On December 16, a seminar on electrolyte balance and health was held jointly by the Drinking Water and Health Branch of the Chinese Nutrition Society and the Digestive Doctor Branch of the Chinese Medical Doctor Association. Six professional institutions jointly issued the "Electrolyte Balance and Health Joint Tips" to remind the public to pay attention to electrolyte balance and correct and reasonable supplement of electrolytes.

Professor Ma Guansheng, chairman of the Drinking Water and Health Branch of the Chinese Nutrition Society, member of the Standing Committee of the Health Communication Branch of the Chinese Preventive Medicine Association, and director of the Department of Nutrition and Food Hygiene of the School of Public Health of Peking University, said that the balance of water and electrolyte is an important foundation for the stability of the internal environment of the human body and is crucial to maintaining health. Under normal conditions, under self regulation, the internal environment of the body, including water, ion concentration, pH and osmotic pressure, maintains a dynamic balance. If water, electrolyte and acid-base balance are disordered, cell function will be affected, which will cause disease and even endanger life.

In order to help the public understand the importance of maintaining the balance of water and electrolytes in the human body, and correctly and reasonably supplement electrolytes, the Drinking Water and Health Branch of the Chinese Nutrition Society, the Digestive Doctor Branch of the Chinese Medical Doctor Association, the Constitution and Health Branch of the Chinese Society of Sports Science, the Health Communication Branch of the Chinese Preventive Medicine Association Kexin Food and Health Information Exchange Center and the Special Fund for Health Communication and Promotion of China Health Promotion Foundation jointly released the Joint Tips on Electrolyte Balance and Health.

Importance of water and electrolyte balance

Water is an important component of human body, accounting for 60-70% of normal adult weight. It plays a vital physiological role in maintaining cell morphology, forming human internal environment, maintaining body fluid osmotic pressure, pH and electrolyte balance, and regulating body temperature. The intake and discharge of water in human body maintain a dynamic balance state to maintain proper hydration state and normal physiological functions. Drinking too little or too much water will lead to the destruction of water balance and osmotic pressure balance, which will affect the health of the body and even endanger life.

The main component of body fluid in human body is water, followed by electrolyte. Body fluid is widely distributed in various parts of the body, which can be divided into extracellular fluid and intracellular fluid according to the distribution area. The electrolyte composition and concentration of extracellular fluid and intracellular fluid were significantly different. The cation of extracellular fluid was mainly sodium ion, the anion was mainly chloride ion, and then bicarbonate ion; The cations of intracellular fluid are mainly potassium ions, and the anions are bicarbonate ions and proteins. Maintaining the electrolyte balance and osmotic pressure balance of intracellular and extracellular fluid is essential to maintain the normal shape and function of cells and maintain the normal physiological function and health of the body.

Electrolyte disorder is harmful to human health. If the electrolyte concentration of extracellular fluid is lower than that of intracellular fluid, the cell will continue to absorb water and exceed the stretch limit of cell membrane, and the cell will break. If the electrolyte concentration of extracellular fluid is higher than that of intracellular fluid, cells will shrink and even die due to dehydration. The disorder of sodium metabolism in the body will cause fatigue, irritability, muscle soreness and other symptoms [1]; The disorder of potassium metabolism may cause apathy, muscle pain and weakness, thirst, nausea and other symptoms [2]; Disordered calcium metabolism can lead to slow reaction, apathy, increased muscle tension, hand and foot twitching and other symptoms [3]; Magnesium metabolism disorder can lead to dizziness, muscle spasm, dyskinesia and other symptoms [4]. Severe electrolyte disturbances can be life-threatening.

When do you need electrolyte supplement in daily life

1. Long time or high intensity physical activity, or high temperature environment operation

During prolonged or intensive physical activity, or work in a high-temperature environment, the body mainly regulates its temperature by sweating and dissipating heat. With the evaporation of sweat, water and electrolytes will be lost. In this case, not only water but also electrolyte are needed. In high temperature environment, it is also necessary to leave the high temperature environment for physical cooling. If a large amount of water is added without electrolyte, electrolyte disorder may occur, and even water poisoning may occur in serious cases, endangering life.

Research shows that, before, during and after a long time of exercise, drinking an appropriate amount of electrolyte water and other ways to supplement water and electrolytes can improve the hydration state of the human body and maintain electrolyte balance, which is conducive to the improvement of sports performance and recovery of fatigue [5], [6].

2. Fever, vomiting, diarrhea, etc

In case of continuous fever or high fever, electrolyte disorder may be caused by a large amount of perspiration, commonly low sodium, low potassium, and low calcium. In this case, electrolytes should be supplemented properly under the guidance of a doctor or according to the physical condition.

Pregnancy vomiting: pregnant women will have nausea, vomiting and other early pregnancy reactions in the early pregnancy. If there is severe vomiting, or even can not eat normally, it will cause too little intake of potassium, sodium and other inorganic salts, which will lead to electrolyte disorders. Some studies have found that for pregnant women during childbirth, proper intake of energy and electrolyte liquids can reduce the incidence of ketosis and vomiting [7].

In case of severe vomiting and inability to eat during pregnancy, seek medical advice in time and supplement electrolytes under the evaluation and guidance of professionals.

Vomiting after drinking: Vomiting after drinking will make the body lose electrolyte, which will aggravate the impact of alcohol on myocardial function. Excessive drinking may also indirectly cause kidney disease, electrolyte disorder and acid-base imbalance [8]. Electrolyte needs to be replenished in time.

