WEEK2: NUTRITION PRINCIPLES

INORGANIC COMPOUNDS
WATER
Water isessentialfor maintaining cellular homeostasis and life sustenance. It comprises 75% of body
weight ininfants to 55% in elderly.
When we talk about water in this chapter, we are essentially referring to the water you drink directly. On
an average, food provides 20% of total water intake in the form of milk, juice, beer, wine, and even caffeinated beverages. But these should not be a major source of ones water intake. Drinking plain water is
the best because it is calorie free, inexpensive and readily available. To a very small extent the body also
gets water from oxidation of macronutrients (metabolic water).
ROLE OF WATER IN THE BODY:
Needed by the brain to manufacture hormones and neurotransmitters
Forming Saliva (important for digestion)
Regulating body temperature through sweating and respiration
Acts as a shock absorber for brain and spinal cord
Helps in delivery of oxygen all over the body
Acts as a carrier for distributing essential nutrients to cells such as minerals, vitamins and glucose
Lubricates the joints
Flushes out body waste
Keeps mucosal membrane moist
Allows body cells to grow, reproduce and survive
supports physical activities. Studies have shown that modest level of dehydration (2% of body mass)
can result in 20% decrease in performance levels in temperate climates and upto 40% decrease in hot
temperatures
High intake of water is shown to have a protective impact on kidneys and there is initial evidence that
CKD (Chronic Kidney Disease) may be inversely related to high water intake.
Important for soft and supple skin. Dehydration results in dry skin and wrinkles
Dehydration can also degrade specific aspects of cognitive performance including visual, vigilance, tension, anxiety, fatigue and visual memory.
Dehydration is also linked to negative mood rating, impaired motor performance and short term memory loss.
Even though thirst is a useful indicator, it is not considered to be fully reliable as the body is already mildly dehydrated by the time an average person starts to notice thirst

REQUIREMENT
You lose water every day through your breath, perspiration, urine and bowel movements. TheInstituteof
Medicinedetermined that an adequate intake (AI) for menis roughly about 13cups 3Lof total beverages
a day. The AI for women is about 9cups 2.2L. Although the 8/8 rule i.e 8 ounce glasses ofwater adayis
easy to remember, you may need to modify your total fluidintake depending on your activity levels, the
climate you live in, your health status and if you are pregnant or breast feeding.

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Exercise: If one engages in any activity that makes them sweat, then that person needs to drink extra water to compensate for the lost water. An extra 1.5-2.5 cups( or 400-600ml) of water should suffice for
shortbouts of exercise, but intense workouts lasting for an hour requires more. With intense exercise or
athletes, water consumption should increase to about 16 ounces offluids approx. 1-1.5 hrs before physical
activity. After this, theyshould institute a sippingprotocol (i.e. about a half cup every 10-15mins).
Athletes should not rely on thirst sensation. After physical activity, they should consume sufficient fluids
to regain a good stateof hydration as indicated by clear urine.
Environment:Hot and humid climate, heated indoor air as in winters, altitudes greater than 8200ft (i.e.
2500m) may trigger increased urination and rapidbreathing. This uses up more fluid reserve which should
be replenished.
Illness /Health Conditions: When you have fever, vomiting or diarrhoea you should drink more water. In
urinary tract infections, stones or bladder infectionone needs to drink more water. Certain heart conditions, some kidney & liver diseases, adrenal disorders might require one to reduce the fluid intake.
Pregnancy and Breast Feeding: Nursing mothers and pregnant women require an additional 13cups and
10 cups respectively.

Table 1: Adequate Intake (AI) Recommendations

Age

AI (in L /Day)

0-6 months

0.7 (from human milk)

7-12 months

0.8 (from human milk and

complementary food & beverages)

1-3 yrs

1.3

3-8 yrs

1.7

9-13 yrs (Boys)

2.4

9-13 yrs(Girls)

2.1

14- 18 yrs (Boys)

3.3

14 - 18 yrs (Girls)

2.3

19 - 70+ yrs (Boys)

3.7

19 - 70+ yrs (Girls)

2.7

ASSOCIATED ISSUES
Water deficit or dehydration produces an increase in the ionicconcentration in the extracellular compartment. This causes the intra cellular water to come out,causing cells to shrink. Thisshrinkageis detected
by two types of brain sensors- one controlling the urge to drink water and another controlling excretion of
urine by sending a message to kidneys mainly viathe antidiuretic hormone, vasopressin to produce a
smaller volume of more concentrated urine.

