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Mineral Water Question

August 17, 2012 Written by JP    [Font too small?]

I was recently contacted by a young lady whose mother has osteoporosis. I was told that she’s unable to have dairy and many calcium-fortified foods such as orange juice and soy products. In addition, she has a difficult time swallowing pills. On the other hand, she very much enjoys mineral water. Her question to me was, “Can I drink mineral water instead of taking a calcium supplement?”.

Before I delve into the mineral water issue, please note that there is almost always a way to incorporate adequate amounts of calcium in your daily routine via fortified and whole foods. For instance, non-dairy foods including collard greens, sardines and sesame seeds provide upwards of 25% of the Daily Value (DV) of this essential mineral. Likewise, milk substitutes made from almonds, coconuts and hemp seeds are frequently fortified with up to 45% of the DV per 8 oz serving. There are also quite a few chewable or liquid calcium supplements available in most health food stores and pharmacies. Simply put, there really isn’t a practical reason why one can’t get optimal amounts of calcium on a daily basis.

In terms of mineral water, the data is fairly straight forward. Mineral waters that are rich in calcium (providing a minimum of 342 mg of calcium/day) support bone mineral density in women who are deficient in the nutrient. Some evidence indicates that alkaline water, abundant in naturally occurring bicarbonate, may also slow the rate of bone breakdown. What’s more, several studies have demonstrated that calcium contained in mineral water is at least as bioavailable as dairy-derived calcium. A controversy that has yet been resolved is the role of trace minerals in select mineral waters. One example is silica, a trace element which has shown some benefit in relation to joint and skeletal integrity. A 12 week study appearing in the October 2010 issue of the Nutrition Journal determined that silica is easily absorbed from mineral rich water. However, the added silica intake “did not affect bone turnover markers in the short-term”.

The bottom line is that mineral rich water can be a good source of dietary calcium. But, reading labels to determine calcium concentration is vitally important. The disparity between calcium levels in various mineral waters can be significant. It also bares mentioning that the key to success with mineral water is consistency. For some, chewing or swallowing a daily calcium supplement may be easier to do than drinking a few glasses of mineral water each and every day. Finally, please remember that there is a whole host of other nutrients, including magnesium, Vitamins D and K, which benefit the skeletal system and generally aren’t found in mineral water. So, don’t place all of your eggs in one basket and assume that mineral water alone is enough to stave off osteopenia and osteoporosis.

Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!

To learn more about the studies referenced in today’s column, please click on the following links:

Study 1 – Consumption of a High Calcium Mineral Water Lowers Biochemical (link)

Study 2 – Calcium Bioavailability from a Calcium-Rich Mineral Water, with Some(link)

Study 3 – Biological Effects of Drinking-Water Mineral Composition on Calcium (link)

Study 4 – Mineral Water as a Source of Dietary Calcium: Acute Effects on (link)

Study 5 – Association Between Calcium Ingested from Drinking Water and Femoral(link)

Study 6 – Effect of Calcium Supplementation as a High-Calcium Mineral Water (link)

Study 7 – Absorption of Silicon from Artesian Aquifer Water and its Impact (link)

Study 8 – Alkaline Mineral Water Lowers Bone Resorption Even in Calcium (link)

Study 9 – Sodium-Bicarbonated Mineral Water Decreases Aldosterone Levels (link)

Study 10 – Bone Remodeling is Not Affected By Consumption of a Sodium-Rich (link)

High-Calcium Water Modulates Bone Metabolism via Parathyroid Function

Source: Am J Clin Nutr. 2000 Apr;71(4):999-1002. (link)

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Posted in Bone and Joint Health, Food and Drink, Nutrition

10 Comments & Updates to “Mineral Water Question”

  1. rob Says:

    I did not know that

    I guess its a soucre but not the best, sardines are supposed to be high in calcuim as well as the otehr vitamins you mentioned.

  2. JP Says:

    Hi Rob,

    You’re absolutely right. Sardines are an excellent source of calcium and a good source of various bone-supportive nutrients including Vitamins B12 and D. I highly recommend them.

    Be well!


  3. Ted Hutchinson Says:

    I quite like this home made magnesium mineral water AFIBBERS Recipe for Magnesium/Bicarbonate Water

    In the UK your water authority usually has a website enabling you to learn the calcium/magnesium content of your tapwater.

    Online calculators or nutritional databases will help you work out if you are meeting the RDA for calcium & magnesium. I think it’s important to stress Dietary Calcium is Superior to Supplements for Protecting Bones

    We also have to remember vitamin d 25(OH)D level at or above 32ng/ml ~ 80nmol/l enables optimum calcium uptake for most people.

  4. JP Says:

    Many thanks for sharing that, Ted. Excellent information as usual. 🙂

    Be well!


  5. JP Says:

    Update 05/13/15:


    Appetite. 2015 May 8. pii: S0195-6663(15)00228-7.

    Habitual total water intake and dimensions of mood in healthy young women.

