Water and Minerals

Dr. M. Volkan YILMAZ

 Water

Most important component substances on earth.

All plants and animals must have water to survive.

If there was no water there would be no life on earth.

How much Water Do We Have?

https://www.otsuka.co.jp/en/nutraceutical/about/rehydration/water/body-fluid/
 Why Water Is Important
Water;
✓ carries nutrients to all cells in our body and
oxygen to our brain.

✓ allows the body to absorb and assimilate

minerals, vitamins, amino acids, glucose and
other substances.

✓ flushes out toxins and waste.

✓ helps to regulate body temperature.

Water Balance

https://pmgbiology.com/tag/adh/
 Sources of Water
o Metabolic Water –
water created from
metabolism

o Foods

o Beverages
 Minerals
Essential minerals are sometimes divided up into major
minerals (macrominerals) and trace minerals
(microminerals).

These two groups of minerals are equally important, but

trace minerals are needed in smaller amounts than major
minerals.

The amounts needed in the body are not an indication of

their importance.

A balanced diet usually provides all of the essential minerals.

 Sodium
Functions
Needed for proper fluid balance, nerve transmission, and
muscle contraction

Sources
Table salt, soy sauce; large amounts in processed foods; small
amounts in milk, breads, vegetables, and unprocessed meats

Recommendation
Women, Men 19-50 years: 1.5 g/day
 Sodium
Deficiency
headache, muscle weakness and spasms/cramps, nausea,
vomiting, confusion, lethargy, appetite loss

What Cause Deficiency

acute diarrhea, excessive sweat loss, diuretic overuse,
cachexia, congestive heart failure

Excess Intake
Hypertension

What Cause Excess Intake

High Salt Consumption
 How much salt?
Salt, also known as sodium chloride, is about 40% sodium
and 60% chloride. It flavors food and is used as a binder and
stabilizer.

It is also a food preservative, as bacteria can’t thrive in the

presence of a high amount of salt.

WHO recommends salt intake of less than 5 grams per day

(2000mg Sodium).

In Turkey, daily salt intake is 9.9 gram according to

2017 Turkey Household Health Research conducted by the
Ministry of Health in cooperation with WHO.
 Chloride
Functions
Needed for proper fluid balance, stomach

Sources
Table salt, soy sauce; large amounts in processed foods; small
amounts in milk, meats, breads, and vegetables

Recommendation
2g/day
 Chloride
Deficiency
Hypochloremia

What Cause Deficiency

Occurs when there's a low level of chloride in your body. It
can be caused by fluid loss through nausea or vomiting or by
existing conditions, diseases, or medications.

Excess Intake
hyperchloremia

What Cause Excess Intake

usually indicates dehydration, but can also occur with other
problems that cause high blood sodium, such as Cushing
syndrome or kidney disease
 Potassium
Functions
Needed for proper fluid balance, nerve transmission, and
muscle contraction

Sources
Meats, milk, fresh fruits and vegetables, whole grains,
legumes

Recommendation
19-50 years : 4.7g/day
 Potassium
Deficiency
severe: cardiac arrhythmias, muscle weakness, glucose
intolerance; moderate: high BP, high risk of kidney stones, CVD
(stroke), increased bone turnover

What Cause Deficiency

Low intake, diuretics; Cushing’s disease, chronic renal disease,
diarrhea, vomiting, laxative abuse

Excess Intake
cardiac arrest
What Cause Excess Intake
excessive intake of potassium supplements, metabolic acidosis,
chronic renal failure, ACE inhibitors, Addison’s disease, angiotensin
receptor blockers and potassium-sparing diuretic
Potassium
 The interplay of sodium and potassium
Sodium and potassium are closely interconnected but have
opposite effects in the body.

Both are essential nutrients that play key roles in maintaining

physiological balance, and both have been linked to the risk of
chronic diseases, especially cardiovascular disease.

High salt intake increases blood pressure, which can lead to heart
disease, while high potassium intake can help relax blood vessels
and excrete sodium while decreasing blood pressure
 The interplay of sodium and potassium
People who ate high-sodium, low-potassium diets had a higher risk
of dying from a heart attack or any cause.

In this study, people with the highest sodium intakes had a 20%
higher risk of death from any cause than people with the lowest
sodium intakes.

People with the highest potassium intakes had a 20% lower risk of
dying than people with the lowest intakes.

