Chapter 9 Impact of Fluids and Beverages on Nutritional Health

Chapter 9

Impact of Fluids and Beverages on Nutritional Health

Ask Yourself

True or False?1. “Soft” water is healthier than hard water.2. Bottled water sold in the U.S. is always

cleaner and safer than most tap water.3. Caffeine can cross the placenta and enter

the fetus.4. Even moderate caffeine users can suffer

from withdrawal symptoms if they stop using caffeine cold turkey.

5. Soft drinks sweetened with sugar contribute to empty calorie intake.

Ask Yourself

6. Energy drinks are regulated and therefore always safe to consume.

7. Enhanced waters provide an important source of nutrients.

8. A 12-ounce beer, a 5-ounce glass of wine, and a 1-ounce shot of tequila all contain the same amount of alcohol.

9. Reflexes are not impaired if your blood alcohol concentration is below the legal limits of intoxication.

10. Drinking alcohol may be associated with an increased risk of breast cancer.

Water

• Adults consume and excrete about 1 ½ to 3 quarts of water a day.

• Most of the water we consume comes from juice, milk, soft drinks, and other beverages including tap water.

• Foods add considerable water to the diet.

• Adults are advised to consume 1-1.5 mL of water from all sources for each calorie expended.

Liquids(550–1,500 mL)

Water input (Total = 1,450–2,800 mL)a

Lungs(350 mL)

Feces(150 mL)

Skin(450–900 mL)

Kidneys(500–1,400 mL)

Water output (Total = 1,450–2,800 mL)b

Water created bymetabolism(200–300 mL)

Foods (700–1,000 mL)

Water

• The makeup of water differs based on:Where it comes from. How it is processed.

• Variations can have significant health implications :One of the most basic distinctions, hard

versus soft water, is based on the concentrations of three minerals:1. Calcium2. Magnesium3. Sodium

• Hard water:

Water with a high concentration of minerals such as calcium and magnesium.

From a health standpoint, hard water seems to be the better alternative.

• Soft water:

Water containing a high sodium concentration.

The excess sodium adds more of the mineral to our already sodium-laden diets.

It dissolves potentially toxic substances such as lead from pipes.

Water

Keeping Water Safe• Water taken from the earth contains different

levels of bacteria, microorganisms, and heavy metals such as lead.

• Environmental Protection Agency (EPA): arm of the government responsible for monitoring municipal water supplies.

• Some potential health threats are: A parasite called Cryptosporidium. The level of lead that comes out of your faucet

(EPA has little control over this).Lead-containing plumbing was banned in

1986.

Water

Bottled Water• Not necessarily any purer or

more healthful than tap water.

• About 25%-40% of bottled water comes from the same municipal water supplies.

• Bottled water may not contain adequate amounts of fluoride.

• Increased the use of nonrenewable resources.

• Cost may be 250-10,000 times higher than tap water.

Water

Juices

Best Choices for Juice• Select a 100%

fruit/vegetable juice.• Read labels; not all juices

are uniformly beneficial.• Avoid “juice drink,” “fruit-

flavored drink,” or “juice blend” because these contain little real juice and have added sugars.

• Select juices that have the most color.

Juices with Benefits• Cranberry juice protects against urinary

tract infections and may protect against heart disease and cancer.

• Citrus juices are rich in flavonoids that help protect against cancer.

• Tomato juice and tomato products are rich in lycopene which may protect against prostate cancer and cardiovascular disease.

Juices

MILK

• Also applies to non animal beverages such as soy milk

• Nutritional content varies per animal species

• Nutrient dense• Intake has been

associated with weight control

• Milk consumption has declined

Caffeinated Beverages

• Caffeine is one of a group of chemicals called xanthines.

• In the U.S. most caffeine is consumed in coffee but teas, carbonated soft drinks, and energy drinks also contribute.

• Reports have linked caffeine to more than 100 diseases but scientists have never confirmed the evidence with the exception of jitteriness.


• Daily caffeine consumption can be habit forming.

• Caffeine dependence syndrome includes three out of these four symptoms upon withdrawal: headache and fatigue; caffeine consumption despite knowledge that it may be causing harm; repeated unsuccessful attempts to cut back; and tolerance to caffeine.

• People with some medical conditions should consume caffeine in moderation or avoid it. Pregnant women advised to limit to <150

mg/day.


• For a healthy person, drinking 1-2 cups of coffee, tea, or cola a day does not pose any hazard.

• People who are sensitive to caffeine and experience headaches, nervousness, and insomnia should avoid it or cut back.

• If you decide to quit, do it gradually.

Coffee• Contains antioxidants which have been

found to reduce inflammation.• Potential health benefits for coffee

drinkers include: Lower risk of type 2 diabetes. Reduced risk of cardiovascular disease and

stroke. Reduced risk of alcohol-related cirrhosis and liver

cancer.

