Powerful solvent for ionic compounds and
neutral molecules in organisms (aqueous medium for biochemical reactions)
Some of its key functions:
1. Hydration and Cell Function: Water is essential for maintaining proper hydration at the cellular
level. It helps to regulate body temperature, transport nutrients and oxygen to cells, and remove
waste products. Influence on structural and functional components of cells (the major body
constituents)
2. Strong influence on state of dissociation of macro molecules.
3. Lubrication and Protection: Water acts as a lubricant, facilitating the movement of joints,
organs, and tissues. It also acts as a cushion, protecting vital organs such as the brain, spinal cord,
and fetus during pregnancy.
4. Digestion and Nutrient Absorption: Water plays a vital role in the digestion and absorption of
nutrients. It helps break down food, assists in the enzymatic processes involved in digestion, and
aids in the absorption of nutrients in the gastrointestinal tract.
5. Waste Removal: Water is involved in the elimination of waste products from the body. It helps
flush out toxins through urine, perspiration, and bowel movements, maintaining the health of the
urinary and digestive systems.
6. Transport Medium: Water acts as a medium for transporting substances throughout the body. It
helps carry nutrients, hormones, and other essential compounds in the bloodstream, ensuring their
delivery to various tissues and organs. Vehicles for transport of solutes.
7. Lessen burden on kidneys and liver by flushing out waste products.
8. Chemical Reactions: Many biochemical reactions in the body, including metabolic processes,
rely on water as a solvent. Water provides a medium for these reactions to occur, facilitating
cellular metabolism and maintaining overall biochemical balance.
9. Maintenance of pH Balance: Water assists in maintaining the body's acid-base balance, which is
crucial for optimal cellular function. It acts as a buffer, preventing drastic fluctuations in pH and
helping to regulate the body's pH levels.
10. Water helps in maintaining osmotic pressure.
 11. Temperature Regulation: Water has a high heat capacity, meaning it can absorb and release
heat without significant temperature changes. This property helps regulate body temperature,
preventing overheating or excessive cooling. Regulation of body temperature (high heat of
vaporization helps in body cooling)
12. Water supports cellular structures; it also contributes information of membranes surrounding
cells.
13. Cognitive Function: Proper hydration is essential for maintaining cognitive function,
concentration, and mental alertness. Dehydration can impair cognitive performance, memory, and
mood.
14. Electrolyte Balance: Water is involved in maintaining the balance of electrolytes in the body,
such as sodium, potassium, and chloride. Electrolytes are crucial for nerve function, muscle
contraction, and maintaining proper fluid balance within cells and tissues.
15. Water helps to restore fluids lost through metabolism, breathing, sweating, and the removal of
waste.

Some effects and symptoms of WATER DEFICIENCY:

1. Thirst: Thirst is the body's natural mechanism to signal the need for water. When the body is
dehydrated, the sensation of thirst becomes more prominent as a way to encourage fluid intake.
Stronger thirst, vague discomfort, loss of appetite.
2. Dry Mouth and Lips: Insufficient water intake can lead to a dry mouth and parched lips. The
mouth may feel sticky, and saliva production may decrease.
3. Dark Urine: Dehydration can cause a decrease in urine volume and concentration. As a result,
urine may become dark yellow or amber in color. In severe dehydration, urine output may be
significantly reduced.
4. Fatigue and Weakness: Water is essential for energy production in the body. Dehydration can
lead to decreased energy levels, feelings of fatigue, and muscle weakness.
5. Dizziness and Lightheadedness: Inadequate hydration can cause a drop in blood pressure,
leading to dizziness and lightheadedness. This can be particularly pronounced when standing up
quickly. Dizziness, laboured breathing with exercise, increased weakness.
6. Headaches and Migraines: Dehydration may contribute to the development of headaches or
exacerbate existing migraines in some individuals.
7. Dry Skin: When the body is dehydrated, it prioritizes water supply to vital organs, leading to
reduced moisture levels in the skin. This can result in dry, flaky skin and an increased risk of skin
problems.
8. Poor Concentration and Cognitive Function: Dehydration can affect cognitive function,
concentration, and overall mental performance. It may impair memory, attention, and decision-
making abilities.
9. Decreased Urination and Constipation: In dehydration, the body tries to conserve water by
reducing urine output. This can lead to infrequent urination and potentially contribute to
constipation as the body tries to extract more water from waste. Failing renal function, less or
no urine formed.
10. Sunken Eyes and Reduced Tear Production: Severe dehydration may cause the eyes to appear
sunken and reduce tear production, leading to dry and irritated eyes.
 11. Failure to regulate excess temperature.
12. Muscle spasms, delirium, and wakefulness.
13. Inability to decreased blood volume to circulate normally.

