Chapter 12

Water and the Major Minerals

Water and the Body Fluid:

● Body needs water more than any other nutrient
● Water accounts for ~60% of an adults body weight
● Lean tissue weight is ~75% water, compared to ~25% of fat
○ Females, obese people and elderly have smaller prop of lean tissues, thus
lower prop of their body weight is water
○ Person body comp influences how much body weight is water
● Carries nutrient and waste throughout body
● Maintains structure of large molecules such as glycogen and protein
● Participates in metabolic reactions
● Serves as solvent for minerals, vitamins, AA, glucose, etc to allow for participation in
metabolic activities
● Acts as a lubricant and cushion around joints, in eyes, spinal cord, amniotic sac
● Aids in regulation of body temp (evaporation of sweat from skin removes excess heat)
● Maintains blood volume

Cellular Fluids and Electrolytes:

● Every cell contains fluid of the exact comp that is best for the cell
● Intracellular fluid: fluid inside cells
● Extracellular fluid: fluid outside cells
○ Interstitial fluid: surrounds each cell
○ Intravascular fluid: in the blood vessels
● Composition of each remain constant under normal conditions
○ ~⅔ inside cell and ~⅓ outside of cell
○ Continually lose and replace their components
● Electrolytes:
○ Salts that dissolve in H2O and dissociate into charged particles called ions
○ EX: NaCl
■ dissociates (separates) into Na+ (cation) and Cl- (anion)
● Electrolyte solutions:
○ Contain dissolved electrolytes (anions and cations are balanced)
○ Conduct electricity
○ milliequivalents per liter (mEq/L)
● Some electrolytes mostly outside cells (Na, Cl, Ca) and some are mostly inside cells (K,
Mg, P, S)
● Electrolytes Attract Water:
○ electrolytes move across membranes, water follows
○ the attraction allows salt to dissolve in water and allows body to move fluids
in and out of cells
● Solutes (dissolved substances) attract water based on conc of solution
○ Osmosis: water movement across a membrane toward more concentrated
solutes
○ Osmotic pressure: amount of pressure needed to prevent movement of water
across membrane
 ○ So water moves from an area of low solute to an area of high solute conc
● Protein attract water and maintain fluid balance
○ Edema: proteins leak out of blood vessels into space between cells, fluid
follows causing edema
○ Transport proteins in cell membrane regulate passage of substance

Regulation of Fluid Balance:

● Fluids maintain blood volume and influences blood pressure
● Water in:
○ consumption of liquids and food
○ metabolic production from oxidation of P-F-C
■ estimated at 250-350 ml/day without exercise
● Water Out:
○ Respiratory
■ Increased by physical activity and altitude
■ Somewhat increased by breathing hot, dry air and cold dry air during
exercise
○ GI tract
○ Skin (sweat)
■ primary mode of fluid loss during exercise and heat stress
○ Renal (urine output)
■ Increases dramatically with increased intake when euhydrated to
eliminate excess water
■ Decreases more gradually with dehydration
■ Less protection against dehydration
● Euhydration: normal body water content
● Hypohydration: body water deficit
● Hyperhydration: body water excess
● Dehydration: loss of body water
○ – >2% affects exercise performance
● Regulated by the kidneys
○ Adjust urine volume and concentrations
■ this influences blood pressures
○ Reabsorb needed substances and water
○ Accommodate variations in food and beverage intake
● Antidiuretic hormone (ADH):
○ Water-conserving hormone produced by hypothalamus which signals pituitary
gland to release eADH
■ stimulates kidney to reabsorb water when blood volume or BP falls too
low or with dehydration or high sodium in blood
■ also triggers thirst -> drinking restores fluid balance
■ restore homeostasis
○ Dehydrated -> body release ADH to conserve water
■ stimulate thirst
■ restore blood volume and homeostasis
○ Alcohol intake depresses ADH activity = fluid loss and dehydration
● Renin:
○ enzyme release by kidneys
 ○ occurs when blood pressure is LOW
○ Renin causes sodium to be reabsorbed, which is accompanied by water
reabsorption
○ converts angiotensin (from liver) into angiotensin I which is then converted to
angiotensin II (powerful vasoconstrictor narrows blood vessels)
■ raises blood pressure and volume
■ also stimulates release of aldosterone (from adrenal gland when
stimulated by angiotensin II)
● hormone that signals kidneys to excrete potassium and retain
sodium
● stimulates the retention of water

Fluid and Electrolytes Imbalance:

