Importance of Water

Importance of Water

• Fluid, electrolyte, and acid balance are essential for optimal cell function.
• Understanding the functions and homeostatic mechanisms used by cells is crucial.
• Changes in fluid, electrolyte, and acid-base balance are common in hospitalized patients.
• Such changes can acutely and chronically affect homeostasis.
• Diseases, trauma, and surgical procedures can disrupt the balance of fluids, electrolytes, and acid-base levels.
• Disruptions lead to alterations in the composition, distribution, or volume of body fluids; even slight changes in pH, electrolyte concentrations, or fluid status can adversely affect cellular function.
• If these imbalances are not corrected, death can occur.
• Water is the most important thing in human life after oxygen.
• People can live for weeks without eating, but only a few days without drinking water.
• Loss of Carbohydrates and Fats for 100% can be life threatening
• 10% loss of water can be life threatening and 20% loss of water is death

Water Content in the Body

• On average, the human body is 42-71% water, depending on age and sex.
• As people age, the proportion of water decreases while the proportion of fat increases.
• Approximately 60% of the water in the body is found inside the cell, and 40% in the extracellular fluid.

Edema

• Edema is the abnormal accumulation of fluid in tissues or body cavities, leading to swelling.
• It can occur in any part of the body but is most commonly observed in the extremities, such as the legs, ankles, and feet.
• Edema is an abnormal accumulation of fluid in the 'third space', including intercellular tissue spaces or body cavities
• 'The fluid in the third cavity' is isolated.
• Increased Hydrostatic Pressure results from conditions like heart failure, these can increase blood pressure within the capillaries, pushing fluid into surrounding tissues.
• Decreased Oncotic Pressure refers to low levels of plasma proteins, as seen in malnutrition or liver disease which reduces the ability of the blood to hold water, allowing fluid to leak out.
• Increased Capillary Permeability is caused by inflammatory processes, like infections or allergic reactions and can make capillary walls more permeable, leading to fluid leakage.
• Lymphatic Obstruction is when the lymphatic system is impaired or blocked by surgery, infection, or cancer, hindering the removal of excess fluid. This results in edema.
• Higher body water percentages are observed in:
  • Adults: 60-70%
  • People with obesity: 45-55%
  • The most metabolically active cells of muscle and internal organs.
• Calcified tissue cells have the lowest water content.
• Body water in athletes is higher than in non-athletes.
• Body water decreases with age and decreased muscle mass.
• Total body water tends to be lower in women than in men.
• As the body fat ratio increases, the total body water ratio decreases.

Functions of Water

• Water's functions include:
  • Digestion, absorption, and transport of nutrients.
  • Excretion of waste elements resulting from metabolism.
  • Control and regulation of body temperature.
  • Ensuring the lubricity of the joints.
  • Transport of electrolytes.
• Body temperature can be lowered due to water, that evaportates through sweat.
• Approximately 1 liter of water evaporated and excreted through sweat eliminates 600 kcal of heat. Various tissues have different water contents.
• Lung 86%, Blood and Kidney 83%, Muscle and brain 75%, Adipose tissue 20%
• If a person doesn't drink enough the results can be:
  • Constipation
  • Urinary tract infections
  • Kidney stones
  • Heart Disease
  • Blood Pressure
  • Diabetes
  • Body Weight Control
  • Cognitive and Physical Performance
  • Skin Health

Water Requirements

• Consuming high water content reduces beverage intake
• Diets high in carbohydrates and fats increases metabolic water.
• Water needs can be met with a diet containing 2000 kcal, 60% from CHO, 30% from fat and 10% from protein. The body can form 267 g of metabolic water.
• Increasing fruit and vegetables in the diet reduces beverage intake
• Amounts vary depending on climate, working conditions, diseases, diet composition, and the body's hormonal balance.
• Fluid loss increases in hot, dry weather, and during heavy physical activity.
• Adults should consume 1 gram of water for each calorie of dietary energy.
• For babies, the water requirements are 1.5 grams per kilogram.
• Adults 35 ml/kg, Child 50-60 ml/kg, Baby 150 ml/kg

Hormonal Control of Water Excretion

• Water excretion from the kidneys is controlled by Anti Diuretic Hormone (ADH).
• An increase of just 1% in plasma density stimulates the hypothalamic thirst center, leading to thirst. Thirst develops.
• Situations that increase water loss:
  • Too much protein and salt in the diet.
  • Kidney diseases.
  • Diarrhea.
  • Hot weather.
  • Infectious diseases.
  • Vigorous physical activity.
  • Cold and dry weather.
• Decreased sensitivity to thirst is seen in:
  • Elderly individuals.
  • Those with acute or chronic diseases.
  • Babies.
  • Athletes indicating dehydration risk.
• Fluid loss through sweat is normally 100 mL.
• Other water loss occurs from the skin.
• Fluid loss through the skin and breathing is called 'hidden fluid loss' that can reach 700-1000 mL daily.

Water Loss Consequences & Dehydration

• It is vital that the amount of water in the body is adequate.
  • 3% loss (1.2 L) of body water leads to decreased blood volume and physical performance.
  • 5% loss (2.1 L) impairs concentration.
  • 8% loss (3.3 L) can lead to dizziness, fatigue, and breathing difficulties.
  • 10% loss (4.2 L) can lead to muscle spasm, extreme fatigue, circulatory and renal failure.
  • 20% loss (8.4 L) can result in death.
• Normal circulatory system function is essential to meet tissue needs and remove waste.
• Intravascular fluid (plasma) volume and pressure must be at a certain volume.
• A decrease in effective circulation volume is defined as dehydration.

