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Water and hydration: Physiological basis in Adults

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A global review of the physiology of hydration in adults, detailing the water distribution in the human body, the water balance and the main recommendations for water intake.

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Water and hydration: Physiological basis in Adults

  1. 1. Developed by for the Hydration for Health Initiative Water and Hydration: Physiological Basis in Adults
  2. 2. Get this content online http://www.h4hinitiative.com/h4h-academy/hydration-lab/ www.h4hinitiative.com 1
  3. 3. Water in the human body Water absorption and distribution in the body Body water balance Body fluid losses Focus on urine production Body water inputs Regulation and maintenance of body water balance Body water balance impairment: dehydration Guidelines for daily water intake Key facts References – References are sorted by slide, at the end of the presentation Content 2 www.h4hinitiative.com
  4. 4. Extracellular fluid 35% of total body water, 14L Intracellular fluid 65% of total body water, 28L Interstitial fluid 28% of total body water, 11L Plasma fluid 7% of total body water, 3L Two thirds of the body water is intracellular Total body water 60% of body weight, 42L 3 Water in the human body Body water content www.h4hinitiative.com
  5. 5. Most of the organs and tissue contain more than 70% water: 4 Water represents on average 60% of body weight in adult men (50-55% in women). Water in the human body Body water content Blood 83% Liver 68% Kidney 83% Adipose tissue 10% Muscle 76% Skin 72% Heart 79% Lungs 79% Spleen 76% Intestine 75% Skeleton (bones) 22% Brain 75% As lean body mass increases, so does body water content. www.h4hinitiative.com
  6. 6. Water appears in the blood as soon as 5 minutes after ingestion Water in the human body Water absorption & distribution in the body Ingested water is absorbed mainly in the small intestine * For a man drinking 2L of water per day. The more a person drinks, the faster body water is renewed. 5 99% of the body water pool is renewed within 50 days* A molecule of water stays in the body on average 10 days* INTERSTITIAL LIQUID CELLS PLASMA AND BLOOD CELLS GASTRO-INTESTINAL TRACT www.h4hinitiative.com
  7. 7. INPUTS LOSSES Body water balance 6 Urine Faeces Sweat Insensible water losses Water from fluids Water from food Metabolic water Body water balance = (sum of water inputs) – (sum of water losses) Body water balance is tightly regulated, to ensure homeostasis and to respond to changes in consumption and losses. www.h4hinitiative.com
  8. 8. 7 Body water balance Body fluid losses The main sources of water losses from the body are urine and sweat, but water is also lost through stools and insensibly through skin and breathing. ≈ 750mL skin evaporation & breathing (usually not perceived by the subject) ≈ 200mL Adaptable Minimum 500mL; Desirable urine osmolarity = 500 mOsm/L (EFSA) > 1600 – 2000 mL Highly variable Adapted to maintain body core temperature LOSSES Urine Faeces Sweat Insensible water losses www.h4hinitiative.com
  9. 9. Body water balance Body fluid losses: urine production Urine is produced from blood filtration in the nephrons 8 Kidney 1 Filtration 2 Reabsorption (water, solutes) 3 Secretion of additional wastes 4 Excretion Peritubular capillaryArtery Corpuscule (glomerulus + Bowman’s capsule) Tubule Blood flow Nephron www.h4hinitiative.com