    Acute negative and positive mood states have been linked with the development of undesirable and desirable health outcomes, respectively. Numerous factors acutely influence mood state including exercise, caffeine ingestion, and macronutrient intake, but the influence of habitual total water intake remains unknown. The purpose of this study was to observe relationships between habitual water intake and mood. 120 healthy females (mean±SD; age=20±2 y, BMI=22.9±3.5 kg⋅m-2 ) recorded all food and liquids consumed for 5 consecutive days. Investigators utilized dietary analysis software to determine Total Water Intake (TWI; total water content in foods and fluids, coffee ingestion, and macronutrient consumption (i.e. protein, carbohydrate, fat)). On days 3 and 4, participants completed the Profile of Mood State (POMS) questionnaire which examined tension, depression, anger, vigor, and confusion, plus an aggregate measure of Total Mood Disturbance (TMD). For comparison of mood, data were separated into three even groups (n=40 each) based on TWI: low (LOW; 1.51±0.27 L/d), moderate (MOD; 2.25±0.19 L/d), and high (HIGH; 3.13±0.54 L/d). Regression analysis was performed to determine continuous relationships between measured variables. Group differences (p<0.05) were observed for tension (MOD=7.2±5.4, HIGH=4.4±2.9), depression (LOW=4.5±5.9, HIGH=1.7±2.3), confusion (MOD=5.9±3.4, HIGH=4.0±2.1), and TMD (LOW=19.0±21.8, HIGH=8.2±14.2). After accounting for other mood influencers, TWI predicted TMD (r2 = 0.140; p=0.050). The above relationships suggest the amount of water a woman consumes is associated with mood state.

    Be well!


  6. JP Says:

    Updated 07/20/15:


    Nutr Hosp. 2015 May 1;31(5):2297-312.

    Magnesium in tap and bottled mineral water in Spain and its contribution to nutritional recommendations.

    INTRODUCTION: An appropriate magnesium intake has proved to have beneficial effects on bone health, reduce insulin resistance and prevent atherosclerosis.

    OBJECTIVE: To determine the concentration of magnesium in drinking water and bottled mineral water in Spain and assess its daily contribution to dietary recommendations.

    METHODS: We used ion chromatography to analyse the magnesium concentrations of public drinking waters in a representative sample of 108 Spanish municipalities (supplying 21,290,707 potential individuals) and 109 natural mineral waters sold in Spain (97 Spanish and 12 imported).

    RESULTS: The water generally contained between 15 and 45 mg/L of magnesium, but in seven municipalities it contained over 45 mg/L. The average magnesium concentration of 97 brands of Spanish natural mineral water was 16.27 mg/L (range: 0.11-141.2 mg/L). Of these, 33 contained between 15 and 45 mg/L of magnesium and four contained over 45 mg/L. Of the 12 imported brands, 4 contained over 45 mg/L. Assuming water consumption is as recommended by the European Food Safety Agency, water containing 15 to 45 mg/L of magnesium provides between 9 and 76.5% of the recommended intake of magnesium for children aged one to thirteen, up to 25.7% in adolescents, between 7.5 and 25.7% for adults, and up to 27% for lactating women. Water with 60 mg/L of magnesium provides between 30 and 102% of the recommended dietary allowance, depending on the age of the individual.

    DISCUSSION: The consumption of public drinking water and natural mineral water in a third of Spanish cities can be regarded as an important supplementary source of magnesium.

    Be well!


  7. JP Says:

    Updated 07/20/15:


    Magnes Res. 2014 Jul-Sep;27(3):131-41.

    Effect of a natural mineral-rich water on catechol-O-methyltransferase function.

    Catechol-O-methyltransferase (COMT) is a magnesium-dependent, catecholamine-metabolizing enzyme, whose impaired activity has been positively associated with cardiovascular diseases, particularly hypertension. Consumption of some natural mineral-rich waters has been shown to exert protective effects on cardiovascular risk factors, eg. by decreasing arterial blood pressure and blood lipids. However, the molecular mechanisms underlying these effects are still poorly understood. So, the aim of this work was to investigate the effect of natural mineral-rich water ingestion upon liver and adrenal glands COMT expression and activity in Wistar Han rats. Over a seven-week period, animals had access to one of the following three drinking solutions: 1) tap water (control group; TW), 2) tap water with added Na(+) (to make the same concentration as in the MW group (TWNaCl group), or 3) natural mineral-rich water [Pedras Salgadas(®), which is very rich in bicarbonate, and with higher sodium, calcium and magnesium content than control tap water (MW group)]. COMT expression and activity were determined by RT-PCR and HPLC-ED, respectively. A higher hepatic COMT activity was found in the MW group compared with the TW and TWNaCl groups. On the other hand, adrenal gland COMT mRNA expression decreased in the MW group compared to TW group. In conclusion, the ability of natural mineral-rich waters to increase hepatic COMT activity may eventually explain the positive cardiovascular effects associated with the consumption of some natural mineral-rich waters.

    Be well!


