WATER IN RELATION TO HUMAN HEALTH

1. WATER IN RELATION TO HUMAN HEALTH Prof. Dr. Faqir Muhammad Anjum (TI) Director General National Institute of Food Science & Technology University of Agriculture, Faisalabad

2. 2/3 of body cells contain water Water plays pivotal role in: Body functions and Biochemical reactions Used as building material in every cell Involved in mechanisms for controlling and maintaining normal body temperature Acts as a medium for carrying: nutrients to cells wastes out of cells Water in life

3. Organisms usually contain 60% to 90% water Lowest- Plant Seed (20%) Highest- Jellyfish (99%) Water helps all organisms in metabolism and plants in photosynthesis and support Water In Life 20% Water 99% Water

4. Human body water composition

5. Water in Human Body • Babies and kids have more water (%) than adults • 70-80% water during birth, drops to 65% after 1 year • Obese people have less water (%) than skinny • Muscle is 75% water • Fat is 20% water • For this reason, older people (who generally have a higher fat % have less water than younger • Women have less water (%) than men due to naturally higher fat content

6. Human Body Water Composition By Organ/Tissue

7. Human Water Balance

8. Water : Recommended Daily Amount (litres/day) • Children – 1.3-1.7 • Men – 3.7 • Women – 2.7 • Pregnant women – 3.0 • Lactating women – 3.8

9. Functions of Water in Human Body • Transports nutrients and oxygen into cells • Regulates body temperature • Detoxifies • Moisturizes the air in lungs • Helps with metabolism • Protects vital organ • Helps organs to absorb nutrients • Protects and moisturizes our joints

10. Fitness and Fat Loss Water important for fitness and fat loss due to: • Fills up stomach/ satiety without adding any calories • Dehydration degrades a person’s ability to exercise and burn calories • Dehydration reduces protein synthesis required for building and/or repair muscles

11. Water contains 1 oxygen atom and 2 hydrogen atoms which are covalently bonded Water molecule is polar, because electrons are not equally shared Because water molecule is polar, it can ionize substances easily, making it a good solvent Water known as ‘The Universal Solvent’ Water As A Solvent

12. Water is a carrier, distributing essential nutrients to cells, such as minerals, vitamins and glucose Many different substances, such as blood and sap, are transported by water Sap and blood contain high amounts of water making them good solvents Being good solvents allows them to dissolve the substances they are transporting Water As A Way of Transport Tree Sap Human Blood Cells

13. Water, being a good solvent, allows many reactions to occur Used in photosynthesis to make NADPH2, and ultimately sugar These reactions release oxygen, which is vital to human life Without water in photosynthesis, organisms unable to obtain energy, and life would be impossible Water As A Reactant

14. Water is an effective lubricant around joints It also acts as a shock absorber for eyes, brain, spinal cord and even for the foetus through amniotic fluid When bones meet at a joint, a fluid between the bones is required to prevent scraping against each other That fluid is called a synovial fluid, which is made mainly of water Many internal organs have fluid around them to keep them protected, e.g., Brain: Cerebro-spinal fluid Lungs: Pleural Fluid Eyes: Mix of fluids Water As A Lubricant Synovial Fluid

15. Hydrolysis/ Energy Release • Water is needed to separate (by a process called hydrolysis) a phosphate group from adenosine triphosphate (ATP) or guanosine triphosphate (GTP) to get energy • Without water hydrolysis is not possible • ATP +H2O = Energy + ADP + Inorganic Phosphate • GTP +H2O = Energy + GDP + Inorganic Phosphate

16. Regulation of Body Temperature • Water has a large heat capacity which helps limit changes in body temperature in a warm or a cold environment • Water allows the body to release heat when ambient temperature is higher than body temperature • The body begins to sweat, and the evaporation of water from the skin surface very efficiently cools the body

17. Regulation of Body Temperature

18. Metabolism • Water is the engine of metabolism • Participates in the biochemical break-down of what we eat

19. Waste Removal • Water removes waste products including toxins that the organs’ cells reject, and removes them through urines and faeces

20. Treatment of Polycystic kidney disease (PKD) • Polycystic kidney disease - Genetic disease that occurs in 1 among 500 individuals and leads to kidney failure in about half of affected individuals • PKD-affected kidney cells divide and multiply inappropriately, and form fluid-filled sacs called cysts • Kidney cysts continue to grow throughout life, destroying normal kidney tissue, leading to kidney failure • Drinking high amounts of water can slow the abnormal cysts growth

21. Water Quality • All people, irrespective of their stage of development and social and economic condition, have the right to access to safe drinking water in quantities and of a quality equal to their basic needs • WHO recognizes that access to adequate water supplies is a fundamental human right • Water-related diseases are a human tragedy, killing millions of people each year (account for 80% of all deaths in developing countries)

22. Chemical contamination in Water and Human Health • Common chemical contaminants include: • Nitrates • Arsenic • Fluoride • Prevalence of arsenic and fluoride in drinking water is known to cause cancer of lungs, bladder, still births, post neonatal mortality, Ischemic heart diseases (heart attack), diabetes mellitus etc.