  10. 10. 9 Body water balance Body water input Drinking water and beverages represent 70 - 80% of total water intake, and therefore are the largest source to compensate body water losses. ≈ 300mL approximates respiratory losses Variable ≈ 20 - 30% of total water intake depends on diet Highly variable ≈ 70 - 80% of total water intake varies between individuals & countries INPUTS Water from fluids Water from food Metabolic water www.h4hinitiative.com
  11. 11. 10 Body water balance Variable fluid intake, adaptable urine volume The adjustment of urine volume is critical to regulate body water balance. PHYSICAL EFFORT HOT ENVIRONMENT SWEAT INPUTS LOSSES LOW URINE VOLUME Athlete / hot environment LOW URINE VOLUME INPUTS LOSSES Sedentary HIGH URINE VOLUME INPUTS LOSSES www.h4hinitiative.com
  12. 12. Regulation & maintenance of body water balance Body water is regulated by the balance between water intake on one hand, and renal excretion of water on the other hand. 11 Thirst -+ AVP Stimulation of Osmoreceptors in hypothalamus - -+ Pituitary gland Water intake Permeability to water Kidneys Water deficit Water excessPLASMA OSMOLALITY Small volume of concentrated urine Water reabsorption Water reabsorption Larger volume of diluted urine - www.h4hinitiative.com
  13. 13. 12 Body water balance impairment Cognitive impairment memory motor skills mood Physical performance body temperature heart rate perceived effort Health implications: risk of kidney stones recurrence Dehydration and/or low fluid intake may impact Possible impacts of dehydration www.h4hinitiative.com
  14. 14. Guidelines for daily water intake Reference values for Total Water Intake* 13 *Total water intake: includes both water from food and from beverages of all kinds Individual water needs vary considerably, therefore there is no single adequate intake that is suitable for everyone. Most of the guidelines for total water intake are based on median population intake EFSA: first to introduce a physiological parameter: desirable urine osmolarity of 500mOsm/L. Country (references) Europe (EFSA, 2010) Australia & New Zealand (NHMRC, 2006) USA & Canada (IoM, 2004) World (WHO, 2003) Men 2,5L/d 3,4L/d 3,7L/d Sedentary 2,9L/d Active 4,5L/d Women 2,0L/d 2,8L/d 2,7L/d Sedentary 2,2L/d Active 4,5L/d www.h4hinitiative.com
  15. 15. Key facts 14 Water balance is tightly regulated Adaptable urine volume An adequate fluid intake contributes to Urine volume varies with fluid intake The maintenance of normal physical & cognitive functions Reducing the risk of kidney stones recurrence Variable fluid intake INPUTS LOSSES Reference values, Europe (EFSA) From 14 to adulthood Total water intake (fluid + food) Women 2.0L/d Men 2.5L/d Water from fluids (estimated at 80% of TWI) Women 1.6L/d Men 2.0L/d www.h4hinitiative.com
  16. 16. Perronet F, Mignault D, du Souich P, Vergne S, Le Bellego L, Jimenez L, Rabasa-Lhoret R (2012). Pharmacokinetic analysis of absorption, distribution anddisappearance of ingested water labeled with D(2)O in humans. Eur J Appl Physiol 112:2213-2222. Sawka MN, Cheuvront SN, Carter R, III (2005). Human water needs. Nutr Rev 63:S30-S39. Wang Z, Deurenberg P, Wang W, Pietrobelli A, Baumgartner RN, Heymsfield SB (1999). Hydration of fat-free body mass: review and critique of a classic body-composition constant. The American Journal of Clinical Nutrition 33:27-39. Pivarnik JM and Palmer RA (1994). Water and electrolytes during exercise. In: Hickson, J.F and Wolinski, I., ed. Water and electrolyte balance during rest and exercise. Boca Raton; CRC Press, 245-262. Marieb EN and Hoehn K (2007). Fluid, electrolyte, and acid-base balance. In: Human Anatomy and Physiology. 7th ed. San Francisco: Benjamin-Cummings Publishing Company, 1036-1048. Watson PE, Watson ID, Batt RD (1980). Total body water volumes for adult males and females estimated from simple anthropometric measurements. The American Journal of Clinical Nutrition 33:27-29. EFSA Panel on Dietetic Products Nutrition and Allergies (NDA) (2010). Scientific Opinion on Dietary Reference Values for water. EFSA Journal 8(3):1459-1507. IOM (Institute of Medicine of the National Academies) (2004). Dietary reference intakes for water, potassium, sodium, chloride and sulfate. 4:73-185. National Academies Press, Washington, DC. Bibliographic references Slide 3 – Body water content 15 www.h4hinitiative.com