● High sodium diet:
○ water retention
○ raise blood pressure and cause swelling (edema)
● Minor imbalanced: managed by drinking water and eating
● Major fluid and electrolytes losses:
○ Severe, prolonged vomiting and diarrhea (sodium loss)
○ Overactive adrenal glands -> potassium loss
○ Uncontrontrolled diabetes -> glucose + fluid loss
○ Heavy sweating
○ Burns
○ Traumatic wounds
● Medical intervention depends on the circumstances surrounding losses
○ Water alone may not correct balance
● ORT (oral rehydration therapy): sugar + salt + water -> lifesaving for dehydration
especially in children

Acid-Base Balance:
● Ions help regulate pH (acidity) of body fluids
● pH must stay within a narrow range to avoid protein damage
● Extreme pH shifts → enzyme malfunction, hemoglobin fails to carry O₂
● Usings: Buffer system (blood), respiration (lungs), excretion (kidneys)
● Buffers in the Blood
● Bicarbonate (HCO₃⁻) = base
● Carbonic acid (H₂CO₃) = acid
● Both work to neutralize excess H⁺ or OH⁻
● CO₂ from metabolism → dissolves in water → forms carbonic acid
● Carbonic acid ↔ H⁺ + bicarbonate
● Balance between these maintains stable blood pH
● Lungs (Respiration)
○ Control carbonic acid levels via breathing rate
○ Too much carbonic acid → breathing speeds up → CO₂ exhaled → pH rises
○ Too much bicarbonate → breathing slows → CO₂ retained → pH lowers
○ Adjusts acid-base balance in minutes
● Kidneys (Excretion)
○ Control bicarbonate levels
 ○ Can reabsorb or excrete bicarbonate depending on pH
○ Adjusts acid-base balance over hours to days
○ Urine pH changes to maintain internal balance\

Water balance/losses:
● Obligatory water excretion:
○ a min of 500 mL (2 cups) of water is excreted to carry away waste each day as
urine
● Water also lost via vapor from lungs, sweat from skin and in feces
● Beyond these loses, excretion adjusts to balance intake
● Losses also depend on environmental conditions (heat, humidity) and body condition
(exercise and fever)
● Daily losses total 2500 mL on average (urine, sweat, lungs, feces)
● So need health kidney and adequate water intake
● Thirst and satiety:
○ sensed by mouth, hypothalamus and nerves
● Dehydration symptoms:
○ First sign is thirst, then Fatigue, dry mouth,, hunger, weakness, exhaustion and
delirium, death
● Water intoxication rare:
○ Excess intake (10-20 L within few hours)
○ Hyponatremia: decrease in conc of sodium in blood
○ Kidney disorders that reduce output
○ Confusion, convulsions and death
○ Safe fluid: replacement during sweating: 1-1.5 L/hr
● Urine Test:
○ Transparent: possible over-hydration
○ Pale straw: normal, well hydrated
○ Transparent yellow: normal
○ Dark yellow: normal, possible mild dehydration
○ Deep amber or honey: normal, possible moderate dehydration
○ Orange: possible severe dehydration
● Body weight lost
○ 1-2%: thirst fatigue weakness, vague discomfort, loss of appetite
■ Exercisers can lose 1-3 lbs of fluids from sweat/hour à 2% lower body
weight
● Finishing with a fluid deficit, can impair next exercise session, if
not replenished
○ 3-4%: Impaired physical performance, dry mouth, reduction in urine, flushed
skin, impatience, apathy
○ 5-6%: Difficulty concentrating, headache, irritability, sleepiness, impaired
temperature regulation, increased respiratory rate
○ 7-10%: Dizziness, spastic muscles, loss of balance, delirium, exhaustion,
collapse

Ways to Monitor Hydration Status

 ● Sweat Rate:
○ Weigh before and after long/hard/hot/humid exercise to learn your sweat rate
● Gauge Urine Color: Should be pale yellow or clear; dark indicates dehydration

Water Sources:
● Water provides about ⅓ of total water intake
● Metabolism generates water as an end product as energy yielding nutrients are
broken down
● General guide: 1.0-1.5 mL water per kcal expended
● Al for total water
○ 2-3 liters (8-12 cups) per day
■ needs vary: ppl who need more or les
■ vary depending on diet, activity, environmental temp, humidity,
medical conditions
■ best beverages: few or no calories: caffeine is a diuretic but still
contribute fluids
○ Health effects:
■ Physical and mental performance
■ Proper functioning of kidneys, heart, GI tract and other systems
● Foods: fruits/veggies (~90% water), meats/cheese (~50% water), milk
● Alcohol: diuretic, can harm health, drink in moderation
● Hard water: high in calcium and magnesium (benefit heart health)
● Soft water: high in sodium (worsen hypertension)
○ can dissolve harmful metals (lead, cadmium) from pipes