• May increase blood pressure.


Tea• Tea leaves are rich in phytochemicals,

antioxidants and caffeine.• Health benefits for tea drinkers include: Decreased risk of cardiovascular disease. Decreased risk of cancer. Protects against neurodegenerative

diseases.• Health benefits appear to be dose-

dependent.



Cocoa• Contains minerals:

potassium, magnesium, phosphorus, and calcium.

• Contains fats and protein.

• Contains antioxidants, phytochemicals, and caffeine.

• May positively influence cardiovascular health.

Soft Drinks

• Standard serving size (increasing)1950s = 6.5 oz1960s = 12 oz1990s = 20 oz2000+ = 32 oz &

64 oz



Soft Drinks• Called soda, pop, soda pop, coke, or fizzy

drinks, all are carbonated soft drinks.• Includes soft drinks sweetened with high-

fructose corn syrup.Contributes to empty-calorie intake in the

U.S. population and its replacement of nutrient-dense foods.

• Includes soft drinks sweetened with artificial sweetener.

Soft Drinks• Nutrition and health issues related to soft drink

consumption: Increased energy consumption. Increased weight. Lower consumption of other nutrients. Lower intake of milk, fruit, and fruit juices. Increased risk of medical problems such as: type

2 diabetes, osteoporosis, dental caries, increased blood pressure.

• No indisputable positive health benefits have been associated with soft drink consumption.


Functional Beverages

Energy Drinks• Nonalcoholic

beverages enhanced with purported energy-enhancing ingredients.

• Primary ingredients are sugar and caffeine.

• Energy drinks tend not to live up to most of the claims made.

Energy Drinks• Nutrition and health concerns:

Not regulated by FDA.Caffeine level unsuitable for children or caffeine-

sensitive individuals.Mixing energy drinks with alcohol can cause heart

arrhythmias.Should not be used before or during exercise.Counter productive for fluid replacement.Combo of stimulant ingredients can be unsafe.Sudden cessation can cause withdrawal

• Should be used with caution.


Sports Drinks• Formulated to replace

fluids and electrolytes (minerals) lost through sweat and provide energy for muscles.

• What should you look for? 6% carbohydrate (glucose,

sucrose, and fructose) Sodium No carbonation No caffeine



Enhanced Waters• Most are no

healthier than other beverages containing sugar.

• The only ingredient in “vitamin waters” that your body might use is sugar.

• Water with fiber?The fiber is maltodextrins and no research

shows it works like fiber from fiber-rich foods• Antioxidant supplemented water?

No research has ever shown antioxidant supplements prevent disease.

• Why is it invigorating or energizing?Same amount of caffeine as a cup of coffee…

• Therapeutic substances like herbs added to help…………?Only if in therapeutic doses and that is

probably NOT the case


Enhanced Waters• Water-soluble vitamins taken in excess

will flush out of the body with water.• Fat-soluble vitamins will not be

absorbed without the presence of fat.• Some of the ingredients may not have

proven health benefits.• A vitamin/mineral supplement is a

better choice.


Alcohol

• Alcohol is not a nutrient and is best described as an organic chemical.

• The most commonly ingested form is Ethanol (EtOH).

• Alcohol is a sedative and central nervous system depressant.

• Alcohol supplies 7 calories/gram.• Alcohol is not an essential nutrient, nor

is it stored in the body.

Alcohol Absorption and Metabolism• Alcohol absorption involves the stomach and the

small intestine.Alcohol absorbed in the small intestine passes

through the portal vein to the liver.• Alcohol dehydrogenase:

A liver enzyme that facilitates conversion of alcohol into acetaldehyde and water.

Acetaldehyde: a substance to which drinking alcohol (ethanol) is metabolized.

• Alcohol that has yet to be metabolized flows through the bloodstream and affects the brain and other tissues.

Alcohol

Alcohol absorption

The upper portionof the small intestineis the primary siteof alcoholabsorption.

Stomach

Esophagus

Mouth

Upper smallintestine

Some alcoholabsorption takesplace here.

Very smallamounts of alcoholare absorbed inthe mouth andesophagus.

Alcohol Absorption and Metabolism• The liver can metabolize a limited amount of

alcohol per hour, no matter how much is consumed.

• Alcohol metabolism rate is dependent on the amount of alcohol dehydrogenase formed.

• Until all alcohol has been metabolized, it circulates through the bloodstream, affecting the brain and other tissues.

• It takes about one hour to metabolize a standard drink.

Alcohol

Alcohol: Influencing Absorption & Metabolism:

• Food Presence of food in the stomach slows absorption. Dietary fat delays emptying time of the stomach.• Gender Men and women absorb and metabolize alcohol

differently. Women will absorb 30% more alcohol into the

bloodstream. Women are more susceptible to alcoholic liver

disease, heart muscle damage, and brain damage.