EXCESSIVE WATER CONSUMPTION: Water intoxication typically results from consuming a large
volume of water in a short time, beyond the body's capacity to excrete it through urine or sweat. It's
important to note that water intoxication is relatively rare and is more commonly seen in specific
circumstances, such as extreme endurance events or certain medical conditions. For most people,
maintaining regular hydration through balanced fluid intake is sufficient to support overall health without
the risk of water intoxication. This can lead to an imbalance in the body's electrolyte levels, primarily
diluting sodium in the blood, which is known as hyponatremia.
1. Dilution of Sodium Levels: When excessive water enters the body, the concentration of sodium
in the blood becomes diluted. This can disrupt the proper functioning of cells, including brain
cells.
2. Symptoms: Early symptoms of water intoxication may include nausea, vomiting, headaches,
confusion, disorientation, and in severe cases, seizures and loss of consciousness.
3. Exercise-Associated Hyponatremia: Athletes who consume excessive amounts of water during
prolonged physical activities, such as marathons, without adequately replenishing electrolytes, are
at higher risk of water intoxication.
4. Risk Factors: Certain factors can increase the risk of water intoxication, including participating
in endurance sports, having a medical condition that affects fluid balance (e.g., kidney disease),
and using certain medications (e.g., diuretics).

DAILY REQUIREMENTS OF WATER

The daily water requirements can vary depending on several factors, including age, sex, body size,
activity level, climate, and overall health. The water required from beverages for adult man ranges from

32-58 ml per kg body weight and for woman, it ranges from 27-52 ml per kg body weight. For children,
the requirement is greater than 60 ml per kg body weight and for adolescent boys it ranges from 47-60 ml
per kg body weight, while, for girls it is 39-49 ml per kg body weight. For pregnant woman, based on
the working intensity, the water required from beverages ranges from 2.1 to 3.2 liters per day. For old
age, irrespective of gender, the present consensus for water requirement from beverages is 33 ml per kg
body weight for sedentary activity and 38 ml per kg body weight for moderate activity.

Here are some general guidelines for daily water intake:

1. National Academies of Sciences, Engineering, and Medicine (NASEM) Recommendations:
 Adult Men: Approximately 3.7 liters (or about 13 cups) of total water intake per day.
 Adult Women: Approximately 2.7 liters (or about 9 cups) of total water intake per day.
Note: These recommendations include water from all sources, including beverages and
food.
2. Institute of Medicine (IOM) Recommendations:
 Adequate Intake (AI) for Total Water: For men, about 3.7 liters (or about 13 cups) per
day. For women, about 2.7 liters (or about 9 cups) per day.
  These recommendations are based on average needs and take into account typical activity
levels and environmental conditions.
It's important to note that these recommendations serve as general guidelines, and individual needs may
vary. Factors like physical activity, climate (hot and humid conditions may increase water needs), and
health conditions (e.g., fever, diarrhea) may necessitate increased water intake.
Additionally, water intake can come from various sources, including not only plain water but also other
beverages like tea, coffee, milk, fruit juices, and foods with high water content (e.g., fruits and
vegetables). It's essential to consider these alternative sources of hydration when determining daily water
intake.
It's worth mentioning that thirst is a reliable indicator of the body's need for water. Paying attention to
thirst cues and ensuring regular fluid intake throughout the day is a good way to stay adequately hydrated.
Individuals with specific health conditions or special circumstances should consult healthcare
professionals for personalized recommendations regarding their water intake.