The Minerals:
● Minerals are inorganic elements
○ not destroyed by heat, air, acid or mixing
○ retain chemical identity
○ stay in the body until excreted: aren’t broken down or changed
○ lost only when leached into water during cooking and water is discarded
● Major minerals: needed and present in larger amounts
● Trace minerals: needed in smaller amounts
● ALL minerals are essential, regardless of the amount needed
● Some foods contain binders that impact mineral bioavailability
○ phytates (legumes, seeds, nuts, grains) and oxalates (spinach, beet greens,
rhubarb, sweet potatoes) that occur in food of plant origin
● Excess of mineral can create an inadequacy of another (mineral interactions)
○ More likely to occur with supplements
○ When sodium intake is high, both it and calcium are excreted
○ High phosphorus = less magnesium absorption

Absorption and Transport:

● Some minerals are: (K)
○ easily absorbed
○ travel freely in blood
○ excreted easily (like water-soluble vitamins)
 ● Others require (Ca):
○ carriers for absorption and transport
○ more like fat-soluble vitamins

Sodium:
● Roles in body
○ Principle cation of ECF
○ Primary regulator of ECF volume
○ Acid-base balance
○ Nerve impulse transmission
○ Muscle contractions
● Sodium readily absorbed in GI tract and travels freely in the blood
● Kidneys filter out and return what is needed
○ amount in = amount out
○ High intake signals thirst
● Sodium deficiency is rare
○ body able to adapt its sodium losses via sweat and urine
● Most sodium is consumed as salt (sodium chloride)
● High sodium intake correlated with high blood pressure (hypertension, HTN)
○ UL = 2300 mg
○ AI = 1500 mg/day (adult)
○ 1 teaspoon sodium chloride (salt) = 6g salt
○ • 1 tsp sodium chloride = 2300 mg sodium
○ CDRR (chronic disease risk reduction) = 2300 mg/day
○ ~90% of Americans exceed sodium rec (3500+ mg/day)
○ Adults with prehypertension or hypertension recommended to consume <1500
mg of sodium
● Eating plan especially for lowering sodium is called DASH (dietary approaches to stop
hypertension)
○ Potassium rich fruits, vegetables, low fat milk products
○ Whole grains, nuts, poultry fish
○ Limit sodium, red meats, sweets, sugary beverages
● Sodium and Bone loss (osteoporosis)
○ High salt intake associated with increased calcium excretion
■ potassium as protective factor (may prevent calcium excretion)
○ Processed foods have the most sodium
■ Processed foods also have reduced potassium
■ Fresh fruits and vegetables have the least sodium and more potassium
■ Hidden sodium in cereals, pudding, sauces
● Sodium Deficiency and Toxicity:
○ Extreme cases: drop in blood sodium levels cause hyponatremia
■ vomiting, diarrhea, heavy sweating
■ caused by water intoxication (ultra-endurance athletes sweats and
loses sodium and consumes excess water)
■ Symptoms: headache, confusion, stupor, seizures, coma
○ Acute symptoms of excessive sodium intake and toxicity are edema and
chronic high blood pressure
○ Prolonged excessive sodium contributes to hypertension
Chloride:
● Essential nutrient
● Major anion of ECF (outside)
● Help maintain fluid and electrolyte balance
● Part of HCL acid in stomach
● Abundant in processed foods and part of sodium chloride
● Recommendation equivalent to those of sodium
○ AL = 2300 mg (19-50yrs)
○ AI = 2000 mg (51-71yrs)
○ AI = 1800 mg (70yrs+)
● UL: 3600 mg/day
● Deficiency and toxicity
○ Diets rarely lack chloride
○ Conditions leading to deficiency
■ Heavy sweating, chronic diarrhea and vomiting leads to acid-base
imbalance
■ Toxicity due to water deficiency (dehydration) causes vomiting

