SESSION 9: WATER AND THE MINERALS Fluid and Electrolytes

Electrolytes – are minerals that carry electrical

charges or ions (particles) when dissolved in water.
Water Quality
These minerals separate into cations or anions.
Hard water – water that contains high amounts of
minerals such as calcium and magnesium. The primary extracellular electrolytes in body fluids
are sodium (cation) and chloride (anion) and the
Soft water – water replacing water minerals with primary intracellular electrolyte- potassium (cation).
sodium.
Moving electrolytes in and out of the cell membrane
Functions of Water requires transport proteins.
✔ Water is an important structural component The Na-K pump is a transport protein that works to
in the body giving shape and rigidity to cells. exchange Na from within the cells to potassium.
✔ Water assists in regulating body temperature. Fluid Volume Deficit (FVD)
✔ Water acts as a lubricant in the form of joint fluid A person experiences vascular, cellular or
and mucous secretions (amniotic sac, spinal cord intracellular dehydration.
and eyes).
Severe FVD – when body fluid levels fall by 10% 0f
- Water is a component of blood, lymph, body weight (medical emergency).
saliva and urine.
Occur from diarrhea, vomiting, or high fever,
- Water may supply trace minerals such as
sweating, diuretics or polyuria.
fluoride, zinc and copper.
- Water also participates as a reactant. Characteristics are: infrequent urination, decreased
- A reactant is a substance that enters into and is skin elasticity, dry mucous membranes, dry mouth,
altered during a chemical reaction. unusual drowsiness, lightheadedness or
disorientation, extreme thirst, nausea, slow or rapid
breathing and sudden weight loss.
Regulation of Fluid and Water in the Body
Older adults and infants are at risk of FVD.
The intake of fluids is balanced with the output
through urine, sweat, feces, and insensible Fluid Volume Excess
perspiration.
This is a condition in which a person experiences
Homeostasis (physiologic equilibrium) – is increased fluid retention and edema.
maintained by electrolytes that include minerals and
blood proteins. It is associated with compromised regulatory
mechanism, excess fluid intake or excess sodium
Electrolyte – salt that dissolves in water and intake.
dissociates into charged particles called ions.

Two important minerals are sodium and potassium.

Minerals
The extracellular distribution of fluid depends on
sodium, potassium influences intracellular water. Provide rigidity and strength to the teeth and
skeleton Serve as a storage depot for other needs of
Water moves within and between the cells in the body Allow proper muscle contraction and
interstitial fluids in response to the levels of these release Influence nerve and muscle functions.
minerals.

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Mineral Categories hormone), digestive enzymes, and
neurotransmitters.
16 essential minerals are divided into two categories.
Ca is a cofactor for several enzymes as well.
Major Minerals are needed daily from dietary sources
in amounts of 100mg or higher. Hormones that Regulate Ca Balance

Trace Minerals are required daily in amounts less • Calcitonin – decreases blood Ca levels.
than or equal to 20 mg. • Parathormone – increases blood Ca levels.
• Vitamin D – promotes Ca deposit into the bones.
Minerals are stable when foods containing them are
cooked. When hypocalcemia occurs;

Major Minerals: Blood Ca levels increase thru:

Calcium Chloride Magnesium Sulfur 1. The small intestine absorbs more Ca

Phosphorus Potassium Sodium 2. The bones release more Ca

Trace Minerals: 3. The kidneys excrete less Ca

Arsenic Boron Chromium Iron Ca Rigor – blood Ca above normal

Cobalt Copper Fluoride Nickel - muscles contract and cannot relax,

hardness/stiffness.
Iodine Silicon Manganese Zinc
Ca Tetany – blood Ca below normal
Selenium Molybdenum
- characterized by uncontrolled muscle
contraction.
MAJOR MINERALS
Ca+ and Hypertension
1. CALCIUM – owns the distinction of being the
Evidence suggests that Ca may protect against HPN.
most abundant mineral in the body.
DASH diet is not particularly low in sodium, but it is
- 99% stored in bones.
rich in Ca+, as well as K+ and magnesium.
2 Important Roles:

▪ Integral part of bone structure.