People with the highest ratio of sodium to potassium in their diets

had double the risk of dying of a heart attack than people with the
lowest ratio, and they had a 50% higher risk of death from any
cause.
Yang Q, Liu T, Kuklina EV, Flanders WD, Hong Y, Gillespie C, Chang MH, Gwinn M,
Dowling N, Khoury MJ, Hu FB.. Archives of internal medicine. 2011 Jul
11;171(13):1183-91
 Calcium
Functions
Important for healthy bones and teeth; helps muscles relax
and contract; important in nerve functioning, blood clotting,
blood pressure regulation, immune system health

Sources
Milk and milk products; canned fish with bones (salmon,
sardines); fortified tofu and fortified soy milk; greens
(broccoli, mustard greens); legumes

Recommendation
950-1000 mg/day
 Calcium
Deficiency
osteoporosis, pre-eclampsia

What Cause Deficiency

low intake or impaired absorption over many years

Excess Intake
kidney stones; hypercalcemia; renal insufficiency

What Cause Excess Intake

excessive intake of calcium supplements; peptic ulcer treatment
 Why Calcium Intake is Important?
In order to perform these vital daily functions, the body works to
keep a steady amount of calcium in the blood and tissues.

If calcium levels drop too low in the blood, parathyroid hormone

(PTH) will signal the bones to release calcium into the
bloodstream.

This hormone may also activate vitamin D to improve the

absorption of calcium in the intestines.
 Why Calcium Intake is Important?
At the same time, PTH signals the kidneys to release less calcium in
the urine.

When the body has enough calcium, a different hormone called

calcitonin works to do the opposite: it lowers calcium levels in the
blood by stopping the release of calcium from bones and signaling
the kidneys to rid more of it in the urine.

The body gets the calcium it needs in two ways. One is by eating
foods or supplements that contain calcium, and the other is by
drawing from calcium in the body.

If one does not eat enough calcium-containing foods, the body will
remove calcium from bones.
Calcium
 Phosphorus
Functions
Key element of bones, teeth, and cell membranes; found in
every cell; helps to activate enzymes, and keeps blood pH
within a normal range; regulates the normal function of
nerves and muscles, including the heart, and is also a
building block of our genes, as it makes up DNA, RNA, and
ATP, the body’s major source of energy
Sources
Dairy products, meat, fish, poultry, eggs, processed foods
(including soda pop)

Recommendation
440mg/day
 Phosphorus
Deficiency
anorexia, muscle weakness, bone pain, rickets, osteomalacia

What Cause Deficiency

near-total starvation

Excess Intake
adverse effects on calcium economy

What Cause Excess Intake

excessive intake of cola beverages and food phosphate additives
 Magnesium
Functions
Plays an important role in assisting more than 300 enzymes
to carry out various chemical reactions in the body such as
building proteins and strong bones, and regulating blood
sugar, blood pressure, and muscle and nerve functions;
needed for making protein, muscle contraction, nerve
transmission, immune system health

Sources
Nuts and seeds; legumes; leafy, green vegetables; seafood;
chocolate; artichokes; "hard" drinking water

Recommendation
350mg/day for men, 300 mg/day for women
 Sulphur
Functions
Found in protein molecules

Sources
Occurs in foods as part of protein: meats, poultry, fish, eggs,
milk, legumes, nuts

Recommendation
 Iron
Functions
Part of a molecule (hemoglobin) found in red blood cells that
carries oxygen in the body; needed for energy metabolism;
important for healthy brain development and growth in
children, and for the normal production and function of
various cells and hormones

Sources
Organ meats; red meats; fish; poultry; shellfish (especially
clams); egg yolks; legumes; dried fruits; dark, leafy greens;
iron-enriched breads and cereals; and fortified cereals

Recommendation
11mg/day for men, 11-16mg/day for women
 Iron
Deficiency
iron deficiency anemia (tiredness, impaired work performance,
failure to thrive in infants)

What Cause Deficiency

Low bioavailable diets, increased requirement (blood loss, growth)

Excess Intake
acute toxicity causes GI problems (constipation, diarrhea, cramps);
chronic toxicity increased risk for bacterial infections, arthropathy,
cardiomyopathy, endocrine dysfunctions
What Cause Excess Intake
overuse of iron supplements
 Factors Effecting Iron Intake
Iron from food comes in two forms: heme and non-heme. Heme is
found only in animal flesh like meat, poultry, and seafood. Non-
heme iron is found in plant foods like whole grains, nuts, seeds,
legumes, and leafy greens.

Heme iron is better absorbed by the body than non-heme iron.

Certain factors can improve or inhibit the absorption of non-heme

iron. Vitamin C and heme iron taken at the same meal can improve
the absorption of non-heme iron.