Potassium:
● Principal intracellular (inside cells) cation
● Role in body:
○ Help maintain fluid and electrolyte balance
○ Helps maintain cell integrity
○ Aids in nerve impulse transmission and muscle contractions
■ trades places with sodium across cell membrane
○ Maintains homeostasis
■ steady heartbeat
● Potassium intakes:
○ Potassium abundant in all cells
○ fresh food are richest source of potassium since processing destroys cells
■ need to consume more fresh fruits, vegetables
○ AI = 3400 mg/day (MEN)
○ AI = 2600 mg/day (WOMEN)
○ UL: none
○ Diets low in potassium raise blood pressure
● Deficiency:
○ increases in blood pressure, kidney stones, bone turnover, salt sensitive ivry
○ if progresses: irregular heartbeats, muscle weakness, glucose intolerance
● Toxicity:
○ muscular weakness, vomiting, occurs from supplements or from certain
disease (IV overdose can stop the heart)
○ no toxicity from foods so no UL
● Sources:
○ all Whole Foods: fruits, vegetables (bananas, potatoes, oranges), meats, milk,
legumes, whole grains
○ Fresh foods high in K VS Processed food: high Na but low K+
Calcium:
● Most abundant mineral in the body
○ ~1% in blood, 99% in bones and teeth
● Majority of body calcium in bones and teeth
○ Part of bone structure to hold body up and as attachment points for muscles
○ Calcium bank: source of calcium for body fluids in case blood calcium drops
● Adequate intake important:
○ Grows a healthy skeleton in early life
○ Bones begin to form
■ Calcium salts form crystals (hydroxyapatite) on collagen matrix
(protein)
■ Mineralization: crystal become denser: strength and rigidity to
maturation bone
○ Also help minimize bone loss in later life
■ Remodeling: bones gain and lose continuously
■ Kids: bone formation > bone loss
■ Adults: balance
■ Older Adults: bone loss > formation -> osteoporosis risk
● Calcium in Body Fluids:
○ Help to maintain normal blood pressure
○ Extracellular calcium
■ Participates in blood clotting
○ Intracellular calcium
■ Binds protein (calmodulin) in cells and activates them
● Regulation of muscle contraction
● Transmission of nerve impulses
● Secretion of hormones
● Activation of some enzyme reactions
● Calcium Balance:
○ maintain by vitamin D, parathyroid hormone, calcitonin
○ Bones, intestines, kidneys
○ blood calcium stays stable (bones compensate if diet is poor)
○ Imbalance:
■ Calcium rigor (too high): muscle can’t relax
■ Calcium tetany (too low): uncontrolled muscle contractions
■ Not caused by diet ALONE usually hormone of vit D issues
● Blood calcium high:
○ Calcitonin release: prevent calcium reabsorption in kidney
■ inhibit activation of vit D
● Blood calcium low:
○ Parathyroid (PTH) release: stimulates vit D activation
■ Stimulates calcium reabsorption in the kidney
■ Enhances calcium absorption in intestines (calcium binding protein
made by vit D in SI)
■ Osteoclast cells break down bone to release calcium into the blood
● Calcium Recommendations:
○ Hormones maintain blood conc regardless of dietary intake
○ When intake is low, bone suffer
 ○ Rec set high:
■ to retain calcium in bones and develop peak bone mass (highest bone
density possible in first 30 yrs of life)
■ rate of calcium absorption varies through life
● newborn 55-60%
● pregnancy 60%
● children and teens 50%
● adults 30%
■ with inadequate intake absorption increase
● increase absorption: vit D (make calcium binding protein to
absorb), stomach acid (keep. Calcium soluble), higher need
(infant, teens, pregnancy)
■ inhibit calcium absorption:
● high protein intake, high sodium intake
● Fiber and some compounds in some plant food
○ RDA: based on bone retention not blood vessels
■ Peak bone mass: ~98% by age 18-20; remaining 2% up till 30-35 then
bone turnover shifts (more breakdown, less buildup)
■ Bone building recipe: Impact/force filled exercise + Ca + D + K
■ 1300 mg/day for adolescents
■ 1000 mg/day for adults up to age 50, men <70
■ 1200 mg/day for women >50 and men >70
■ UL: set to avoid kidney stones from excessive supplement use
● 2500 mg/day (adults 19-50)
● 2000 mg/day (adult > 51)
● Dietary protein and calcium:
○ High protein intake increases calcium excretion
○ May enhance absorption and strengthen bones
● Sources:
○ Best sources: Milk, cheese, yogurt, calcium-fortified products.
○ Other sources:
● Fortified OJ, tofu, canned fish with bones (e.g., sardines), oysters.
● Leafy greens: kale, bok choy, mustard/turnip greens, broccoli.
● Almonds, sesame seeds, tortillas, seaweed (e.g., nori).
○ Low-absorption veggies (binders present): spinach, rhubarb, Swiss chard.
○ Bioavailability:
■ ~50%: kale, bok choy, broccoli.
■ ~30%: milk, yogurt, tofu.
■ ~20%: almonds, beans, seeds.
■ <5%: spinach, chard.
● Calcium Deficiency:
○ Peak bone mass: achieved by late 20s
○ Bone loss: begins at ages 30-40
○ Osteopenia: low bone mass
■ less severes
○ Osteoporosis: porous and fragile bones, silent disease
■ body shows no symptoms
 ○ Reaching peak bone mass means denser bones protect against inevitable
age-related bone loss and fractures

