NUTRITION

UNIT VIII - WATER & ELECTROLYTES

UNIT VIII - WATER & ELECTROLYTES
 Water: Daily requirement, regulation of water
metabolism, distribution of body water,
 Electrolytes:Types, sources, composition of body fluids

 Maintenance of fluid & electrolyte balance

 Over hydration, dehydration and water intoxication

 Electrolyte imbalances
 THE HUMAN BODY
 The human body – contains 60 – 70% of water
 To keep the body productive and prevent health
problems - need to maintain water level throughout
the day
 Survival without food – many days and months
 Survival without water – not more than three days
 THE HUMAN BODY
 Why to drink water?

 Human body loose water by daily activities –

sweating, breathing, talking, urinating and other
activities.
 WATER: DAILY REQUIREMENT
 Does not matter the climate – always need to
drink plenty.
 In Hot and humid climate – drink plenty of water –
to stay cool and not to get dehydrated.
 In a cold climate – lose lot of water through
urination – require plenty of water for drinking to
replace it.
 WATER: DAILY REQUIREMENT
 Approximate adequate daily intakes of fluids
(including plain water, milk and other drinks) in
litres per day include:
 Infants 0–6 months – 0.7 l (from breastmilk or
formula)
 Infants 7–12 months – 0.9 l (from breastmilk,
formula and other foods and drinks)
 WATER: DAILY REQUIREMENT
 Children 1–3 years – 1.0 l (about 4 cups)

 Children 4–8 years – 1.2 l (about 5 cups)

 Girls 9–13 years – 1.4 l (about 5-6 cups)

 Boys 9–13 years – 1.6 l (about 6 cups)

 WATER: DAILY REQUIREMENT
 Girls 14–18 years – 1.6 l (about 6 cups)

 Boys 14–18 years – 1.9 l (about 7-8 cups)

 Women – 2.1 l (about 8 cups)

 Men – 2.6 l (about 10 cups).

 WATER: DAILY REQUIREMENT

 These adequate intakes include all fluids, but it is

preferable that the majority of intake is from plain
water (except for infants where fluid intake is met
by breastmilk or infant formula).
 FUNCTION OF WATER
1. Aqueous medium for the various biochemical reactions

2. Participates as a reactant in several metabolic reaction

3.Vehicle for transport of solutes

4. Regulation of body temperature.

 SOME FOODS INCLUDE:
 Fruits- apple, banana, watermelons, melons, grapefruit, strawberries,
etc.
 Vegetables- celery, lettuce, radish, zucchini, spinach, tomato, eggplant,
etc.
 Diary- milk, yogurt
 Soup
REGULATION OF WATER METABOLISM
1. Antidiuretic Hormone or Vasopressin
2.Hypothalamus
3.Adrenal Cortex
4.Renin – Angiotensin System
5.Prostaglandins
6.Solutes
REGULATION OF WATER METABOLISM

1. Antidiuretic hormone
(ADH) or Vasopressin -
Has the property to
enhance water
reabsorption
 REGULATION OF WATER
METABOLISM

2. Hypothalamus
 Thirst centre.
 Beside this,
osmoconcentration of
plasma also stimulates
supraoptic and
paraventricular nuclei.
REGULATION OF WATER METABOLISM
3. Adrenal Cortex
 Aldosterone has control
excretion of sodium and
Potassium by the kidneys.
 3 Hormones – a. ADH,
b.Aldosterone, c.ANH
REGULATION OF WATER METABOLISM
a. ADH (Antidiuretic
Hormone) – from posterior
pituitary acts on the kidney to
promote water reabsorption –
prevents its loss in urine.
REGULATION OF WATER METABOLISM
b. Aldosterone from the
adrenal gland acts on the
kidney to promote sodium
reabsorption - prevents loss
in urine.
REGULATION OF WATER METABOLISM
c. ANH (Atrial Natriuretic
Hormone) from the atrium
of the heart – acts on kidney
– to promote Na+ excretion
– Excreted in urine
REGULATION OF WATER METABOLISM
4. Renin-Angiotensin System:
Angiotensin II
Stimulates - synthesis & secretion of

Aldosterone Vasopressin,

Renal absorption of Na+ and H2O.

REGULATION OF WATER METABOLISM
5. Prostaglandins:
Prostaglandins
inhibiting the ADH effect of
vasopressin
Increase urinary loss of water
& increasing the sodium.
REGULATION OF WATER METABOLISM

6. Solutes

 Osmotic effect of Na+ helps to retain water in ECF.

 Elevation in plasma Na+ raises the ECF volume.

 K+ - retain water in cells

DISTRIBUTION OF BODY WATER
 ELECTROLYTES: DEFINITION
Electrolyte: A substance that dissociates into ions in
solution and acquires the capacity to conduct
electricity.
 ELECTROLYTES: TYPES
1. Strong Electrolyte 2. Weak Electrolyte 3. Nonelectrolyte

• Dissociates • Does not dissociate • Dissociates partially

completely. • Is present in solution • Poor conductors
• Is present in solution exclusively as
exclusively as ions. molecules.
• Are good • Do not conduct
conductors of electricity
electricity
 ELECTROLYTES IN HUMAN BODY

 Sodium  Calcium
 Potassium  Magnesium
 Chloride  Phosphate
 FOOD SOURCES - CHLORIDE
 Chloride is found in table salt or sea salt as
sodium chloride.
 It is also found in many vegetables. Foods with
higher amounts of chloride include seaweed, rye,
tomatoes, lettuce, celery, and olives.
 Chloride, combined with potassium, is also found
in many foods.
Electrolytes: Composition of body fluids
MAINTENANCE OF FLUID & ELECTROLYTE BALANCE
 Maintenance and balance of electrolytes in the
human body is essential for normal cells and
organs.

