Water

Vital nutrient crucial to every bodily Vital nutrient crucial to every bodily functionfunction

Medium for chemical reactionsMedium for chemical reactions

Contributes to the structure of tisseueContributes to the structure of tisseue

Regulates body temp.Regulates body temp.

Lubricant in digestion,water in saliva Lubricant in digestion,water in saliva facilitates chewing(Hydrolysis of facilitates chewing(Hydrolysis of nutrients)nutrients)

EnzymesEnzymes

-substances that initiate and accelerate a chemical -substances that initiate and accelerate a chemical reactionreaction

CoenzymesCoenzymes

-portion of the enzyme required for activation of -portion of the enzyme required for activation of protein molecule to from the whole enzymeprotein molecule to from the whole enzyme

HormonesHormones

-Glandular secretions that stimulate and retard life -Glandular secretions that stimulate and retard life processes processes

Body’s Source Of Water->Drinking water and beverages.->Drinking water and beverages.

6-8 glasses per day6-8 glasses per day

->ingested solid food ->ingested solid food

Metabolic water- from the metabolism of Metabolic water- from the metabolism of carbohydrates, proteins, and fatscarbohydrates, proteins, and fats

Water requirements are based on body size Water requirements are based on body size and are determined per kg of body weightand are determined per kg of body weight

Body Fluids-basic Cell

processesWaterWater

ProteinProtein

Solutions of electrolytes( +,- Solutions of electrolytes( +,- ions)ions)

eg. Sodium, eg. Sodium, Potassium ,ChloridePotassium ,Chloride

Nonelectrolytes (less)Nonelectrolytes (less)

eg. Glucose, urea eg. Glucose, urea

makes up 65% of our body weight ( 10% makes up 65% of our body weight ( 10% loss can already cause metabolic loss can already cause metabolic disorders)disorders)

Percentage of water present depends on amt Percentage of water present depends on amt of fat in the body. More fat, less waterof fat in the body. More fat, less water

Also related to body surface and metabolic Also related to body surface and metabolic activity. At birth 78%, adulthood 65%)activity. At birth 78%, adulthood 65%)

Inter-Extracellular Fluids

Intracellular( within)

Contains 60% waterContains 60% water

Consists of water and Consists of water and solutessolutes

Site of metabolic processesSite of metabolic processes

Ionic solutes: potassium Ionic solutes: potassium and manganese cationsand manganese cations

Mostly Protein, phosphate, Mostly Protein, phosphate, carbonate&sulfate anionscarbonate&sulfate anions

Extracellular

Contains 40% waterContains 40% water

Interstitial fluid and Interstitial fluid and blood plasmablood plasma

Environment surrounding the Environment surrounding the cellcell

Sodium is major cationSodium is major cation

Less protein,Chloride and Less protein,Chloride and Bicarbonate are anionsBicarbonate are anions

Osmotic Equilibrium

-inter& extracellular fluids are stable; -inter& extracellular fluids are stable; no gains or losses of Na, Kno gains or losses of Na, K

-no abnormal shift of water into or out -no abnormal shift of water into or out of cells that can impair cellular of cells that can impair cellular functionsfunctions

Water Balance

Achieved when there is osmotic Achieved when there is osmotic equilibrium bet. different body fluid equilibrium bet. different body fluid compartments and when water intake= compartments and when water intake= outputoutput

Mechanism for regulating the flow of Mechanism for regulating the flow of waterwater

Excreted in Urine, feces,sweat,expired Excreted in Urine, feces,sweat,expired air air

Sodium

An essential nutrientAn essential nutrient

Functions:Functions:

Maintains extracellular fluid volumes Maintains extracellular fluid volumes and cellular osmotic pressuresand cellular osmotic pressures

Aids in transmission of nerve impulses; Aids in transmission of nerve impulses; permeablity of cell membrane; muscular permeablity of cell membrane; muscular contractioncontraction

Needs depends on age, environmental Needs depends on age, environmental temp.,humidity, amt. of physical activity.temp.,humidity, amt. of physical activity.

