Water: The Most Essential Nutrient PDF

# Water: The Most Essential Nutrient - The body needs more water per day than any other nutrient. - One can survive a deficiency of any other nutrient sometimes for months or years. - One can only survive a few days without water. In less than a day, a lack of water alters the body's metabo...

# Water: The Most Essential Nutrient - The body needs more water per day than any other nutrient. - One can survive a deficiency of any other nutrient sometimes for months or years. - One can only survive a few days without water. In less than a day, a lack of water alters the body's metabolism. - Water makes up approximately 60% of an adult's body weight. - Water is found in: - Blood vessels - Cells - Chemical structure of cells, tissues, organs. - Water participates in many chemical reactions. ## Water: The Most Essential Nutrient - Nutrient most needed by the body. - Makes up part of every cell, tissue, organ. - Accounts for about 60-70% of body weight: - Bone > 20% water. - Muscle ~ 75% water. - Teeth ~ 10% water. - Loss of 10% of water is serious and 20% may lead to death. - Water is needed by every living cell and almost every process that takes place within the body is dependent on water. ## Why Is Water the Most Indispensable Nutrient? - Water helps to deliver nutrients and removes waste from cells. - Water is the body's cleansing agent. - Water is a nearly universal solvent. - Water's incompressibility (lubrication & cushioning) is unique. - Water plays a role in thermoregulation. - Water balance: Water intake needs to equal water loss. ## Water's Effect on the Body | Effect | Description | |---|---| | Regulates body temperature | Helps to keep the body cool. | | Moistens tissues | Keeps tissues such as those in the mouth, eyes, and nose moisturized. | | Protects body organs and tissues | Helps to protect the body from damage. | | Helps prevent constipation | Helps to ensure that waste products move through the body efficiently. | | Lubricates joints | Helps to keep joints moving smoothly. | | Lessens the burden on the kidneys and liver | Helps to flush out waste products. | | Carries nutrients and oxygen to cells | Helps to deliver essential nutrients and oxygen to the body. | | Helps dissolve minerals and other nutrients | Makes nutrients accessible to the body. | ## Deciding How to Hydrate - Here is a recommended breakdown of how to balance your beverage intake to optimize health benefits of certain beverages and mitigate the excess calories of others. - Individuals who drink water are more likely to have a lower calorie intake and have a healthier diet pattern including fruit, vegetables, and low-fat milk. (Source: Popkin, 2005). - Also, drinking water instead of three sugary drinks a week for a year could save 6,084 grams of sugar, which is 24,336 calories. (Source: American Journal of Public Health, January 2007). ## Signs of Dehydration | Body Weight Lost (%) | Symptoms | |---|---| | 0 | Thirst. | | 2 | Stronger thirst, vague discomfort and sense of oppression, loss of appetite, increasing hemoconcentration. | | 4 | Less movement, lagging pace, flushed skin, impatience; in some, weariness and sleepiness, apathy; nausea, emotional instability. | | 6 | Tingling in arms, hands, and feet; stumbling, headache; heat exhaustion (symptoms: faintness, dizziness, fatigue, nausea, headache, increased body temperature, pulse, and respiratory rate). | | 8 | Labored breathing, dizziness, cyanosis (bluish color of skin caused by poor oxygen flow in body), indistinct speech, increasing weakness, mental confusion. | | 10 | Muscle cramps; inability to balance with eyes closed; general incapacity, delirium and wakefulness; swollen tongue, circulatory insufficiency; marked hemoconcentration and decreased blood volume; failing kidney function. | | >10 | Increasing risk of death, especially if associated with illness or extreme heat and exercise. | ## Water Intoxication - Hyponatremia, a word cobbled together from Latin and Greek roots, translates as "insufficient salt in the blood." Quantitatively