Calcium Adequate Intake
▪ Serves as a Ca bank available to the body
fluids if blood Ca drops. Adolescence: 1300 mg/day

Ca in Bone 19-50 y/o: 1000 mg/day

Calcium salts form crystals on a matrix of the protein Over 50 y/o: 1200 mg/day
collagen.
Ca Sources:
As the crystals become denser, they give strength
o Milk and milk products = the most abundant
and rigidity to the maturing bones.
source of Ca.
Ca in Body Fluids o Dairy products (cheese, yogurt,
o Oysters, salmon, small fish.
1 percent of calcium circulates in the body fluid as
o Vegetables, such as mustard greens, kale,
ionized Ca
parsley, watercress and broccoli.
Helps regulate muscle contractions, transmit nerve o Tofu
impulses, blood clot, secrete hormones (parathyroid
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Spinach and Swiss chard Ca Toxicity

- Contain binders, that prevent calcium Over supplementation may cause constipation,
absorption. urinary stone formation affecting kidney function,
and reduced absorption of iron, zinc and other
Chemical compounds in foods that combine with
minerals.
nutrients (especially minerals) to form complexes
the body cannot absorb.

Ex: phytates, and oxalates 2. PHOSPHORUS

Factors favoring Ca absorption: - 2nd most abundant mineral in the body.

⮚ Lactose - 85% - is in our bones and teeth.

⮚ Acidity of digestive mass - Part of the body’s buffer systems (phosphoric acid)
- The other 15% of phosphorus functions in: In
⮚ Sufficient Vitamin D energy transfer.
⮚ Body’s need for higher amounts (pregnancy) - Part of DNA and RNA, the genetic material in every
cell.
Factors that hinder Ca Absorption:
- Component of phospholipids used for
⮚ Aging
transportation and structural functions.
⮚ Binders such as phytic acid and oxalic acid Dietary RDA - 700mg/day for men/women, 19yrs. old and
fat older.
⮚ Drug use (anticonvulsants, tetracycline, antacids Sources are: dairy foods, eggs, meat, fish, poultry
etc.) Excessive phosphorus intake and cereal grains, soft drinks.
⮚ Laxative use Ph Deficiency: unknown
⮚ Sedentary lifestyle Toxicity: possible from Ph supplements,
cause Ca excretion from the body.

Ca and Osteoporosis

Characterized by reduced density of the bones. 3. MAGNESIUM

Bones become porous and fragile and fracture - 1 ounce is present in the body.
easily A.K.A. Adult Bone Loss.
- over half of it is in the bones.
Factors related to the dev’t of Osteoporosis:
- Only 1% present in the body fluids.
⮚ Nutrition / Ca intake
- Regulates nerve and muscle functions.
⮚ Alcohol
- Assists hundreds of enzymes throughout the body.
⮚ Smoking
- Has a role in the blood clotting process and the
⮚ Caffeine immune system.
⮚ Sedentary Lifestyle RDA - 420mg/day for men; 32omg/day for women.

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Mg Deficiency Na Food Sources:

Result from vomiting, diarrhea, alcohol abuse or o Salt, soy sauce, processed foods – highest
CHON malnutrition, use of diuretics, who have been sodium.
fed incomplete fluids IV for too long after surgery o Whole, unprocessed foods, such as fresh
(TPN) fruits and vegetables – lowest sodium.

Severe Mg def. – Tetany = an extreme and Na Deficiency

prolonged contraction of the muscles similar to Ca
Headache, muscle weakness, reduced ability to
tetany.
concentrate, loss of memory and appetite.
Mg Toxicity
Hyponatremia – concern for endurance athletes.
When taken with Ca supplements will cause diarrhea
Secondary hyponatremia – neurologic and kidney
and dehydration.
disorders.

Na Toxicity
4. SULFUR
❖ Hypertension and edema
- Present in all CHONs and plays its most important ❖ DASH diet
role in shaping strands of CHON, thiamine and
Approaches to stop HPN:
biotin.
✔ Emphasizes fruits, veggies, low-fat
- No DRI.
dairy products which includes whole
- Sulfur is found in all CHON containing foods, grains, nuts, poultry, fish.
also no deficiencies develop.
✔ Calls for reduced intakes of red meat,
Toxicity of sulfur is not a health issue. butter other high-fat foods.

✔ Done in combination with reduced Na

5. SODIUM intake.

- Principal electrolyte in the extracellular fluid (fluids

outside the cells), BP and volume are maintained
6. POTASSIUM
- Primary regulator of all body fluids in and out of - Principal positively charged ion inside the body
the cells cells.
- Helps maintain normal fluid & acid-base balance - Critical to keeping the heartbeat steady.
Essential to muscle contraction and nerve
transmission Na. - The sudden deaths that occur in severe diarrhea
and in children with kwashiorkor or people with
RDA – ¾ spoon of salt/day eating disorders are likely due to heart failure caused
AI- 1.500mg/day for adults by potassium loss.

• Too much sodium can contribute to high BP AI – 4,700mg for adults.