Increases when there is significant loss Increases when there is significant loss when sweating, diarrheawhen sweating, diarrhea

3-4g of salt per day 3-4g of salt per day

Sodium balance is maintained by Sodium balance is maintained by renal(kidney) and hormonal renal(kidney) and hormonal mechanisms(adrenal gland)mechanisms(adrenal gland)

Salt and Na containing cpd. Flavoring agentsFlavoring agents

Technological reasons: raise the bp of Technological reasons: raise the bp of water, lower the fressing pt of water; water, lower the fressing pt of water; preservative of food;cure meats, preservative of food;cure meats, ferments food, etc…ferments food, etc…

Consumption of SodiumSodium naturally on food and Sodium naturally on food and Discretionary sodium( salt added) <limitDiscretionary sodium( salt added) <limit

Sodium free- < 5mg per servingSodium free- < 5mg per serving

Very low sodium – 35 mg or lessVery low sodium – 35 mg or less

Low sodium- 140 mg or lessLow sodium- 140 mg or less

Reduced sodium- 75% lessReduced sodium- 75% less

Unsalted,no salt added, w/o salt- salt Unsalted,no salt added, w/o salt- salt not used in the preparationnot used in the preparation

POTASSIUM

Principal cation in intracellular fluid Principal cation in intracellular fluid

Present in very small amount in Present in very small amount in extracellular fluid extracellular fluid

Extracellular Potassium Extracellular Potassium – control cardiac – control cardiac function , muscle and nerve irritability function , muscle and nerve irritability

Intracellular potassiumIntracellular potassium – essential in many – essential in many cellualr enzymatic functions :cellualr enzymatic functions :

Glycogen synthesis Glycogen synthesis

Glucose degradation Glucose degradation

Amino acid uptakeAmino acid uptake

POTASSIUM

It assists in the regulation of the acid-base balance.It assists in the regulation of the acid-base balance.

It assists in protein synthesis from amino acids and It assists in protein synthesis from amino acids and in carbohydrate metabolism.in carbohydrate metabolism.

It is necessary for the building of muscle and for normal body It is necessary for the building of muscle and for normal body growth.growth.

It is essential for the normal electrical activity of the It is essential for the normal electrical activity of the heart.heart.

Maintaining a balance between the many electrical and chemical Maintaining a balance between the many electrical and chemical processes of the bodyprocesses of the body

POTASSIUM (cont)

Minimum amount of potassium : 300 Minimum amount of potassium : 300 mEq(milliequivalents) per day mEq(milliequivalents) per day

Maximum amount of potassium : 400 mEqMaximum amount of potassium : 400 mEq

Potassium Deficiency (hypokalemia)

Caused by prolonged potassium-free dietCaused by prolonged potassium-free diet

Reduced intake of bicarbonate precursor Reduced intake of bicarbonate precursor

Excessive losses from :Excessive losses from :

DiarrheaDiarrhea

Acidosis Acidosis

DiureticsDiuretics

Steroids Steroids

PurgativesPurgatives

Severe potassium deficiency quickly leads to electrolyte imbalance Severe potassium deficiency quickly leads to electrolyte imbalance which affects all muscles, nerves and numerous key body which affects all muscles, nerves and numerous key body functions.functions.

Potassium Deficiency (cont)

Manifested by :Manifested by :

Muscle weakness Muscle weakness

Paralysis Paralysis

Reduced reflexes Reduced reflexes

Mental confusion Mental confusion

Cardiovascular signs :Cardiovascular signs :