speaking, it means having a blood sodium concentration below 135 millimoles per liter, the normal concentration lying somewhere between 135 and 145 millimoles per liter. - Severe cases of hyponatremia can lead to water intoxication, an illness whose symptoms include headache, fatigue, nausea, vomiting, frequent urination, and mental disorientation. - "Rapid and severe hyponatremia causes entry of water into brain cells leading to brain swelling, which manifests as seizures, coma, respiratory arrest, brain stem herniation and death." (M. Amin Arnaout, chief of Nephrology, Massachusetts General Hospital and Harvard Medical School). # Minerals - an overview - Chemical elements required by the body in very small amounts for growth, repair, and regulation of vital body functions. - Minerals are considered inorganic because they are typically not bonded to carbon atoms. - Minerals are key participants in body metabolism, muscle movement, and body growth among other important functions. - Minerals regulate acid-base balance; water balance; muscle contraction; response of nerves to stimuli. - Minerals are components of enzymes, hormones, blood, and other vital body compounds. - Minerals from animal foods have a higher bio-availability than minerals from plant foods because of the absence of binders or other inhibitors. Bio-availabiltiy of minerals ranges from 5% to almost 100%. - Absorption of minerals is higher when requirements are high. Like in pregnancy, during growth phase, etc. - Most minerals are toxic when ingested in even slightly higher amounts than the safe levels recommended. - Taking an individual mineral as a supplement in doses greater than the RDA can greatly diminish the absorption and metabolism of other minerals. - E.g. Phosphorus supplements inhibit the absorption of Magnesium. ## Mineral Bioavailability - Some minerals compete for the same absorption sites. Megadosing with one mineral can thus impede absorption of another. - High-fiber diets reduce absorption of iron, calcium, zinc, and magnesium. - Phytate (a component of whole grains) binds minerals and carries them out of the intestine unabsorbed. - Oxalate (found in spinach and rhubarb) binds calcium, reducing its absorption. ## Mineral Bioavailability - A diagram shows the factors that affect the bioavailability of minerals, including: - Fiber - Person's need - Phytate - Polyphenols - Oxalate - Acidity of intestinal environment - Other minerals competing for absorption ## Mineral Wheel - The mineral wheel shows the complex interactions between different minerals. - Some minerals require other minerals to be present in order to do their job (single arrows on the lines of the mineral wheel). - Other minerals interfere with another's bioavailability (double, opposing arrows on the lines of the mineral wheel). - The simplified mineral wheel illustrates the interactions of only 23 minerals. Imagine the complexity if all 73 naturally occurring minerals and elements were included. - A link to a website is included: [http://www.criticalelements.com.au/health.html](http://www.criticalelements.com.au/health.html) # Classification of Minerals - Minerals can be divided into 3 main groups: - **Macro or Major Minerals** (body needs relatively more) - Sodium, potassium, magnesium, calcium, phosphorus, sulfur, chloride. - Present in body tissues at concentrations > 50 mg/kg (50 ppm). - **Micro or Trace Minerals** (body needs relatively less) - Chromium, manganese, iron, cobalt, molybdenum, copper, zinc, fluoride, iodine, selenium, silicon, tin, arsenic, nickel… - Present in body tissues at concentrations < 50 mg/kg (50 ppm). - **Trace Contaminants With No Known/Specific Function** - E.g.: Lead, Mercury, Aluminum, etc… # Calcium - RDA: 600 mg/day (adults); 1200 mg/day (Preg./Lact.). - Functions: Formation of bones & teeth; coagulation of blood; muscle contraction and relaxation; nerve impulse transmission. - 99% of the body calcium resides in bones and teeth, and the rest 1% as circulating calcium in blood. - Sources: Milk and its products, cereals & millets, green leafy vegetables, nuts, legumes, tofu. Millet “Ragi” is very rich in calcium. - Bioavailability from plant sources is poor due to binders like oxalic acid and phytic acid. ## Calcium - Most abundant mineral in animal tissues. - Lots of functions: - Bone structure. - Nerve function. - Blood clotting. - Muscle contraction. - Cellular metabolism. ## Calcium Deficiency - Rickets & Osteo-malacia if Vit.D. deficiency is also accompanied. - Osteoporosis – especially in women, wherein the bones become porous, thin, brittle, diminish in size and break easily. - Deficiency of calcium can also cause Tetany (muscle spasms in legs and arms). - Acute calcium deficiency does not occur without a lack of vitamin D. - Toxicity / Excess (> 2500 mg/day): Renal Calculi (kidney stones); Hyper-calcemia (deposits in joints and soft tissue); Bradycardia (slow heart rate and shortness of breath), etc… ## Bone Mass and Osteoporosis - We generally build bone up to ~ age 30. - People who have high peak bone mass at age 30 have a very low risk for osteoporosis. - People with low peak bone mass usually develop osteoporosis by age 60. - Women begin to lose 3-5% of their bone mass annually after menopause. ## Tetany - Hyper-reflexia (overactive neurological reflexes), carpopedal spasm (spasms of the hands and feet) and laryngospasm (spasm of the larynx, the voice box). ## Calcium Absorption - Dependent on Vitamin D. - Absorption depends on need – particularly high during growth, pregnancy, and lactation. - Both Ca and P are required for bone formation and other non-skeletal functions. Dietary ratio of 1:1 to 2:1 is good for most people. - Factors interfering with absorption of Calcium i.e. Bioavailability is decreased by: - High Phosphorus (milk, meat, colas). - Oxalates (Spinach, tomato). - Phytates (grains). - Wheat bran. - Low estrogen levels (postmenopausal women). - Sodium (salt). - Tannins (black coffee, tea). - Alcohol. # Phosphorus - RDA: 600-700 mg per day. - Experts believe that the intake of calcium and phosphorus should be approximately on a 1:1 ratio for optimal utilization of both the minerals. - Functions: Aids formation & maintenance of bones & teeth; helps in macro-nutrient metabolism. - Sources: Widely distributed in both plant as well as animal foods. Calcium rich foods will usually be adequate in Phosphorus, like Milk. Other good sources are meat, poultry, fish, eggs, and legumes. Fruits/vegetables are fair sources. ## Phosphorus - Deficiency: Rarely seen - muscular weakness and poor bone maintenance. - Toxicity: Rare - Hyper-phosphatemia may decrease calcium and magnesium absorption/ availability in the body. This happens when supplements of Phosphorus are taken over and above the dietary intake. # Sodium - RDA: 2 to 3 gm/day. Demand is more for heavy workers / physical labourers. - Functions: Acid - base balance, water balance. Muscle contraction and nerve impulse transmission. - Sodium, Potassium, and Chloride are collectively referred to as electrolytes. - Sources: Common / table salt (39% sodium). 1 tsp contains ~ 2300 mg sodium. Also in MSG, baking powder, baking soda. - Milk and milk products, green leafy veg., bakery products, processed foods, sauces, soups, pickles, chips, etc. ## Deficiency of Sodium - Sodium deficiency (Hyponatremia) does not normally result from inadequate dietary intakes. - In rare cases, excessive water intake can cause low sodium levels in the blood. - Hyponatremia can be caused by prolonged excessive sweating, prolonged vomiting or diarrhea or the use of some diuretics. - Symptoms of hyponatremia include headache, muscle cramps, fainting, fatigue, and disorientation. Hyponatremia is something to watch for with intense sport competitions that last for many hours. - Other symptoms of sodium deficiency include nausea, vomiting, dizziness, apathy, exhaustion, fluid & electrolyte imbalance, drowsiness, and possibly coma. # Potassium - RDA: 2-3 gm / day. - Functions: maintains acid-base balance; water balance; regulates muscle activity; transmits nerve impulses. Counteracts the