  8. JP Says:

    Updated 07/20/15:


    Clin Ter. 2014;165(5):e346-52.

    The therapeutic activity of sulphate-bicarbonate-calcium-magnesiac mineral water in the functional disorders of the biliary tract.

    BACKGROUND AND AIM: Functional disorders of the biliary tract involve gallbladder and sphincter of Oddi and cause pain and/or digestive troubles. In this context, in addition to pharmacological treatments, an important role is played by the use of sodium-sulphate and sulphate-bicarbonate mineral waters that, because of their composition into ions macro and trace elements, can stimulate the release or modulate the activity of some neurohumoral regulators of the digestive process. We want to do a study on the effects of hydropinotherapy with a sulphate-bicarbonate-calcium-magnesium mineral water in patients suffering from pain and other symptoms caused by biliary dyskinesias, biliary sand (without gallstones), or following a cholecystectomy (post-cholecystectomy syndromes).

    MATERIALS AND METHODS: We enrolled 43 patients suffering from those affections; all the patients did two cycles in one year of hydropinotherapy with Acqua Santa at Italy’s Chianciano Spa; 20 of these patients did a third cycle of hydropinotherapy in the second year of the study. At the end of the second and of the third cycle we compared the frequency of eleven main symptoms in both groups and we also performed an longitudinal-observational study on the frequency of those symptoms before the beginning of the first cycle of the therapy and at the end of the second and of the third cycle. Statistical analyses were based on the use of Pearson’s χ2 test.

    RESULTS: The frequency of the symptoms observed at the end of second and third cicle of hydropinotherapy was significantly lower than that considered before starting therapy. The differences were statistically significant.

    CONCLUSIONS: The results of our research regarding the hydropinotherapy by sulphate-bicarbonate-calcium-magnesium mineral water show a significant improvement of symptoms in patients suffering from disturbances of biliary tract.

    Be well!


  9. JP Says:

    Updated 07/13/16:


    Nutrients 2016, 8(7), 400;

    An Intervention with Mineral Water Decreases Cardiometabolic Risk Biomarkers. A Crossover, Randomised, Controlled Trial with Two Mineral Waters in Moderately Hypercholesterolaemic Adults

    Water intake is essential for health maintenance and disease prevention. The effects of an intervention with two mineral waters, sodium-bicarbonated mineral water (BW) or control mineral water low in mineral content (CW), on cardiometabolic risk biomarkers were studied. In a randomised-controlled crossover-trial, sixty-four moderately hypercholesterolaemic adults were randomly assigned to consume 1 L/day of either BW (sodium, 1 g/L; bicarbonate, 2 g/L) or CW with the main meals for eight weeks, separated by an eight-week washout period. Blood lipids, lipid oxidation, glucose, insulin, aldosterone, urine pH, urinary electrolytes, blood pressure, body weight, fluid intake, energy, and nutrients from total diet and beverages were determined. Total cholesterol, LDL cholesterol, and glucose decreased (p < 0.01), oxidised LDL tended to decrease (p = 0.073), and apolipoprotein B increased during the intervention, without water type effect. Energy and carbohydrates from beverages decreased since soft drinks and fruit juice consumptions decreased throughout the trial. BW increased urinary pH (p = 0.006) and reduced calcium/creatinine excretion (p = 0.011). Urinary potassium/creatinine decreased with both waters. Consumption of 1 L/day of mineral water with the main meals reduces cardiometabolic risk biomarkers, likely to be attributed to a replacement of soft drinks by water. In addition, BW does not affect blood pressure and exerts a moderate alkalizing effect in the body. Be well! JP

  10. JP Says:

    Updated 06/21/17:


    J Am Coll Nutr. 2017 Jun 19:1-5.

    Calcium Bioavailability from Mineral Waters with Different Mineralization in Comparison to Milk and a Supplement.

    OBJECTIVE: The aim of the present study was to compare the bioavailability of calcium from 3 mineral waters with different concentrations of minerals with that of milk and a calcium supplement.

    METHODS: A single-center, randomized controlled trial with a crossover design with 21 healthy men and women was conducted at the Institute of Food Science and Human Nutrition, Leibniz University Hannover. The participants consumed the 5 test products providing 300 mg of calcium each on 5 examination days with 1-week wash-out phases in between. Primary outcome variables were the area under the curve of serum calcium levels for 10-hour (AUC0-10h) and 24-hour urinary calcium excretion.

    RESULTS: In all groups, no significant differences in the AUC0-10h of serum calcium levels as well as in the 24-hour urinary calcium excretion were observed. Likewise, mean changes in serum phosphate and urinary phosphate, as well as serum parathormone, showed no differences between the groups.

    CONCLUSION: Given an equivalent bioavailability of calcium in all test products, neither a high concentration of SO42- or of HCO3 influenced the bioavailability of calcium. Accordingly, the use of mineral water with high concentrations of calcium constitutes a calorie-free calcium source that can improve calcium supply.

    Be well!


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