23. Nitrates • Bacteria in drinking water in the human body can transform nitrates/ nitrites into nitrosamines, a compound formed by the reaction between nitrite and secondary amines • Blue-baby syndrome (methemoglobinemia) is caused by exposure to elevated levels of nitrite in infants less than 6 months old • Blood’s ability to carry oxygen is affected • result in a bluish color in the infant’s skin

24. Arsenic • Various studies have been conducted in arsenic affected countries - notably Argentina, Chile, China, Japan, and Taiwan - to find the potential of arsenic exposure to cause development of cancer • Continuous arsenic exposure canlead people to develop arsenicosis,which in turn elevates the riskof cancer

25. Arsenic • Arsenic ingestion increases risk of lungs and kidney cancer • Skin lesions are the most common manifestations in arsenicosis patients

26. Fluoride • Fluorosis - Ingestion of excess fluoride, most commonly in drinking-water affects: • Teeth • Bones • Moderate amounts lead to dental effects • Moderate-level chronic exposure (above 1.5 mg/L of water - the WHO guideline value for fluoride in water) is more common • Long-term ingestion of large amounts can lead to severe skeletal problems • Fluorides lower the intelligence capacity of humans • Children are more susceptible to fluoride toxicity

27. Safe levels of chemical contaminants in drinking water

28. Pharmaceuticals and Water Quality

29. Water and Sanitation-related Diseases

30. Water-borne Diseases • As per USAID report, an estimated 250,000 child deaths occur each year in Pakistan due to water-borne disease • A study conducted by UNICEF found that 20-40% of the hospital beds in Pakistan are occupied by patients suffering from water-related diseases, such as typhoid, cholera, dysentery and hepatitis, which are responsible for one third of all deaths (Pak-SCEA 2006)

31. Microbial Quality Standards for Drinking Water • Water containing maximum 100 bacteria and no single coliform, considered safe for drinking • Microbiological standards applied to determine safety of water • Drinking water must meet defined standards otherwise poor quality water hazardous to health • Hence, improvement in drinking water quality results in substantial reduction in disease prevalence

32. Water Deficiency / Dehydration • Being 2% dehydrated can seriously degrade physical and mental functions • Being 15% dehydrated is likely to be lethal

33. Water deficiency: symptoms

34. Diseases caused by dehydration over a long period of time • Symptoms of mild health problems • Digestive problems - constipation, bad breath, acnes • Skin disorders - dryness, dull-looking, sensitive • Others -fatigue and lower concentration level • Symptoms of more severe health problems • Prolonged dehydration could contribute to arthritis, migraine and the malfunctioning of the digestive system • Insufficient water intake results in inefficient toxin removal, which may induce high uric acid; diabetes; liver, kidney and heart diseases; high blood pressure and even intestinal cancer • It may accelerate aging in the long run

35. Signs of Dehydration • Allergies • Asthma • Arthritis • High cholesterol/ heart problems • High blood pressure • Diabetes • Peptic Ulcers • Angina • Migraines • Obesity and weight control problems • Water retention • Chronic back pain

36. Effects of Water Deficiency • Low blood pressure • Clotting of blood • Kidney malfunction • Severe constipation 

37.  Hyperhydration- water intoxication • When too much water enters the body's cells, the tissues swell • Cells try to maintain concentration gradient • Excess water outside the cells (the serum) draws out sodium from within the cells into serum in an attempt to re-establish the necessary concentration • Kidneys can tolerate about 17 litres water in a day • Excessive ingestion of water and other liquids resulted in extra work for the body • Signs of water intoxication: • Hyponatriemya - decreased amount of natrium in blood) • Rubdomiolysis - damage of muscularity (collapse of skeleton) , acute incompetence of kidneys

38. Hyponatremia • Hyponatremia, a metabolic condition in which there is not enough sodium in body fluids outside the cells • It is most common electrolyte disorder in the U. S. • In hyponatremia, the imbalance of water to salt is caused by one of three conditions: • Euvolemichyponatremia- total body water increases, but the body's sodium content stays the same • Hypervolemichyponatremia- both sodium and water content in the body increase, but the water gain is greater • Hypovolemic hyponatremia- water and sodium are both lost from the body, but the sodium loss is greater