effect of sodium and seems to lower blood pressure (Na:K ratio 1:1) - Sources: Fruits (eg. banana, orange), vegetables (eg. potato, tomato), milk and its products, meats, legumes - fairly widespread. - Deficiency: HYPOKALEMIA: Rarely seen - Muscle cramps, rapid & irregular heartbeat, loss of appetite, weakness, nausea.. - Toxicity: Hyperkalemia: Rare - Slow heartbeat leading to weakness in heart that causes mental confusion & anxiety. # Magnesium - RDA: Women-350 mg/day and Men-400 mg/day. - Functions: Regulates metabolism of fats, carbohydrates & proteins; gives strength to bones & teeth (70% of Mg is in the skeleton); activates enzymes; aids muscle relaxation and nerve transmission; keeps the immune system working properly. - Sources: Nuts, legumes, whole grains, green vegetables (Mg is a a part of chlorophyll), soybeans, chocolate, seafood. Refined foods are poor sources. - Deficiency: Irritability, Tetany, Weakness, Hyper-reflexia. # Trace Elements: Zinc - RDA: 5-12 mg/day. Upper limit is recommended for growing children. - Functions: Zinc is present in small amounts in all tissues of the body. Total content of the body is over 2.0 g. - Cofactor for over 100 enzymes, so aids in protein synthesis, aids normal growth and sexual maturation, helps in Insulin synthesis, increases immunity, affects normal sensitivity to taste and smell. - Helps “turn on” genes in DNA, leading to protein production for growth. ## Zinc - Sources: Protein rich foods. Meat, Milk, Liver, Poultry, Sea foods, Legumes, Nuts, Whole grains, greens. - Deficiency: Delayed wound healing; Loss of appetite, dwarfism & impaired sexual development in children; Rash, diarrhea, reduced sense of taste and smell, hair loss, hindered growth in children. - Zinc deficiency is usually associated with severe malnutrition. - Does zinc help prevent colds? - No strong evidence that colds are prevented by zinc if adequately nourished. - Megadozes of zinc have a depressing effect on the immune system! # Trace Elements: Iron - RDA: Children (1-17 yrs) – 9 to 32 mg per day, Adult males- 17 mg, Females - 21 mg, Pregnancy - 35 mg - Functions: - Plays an essential role in the formation of Haemoglobin and helps in carrying oxygen. - Aids brain development. - Aids regulation of body temperature. - Helps muscle activity as part of myoglobin (the iron protein molecule in muscles). - Helps in immune functions. ## Trace Elements: Iron - Sources: Liver, meat, legumes, poultry, dark green leafy vegetables, broccoli, peas, dried fruits, potatoes, eggs, whole grain cereals, jaggery, etc… - Bio-availability of iron from animal foods (haeme iron) is about 25% as compared to 5-15% in plant foods (non-haeme iron). - Absorption is maximum (up to 50%) when body stores are low, requirements are more, or losses are more. ## Iron Deficiency - Iron Deficiency can lead to: - Iron Deficiency Anaemia: IDA is characterized by a low hemoglobin level (small RBCs) and decreased oxygen carrying capacity. - Other symptoms include: - Dizzy spells, sunken eyes, pale skin. - Lethargy, feeling tired, weakness, listlessness. - Decreased immune function or resistance to infections causing increased morbidity & mortality. - Decreased work and school performance. - Slow cognitive and social development during childhood. - Difficulty maintaining body temperature. - There is some research evidence to suggest that dietary iron deficiency can lead to PICA. - PICA - a curious appetite for non-food substances such as ice, clay, paste, soil, or other non-nutritious substances. - Commonly seen in children and pregnant women. ## Iron: Heme vs. Nonheme - A diagram shows the difference between heme and nonheme iron, with heme iron being found in animal products and nonheme iron being found in plant products. - Heme accounts for about 10% of the average daily iron intake, but it is well absorbed (about 25%). - Nonheme iron accounts for the remaining 90%, but it is less well absorbed (about 17%). ## Factors That Affect Iron Absorption | Factors That Increase Absorption | Factors That Decrease Absorption | |---|---| | High