DISTRIBUTION OF BODY WATER

The distribution of body water refers to the partitioning of water within different compartments of the
body. The human body is divided into various compartments, each containing different amounts of water.
Here are the main compartments of body water:
1. Intracellular Fluid (ICF): The intracellular fluid refers to the water present inside the cells. It
constitutes the largest portion of total body water, accounting for approximately 60% of body
weight. The ICF is primarily found within cells and includes water within the cytoplasm and
other cell components. Two third of the body water is intracellular.
2. Extracellular Fluid (ECF): The extracellular fluid is the water found outside the cells. It
comprises about 40% of body weight. The ECF is further divided into two sub-compartments:
The extracellular fluid consists of plasma and interstitial fluids.
a. Interstitial Fluid: This fluid surrounds and bathes the cells, providing them with nutrients and
removing waste products. Interstitial fluid accounts for the majority of ECF.
b. Plasma: Plasma is the liquid portion of blood and makes up a small portion of ECF. It is responsible
for transporting various substances, such as nutrients, hormones, and cells, throughout the body.
The distribution of water between these compartments is regulated by osmotic forces, which help
maintain fluid balance and ensure proper cellular function. Osmosis, the movement of water across cell
membranes, allows for the exchange of water and solutes between the ICF and ECF compartments.
It's important to note that fluid distribution can change in certain circumstances, such as dehydration or
fluid overload. In these situations, the body may shift water between compartments to maintain
homeostasis.

Water makes up a significant portion of the human body composition. The exact percentage of water in
the body can vary based on factors such as age, sex, body composition, and overall health. On average,
water constitutes approximately:
1. Lean Adults: In lean adult males, water typically accounts for about 60% to 65% of total body
weight. In lean adult females, it ranges from 50% to 60% due to differences in body composition
(e.g., higher proportion of adipose tissue).
2. Infants and Children: The water content in infants is higher, usually ranging from 70% to 75%
of body weight. This higher percentage is primarily due to the higher water content in the body's
 organs and tissues. As children grow and their body composition changes, their water percentage
gradually decreases to adult levels.
3. Adipose Tissue: Adipose tissue, or body fat, contains less water compared to other body tissues.
This is why individuals with a higher percentage of body fat typically have a lower overall water
percentage. Adipose tissue contains only 10% of water.
It's important to note that the water content in specific organs and tissues can vary. Here are some
approximate water percentages for various body components:
 Muscles: Muscles are approximately 75% water. This high water content is essential for
maintaining proper muscle function and performance.
 Blood: Blood is composed of about 80% water. It plays a vital role in transporting nutrients,
oxygen, and waste products throughout the body.
 Bones: Bones have a lower water content compared to other tissues, comprising roughly 20%
water. However, water still plays a role in the structure and function of bone tissue.
 Organs: Different organs have varying water content. For instance, the brain and heart are
composed of approximately 73% water, while the lungs are about 83% water.

It constitutes about 70 percent of the total body weight and within which the major cations like sodium,
potassium, calcium, hydrogen, magnesium and anions like chloride, bicarbonate and protein of the body
are dissolved.
Without water there would be no form of life and it forms the intracellular medium within which
metabolic reactions characteristics of living substances take place. Water-deprivation brings about death
earlier than that of food-deprivation. If water is given instead of food, life may continue for several weeks
by the loss of most of the body fat and 50 percent, of tissue protein.

Water makes up 50-70% of the weight of the human body. Total body water in an average human being,
weighing about 70 kg is 40 liters to 45 liters. In human being it is about 65% of the body weight in males
and about 10% less in females. But the above values vary mostly with the relative degrees of leanness and
fatness of the individual. In lean person, the value is higher than that of in obese person. In general,
woman contains more fat than man. The total body water content can be deter mined most accurately by
the process of desiccation.
 Figure . Distribution of total body water among compartments

REFERENCES
1. A textbook of nutrition for nurses by Molly sam, N geetha
2. Recommended Daily Allowances, ICMR
3. https://www.biologydiscussion.com/human-physiology/body-fluid/total-body-water-and-its-
distribution-human-physiology-biology/81230
4. https://sitn.hms.harvard.edu/uncategorized/2019/biological-roles-of-water-why-is-water-
necessary-for-life/