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When body contains excess of water the reverse process occurs. Thus kidneys playa key role in regulating fluid balance. Theywork more efficiently in the presence of abundant water supply and also by
economise on water by producing more concentrated urine and more wear and tear in tissues.
PhysicalPerformance: Deteriorating effects in physicalperformance in athletes have been observed
under low levels of dehydration. A 20% reduction in water volume causes reduced endurance, increased
fatigue, altered thermoregulatorycapability, reduced motivation and increased perceived effort.
Exercising in hot conditions with inadequate fluid replacement is associated withhyperthermia, reduced
stroke volume, cardiac output, decreased BP,decreased blood flow to muscles. Children are at greater risk
of voluntary dehydration.
Cognitive Performance: Mild levels of dehydration can produce disruptionsin mood and cognitive functioning such as concentration, alertness, short term memory, perceptual discrimination, arithmetic ability,
visuomotor tracking, psychomotor skills.
Dehydration and delirium: Dehydration is a risk factor fordelirium and delirium presents as dementia
in elderly and the very ill.
GI function: Gastric emptying rate is increased by increase in total volume consumed and lowered by
higher energy density and osmolality. Constipationcharacterised by slow GI transit, small & hard stools,
difficulty inpassing stool, has a number of causes like inadequate fibre intake, poor diet, illness, medications and in most cases an inadequate water intake.
Kidneyfunction: A well functioning Kidney is crucial in regulating water balance and blood pressureas
well as removing waste.i.efiltration of waste from blood stream and excretion viaurine.
Heart function & hemodynamic response: Blood volume, blood pressure and heart rate are closely
linked.
Blood volume is normally regulatedbymatching water intake and water output. Decrease can occur
through loss of body water through sweat, as seen with exercise.
Head aches: Water deprivation and dehydration can lead to headaches.
Skin: Ourskin contains 30% water which gives it plumpness, elasticity and resilience.
Hydration and Chronic diseases: Good hydration levels reduces the risk of urolithiasis (formaion of
stones in kidney & bladder) also reduces constipation,exercise asthma, hypertonic dehydration in infants,
hyperglycaemic in diabetic ketoacidosis, reduces UTI (urinary tract infection), hypertension, fatal coronary heart disease, venous thromboembolism & cerebral infarct. But all theseeffects are still awaiting
confirmation by clinicaltrials.

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OXYGEN

Of all the chemical elements, oxygen (O2) is the most vital to the human body. There are hundreds of
known bio-chemical reactions in the body that utilise oxygen.

Almost all of the body's activities, from brain function to elimination, are regulated by oxygen. The energy supplied by oxygen allows one to think, feel and act. Complete cellular oxygenation is the precursor to
optimal health.
Oxygen Delivery: In the human body, oxygen is taken in through respiration. In the lungs, it diffuses
through membranes into red blood cells. The heme group (that consists of iron) of haemoglobin binds
and carries oxygen all over the body. A litre of blood can dissolve almost 200cc of oxygen.

ROLE OF OXYGEN IN THE BODY

Oxygen has many functions in the body of which the two primary ones are energy production and detoxification. An enzyme in cells called monooxygenase, which also has an active attraction to oxygen because
of the presence of an atom of iron, takes up oxygen from the blood. The enzyme uses oxygen to catalyse
many oxidation reactions in the body. Some of these involve production of energy by combination of glucose with oxygen, producing ATP. If one makes less than 10% ATP than normal, they will feel sluggish
and tired. Its falling production can result in the death of the person. Energy is life and for producing this
energy, the human body depends on oxygen.
Its another role in clearing cellular waste is by oxidation or burning off the waste. This process is called
oxygen reduction cycle. The end products are removed through blood and into the filtering organs - liver,
skin, lungs or kidneys. Complete cellular oxidation is thus vital to keep the cells healthy and free from
waste products.
Brain cells are also extremely sensitive to oxygen and its deprivation can cause them to die within five
minutes. Even decrease of oxygen to the brain and other cells in the body can give rise to diseases. Use of
Oxygen /Ozone is of therapeutic use in treatment in cancer, alzheimer, parkinson etc.
Increased oxygen uptake improves alertness, memory and reflexes. For the elderly it can protect them
against senility and related disorders.
Oxygen intake capacity is also an indication of the health and endurance of a person. While exercising,
the cells require energy and they produce lactic acids and other waste products which need to be efficiently removed. The more volume of oxygen a person takes in with each breath the better their body is able to
cope with the physical stress it is placed under.
VO2 Max is a measure of the volume of oxygen a body consumes per minute. As the exercise intensity
increases, so does their oxygen consumption. But there comes a point where it cannot supply enough
oxygen to sustain the effort. When this happens, even with increasing intensity, the person is not able to
increase their oxygen consumption. This is the VO2 max for that person.