Diarrhea: When diarrhea occurs, more water and electrolytes will be lost, and dehydration may occur with electrolyte disorder, so electrolytes need to be supplemented properly. Severe diarrhea may lead to hyponatremia, hyperchloremia, hypocalcemia, and hypokalemia, which should be treated promptly. Therefore, diarrhea patients should not only be treated according to the causes, but also pay attention to maintaining electrolyte balance [9].

3. In some cases, electrolyte supplementation should be careful

In the case of chronic renal failure, acute and chronic heart failure, endocrine diseases and other related diseases, patients may suffer from electrolyte disorders due to physical impairment. For patients with the above diseases, they should seek medical advice in time and correct electrolyte disorders reasonably under the evaluation and guidance of doctors.

How to scientifically supplement water and electrolyte

As for water supplement, adult men should drink 1700 mL of water every day, and women should drink 1500 mL of water every day. The appropriate daily intake of drinking water for pregnant women is 1700 mL, and that for nursing mothers is 2100 mL. During physical activity, pay attention to the water intake before and after physical activity, and supplement 100-200 mL of water every 15-20 minutes; When the amount of physical activity increases, take 300~500 mL more water every day; When the weather is hot or the amount of physical activity increases significantly, the amount of drinking water should be appropriately increased according to the amount of sweat, and electrolytes should be supplemented as appropriate.

With regard to electrolyte supplement, the following methods can be used in case of the above situations:

Supplement through food. Under normal circumstances, it is recommended to supplement electrolytes through food. Many foods contain rich vitamins, minerals, etc., which can effectively supplement electrolytes. For example, eating bananas, spinach and other foods can increase the intake of potassium ions; Eating milk, bean products, fish and shrimp can increase the intake of calcium ions; Dark green leafy vegetables, nuts, etc.

Use electrolyte water or electrolyte drinks. Electrolyte water or electrolyte drink is a drink made by dissolving a group of compounds with water according to relevant standards, which can supplement water and electrolyte.

After a large amount of perspiration due to high temperature, exercise and other reasons, drinking an appropriate amount of electrolyte water or electrolyte drinks can supplement the lost electrolyte [10]. Drinking electrolyte drinks after sports dehydration is conducive to the supplement of body water and the improvement of hydration state [11].

People with pregnant vomiting, fever, diarrhea or vomiting should seek medical advice in a standardized manner. Under the evaluation and guidance of the doctor, they should drink electrolyte water or electrolyte drinks appropriately to supplement the lost electrolyte.

People working in special environments such as high temperature can choose electrolyte water or electrolyte drinks to supplement water and electrolyte in a timely manner.

Drugs and other clinical approaches. For patients with excessive electrolyte loss due to diseases, it is necessary to seek medical advice in a standardized manner and supplement electrolytes under the evaluation and guidance of doctors.

At the same time, the reporter noticed that in the recommendations on the prevention of COVID-19 infection issued by relevant departments, it also clearly indicated that "pay attention to the balance of water and electrolyte" or "supplement drinking water with a certain amount of electrolyte".

Experts attending the meeting said that the balance of water and electrolyte is an important basis for the stability of the internal environment of the human body, which is crucial to maintaining health. They hope that the public can better understand the relevant health knowledge and take care of their own and family health.

reference material:

[1] Jiang Zhuming Clinical water and electrolyte balance (3rd edition) [M]. Beijing: People's Medical Publishing House, 2013

[2] Zhu Lei Balance and disorder of body fluid metabolism [M]. Beijing: People's Medical Publishing House, 2011

[3] Luo Mingsheng, Gao Tianhui. Modern Clinical Medicine Dictionary [M]. Sichuan: Sichuan Science and Technology Press, 2001

[4] Wang Tinghuai. Physiology (9th Edition) [M]. Beijing: People's Medical Publishing House, 2018

[5] Sawka MN, Burke LM, Eichner ER, Maughan RJ, Montain SJ, Stachenfeld NS: American College of Sports Medicine position stand. Exercise and fluid replacement. Med Sci Sports Exerc 2007, 39(2):377-390.

[6] Peacock OJ, Thompson D, Stokes KA: Impact of a carbohydrate-electrolyte drink on ingestive behaviour, affect and self-selected intensity during recreational exercise after 24-h fluid restriction. Appetite2013, 60(1):5-12.

[7] Li Qi, Xu Yajun, An Lin, Zhao Yangyu, Fan Ling, Cai Yan, Liu Caixia, Wu Fangyin, Yang Hailan, Sun Lizhou, He Jing, Ma Yanyan, Pang Ruyan A multicenter prospective study on the role of energy and electrolyte fluid intake in pregnant women during labor [J]. China Research Hospital. 2021,8 (4): 5

[8] Zhang Daoyou, Jin Ming. New progress in research on the effect of alcohol abuse on kidney and water electrolyte metabolism [J]. Medical review 1999, (11): 499-500

[9] Zhong Kewen, Mai Zhizhou, Zhang Yinghua Correlation between electrolyte disorder and etiology of infectious diarrhea in children Medical examination and clinical practice [J] Medical laboratory and clinic. 2007,18 (3): 779-780

[10] Liang Chunyu, Shi Xiaocai, Yan Yi Fluid Replenishment Program and Exercise Ability of Athletes [J] Chinese Journal of Sports Medicine, 2020, 39 (6): 9

[11] Wu Yifan, Huang Xianren, Yu Yingxiang, etc The influence of seasonal adaptation on the recovery of body fluid after sports promoted by sugar electrolyte drinks for healthy young men [J] Journal of the Chinese Academy of Medical Sciences, 2021,43 (5): 11

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