body demand for red blood cells (blood loss, high altitude, physical training, pregnancy) | Low need for iron (high level of storage iron) | | Low body stores of iron | Phytic acid in whole grains and legumes | | Heme iron in food | Oxalic acid in leafy vegetables | | Meat protein factor (MPF) | Polyphenols in tea, coffee, red wine, and oregano | | Vitamin C intake | Reduced gastric acidity | | Gastric acidity | Excessive intake of other minerals (zinc, manganese, calcium) | ## Iron Toxicity - Once iron is in the body, it is hard to get rid of. In individuals who can absorb much iron, large doses of iron supplements can damage the liver and do other damage as well. - Two broad types of iron overload disorders: - Hemochromatosis is usually caused by a genetic disorder and is much more prevalent in men than in women. It is a genetic defect that allows continued absorption of iron past the body’s ability to store it safely. - In Hemochromatosis, iron overload is associated with damage to cells. It is characterized by improper processing by the body of dietary iron which causes iron to accumulate in a number of body tissues, eventually causing organ dysfunction. Mainly affects the liver. High risk for heart disease, liver cirrhosis and cancer. - Symptoms include fatigue, joint pain, skin that turns gray or bronze, and symptoms of liver disease such as nausea and stomach pain. ## Iron Overload Disorder - **Haemosiderosis** or iron overload disorder (without cell damage): - The term haemosiderosis is generally used to indicate the pathological effect of iron accumulation in any given organ, which mainly occurs in the form of haemosiderin. Sometimes, the simpler term siderosis is used instead. - Excess iron is deposited mainly as hemosiderin in the liver and spleen (harmless) but with time, parenchymal deposition may lead to hepatic fibrosis and myocardial damage. - Iron poisoning is the most common cause of poisoning death in children under 6 years old. Hence, it is especially important to keep iron supplements away from children. Consuming 1 to 3 grams of iron can be fatal to children under 6, but even lower doses can cause severe symptoms such as vomiting and diarrhea. # Iodine - RDA: 150µg per day - all adults. Pregnancy & Lactation: + 25 µg/day. - Functions: synthesis of thyroid hormone (thyroxin) & normal functioning of thyroid gland; contributes significantly to the normal growth & development. Thyroxin regulates Basal Metabolic Rate (BMR). - Sources: Iodized salt, sea foods, cod liver oil, water, also found in small amounts in milk, meat, vegetables, cereals, etc… ## Causes of Iodine Deficiency Disorders | Iodine Deficiency Disorders | Explanation | |---|---| | Low dietary intake | Low iodine levels in the soil and hence in the consumed food | | Inadequate utilization | Low consumption of sea food; economic restrains | ## Iodine - Deficiency: Collective term is IDD or “Iodine Deficiency Disorders" which includes a spectrum of disorders as given below - - Goiter (enlargement of thyroid gland). - Retarded physical development & impaired mental function. - Increased rate of abortions & still births. - Cretinism - characterized by stunted growth/ dwarfism, mental deficiency, deaf mutism, squint, etc. - Psychomotor defects, etc… ## The Adverse Effects of Iodine Deficiency - A diagram shows the adverse effects of iodine deficiency, with a spectrum from mild to severe: - **Mild Deficiency:** - Nodular goiter and hyperthyroidism. - **Severe Deficiency:** - Poor growth, stunting. - Goiter and hypothyroidism. - Lower intelligence, poor educability. - **Between Mild and Severe:** - Mental retardation, cretinism. - Increased infant mortality. - Source: www.iccidd.org # Fluoride - RDA: 3 to 4 mg per day. Accepted level in water: 1 ppm is ideal. - Functions: Helps in formation of tooth enamel and increases resistance against dental caries; keeps bones strong. - Sources: Drinking water, fluoridated toothpastes, sea fish, cheese, tea, etc.. - Deficiency & Toxicity: Fluoride is called a 'two edged sword' - deficiency (< 0.5 