 Positively charged ions – cations. Eg: Na+, K+

 Negatively charged ions – anions. Eg: Cl-, HCO-3

 MAINTENANCE OF FLUID & ELECTROLYTE BALANCE
SODIUM
 Existence:
Sodium exists as NaCl, Na2CO3, NaHCO3 in an
ECF 40% (exchangeable form),
50% in bones, and remaining 10% in soft tissue
(non-exchangeable form)
 Total body sodium – 4000 mequ/L (1.8g/kg)
MAINTENANCE OF FLUID & ELECTROLYTE BALANCE
SODIUM
MAINTENANCE OF FLUID & ELECTROLYTE BALANCE
SODIUM – FUNCTIONS
MAINTENANCE OF FLUID & ELECTROLYTE BALANCE
SODIUM – DAILY REQUIREMENT
MAINTENANCE OF FLUID & ELECTROLYTE BALANCE
SODIUM – DISTRIBUTION IN HUMAN BODY
MAINTENANCE OF FLUID & ELECTROLYTE BALANCE
POTASSIUM
MAINTENANCE OF FLUID & ELECTROLYTE BALANCE
POTASSIUM
MAINTENANCE OF FLUID & ELECTROLYTE BALANCE
POTASSIUM – PHYSIOLOGICAL ROLES OF POTASSIUM
MAINTENANCE OF FLUID & ELECTROLYTE BALANCE
POTASSIUM – PHYSIOLOGICAL ROLES OF POTASSIUM
MAINTENANCE OF FLUID & ELECTROLYTE BALANCE
CHLORIDE
 MAINTENANCE OF FLUID & ELECTROLYTE BALANCE
CHLORIDE

 A normal adult human body contains approximately 81.7

g chloride.
 On the basis of a total obligatory loss of chloride of
approximately 530 mg/day,
 A dietary intake for adults of 9 mg of chloride per kg of
body weight has been recommended (equivalent to
slightly more than 1 g of table salt per person per day).
MAINTENANCE OF FLUID & ELECTROLYTE BALANCE - CALCIUM
MAINTENANCE OF FLUID & ELECTROLYTE BALANCE - CALCIUM
 Adult human body contains – 1100g (27.5mol) of
Calcium.
 99% of Calcium is in bone.
 Blood Calcium level are normally 9 – 10.2 mg/dL (2.25
to 2.55 mmol/L)
 Of the total – 50% is free ionized Ca, 9% combined with
various anions (bicarbonate, citrate, phosphate, lactate,
sulphate)
MAINTENANCE OF FLUID & ELECTROLYTE BALANCE - CALCIUM

 Remaining 40% bound to serum protein – mainly

albumin.
 Free ionized Ca important for component of the total
Ca.
 In plasma, ionized Ca maintained within a tight range –
1.0 – 1.25mmol/l
MAINTENANCE OF FLUID & ELECTROLYTE BALANCE - MAGNESIUM
MAINTENANCE OF FLUID & ELECTROLYTE BALANCE - PHOSPHATE
FLUID AND ELECTROLYTE BALANCE
 Adrenal gland

Secreting Aldosterone

Regulates Na+ reabsorption by kidneys

Aids in controlling ECF volume

 Pituitary Gland

Secrets ADH

Kidney reabsorbs water

Regulates osmotic pressure of ECF

OVER HYDRATION
 1. Isotonic
Over hydration Over hydration
Known as hypervolemia,
results from excessive
fluid in the extracellular
fluid compartment, causes
circulatory overload and
interstitial edema
Causes - Inadequately
controlled IV therapy,
Renal failure, Long term
corticosteroid therapy
2. Hypertonic 3. Hypotonic
Over hydration
Water intoxication;
Caused by excessive
electrolyte imbalance due
sodium intake
to dilution
Causes - Congestive heart
Causes - Excessive failure, Syndrome of
sodium ingestion, Rapid inappropriate antidiuretic
infusion of hypertonic hormone secretion
saline (SIADH), Inadequately
controlled IV therapy
 DEHYDRATION
 Dehydration occurs when the fluid intake of the body is
not sufficient to meet the fluid needs of the body
 The goal of treatment is
 To restore fluid volume,
 Replace electrolytes as needed,
 And eliminate the cause of the fluid volume deficit
TYPES OF FLUID VOLUME DEFICIT
1. Isotonic Dehydration 2. Hypertonic Dehydration 3. Hypotonic Dehydration

Definition - Water Definition - Water Definition -

and dissolved loss exceeds Electrolyte loss
electrolytes are lost electrolyte loss, exceeds water loss,
in equal proportion shrinks cells cells swell

Causes - Excessive
Causes - Inadequate Causes - Excessive
fluid replacement,
intake of fluids and perspiration,
Renal failure,
solutes, Fluid shifts Hyperventilation,
Chronic
between Diarrhoea, ESRD,
malnutrition,
compartment Diabetes insipidus
Chronic illness
 WATER INTOXICATION
 Water intoxication - water
poisoning, hyperhydration, overhydration, or water
toxemia.
 It is a potentially fatal disturbance in brain functions that
results when the normal balance of electrolytes in the
body is pushed outside safe limits by
excessive water intake.
 Electrolyte Deficit Excess
imbalance
Sodium imbalance Hyponatremia Hypernatremia

Potassium imbalance Hypokalemia Hyperkalemia

Calcium imbalance Hypocalcemia Hypercalcemia

Phosphate imbalance Hypophosphatemia Hyperphosphatemia

Magnesium imbalance Hypomagnesemia Hypermagnesemia

Chloride imbalance Hypochloremia Hyperchloremia