  17. 17. Armstrong LE (2005). Hydration assessment techniques. Nutr Rev. 63:S40-S54. Marieb EN and Hoehn K (2007). Fluid, electrolyte, and acid-base balance. In: Human Anatomy and Physiology. 7th ed. San Francisco: Benjamin-Cummings Publishing Company, 1036-1048. Bibliographic references 16 Shaffer EA and Thomson ABR (1994). First principles of gastroenterology: the basis of disease and an approach to management. Canadian Association of Gastroenterology; Astra Pharma Inc. Perronet F, Mignault D, du Souich P, Vergne S, Le Bellego L, Jimenez L, Rabasa-Lhoret R (2012). Pharmacokinetic analysis of absorption, distribution anddisappearance of ingested water labeled with D(2)O in humans. Eur J Appl Physiol 112:2213-2222. Slide 5 – Water absorption and distribution in the body Slide 4 – Water content in the human body www.h4hinitiative.com
  18. 18. Grandjean A and Campbell S (2004). Hydration: Fluids for Life. A monograph by the North American Branch of the International Life Science Institute. Washington DC: ILSI North America. EFSA Panel on Dietetic Products Nutrition and Allergies (NDA) (2010). Scientific Opinion on Dietary Reference Values for water. EFSA Journal 8(3):1459-1507. Bibliographic references Slide 6 – Body water balance 17 www.h4hinitiative.com
  19. 19. Sherwood L (2010). Human Physiology: From Cells to Systems. 7th ed. Belmont: Brooks/Cole, Cengage Learning. Grandjean AC, Reimers KJ,Buyckx ME (2003). Hydration: issues for the 21st century. Nutr Rev 61:261-271. Hoyt RW (1996). Environmental influences on body fluid balance during exercise: altitude. In: Buskirk, E.R. and Puhl, S.M., ed. Body fluid balance: exercise and sport. Boca Raton: CRC PressINC, 183-196. EFSA Panel on Dietetic Products Nutrition and Allergies (NDA) (2010). Scientific Opinion on Dietary Reference Values for water. EFSA Journal 8(3):1459-1507. Powers SK and Howley ET (1997). Exercise Physiology. Theory and Application to Fitness and Performance. 3rd ed. Colombus: WCB/McGraw-Hill. Montain SJ, Cheuvront SN, Lukaski HC (2007). Sweat mineral-element responses during 7 h of exercise-heat stress. Int J Sport.Nutr Exerc Metab 17:574-582. Bibliographic references Slide 7 – Body fluid losses 18 www.h4hinitiative.com
  20. 20. Brenner BM and Rector FC (2008). The Kidney. 8th. Philadelphia: Saunders Elsevier. Valtin H and Schafer JA (1995). Renal function. 3rd ed. Boston: Little, Brown, and Co. Guyton AC and Hall JE (2006). Textbook of medical physiology. 11th ed. Philadelphia: Elsevier Saunders. Bibliographic references Slide 8 – Body fluid losses: urine production 19 www.h4hinitiative.com
  21. 21. EFSA Panel on Dietetic Products Nutrition and Allergies (NDA) (2010). Scientific Opinion on Dietary Reference Values for water. EFSA Journal 8(3):1459-1507. Hoyt RW (1996). Environmental influences on body fluid balance during exercise: altitude. In: Buskirk, E.R. and Puhl, S.M., ed. Body fluid balance: exercise and sport. Boca Raton: CRC PressINC, 183-196. Food Standard Agency (2002). McCance; Widdowson’s The Composition of Foods. 6th ed. Cambridge; The Royal Society of Chemistry. Sontrop JM, Dixon SN, Garg AX, Buendia-Jimenez I, Dohein O, Huang SH, Clark WF (2013). Association between water intake, chronic kidney disease, and cardiovascular disease: a cross-sectional analysis of NHANES data. Am. J Nephrol. 37:434-442. Ma G, Zhang Q, Liu A, Zuo J, Zhang W, Zou S, Li X, Lu L, Pan H, Hu X (2012). Fluid intake of adults in four Chinese cities. Nutr.Rev. 70:Suppl 2, S105-S110. EFSA (2008). The EFSA Concise European Food Consumption Database. http://www.efsa.europa.eu/en/datexfoodcdb/datexfooddb.htm. Accessed July 2013. Bibliographic references Slide 9 – Body water inputs 20 www.h4hinitiative.com