Poor pulsePoor pulse

Weak heart sounds Weak heart sounds

Cooked Lima beans581Cooked Lima beans581

Banana440Banana440

Avocado136Avocado136

Potatoes130.3Potatoes130.3

Tomatoes96.7Tomatoes96.7

Oranges90Oranges90

Frozen peas63.3Frozen peas63.3

Cauliflower43.8aCauliflower43.8a

Dried Aproicots35.3Dried Aproicots35.3

Raisins16.5Raisins16.5

Canned Tuna6Canned Tuna6

Pork5.5Pork5.5

Chicken3.9Chicken3.9

Salmon3.8Salmon3.8

Cod3.7Cod3.7

Whole milk2.8Whole milk2.8

SourcePotassium: Sodium ratio

Potassium Excess

HyperkalemiaHyperkalemia

occurs when the level of potassium in occurs when the level of potassium in the bloodstream is higher than normalthe bloodstream is higher than normal

Sudden increase intake about 18 g of Sudden increase intake about 18 g of potassium potassium

Can cause fatal cardiac arrest Can cause fatal cardiac arrest

CHLORIDE

Occurs in the combination with sodium or Occurs in the combination with sodium or potassium cations potassium cations

Highest concentrations: in the secretions of Highest concentrations: in the secretions of the gastrointestinal tract and in the CSF the gastrointestinal tract and in the CSF

Low concentration : in muscles and nerve Low concentration : in muscles and nerve tissues tissues

Anion component of hydrogen chloride (HCL) Anion component of hydrogen chloride (HCL) in gastric juices in gastric juices

Initiation of digestion of protein Initiation of digestion of protein

Functions of Chloride:

Regulate the osmotic pressure Regulate the osmotic pressure

Regulate the water balance in the body Regulate the water balance in the body

Acts as a coenzyme in the digestive processActs as a coenzyme in the digestive process

Helps maintain the acid-base balance of the Helps maintain the acid-base balance of the blood blood

Enhances the ability of the blood to carry Enhances the ability of the blood to carry large amounts of COlarge amounts of CO2 2 to the lungs for to the lungs for exhalation exhalation

Aids in the conversion of potassium Aids in the conversion of potassium

Chloride Deficiency

HYPOAKALEMIC ALKALOSISHYPOAKALEMIC ALKALOSIS

Marked loss of chloride Marked loss of chloride

condition in which the concentration condition in which the concentration of potassium (Kof potassium (K++) in the blood is low) in the blood is low

Alkalosis- increase in the concentration of Alkalosis- increase in the concentration of bicarbonate (accumulation of base) body bicarbonate (accumulation of base) body fluids becoming too alkalinefluids becoming too alkaline

Chloride Deficiency (cont)CAUSES:CAUSES:

Low-potassium dietLow-potassium diet

DiarrheaDiarrhea

Excessive vomiting Excessive vomiting

Excessive sweating Excessive sweating

HyperchloremiaToo much chloride may be caused by:Too much chloride may be caused by:

• • eating or absorbing too much ammonium chloride, eating or absorbing too much ammonium chloride, or the bowel’s reabsorbing too much chlorideor the bowel’s reabsorbing too much chloride

• • dehydration, which raises the proportion of dehydration, which raises the proportion of chloride to other fluids in the bloodchloride to other fluids in the blood

Too much chloride from salted foods can:Too much chloride from salted foods can:

Increase your blood pressureIncrease your blood pressure

Cause a buildup of fluid in people with congestive Cause a buildup of fluid in people with congestive heart failure or cirrhosisheart failure or cirrhosis

Food Sources Common table salt Common table salt

Dairy Dairy

Meat products Meat products

Fruits and vegetablesFruits and vegetables

  tomatoes, lettuce, tomatoes, lettuce, celery, olives, seaweed celery, olives, seaweed and the grain, rye and the grain, rye

Daily chloride intake : 2 Daily chloride intake : 2 to grams to grams

Acid-Base

Balance

Acid-Base Balance

Normal pH in the blood is Normal pH in the blood is 7.35 – 7.35 – 7.7.445 5

Prevented by lung and kidneysPrevented by lung and kidneys

““acidosis”- accumulation of acidacidosis”- accumulation of acid

““alkalosis” – accumulation of alkalosis” – accumulation of basebase

Classification of FoodsGrouped as: Grouped as:

Alkali-producingAlkali-producing

Acid-producingAcid-producing

NeutralNeutral

Alkali-producing Foods

Fruits (except cranberries, prunes and plumsFruits (except cranberries, prunes and plums))

Vegetables (exceVegetables (except corn and lentilspt corn and lentils))

MilkMilk

NutsNuts

Once metabolized will yield an Once metabolized will yield an alkaline ashalkaline ash

Produce NaProduce Na++, K, K++, Ca, Ca22++ and Mg and Mg22++

Acid-producing Foods

MeatMeat

CerealsCereals

Eggs Eggs

Will yield acid end productsWill yield acid end products

Produce P, S, and ClProduce P, S, and Cl

REMEMBER!!

The Human Body has a The Human Body has a wide range of wide range of adaptability!!adaptability!!

However....

Lactic acidLactic acid and and acetoacetic acidacetoacetic acid which are which are produced in the body in produced in the body in high amounts in certain high amounts in certain conditions can cause conditions can cause acidosisacidosis!!!!But still, the human

body can adapt to this...

Effects of H2O and

Electrolyte Imbalance on Oral HealthGeneral dehydration or edema of tissues General dehydration or edema of tissues will cause shrinkage or swelling of the will cause shrinkage or swelling of the oral tissuesoral tissues

High salt diet resulting to high sodium High salt diet resulting to high sodium residue tend to accumulate body waterresidue tend to accumulate body water

Low-carbs, high-fat diet or high Low-carbs, high-fat diet or high protein diet for loss of weight tend protein diet for loss of weight tend to lose large amounts of water from the to lose large amounts of water from the excessive oxidation of body fatsexcessive oxidation of body fats

Xerostomia ““Dry mouth”Dry mouth”

Result from decrease salivary flow due to dehydrationResult from decrease salivary flow due to dehydration

Associated with lack of lubrication of mucosal Associated with lack of lubrication of mucosal surfacessurfaces

Roof of the mouth and tongue develop a burning Roof of the mouth and tongue develop a burning sensation sensation

Corners of the mouth become macerated and infected Corners of the mouth become macerated and infected causing a tendency of causing a tendency of lickinglicking

Promotes dental plaque formation and more dental Promotes dental plaque formation and more dental caries productioncaries production

Hypertension

Hypertension

““HBP”HBP”

Elevated arterial blood pressureElevated arterial blood pressure

Can lead to:Can lead to:

Stoke (brainStoke (brain))

failure, (CHDfailure, (CHD))

Renal failure (kidneyRenal failure (kidney))

Systolic and diastolic pressures Systolic and diastolic pressures >> normal normal

Normal BP (age groups)Age Group BP

Infants 90/60

3-6 110/70

7-10 120/80

11-17 130/80

18-44 140/90

45-64 150/95

65 and above 160/95

Hypertension

Mild : diastolic pressure is 9Mild : diastolic pressure is 90 – 0 – 105105

Moderate : Moderate : diastolic pressure isdiastolic pressure is 105 – 105 – 120120

Severe : Severe : diastolic pressure is diastolic pressure is exceeds exceeds 120120

...Among adults more men have hypertension that female

Causes

Maybe:Maybe:

unknown (essential hypertensionunknown (essential hypertension) or) orknown (secondary hyknown (secondary hypertensionpertension))

Factors contributing:Factors contributing:- genetics, environment, nutritional ones, obesity, genetics, environment, nutritional ones, obesity,

smoking, stress, diabetes, high cholesterol level and smoking, stress, diabetes, high cholesterol level and excessive sodium intake excessive sodium intake

Treatment

Weight lossWeight loss

Relaxation, meditation and biofeedback Relaxation, meditation and biofeedback techniquestechniques

Use of Kempner (rice-fruitUse of Kempner (rice-fruit) semistarvation ) semistarvation dietdiet

Limit dietary sodium intake to 200-250mgLimit dietary sodium intake to 200-250mg

Oral diureticsOral diuretics

↓sodium intake + diuretics = reduction of intracellular fluid volume, plasma volume and total exchangeable sodium

TY!