• The more a foodstuff is processed, the higher K Sources:
• the sodium content becomes.
• Processed foods contain not only more o Whole unprocessed foods
sodium, but also less potassium. o White potatoes with skin
o Tomatoes, bananas, oranges
o Dairy products, legumes
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K Deficiency (Hypokalemia) - Helps them carry and hold oxygen and then release
it.
Results more often from excessive losses than from
deficient intakes. - Hemoglobin carries oxygen from the lungs to
tissues throughout the body.
Arises from:
- Myoglobin holds oxygen for the muscles to use
✔ DHN when they contract.
✔ Prolonged vomiting or diarrhea - Vital to the processes by which cells generate
K Toxicity (Hyperkalemia) energy.
- Needed to make new cells, amino acids,
Does not result from overeating of foods high in K+ hormones, and neurotransmitters.
Can result from overconsumption of K+ salts or Types of Protein Iron:
supplements and from certain diseases or
medications. • Transferrin = the blood protein that carries
the iron to tissues throughout the body.
Potassium injection should not be directly injected • Ferritin = a special storage-proteins in the
into the vein, because it can stop the heat beating. liver, bone marrow, and other organs.
= Liver is the main site of iron storage in the
body.
7. CHLORIDE • Hepcidin = a hormone produced by the liver
that are inversely related to the efficiency of
- Major negative ion of the extracellular fluids, where
iron absorption.
it occurs primarily with Na.
= High blood concentration of the hormone
- Part of HCL acid = which maintains the strong are associated with low iron absorption.
acidity of the gastric fluids.
Fe Deficiency
RDI – 2,300mg/day for adults
Most common nutrient deficiency worldwide
Cl Food Sources: Depletion of Fe stores

o Salt – major food source. At risk:

o Processed foods – major contributor of Cl to
✔ Women
people’s diet.

Cl Deficiency ✔ pregnancy

✔ Infants & young children

Would occur from the same circumstances as
sodium deficiency or from excessive vomiting. Causes of Iron Deficiency:
Toxicity may occur because of dehydration causing Inadequate intake
imbalance of chloride to the other electrolytes.
Blood loss = is the primary non-nutritional cause
Parasitic infection of the GI tract may lead to blood
loss.
TRACE MINERALS – needed by the body in
tiny quantities. Iron Deficiency Anemia

1. IRON Iron deficiency – refers to depleted body iron stores

- Component of hemoglobin in RBC and myoglobin without regard to the degree of depletion or to the
in muscle cells. presence of anemia.

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Iron deficiency anemia – refers to severe depletion Fe Sources:
of iron stores that results in a low hemoglobin
a. Heme Fe – most absorbable form.
concentration.
- bound into the iron-carrying proteins hemoglobin
- RBCs are pale and small.
and myoglobin in meats, poultry, fish.
- Also called microcytic hypochromic anemia.
b. Nonheme Fe – less absorbable form.
Manifestations:
- meats and plant foods such as veggies, grains
✔ Fatigue, weakness, headaches, apathy, pallor,
and poor resistance to cold temperatures Iron absorption from foods can be maximized by two
substances that enhance iron absorption: MFP factor
✔ The skin becomes noticeably pale
and Vit. C.
✔ Dark-skinned person, the tongue and eye lining, Some substances can impair iron absorption:
will be very pale
o Tannins of tea and coffee
Children: irritable, restless, and unable to pay o Calcium in milk
attention. o Phytates that accompany fiber in legumes
PICA and whole grain cereals.

- Craving for non-nutritious or harmful substances,

such as ice, clay, paste, grass, stones, or clothing r/t 2. ZINC
Fe or Zn deficiencies.
- More than 200 enzymes throughout the body
- A.K.A. Geophagia, clay-eating behavior depend on it.
- Results in Iron or zinc deficiency. - Affects our growth process, taste and smell ability,
Fe Overload healing process, immune system and carbohydrate
metabolism by assisting insulin function.
Hemochromatosis – caused by genetic d/o that
enhances Fe absorption. - Needed to produce the active form of Vit. A in
visual pigments and is essential to wound healing,
Other causes: taste perception, the making of sperm, and fetal
development.
o Repeated BT
RDA – Men: 11mg/day
o Massive doses of Fe supplements
Women: 8mg/day
o Manifestations:
Zinc Sources:
o Apathy, lethargy, and fatigue
o Foods high in CHON, such as shellfish,
Fe Poisoning
especially oyster, meats, fish, poultry, liver,
Toxicity from excess Fe whole-grain products, legumes and eggs.
o breast milk is also a good source of zinc for
Rapid ingestion of massive amounts of Fe causes
infants.
DEATH.

Fe Recommendation - Men 19 above: 8mg/day

Albumin – Zinc’s main transport vehicle in the
Women 19-50y/o: 18mg/day bloodstream.