Bran fiber, large amounts of calcium particularly from

supplements, and plant substances like phytates and tannins can
inhibit the absorption of non-heme iron
 Risk Groups for Iron Intake
Pregnant women—during pregnancy a woman produces much
greater amounts of red blood cells for the fetus, increasing the
need for additional dietary or supplemental iron.

Menstruating women—women who experience heavy bleeding

during menstruationcan develop IDA.

Children—infants and children have high iron needs due to their

rapid growth.

Elderly—older ages are associated with a higher risk of poor

nutrition and chronic inflammatory diseases that can lead to
anemia.
 Risk Groups for Iron Intake
Vegetarians—those who eat a diet without heme iron from meats,
fish, and poultry may develop IDA if they do not include adequate
non-heme iron foods in the diet.

Endurance athletes—running can cause trace amounts of

gastrointestinal bleeding and a condition called “foot-strike”
hemolysis that breaks down red blood cells at a faster rate.

People with chronic kidney failure on dialysis—the kidneys make

a hormone called erythropoietin (EPO) that signals the body to
make red blood cells. Kidney failure reduces the production of EPO
and therefore blood cells. In addition, there is some blood loss
during hemodialysis.
 Risk Groups for Iron Intake
In Turkey, 10 mg/day of elemental iron supplement have been
provided to 4-12 months old infants free, by Turkish Ministry of
Health since 2004 within the scope of “Protecting, Promoting, and
Supporting Breastfeeding and Program for Prevention and Control
of Iron-Deficiency Anemia: Turkey Strong Like Iron”.
Iron
 Zinc
Functions
Part of many enzymes; needed for making protein and
genetic material; has a function in taste perception, wound
healing, normal fetal development, production of sperm,
normal growth and sexual maturation, immune system
health

Sources
Meats, fish, poultry, leavened whole grains, vegetables

Recommendation
9.4-16.3 for men, 7.5-12.7 for women (range changes
according to phytate consumption)
 Zinc
Deficiency
growth retardation, hair loss, skin lesions, loss of appetite, loss of
taste sensation, delayed sexual maturation; acrodermatitis
enteropathica

What Cause Deficiency

Low intake, high cereal fibre and legume (phytate) diet

Excess Intake
acute toxicity causes nausea and vomiting; chronic toxicity causes
copper deficiency

What Cause Excess Intake

contaminated water (galvanized containers)
Zinc
 Iodine
Functions
Found in thyroid hormone, which helps regulate growth,
development, and metabolism

Sources
Seafood, foods grown in iodine-rich soil, iodized salt, bread,
dairy products

Recommendation
150 mcg/day
 Iodine
Deficiency
iodine deficiency disorders (goiter, cretinism)

What Cause Deficiency

low intakes in areas where soil is iodine deficient; excessive intakes
of goitrogens (brassica vegetables); mutations in Pendrin gene
resulting in defective iodination of thyroglobulin

Excess Intake
rapid heart rate, trembling, excessive sweating, lack of sleep,
weight loss

What Cause Excess Intake

high intakes of seafood or seaweed contaminated with iodine
 Selenium
Functions
Component of selenoproteins and enzymes; have antioxidant
properties that help to break down peroxides, which can
damage tissues and DNA, leading to inflammation and other
health problems

Sources
Meats, seafood, grains

Recommendation
70 mcg/day
 Selenium
Deficiency
associated with Keshan disease (cardiomyopathy) and Kashin-Beck
disease (osteoarthropathy); impaired immune function

What Cause Deficiency

low intakes in areas where soil is selenium deficient

Excess Intake
brittle hair and nails, skin lesions, garlic breath

What Cause Excess Intake

excessive intake of supplements and high selenium foods e.g.
Brazil nuts
 Copper
Functions
Part of many enzymes; needed for iron metabolism

Sources
Legumes, nuts and seeds, whole grains, organ meats,
drinking water

Recommendation
1.6 mg/day for men, 1.3mg/day for women
 Copper
Deficiency
anemia, neutropenia, bone fractures; Menkes syndrome; X-linked
cutis laxa (sagging skin, impaired connective tissues)

What Cause Deficiency

premature birth; excessive intakes of zinc

Excess Intake
acute toxicity causes vomiting, diarrhea, hemolytic anemia;
chronic toxicity causes hepatitis, cirrhosis, jaundice; Wilson’s
disease
What Cause Excess Intake
contaminated drinks and foods (copper pipes)
 Manganese
Functions
Part of many enzymes

Sources
Widespread in foods, especially plant foods

Recommendation
3 mg/day
 Fluoride
Functions
Involved in formation of bones and teeth; helps prevent
tooth decay

Sources
Drinking water (either fluoridated or naturally containing
fluoride), fish, and most teas

Recommendation