to 0.7 ppm in water) causes dental caries & bone loss and excess (> 1.5-2 ppm) causes Fluorosis (mottled stains on teeth). Excess fluoride also causes dense bones which are painful. ## Fluoride - Fluoride inhibits bacterial damage to tooth enamel, inhibiting tooth decay. - Particularly important in infancy and childhood. - Adequate fluoride = 40-60% fewer dental caries. ## Sources of Fluoride - A diagram shows the sources of fluoride: - Fluoride supplements. - Toothpaste enhanced with fluoride. - Fluoridated water supplies. - Food processed with fluoridated water. - Mouthwash enhanced with fluoride. # Copper - RDA: 1.5 to 3 mg/ day for all ages. - Functions: Considered a “twin” to Iron - aids in formation of haemoglobin and helps in absorption of iron. Part of many enzymes, aids energy production, helps in synthesis of Collagen. - Sources: Meat, shellfish, liver, legumes, nuts, whole grain cereals, dried fruits. - Deficiency: Occurs in association with Iron Deficiency Anemia & PEM. Poor growth. # Cobalt - RDA: Not clearly determined. - Functions: Component of Vitamin B12 - helps to maintain healthy RBCs. - Sources: Animal foods. - Deficiency: Not seen in humans. But deficient production of Vit. B12 is seen in animals. # Chromium - RDA: Not known. - Functions: Improves uptake of Glucose; co-factor in Insulin synthesis. - Sources: Meats, Whole grains, Cheese, GLVs. - Deficiency: Unable to maintain normal blood glucose levels. # Selenium - RDA: Not known. - Functions: Aids the anti-oxidant system and helps in antibody production with Vitamin E. Helps in the synthesis of the active thyroid hormone. - Sources: Meats, organ meats, eggs, whole grains. - Deficiency: Decreased antibody production. Muscle pain and muscular weakness. Can cause a type of Heart Disease. - Deficiency is mostly seen in patients of PEM. # Molybdenum - RDA: Not clearly defined. - Functions: Aids the action of some enzymes in metabolic reactions. - Sources: Beef, Kidney, Liver, Milk, Legumes, Cereals, Nuts. - Deficiency: not commonly seen : Mouth and Oesophageal cancer ; Physical defects & mental retardation in infants. # Summary Box - 1: The Macrominerals | Mineral | Function | RDA | Deficiency | Sources | |---|---|---|---|---| | Calcium | Bone & teeth formation, Blood clotting, Muscle contraction, Nerve transmission | Adults: 400 mg | Tetany, Rickets, Osteoporosis | Dairy products, Meat products, Leafy vegetables | | Phosphorus | Bone & teeth formation, Energy metabolism, Nucleic acid synthesis, Acid base balance | 1 g | Not seen often Can cause bone loss, anorexia | Dairy products, Meat products, Leafy vegetables | | Sodium | Extracellular fluid component, Water balance Acid base balance | 5 g | Cramps, Acid-base imbalance, Water imbalance | Table salt | | Potassium | Major Intracellular fluid component, Acid-base balance; Nerve transmission, Muscle action | 5 g | Muscle weakness, Arrhythmias | Fresh fruits, meats, whole grains, vegetables | | Magnesium | Coenzyme in metabolic reactions, Nerve conduction | 350 mg | Tremors, spasm | Meat, cheese, eggs, nuts, legumes | # Summary Box - 2: The Microminerals | Mineral | Function | RDA | Deficiency | Sources | |---|---|---|---|---| | Iron | Haemoglobin & Myoglobin formation, Cellular oxidation reactions, Antibody formation | Male:28 mg | Anaemia, fatiguability. Impaired immune function | Meat products, Liver, Green leafy vegetables | | Iodine | Thyroxine synthesis | Adults 150µg | Goitre, cretinism, hypothyroidism, Infertilty, still births | Iodized salt, Plant products grown in iodine rich soil | | Zinc | Essential enzyme constituent, Protein metabolism, Immune function, Insulin storage, Sexual maturation | 15 mg | Retarded sexual and physical activity; Impaired wound healing. | Dairy products, Meat products, Eggs, whole grains | | Selenium | Antioxidant function Forms glutathione peroxidase, spares Vitamin E | 70 µg | Impaired immune function, Keshan disease | Liver, meats, whole grains, sea food | | Fluoride | Bone and teeth constituent | < 1 mg | Dental caries | Flouridated water, toothpaste |