39. Rhabdomyolysis • Breakdown of muscle fibers result in the release myoglobin into the bloodstream • Some of these are harmful to kidneys and frequently result in kidney damage • Rhabdomyolysis affects about one out of10,000 peoplein the United States, with slighter higher incidence in men • Rhabdomyolysis accounts for an estimated eight to fifteen percent of cases of acute renal failure • About five percent of rhabdomyolysis cases result in death • There are two crucial factors involved in the development of myoglobinuric ARF (acute renal failure): • Hypo-volemia/dehydration • Aciduria

40. Situation of Drinking Water in Pakistan • Water and sanitation are ignored sector sin Pakistan • Majority of Pakistani people do not have access to safe drinking water and lack satisfactory sanitation systems • In 2005, approximately 38.5 million people did not have access to safe drinking water and approximately 50.7 million people lacked access to improved sanitation facilities in Pakistan • With the same trend, by 2015, 52.8 million people will be deprived of safe drinking water and 43.2 million people will be lacking adequate sanitation facilities in Pakistan Khan and Javed (2007)

41. Situation of Drinking Water in Pakistan • Hence quality of drinking water in Pakistan far from being satisfactory • Rivers and sub-soil water contaminated due to disposal of untreated domestic and industrial fluid wastes • Contamination starts right in the mountains • Tourists to the hill stations contribute to garbage • Shandur Festival, at 12,520 ft. altitude gathers almost 20,000 people • Produce around 5,000 kg garbage – pollutes glaciers, lakes and rivers • Causes toxicity in residents using it

42. Situation of Drinking Water in Pakistan • Tourist points like Murree become heavily polluted contributed by tourists • Naturally garbage produced finds its way into water channels that supply drinking water to downstream areas • Survey conducted by NIH, Islamabad - upward trend in nitrate contents in drinking water of Islamabad and Rawalpindi • Bacteriological examination shows 94% water samples unsuitable for human consumption • Situation alarming because samples taken from posh F-11, G-7, G-9, G-11, and Airport areas in Islamabad • If this quality of water in model and modern city, imagine situation in other cities

43. Situation of Drinking Water in Pakistan SOME NEWSPAPER REPORTS • Residents of some villages on banks of River Chenab near Chiniot reported to suffer from stomach diseases due to poor quality drinking water • Reports appeared a few years back from Manga Mandi near Lahore • residents suffered from bone deformations • Unsafe drinking water reports from Sheikhupura, Lahore, Toba Tek Singh, Qsur, Hyderabad, Peshawar and other cities • In Karachi, people sell dirty water after recycling • Increased risk of kidney, stomach and skin diseases • Seashores exposed to oil contamination because of ship breaking in Gadani and leakage from oil tankers

44. Situation of Drinking Water in Pakistan • Oil drained into water damages marine life and pollutes environment • It finds its way into drinking water in Karachi • residents develop diseases and allergies • Practically no organized solid disposal system in any city in Pakistan • Solid waste dumped in some open places and then burnt • Gives rise to numerous chemicals including dioxin - highly toxic man-made organic chemical

45. Bacterial Contamination in Water • Campylobacter: diarrhoea • E. coli: Bloody diarrhoea, mild fever, anaemia • Pseudomonas: dermatitis and infections in urinary tract, respiratory system, soft tissues, bones, joints, gastrointestinal tract • Shigella: gastroenteritis, bacillary dysentery • Salmonella: Nausea, vomiting, abdominal cramps, diarrhoea, fever, headache • Vibriocholerae: abdominal pains, mild fever, chills, and headache, watery diarrhoea followed by lethargy and dehydration.

46. Viruses Contamination in Water • Noroviruses - Group of viruses that cause gastroenteritis, inflammation of lining of stomach and intestines • Hepatitis A – Results in inflammation of liver • Sources of infection: • an infected person who didn’t wash his or her hands after using washroom • drinking untreated water or • eating food washed in untreated water • Rotavirus: Very common cause of severe diarrhoea among infants and children

47. Take Home Message Drink ample quantity of GOOD QUALITY water: • Helps in digestion and avoid constipation • Relieves fatigue • Less cramps and sprains • Good mood • Natural remedy for headache • Look younger with healthier skin • Lose weight • Better productivity at work • Less likely to get sick and feel healthy • Reduce risks of kidney failure