water. water essential nutrient – no calories essential nutrient – no calories part of every...
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WATERWATER
WATERWATER
Essential nutrient – NO caloriesEssential nutrient – NO calories Part of every cellPart of every cell
muscle muscle 75% 75%
bones bones 25% 25%
teeth teeth 10% 10%
fat tissue fat tissue 20-33%20-33%
Higher body fat = Less H2OHigher body fat = Less H2O
Higher lean = Higher H2OHigher lean = Higher H2O
WATER COMPARTMENTSWATER COMPARTMENTS
WATERWATER Do not store waterDo not store water How long can we survive without water?How long can we survive without water? Water varies by:Water varies by: Age – caused by loss of extracellular fluidAge – caused by loss of extracellular fluid embryo = ~97% embryo = ~97% newborn = ~75%newborn = ~75% adult = ~60%adult = ~60% elderly = ~<60% (~50%)elderly = ~<60% (~50%) Gender- because of LBM relationshipGender- because of LBM relationship Men = 60% of body weightMen = 60% of body weight Women = 50% of body weightWomen = 50% of body weight
WATER WATER ESTIMATESESTIMATES
FUNCTIONSFUNCTIONS Building material – part of every cellBuilding material – part of every cell Medium for chemical reactions – chemicals (enzymes, Medium for chemical reactions – chemicals (enzymes,
hormones, coenzymes) dissolve and act on metaboliteshormones, coenzymes) dissolve and act on metabolites Hydolysis – digestionHydolysis – digestion Transport medium – solvent for waste productsTransport medium – solvent for waste products Lubricant – water filled sacs around jointsLubricant – water filled sacs around joints Shock absorber – around brain and spinal cordShock absorber – around brain and spinal cord Temperature control – cools skin, excess heat from Temperature control – cools skin, excess heat from
metabolic reactionsmetabolic reactions Blood volume Blood volume
FLUID BALANCEFLUID BALANCE
Fluid lossFluid loss Concentration of electrolytesConcentration of electrolytes Water absorbed from salivaWater absorbed from saliva Dry mouth, thirst stimulatedDry mouth, thirst stimulated Children, elderly, athletesChildren, elderly, athletes
WATER REGULATIONWATER REGULATION
WATER LOSSESWATER LOSSES
Normal 2-3 liters/dayNormal 2-3 liters/day Urine = 500-1400 mlUrine = 500-1400 ml Skin = 450-900 mlSkin = 450-900 ml Lungs = 350 mlLungs = 350 ml Feces = 150 mlFeces = 150 ml Insensible losses (skin, lungs, feces)Insensible losses (skin, lungs, feces) GI tract 8 liters/day secreted as GI tract 8 liters/day secreted as
digestive juices digestive juices reabsorbed in colon reabsorbed in colon
WATER OUTPUTWATER OUTPUT
LOSSES INCREASEDLOSSES INCREASED
AlcoholAlcohol CaffeineCaffeine Diuretics Diuretics
OUTPUT DEPENDS ONOUTPUT DEPENDS ON
Total intakeTotal intake Metabolic disturbancesMetabolic disturbances Altered dietary intake: protein, Altered dietary intake: protein,
NaCl, CHO increase urine output NaCl, CHO increase urine output for urea, ketones, and Nafor urea, ketones, and Na
Output of 1 liter/day = Output of 1 liter/day = concentrated urine concentrated urine increased increased risk of stones in susceptible peoplerisk of stones in susceptible people
WATER SOURCESWATER SOURCES
Fluids = 550-1500 mlFluids = 550-1500 ml Solid food = 700-1000 mlSolid food = 700-1000 ml Metabolic water = 200-300 mlMetabolic water = 200-300 ml Needs = lossesNeeds = losses Input and output normally in equilibriumInput and output normally in equilibrium Obligatory waste excretion – need at Obligatory waste excretion – need at
least 500 ml to excrete metabolic least 500 ml to excrete metabolic wasteswastes
WATER INPUTWATER INPUT
DEHYDRATION – LOW WATER DEHYDRATION – LOW WATER LEVELSLEVELS
Physical causes:Physical causes: VomitingVomiting DiarrheaDiarrhea Blood lossBlood loss FeverFever Weight lossWeight loss Work in high temperatures/hot climatesWork in high temperatures/hot climates Strenuous physical exerciseStrenuous physical exercise
SYMPTOMSSYMPTOMS
Thirst – not always reliableThirst – not always reliable Loss of appetite Loss of appetite Decreased blood volumeDecreased blood volume Impaired physical performanceImpaired physical performance Impaired temperature regulationImpaired temperature regulation Muscle spasmsMuscle spasms General debilitationGeneral debilitation
LAB TESTS TO DIAGNOSELAB TESTS TO DIAGNOSE
Increased hematocritIncreased hematocrit Increased serum sodiumIncreased serum sodium Increased albuminIncreased albumin Increased BUNIncreased BUN
WATER LOSSESWATER LOSSES
3% of body weight 3% of body weight decreased decreased physical performancephysical performance
4-5% body weight 4-5% body weight impaired impaired mental functionmental function
10% of body weight 10% of body weight life life threateningthreatening
20% body weight 20% body weight fatal fatal
DEHYDRATION CHARTDEHYDRATION CHART
REHYDRATIONREHYDRATION Drinking enough fluid?Drinking enough fluid? color of urinecolor of urine volume of urinevolume of urine weight lossweight loss For every pound lost drink 2 cups of fluidFor every pound lost drink 2 cups of fluid During exercise – 1 quart fluid for every 1000 cal During exercise – 1 quart fluid for every 1000 cal
spentspent drink 8-10 ounces every 15-20 min. of strenuous drink 8-10 ounces every 15-20 min. of strenuous
exercise – may sweat 3 times that much exercise – may sweat 3 times that much At risk for Na depletion if longer than 4 hour At risk for Na depletion if longer than 4 hour
workout – athletes acclimate, sweat less salty as workout – athletes acclimate, sweat less salty as become more conditionedbecome more conditioned
WHAT TO DRINKWHAT TO DRINK
? Caffeine - increases urination? Caffeine - increases urination ? Soft drinks - empty calories? Soft drinks - empty calories ? Gatorade, Allsport, Powerade - little nutritional ? Gatorade, Allsport, Powerade - little nutritional
valuevalue ? Beer - ETOH dehydrating effect, increase ? Beer - ETOH dehydrating effect, increase
urinationurination ? Juice? Juice
Vit C and KVit C and K ? Water? Water ? Glucose polymers & CHO powders – can ? Glucose polymers & CHO powders – can
provide energy value with less sweetnessprovide energy value with less sweetness ? Salt tablets – increase dehydration? Salt tablets – increase dehydration
WATER INTOXICATIONWATER INTOXICATION
Kidneys are overwhelmed – can’t excrete fast Kidneys are overwhelmed – can’t excrete fast enoughenough
Caused byCaused by
Greatly increased water intakeGreatly increased water intake
Increased secretion of antidiuretic hormoneIncreased secretion of antidiuretic hormone
Acute weight gainAcute weight gain Physical symptomsPhysical symptoms
HeadachesHeadaches
Blurred visionBlurred vision
CrampsCramps
Eventually convulsionsEventually convulsions
LABORATORY SIGNSLABORATORY SIGNS
Decreased hematocritDecreased hematocrit Decreased serum sodiumDecreased serum sodium Decreased albuminDecreased albumin Decreased BUNDecreased BUN Excess water dilutes Na Excess water dilutes Na
decreases Na concentration in ECF decreases Na concentration in ECF water enters cells and upsets water enters cells and upsets balancebalance