Water

NUTRITION AND DIET THERAPY BY: ROSELLE JOY C. BALAQUIT, RN

Objectives
• Describe functions of water in body
• Explain fluid balance and its maintenance
• Name causes and consequences of water
depletion
• Give some causes and consequences of
positive fluid balance
• Describe acid-base balance in human body

NUTRITION AND DIET THERAPY BY: ROSELLE JOY C. BALAQUIT, RN

Facts
• Humans can live approximately 30 to 45
days without food but only 10 to 14 days
without water
• Present in all body cells
• 50 to 60 percent of body weight of
normal adults
• Percentage highest in newborns and
decreases with age

NUTRITION AND DIET THERAPY BY: ROSELLE JOY C. BALAQUIT, RN

• Two basic compartments:
• Intracellular fluid (ICF)
Within cells
65 percent of total body fluid
• Extracellular fluid (ECF)
Outside cells
35 percent of total body fluid
Found in intravascular fluid (in
bloodstream), interstitial fluid (between
cells), and glandular secretions

NUTRITION AND DIET THERAPY BY: ROSELLE JOY C. BALAQUIT, RN

Functions
• Major component of blood plasma
• Solvent and transport for nutrients and
waste products
• Essential component for hydrolysis and
metabolism
• Lubricant in joints and digestion
• Body coolant through perspiration
• Shock absorber
NUTRITION AND DIET THERAPY BY: ROSELLE JOY C. BALAQUIT, RN
Sources
• Best:
• Drinking water
• Second-best:
• Other beverages
• Other:
• Fruits, vegetables, soups, milk, and gelatin
desserts
• Energy metabolism produces water
NUTRITION AND DIET THERAPY BY: ROSELLE JOY C. BALAQUIT, RN
Estimated Daily Fluid Intake
for an Adult
• Ingested liquids:
• 1,500 mL
• Water in foods:
• 700 mL
• Water from oxidation:
• 200 mL
• Total = 2,400 mL
NUTRITION AND DIET THERAPY BY: ROSELLE JOY C. BALAQUIT, RN
Fluid and Electrolyte
Balance
• Electrolytes measured in milliequivalents (mEq/L)
• Water losses must be replaced in volume and
electrolyte content
• Sensible water loss
 Noticeable
 Water lost through urine
• Insensible water loss
 Unnoticeable
 Water lost through feces, perspiration, and
respiration
NUTRITION AND DIET THERAPY BY: ROSELLE JOY C. BALAQUIT, RN
• Solute
Substance dissolved in solution
• Osmosis
Water flows from side with lesser amount of
solute to side with greater solute
concentration
• Potassium, sodium, and chloride maintain
balance between ICFs and ECFs
• Potassium
Principal electrolyte in ICF
• Sodium
Principal electrolyte in ECF
NUTRITION AND DIET THERAPY BY: ROSELLE JOY C. BALAQUIT, RN
• Osmolality
 Measures particles in solution
• When electrolytes in ECF increase, ICF moves to
ECF to equalize concentration of electrolytes on both
sides of membrane
 Reduces amount of water in cells
• Hypothalamus stimulates pituitary gland to excrete
antidiuretic hormone (ADH)
• ADH causes kidneys to reabsorb water
• Thirst causes healthy person to drink fluids
• When sodium in ECF reduced, water flows from ECF
into cells
 Causes cellular edema

NUTRITION AND DIET THERAPY BY: ROSELLE JOY C. BALAQUIT, RN

• Adrenal glands secrete aldosterone
 Triggers kidneys to increase amount of sodium
reabsorbed
• When sodium replaced in ECF, excess water moves
back to ECF
 Relieves edema
• Amount of water use varies
 Depends on age, size, activity, environmental
temperature, and physical condition
• Average adult requirement:
 1 milliliter (mL) for every calorie of food
consumed
 Increased requirements during youth, fever,
diarrhea, unusual perspiration, and hyperthyroidism
NUTRITION AND DIET THERAPY BY: ROSELLE JOY C. BALAQUIT, RN
Dehydration
• Occurs when amount of water in body inadequate
• Caused by inadequate intake or abnormal loss
 Loss can occur from severe diarrhea, vomiting,
hemorrhage, burns, diabetes mellitus, excessive
perspiration, excessive urination, or use of certain
medications (e.g., diuretics)
• Symptoms:
 Low blood pressure, thirst, dry skin, fever, and
mental disorientation
• As water lost, electrolytes also lost
• Treatment:
 Replacement of electrolytes and fluids
NUTRITION AND DIET THERAPY BY: ROSELLE JOY C. BALAQUIT, RN
• 10 percent loss of body water can cause
serious problems
• 20 percent loss of body water can cause
circulatory failure and death
• Blood volume and nutrient absorption
reduced
• Kidney function upset
• Infants at high risk for dehydration during
fever, vomiting, and diarrhea
• Treatment may involve intravenous (IV)
fluids
NUTRITION AND DIET THERAPY BY: ROSELLE JOY C. BALAQUIT, RN
• Thirst sensation lags behind body’s need for water
• Especially in elderly, children, athletes, and ill
• Feeling thirsty not reliable indicator of when body
needs water
• Prevention:
• Drink fluids throughout day
• Failure to replace water lost through perspiration could
lead to one of four stages of heat illness:
1. Heat fatigue
2. Heat cramp
3. Heat exhaustion
4. Heat stroke