≥50y/o: 8mg/day

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Zinc Deficiency Toxic goiter – caused by a substance called
goitrogens (a substance that suppress the actions of
Commonly seen in Egypt, Iran, and Turkey were
the thyroid gland)
diets are high in fiber and phytate.
Foods like cabbage, kale, brussels sprouts,
Marked by dwarfism, or severe growth retardation,
cauliflower, broccoli, and kohlrabi.
and hypogonadism or arrested sexual maturation,
reduced ability to taste (hypogeusia), and reduced Iodine Toxicity
ability to smell (hyposmia)
Thyrotoxicosis (hyperthyroidism) with the symptoms
Other causes: sweating, palpitations, sudden weight loss, tremors,
fatigue, muscle weakness.
Blood loss due to parasitic infections, climate that
increase sweat losses, and the practice of clay
eating.
4. FLUORIDE
At risk:
- Element involved in the formation of bones for
✔ Pregnant teenagers need zinc for their own mineralization and helps make teeth resistant to
growth as well as the developing fetus. decay.

✔ Vegetarians = increase fiber in the diet may - Part of tooth formation.

contain phytate. RDA – Men: 4mg/day
Zn Toxicity Women: 3mg/day
From supplementation produces GI distress leading F Sources:
to vomiting and diarrhea, fever and exhaustion
(similar to flu) o Fortified water
o F toothpaste
Decreases iron, copper and HDL. o Tea, sea food

Fluoride Deficiency
3. IODINE Fluorosis – mottling or brown spotting of the tooth
- Integral part of the thyroxin, which regulate growth enamel from ingestion of too much fluoride during
and development, basal metabolic rate, and body tooth development.
temperature Prevention:
RDA: 150mcg/day for men and women
✔ Monitor F content of the local water supply
Tolerable Upper Intake Level: 1,100mcg
✔ Supervise children
I Sources: Iodized salt; Seafood
✔ Use F supplements as ordered
Iodine Deficiency

This deficiency reduces thyroxin produced

5. SELENIUM
Goiter – an enlargement of the thyroid gland due to
iodine deficiency. - Assists a group of antioxidant enzymes called
glutathione peroxidases
Cretinism (mental and physical retardation).
- Glutathione peroxidases and Vit. E work together
Simple goiter – caused by iodine deficiency. to prevent cell and lipid membrane damage.

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- Plays role in converting thyroid hormone to its Jaundice, liver cirrhosis, hypoglycemia, brownish-
active form. yellow ring around corneoscleral junction.

RDA – 55 to 70 µg/day

Se Sources: 7. MANGANESE

o Organ meats - Is a cofactor for many enzymes, helping to

o Fish, eggs facilitate dozens of different metabolic processes.
o Whole grains, vegetables
Mn Toxicity
Se Deficiency
Seen in miners who inhale large quantities of
Associated with heart disease. (Keshan disease) in manganese dust
children and young women which includes
Causes symptoms of brain disease (dementia and
cardiomyopathy and heart failure.
Parkinson’s disease), along with abnormalities in
Se Toxicity appearance and behavior.

Hair and nail brittleness and loss. RDA - Men: 2.3mg/day

Other effects are liver damage, vomiting, and Women: 1.6mg/day

diarrhea.
Mn Sources: Nuts, whole grains, green leafy
vegetables.

6. COPPER

- A coenzyme involving antioxidant rxns. and energy 8. CHROMIUM

metabolism.
- Associated with insulin and required for the release
- Component of wound healing. of energy from glucose.

- A constituent of nerve fiber protection. - Main component of GTF (Glucose Tolerance Factor)

- A required element for iron use. AI – Men (19-50 y/o): 35 µg/day; (51above): 30 µg/day

- One of the most vital roles is to help cells use iron. Women (19-50y/o): 25 µg/day; (50above): 20 µg/day

RDA: 900 µg/day Cr Sources: Meat, unrefined foods such as liver,

brewer’s yeast, nuts, cheeses.
Cu Sources: Organ meats, legumes, whole grains,
seafood, nuts, and seeds and water flowing through Chromium deficiency
copper pipes.
Diabetes-like condition may develop with elevated
Cu Deficiency blood glucose and impaired glucose tolerance.

Bone demineralization and anemia

Can be caused by zinc toxicity Other Trace Minerals:

Copper Toxicity Molybdenum - works as a part of several

Some genetic disorders create a copper toxicity metal-containing enzymes.

Wilson’s disease (prevent the body from getting rid RDA: 45ug/day
of copper)
Nickel – important for the health of many tissues.

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