• Ethnicity Native Americans have higher rates of liver

damage due to alcohol consumption.

Alcohol

• Women have a lower capacity to metabolize alcohol because of:

Body composition – have less water in their bodies.

Enzymes – lower activity of alcohol dehydrogenase in the stomach.Causes a larger

proportion of ingested alcohol to reach the blood.

Alcohol and Its Effects• Alcohol is distributed through the body

and affects the central nervous system even in small concentrations.Even small amounts can slow reactions.Higher blood alcohol content (BAC) leads to

increased loss of mental and physical control.

Large amounts of alcohol over a short period of time can lead to loss of consciousness or even death.

Alcohol

Alcohol and Its Effects• Alcohol and Medications: Use of prescription or over-the-counter

medications can increase the effects of alcohol.

Chronic, heavy drinking appears to activate an enzyme that may be responsible for changing the over-the-counter pain reliever acetaminophen and many others into chemicals that can produce liver damage, even when taken in recommended doses.

• Alcohol and Sex Hormones: Alcohol alters the sex hormones in men

and women.

Alcohol

Alcohol and Its Effects

• Alcohol and Urine Output: Alcohol blocks antidiuretic hormone (ADH), leading

to water loss and eventual dehydration.• Alcohol and Hangovers: A group of ailments including headache, nausea,

vomiting, sensitivity to light and sound, dry mouth, and irritability.

• Alcohol and Blood Alcohol Level (BAL): BAL indicates the amount of alcohol in the

bloodstream. BAL is affected by amount and speed at which

alcohol is consumed.

Alcohol

Alcohol

Alcohol and Driving• Never drink and drive.

Even one drink can impair your response time. In most states, the legal limit for driving is

0.08 and for those under 21 there is zero tolerance.

If this limit is exceeded, the driver could receive a DUI (driving under the influence) or DWI (driving while intoxicated), which is a felony in some states.

Alcohol and Tolerance• Continued exposure to alcohol causes increased

tolerance. Tolerance Decrease of effectiveness of drug after a period of

prolonged or heavy use. Metabolic tolerance Increased efficiency of removing high levels of

alcohol from the blood due to long-term exposure, leading to more drinking and possible addiction.

Functional tolerance: Actual change in sensitivity to a drug resulting in

hallucinations and convulsions when alcohol is removed.

Alcohol

Alcohol and Tolerance

• Alcohol abuse (problem drinker) A person who experiences psychological,

social, family, employment, or school problems because of alcohol. Problem drinkers often binge drink and turn to alcohol when facing problems or making decisions.

• Alcohol dependency (alcoholism): A dependency on alcohol marked by

compulsive, uncontrollable drinking with negative effects on physical health, family relationships, and social health.

Alcohol

Impact of Alcohol on Nutrition

• If you are in good health and otherwise well nourished, the occasional consumption of alcohol will probably have little effect on your nutritional status.

Alcohol and mixers can contribute additional calories which can cause unwanted weight gain.

Alcohol

Impact of Alcohol on Nutrition

• Excessive intake of alcohol on a regular basis will compromise your nutritional status.

Protein deficiency can develop:Depression of protein synthesis in the cells.Substituting alcohol for food, resulting in poor

diet. Stomach cells become inflamed and vulnerable to

ulcer formation. Intestinal cells fail to absorb vitamins. Liver cells lose efficiency in activating vitamin D,

and the production and excretion of bile are altered. Lowered red blood cell formation due to

acetaldehyde interfering with metabolism.

Health Benefits of Alcohol• Drinking moderate amounts appears to be

healthy for people who do not have problems with alcohol abuse or dependency.

• People who consume one to two drinks daily have lower mortality rates than nondrinkers.

• Like any other drug, there is a beneficial dose and a level (dose) that will cause harm.

• Most research indicates wine consumption to be most beneficial; it appears that the benefits are from the alcohol itself.

The protective effect is the result of increased levels of high-density lipoprotein (HDL) cholesterol.

It also inhibits blood from forming clots, reducing risk of death from heart attack.

Alcohol

Alcohol

Health Risks of Alcohol• Moderate consumption is not risk free:

Deaths reduced by moderate alcohol consumption generally occur in people 45 years of age and older.

Most deaths due to alcohol consumption occur in people younger than 45 years of age.

Among young adults, the risks far outweigh the benefits.

Health Risks of Alcohol• Alcohol affects judgment & slows reflexes, which

leads to:• Increased accidents: falls, motor vehicle

accidents.• Increase in homicide and suicide.• Drug Interactions: Drugs, like alcohol, are

metabolized in the liver.• Drugs: substances that can modify one or more

of the body’s functions.• Liver has limited processing capacity and drugs

and alcohol will compete with each other.• Increased risk of medication side effects.