Phosphorus:
● Second most abundant mineral in body
○ 85% combined with Hydroxyapatite crystals of bone and teeth mineralization
● Roles in body:
○ Part of major buffer system
○ Part of DNA and RNA (essential for growth)
○ Assists in energy metabolism (ATP, activates many enzymes and B vitamins
○ Helps transport lipids in the blood (lipoproteins)
○ Structural components of cell membranes (phospholipids)
○ Present in phosphoproteins (casein in milk)
● Deficiencies unlikely
○ but muscular weakness and bone pain
● Toxicity:
○ calcification of non skeletal tissues
● Best sources:
○ Protein-rich foods: meat, poultry, fish, milk, cheeses nuts
○ Processed food and soft drink (phosphate additives)
● RDA: 700 mg/day (adults)
● UL:
○ toxicity rate (reflects kidney failure)
○ 4000 mg
● High phosphorus from soda diet not responsible for low BMD, more a low Ca due to
poor diet overall

Magnesium:
● Body location:
○ more than ½ is in bones
■ reservoir is to ensure normal blood conc
○ rest is in muscles and soft tissues, some in ECF
● Roles:
○ Maintain bone health (mineralization in ½ bones)
○ Energy metabolism and ATP production
■ cofactor in >300 enzyme system
■ adds last phosphate to ATP
■ support protein, fat, nucleic acid synthesis
○ Works to balance calcium roles
■ Inhibit muscle contractions and blood clotting (opposes Ca2+)
■ Controls blood pressure and lung function
○ Supports normal function of immune system and CNS
● Sources:
○ Legumes, seeds, nuts, dark leafy green veg, fish (halibut, salmon), hard water
and mineral water (50% bioavailable)
○ Green vegs give magnesium because of chlorophyll molecules which contain
the ion
 ● Average US intake below recommendation
○ Exacerbate inflammation and chronic disease
● Deficiency rarely occurs
○ Impairs CNS activity, muscle cramps, tetany, seizure
● Toxicity:
○ diarrhea, nausea, abdominal cramps
● Protective against hypertension
● RDA:
○ 400 mg/day (Men 19-30yrs)
○ 310 mg/day (Women 10-30yrs)
● UL:
○ 350 mg/day (nonfood sources)

Sulfate:
● Roles:
○ components of AA methionine and cysteine
○ Form disulfide bridges -> stabilize protein structure
● Deficiency: rare unless protein intake is severely inadequate
○ animal and plant protein.
● Toxicity: not reported
● NO RDA/UL bc of easy adequacy with protein intake
● Sources:
○ food, water, beverage
○ AA: methionine, cysteine
● Helps determine shape/functions of protein molecules
○ Rigid structure of hair, skin and nails

Osteoporosis and Calcium:

● Hip fractures: 300,000 hospitalization per year
● Hip replacement
● Loss of independence
● Death form complication
● Cortical bone:
○ hard outer shell
○ gives up calcium to blood
○ slow and steady rate
● Trabecular bone:
○ Lacy matrix
○ give up calcium when diet runs short
○ sensitive to hormones governing day-to-day calcium need
● Gender and hormones:
○ men have greater BDM at maturity
○ Women have greater bone loss later in life
○ At menopause, estrogen declines and rapid bone loss occurs
■ Women may lose up to 20% of their bone mass 6-8 years following
menopause
● Genes likely influence peak bone mass achieved during growth and later bone loss
 ● Two factors within person control that accelerate bone loss are smoking and alcohol
abuse
● Physical activity stimulates bones to grow denser, especially during adolescence
● Hormones that promote muscles growth also support bone groth

Dietary nutrients;
● Calcium: intake during growing years
○ 9-18yrs old 1300 mg
● Adequate protein protects bones
● Vit D,K,C and A also play roles with interactions with bone metabolism
● Omega-3 fatty acids may preserve bone integrity
● Overall diet adequacy:
○ Diet high in soda, salt and processed foods associated with low bone density

Supplements:
● Dietary calcium supports bone health better than supplements
● Various forms (vit D may include magnesium)
○ Calcium carbonate, citrate, gluconate, lactate, malate or phosphate
○ Bone meal, oyster shell or dolomite
■ Often contain lead
○ Smaller doses absorbed better than large doses
■ 500 mg