  22. 22. Perrier E, Vergne S, Klein A, Poupin M, Rondeau P, Le Bellego L, Armstrong LE, Lang F, Stookey J, Tack I (2012). Hydration biomarkers in free-living adults with different levels of habitual fluid consumption. Br J Nut, 109(9), 1678-1687. Perrier E, Rondeau P, Poupin M, Le Bellego L, Armstrong LE, Land F, Stookey J, Tack I, Vergne S, Klein A (2013). Relation between urinary hydration biomarkers and total fluid intake in healthy adults. European Journal of Clinical Nutrition, 67(9), 939-943. Sawka MN, Burke LM, Eichner ER, Maughan RJ, Stachenfeld NS (2007). American College of Sports Medicine position stand. Exercise and fluid replacement. Med Sci Sports Exerc, 39:377-390. Bibliographic references Slide 10 – Variable fluid intake, adaptable urine volume 21 Guyton AC and Hall JE (2006). Textbook of medical physiology. 11th ed. Philadelphia: Elsevier Saunders. Slide 11 – Regulation & maintenance of body water balance www.h4hinitiative.com
  23. 23. Armstrong LE, Ganio MS, Casa DJ, Lee EC, McDermott BP, Klau JF, Jimenez L, Le Bellego L, Chevillotte E, Lieberman HR (2012). Mild dehydration affects mood in healthy young women. J Nutr 142:382-8. Ganio MS, Armstrong LE, Casa DJ, McDermott BP, Lee EC, Yamamoto LM, Marzano S, Lopez RM, Jimenez L, Le Bellego L, Chevillotte E, Lieberman HR (2011). Mild dehydration impairs cognitive performance and mood of men. Br J Nutr 106:1535-43. Pross N, Demazières A, Girard N, Barnouin R, Santoro1 F, Chevillotte E, Klein A, Le Bellego L (2012). Influence of progressive fluid restriction on mood and physiological markers of dehydration in women. Br J Nutr 13:1-9. Sawka MN, Coyle EF (1999). Influence of body water and blood volume on thermoregulation and exercise performance in the heat. Exerc Sport Sci Rev 27:167-218. Curhan GC. (2007) Epidemiology of stone disease. Urol.Clin North Am 34:287-293. Trinchieri A, Cappoli S, Esposito N, Acquati P. (2008) Epidemiology of renal colic in a district general hospital. Arch.Ital.Urol. Androl. 80:1-4. Irving RA, Noakes TD, Rodgers AL, Swartz L. (1986) Crystalluria in marathon runners. 1. Standard marathon--males. Urol. Res 14:289-294. Bibliographic references Slide 12 – Possible impacts of dehydration 23 www.h4hinitiative.com
  24. 24. EFSA Panel on Dietetic Products Nutrition and Allergies (NDA) (2010). Scientific Opinion on Dietary Reference Values for water. EFSA Journal 8(3):1459-1507. IOM (Institute of Medicine of the National Academies) (2004). Dietary reference intakes for water, potassium, sodium, chloride and sulfate. 4:73-185. National Academies Press, Washington, DC. NHMRC (National Health and Medical Research Council) (2006). Nutrient Reference Values for Australia and New Zealand Including Recommended Dietary Intakes. Commonwealth of Australia, Canberra. WHO (World Health Organization) (2003). Domestic water quantity, service level and health. WHO/SDE/WSH/3.02. Bibliographic references Slide 13 – Guidelines for daily water intake 24 www.h4hinitiative.com
  25. 25. Access Adults Monograph online To learn more http://www.h4hinitiative.com/h4h- academy/hydration-lab/ Visit the H4H website www.h4hinitiative.com 25 www.h4hinitiative.com
  26. 26. Developed by for the Hydration for Health Initiative

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