Alcohol

• Night blindness• Breast cancer• Other cancers• Liver damage

Alcoholic hepatitisCirrhosis

• High blood pressure and stroke

• Pancreatitis• Gastrointestinal

symptoms• Brain damage• Decreased sex

hormone production• Anemia• Emotional and social

problems

Other Risks of Alcohol

Alcohol

Pros and Cons of Alcohol Consumption• Compare your age/gender to the leading causes

of death for those of similar ages/gender.Leading causes of death for men under 40

years of age and women under 50 years of age (premenopausal) are accidents and breast cancer, respectively. • In this case, risks of low to moderate alcohol

consumption outweigh the benefits.Leading cause of death for men over 40 years

of age and women over 50 years of age is heart disease. • In this case, the benefits of low to moderate

alcohol consumption outweigh risks.

Alcohol

Alcohol

Alcohol Abuse• Alcoholism is a dependency on alcohol

characterized by: Craving (a strong need to drink). Loss of control (being unable to stop drinking

despite a desire to do so). Physical dependence. Withdrawal symptoms. Tolerance (increased difficulty of becoming

drunk).

Alcohol Abuse• Use: ingestion of alcohol or other drugs

without experiencing any negative consequences.

• Misuse: a person experiences negative consequences from his/her use of alcohol or other drugs.

• Abuse: continued use of alcohol or other drugs in spite of negative consequences.

• Dependency/Addiction: compulsive use of alcohol or other drugs regardless of adverse or negative consequences.Needs professional help.

Alcohol

Alcohol

Alcoholics Anonymous (AA)• Well-known method to deal with alcohol

addiction.• Established in 1935.• Through group meetings, self-

proclaimed alcoholics come together for counseling, guidance, and support with the primary purpose of staying sober and helping others to achieve sobriety.

Alcohol

• What is Binge Drinking?At least five drinks at one time for a man.At least four drinks at one time for a

woman.

• Short-Term Reactions Include:Vomiting, dizziness, impaired mental

capabilities, and hangover.

• Serious Problems Include:Risky sexual behavior.Alcohol-related injuries or even death.

According to the Dietary Guidelines for Americans, “If you drink alcoholic beverages, do so in moderation.”

Moderation is defined as the following:• Men: No more than two drinks per day.• Women: No more than one drink per day.

What Is a Drink?

What Is a Drink?

Alcohol is alcohol is alcohol. It does not matter if the beverageof choice is beer, wine, winecooler, a cocktail, or a mixed drink.

It’s really how much that counts.

What Is a Drink?

• 12 oz of regular beer• 5 ounces of wine• 1 ½ ounces of 80-proof

distilled spirits• 12 ounces of wine/malt

or spirit-based cooler• 3 oz of sherry or port• 9.75 oz of malt liquor

People who should not drink alcoholic beverages:

• Children and adolescents.• Individuals of any age who cannot restrict their

drinking to moderate levels.• Women who may become pregnant or who are

pregnant. A safe alcohol intake has not been established for women at any time during pregnancy, including the first few weeks.

• Individuals who plan to drive, operate machinery, or take part in other activities that require attention, skill, or coordination. Most people retain some alcohol in their blood up to 2 to 3 hours after a single drink.

• Individuals taking prescription or over-the-counter medications that can interact with alcohol.

What is Fetal Alcohol Syndrome (FAS)?A pattern of birth defects found in the children of

mothers who drank alcohol during pregnancy.• One of the primary sources of birth defects in the

U.S.• Most common source of preventable birth defects.Defined by four criteria:

1. Maternal drinking during pregnancy.2. Characteristic pattern of facial abnormalities.3. Growth retardation.4. Brain damage including intellectual difficulties or

behavioral problems.

Fetal Alcohol Syndrome

How Does Alcohol Get Into the Baby’s Body?

•Alcohol passes from the mother to the baby through the placenta.•The unborn baby’s ability to metabolize alcohol is slower than the mother’s.As a result, the baby’s BAC is higher and alcohol remains in the baby’s blood longer than in the mother’s.

How Much Alcohol Causes FAS?•No quantity of alcohol use during pregnancy is considered safe.•An average of one drink a day increases risk.•Especially hazardous use includes:

Binge drinking.Frequent heavy

drinking.


• Typical traits of FAS… Small eyes with drooping upper lids. Short upturned nose, flat

cheeks. Undeveloped groove in

center of upper lip. Mental retardation, impaired

learning … Memory problems, seizures• Irreversible abnormalities of

the brain and other organs.FAS is completely Preventable if pregnant

women do not drink


Fetal alcohol syndrome is completely preventable if pregnant women do not consume alcohol.

Everything a woman eats or drinks affects her baby. No quantity of alcohol use during pregnancy has been established as safe.

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Chapter 9 Impact of Fluids and Beverages on Nutritional Health