What Color is Your Urine?

• Possible colors are very good, good, acceptable, slightly dehydrated, dehydrated, very dehydrated and severely dehydrated.

Water Consumption

• Consume appropriate amounts of fluid to remove metabolic wastes.
• Drinking liquids with meals increases satiety.

Oral Rehydration Therapy

• Oral rehydration therapy (ORT), introduced in the 1960s, is a gold standard for treating fluid loss from acute diarrhea.
• UNICEF produces a dry mixture that includes;
  • 3.5 g salt
  • 2.5 gr baking soda
  • 1.5 gr potassium chloride
  • 20 g of glucose
  • The mixture is given to the child by dissolving in 1 liter of boiled cooled water.
• An alternative way to prepare a version of ORT at home includes:
  • 1 liter of water or tea (potassium)
  • 2 tablespoons sugar + lemon juice (potassium)
  • 1/2 teaspoon salt
  • 1/4 teaspoon cooking soda, given as 20 mL per body weight per hour.

Safe Water

• Healthy and safe water does not contain harmful bacteria, toxic materials, or chemicals.
• Spring waters, drinking waters, and natural mineral waters sold commercially under the Ministry of Health are safe.
• Packaged waters get facility, production permission, and health certificates from the provincial Health Directorate.
• Ways to provide clean water include:
  • Straining to remove gravel and fine sand
  • Boiling for 3-5 minutes.
  • Chlorination.
• Chlorination in rural areas include dissolving 40 g of lime cream in 1 liter of water.
• Calcium can sink to the bottom, then add 3-10 drops to 1 liter of water, and let it sit for 30 minutes.
• Excess water taken can be excreted through the kidneys and sweat
• Rapid fluid intake above the water excretion capacity of the kidneys causes a decrease in blood sodium level is defined as 'hyponatremia' Symptoms: • Confusion, nausea and muscle spasms
• Aim to drink the best drink that you can to ensure hydration, water.
• Choosing healthy beverages can help to maintain a healthy weight and preventing obesity.

Beverages

• The liquid requirement must first be met with water
• Drinks other than water are tea, coffee, herbal teas, milk, ayran, kefir, fruit juice, vegetable juices, soda, mineral water, carbonated drinks with added sugar, drinks with added artificial sweetener (light – diet drinks), energy drinks, sports drinks and alcohol.
• The total recommended daily fluid intake is; 2500 mL for men and 2000 ML for women or 2500-3000 mL.
• Limit intake; Sweetened drinks, light drinks, artificial sweeteners
• Increase intake; Süt, Alkollü icecekler, şekersiz çay kahve, su.
• Water does not contain energy and is key for hydration.
• Waters can be flavored with ices made of mint, cinnamon stick, lemon, fruit.
• Drink water at every meal, between meals, before and after exercise.
• Aim for drinking 8 cups of water a day.
• Tea is the most commonly consumed drink after water.
• Tea aids the intake of potassium and fluorine
• Black tea (oxidized), green tea (non-oxidized), and oolong tea (semi-oxidized tea) can be consumed.
• Drinking Green tea (3 cups/ day) and black tea (4-5 cups/day), can have a blood pressure lowering effect.
• tea consumption can also reduce the risk of diabetes and all-cause death
• Coffee provides as much potassium as vegetables and fruits other than potatoes providing 946-1183 mL.
• moderate coffee consumption in healthy people reduces the risk of chronic diseases such as certain types of cancer, cardiovascular diseases, type 2 diabetes, Parkinson's and the risk of death due to all causes, due to Its beneficial effects from the phenolic acids it contains.
• One cup (240 mL) of tea and coffee greatly contributes to the intake of these phytochemicals, and may have more intake of phytochemicals than 1 cup of fruits and vegetables.
• The beneficial effects of tea and coffee can be attributed to phytochemicals like
• Caftaric acid, trigonelline, diterpenes and soluble fibre
• A variety of these phenolic and polyphenolic substances are bioactive and antioxidant effective
• Fat oxidation is prevented, can increase insulin sensitivity,glucose absorption and utilization are regulated, nitric oxide production and vasodilation are stimulated
• Caffeine is the active ingredient in tea and coffee
• Tea contains less caffeine than coffee
• Decaf tea and coffee have approximately 10 mg/240 mL or less of caffeine
• Excessive caffeine intake (>5 mg/kg) in children increases anxiety and withdrawal/abstinence symptoms.
• Caffeine intake should be < 400 mg/day in adults, 200-300 mg/day in pregnant.
• Milk (low-fat) contributes to fluid intake.
• Provide high-quality protein, vitamins (vitamin A and riboflavin) and minerals (calcium, magnesium, potassium)
• Drinks sweetened with artificial sweeteners are not recommended for children due to tooth decay.
• Sports drinks help to replace the water, electrolytes and energy lost after exercise.
• Consume drinks that naturally contain electrolytes such as calcium (Ca), magnesium (Mg), sodium (Na), potassium (K)
• Flavored soda/with added sugar is not recommended to ever be consumed
• Herbal teas contain carotenoids, phenolic acids, flavonoids, coumarins,alcaloids and saponins which gives antioxidant, antibacterial, antiviral, anti-inflammatory, antiallergic and antithrombotic effects. Use should have attention to allergic effects and drug interactions!!!