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REQUIREMENT
An average adult at rest inhales and exhales close to 7 or 8 L of air per minute. This totals about 11,000 L
of air in a day (Ref2). Based on the concentration of oxygen in the air inhaled and exhaled, an average
human being uses about 550L of pure oxygen (or 19 cu ft) per day.
The rate of cellular respiration increases with exercise intensity, with vigorous high intensity exercise
causing a 25- fold increase in the demand for O2 in working muscles.
Most people do not breathe properly and practice shallow breathing by only filling up the upper portion of
their lungs raising their chest. Deep breathing is possible when one breathes through their stomach when
their diaphragm pushes out in the effort to take in air. When we are born we naturally do deep breathing.
If you see an infant sleeping, you will see their stomach rise and fall with every breath. One should consciously practice deep breathing through the day.
Eastern religions incorporate consciousness of breath as an important part of their teaching. Deep breathing techniques allow the body to take in greater volume of oxygen. This is especially important today for
those living in cities where the air quality is poor and concentration of oxygen in the air is falling.

ASSOCIATED ISSUES
The OXYGEN -NUTRIENT PERFORMANCE RELATIONSHIP: Iron is a critical element in the delivery of oxygen to working tissues. If stores of iron become so low as to cause haemoglobin to drop, iron in
myoglobin and iron containing enzymes are scavenged to maintain RBC haemoglobin. As a result of this
it is possible for an athlete to experience a reduction in performance even if haemoglobin & hematocrit (is
a measure of volume of RBCs to total volume of blood) appears in normal range. So it is important that
Ferritin levels be measured as well (Ferritin is a protein inside cells that stores iron and gives an indication of the amount of iron present in the blood).

Physical activity can alter blood iron status and vice versa. Athletes with higher exercise durations and
workloads appear to store less iron (ferritin). So they are at higher risk of compromised iron status than
non athletes. Even endurance athletes who put in large number of training hours are at highest risk of poor
iron status even though they rely mostly on aerobic metabolic processes to achieve their endurance
(Ref3). This happens because blood volume increases at a faster rate than the red blood cells count.
This makes it important for athletes to have good supplementation of nutrients and vitamins, mainly folate, B12, magnesium - all of which help in production of red blood cells.

LOSS OF BLOOD IN URINE: A chronic loss of blood in urine, a condition brought on by frequent high
intensity and long duration practice sessions, contributes to anaemia and it reduces competitiveness in the
athlete.

OXIDATIVE STRESS: An imbalance caused between inadequate presence of antioxidants and increased
reactive oxygen species (ROS). Certain minerals diminish ROS production and vitamins help eliminate
them altogether.

EXERCISE INDUCED ASTHMA (EIA): It compromises an athletes ability to take in oxygen. Athletes
involved in cold weather and cold environment sports are at a greater risk of this due to large volume of
cold and dry air that moves into the lungs. With symptoms including coughing, wheezing, tight chest,

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shortness of breath and early fatigue, it may occur in people who do not suffer from chronic asthma.

References:
Ref1: Water, Hydration and Health. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2908954/
Ref2:
How
question98.htm

much

oxygen.

http://health.howstuffworks.com/human-body/systems/respiratory/

Ref3: Endurance athletes and their Ferritin levels: https://runnersconnect.net/running-nutrition-articles/

ferritin-levels-runners/

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