NUTRITION AND DIET THERAPY BY: ROSELLE JOY C. BALAQUIT, RN

Signs of Dehydration
• Health history reveals inadequate intake of
fluids
• Decrease in urine output
• Weight loss
• Sunken eyes
• Increased furrows and fissures on tongue
• Dry oral mucous membranes
• Decreased skin turgor
• Changes in neurological status
NUTRITION AND DIET THERAPY BY: ROSELLE JOY C. BALAQUIT, RN
Excess Water Accumulation
• Positive water balance
• More water taken in than excreted
• Results in edema
• May be caused by hypothyroidism,
congestive heart failure, hypoproteinemia,
some infections, some cancers, and some
renal conditions
• Fluids and sodium may be restricted
NUTRITION AND DIET THERAPY BY: ROSELLE JOY C. BALAQUIT, RN
Acid-Base Balance
• Regulation of hydrogen ions
• Acid gives off hydrogen ions
• Base picks up hydrogen ions
• Acidic substances have pH of 1 to 7
• Alkaline substances have pH of 7 to
14
• pH of 7 considered neutral
NUTRITION AND DIET THERAPY BY: ROSELLE JOY C. BALAQUIT, RN
• Blood plasma has pH of 7.35 to 7.45
• Intracellular fluid has pH of 6.8
• Kidneys maintain acid-base balance
• What person eats affects acidity of urine
• Not of body

NUTRITION AND DIET THERAPY BY: ROSELLE JOY C. BALAQUIT, RN

 Buffer Systems
• Regulate hydrogen ion content in body fluids
• Mixture of weak acid and strong base
• Normal buffer system ratio of base to acid:
• 20:1
• Carbonic acid and sodium bicarbonate form body’s
main buffer system
• Carbonic acid moves easily to buffer strong alkali
• Sodium bicarbonate moves easily to buffer strong acid
• Amounts easily adjusted by lungs and kidneys to suit
body’s needs

NUTRITION AND DIET THERAPY BY: ROSELLE JOY C. BALAQUIT, RN

• End products of metabolism:
 Carbon dioxide and water
• Together, can form carbonic acid
• Medulla oblongata in brain causes breathing rate to
increase if amount of carbon dioxide more concentrated
than should be
 Increases rate at which body rids itself of carbon
dioxide
• Excess sodium bicarbonate excreted via kidneys
• Kidneys can excrete urine from pH of 4.5 to 8
• pH of average urine: 6

NUTRITION AND DIET THERAPY BY: ROSELLE JOY C. BALAQUIT, RN (continues)

Acidosis and Alkalosis
• Acidosis can be caused by renal failure,
uncontrolled diabetes mellitus,
starvation, or severe diarrhea
• Alkalosis can occur when body has
suffered loss of hydrochloric acid from
severe vomiting or has ingested too
much alkali (e.g., too many antacid
tablets)

NUTRITION AND DIET THERAPY BY: ROSELLE JOY C. BALAQUIT, RN

Conclusion
• Water
• Component of all tissues
• Solvent for nutrients and body wastes
• Provides transport for both
• Essential for the following:
• Hydrolysis
• Lubrication
• Maintenance of normal temperature

NUTRITION AND DIET THERAPY BY: ROSELLE JOY C. BALAQUIT, RN

• Best sources:
Water, beverages, fruits, vegetables, soups, and
water-based desserts
• Dehydration can result from lack of water
• Positive water balance
Excess accumulation of water in body
• Acid-base balance
Regulation of hydrogen ions in body
• Healthy people have intricate maintenance
systems for fluid, electrolytes, and acid-base
balance
NUTRITION AND DIET THERAPY BY: ROSELLE JOY C. BALAQUIT, RN