Effects of mineral waters on acid–base status in healthy adults:

Results of a randomized trial

authored by: Paulina Wasserfurth, Inga Schneider, A. Ströhle, Josefine Nebl, Norman Bitterlich, Andreas Hahn
Abstract: Background: The ‘Western diet’ typically consumed in industrialized countries is characterized by high amounts of processed cereal grains and animal products while being low in vegetables, tubers, and fruits. This dietary behavior leads to imbalances of acid–base status in favor of the acids and may cause low-grade metabolic acidosis (LGMA) that is associated with negative effects on health in the long run, including urolithiasis, bone loss, and even cardiometabolic diseases. Therefore, it has become of great interest to find dietary strategies that can be used to neutralize the acid load associated with Western diets. Objective: The aim of this study was to investigate whether the diet-dependent net acid load can be reduced by the daily consumption of mineral waters with different bicarbonate content and different potential renal acid load (PRAL). Methods: A single-centered, randomized trial including 129 healthy men and women aged from 18 to 75 years was conducted. Participants consumed 1,500–2,000 mL of one of four mineral waters with different bicarbonate content and different PRAL values daily for 4 weeks: low bicarbonate, high PRAL (LBHP, HCO ₃ ⁻: 403.0 mg/L, PRAL: 10.7); medium-high bicarbonate, medium PRAL (MBMP, HCO ₃ ⁻: 1816.0 mg/L, PRAL: −10.8); high bicarbonate, low PRAL (HBLP, HCO ₃ ⁻: 2451.0 mg/L, PRAL: −19.3); medium-high bicarbonate, low PRAL (MBLP, HCO ₃ ⁻: 1846.0 mg/L, PRAL: −22.1). Throughout the study, participants were asked to maintain their usual dietary habits. The primary outcome was the net acid excretion (NAE) measured in the 24-h urine output. Results: Consumption of the three mineral waters: MBMP, HBLP, and MBLP led to a significant decrease in NAE values. Within the MBMP group, the NAE could be reduced by 48% (P = 0.001), while consumption of HBLP led to a reduction of 68% (P < 0.001) and MBLP to a reduction of 53% (P = 0.001). Moreover, a slight increase in serum bicarbonate could also be observed in the groups that drank HBLP (P = 0.057) and MBLP (P = 0.001). Conclusion: Daily consumption of at least 1,500–2,000 mL of mineral water rich in bicarbonate (>1800.0 mg/L) with medium or low PRAL (<−11 mEq/L) can effectively reduce the NAE level by reducing the dietary acid load under free-living conditions in healthy adults.
Organisation(s): Institute of Food Science and Human Nutrition
Nutrition Physiology and Human Nutrition Section
External Organisation(s): Medicine and Service Ltd
Type: Article
Journal: Food & nutrition research
Volume: 63
ISSN: 1654-661X
Publication date: 03.12.2019
Publication status: E-pub ahead of print
Peer reviewed: Yes
ASJC Scopus subject areas: Food Science, Nutrition and Dietetics, Public Health, Environmental and Occupational Health
Sustainable Development Goals: SDG 3 - Good Health and Well-being
Electronic version(s): https://doi.org/10.29219/fnr.v63.3515 (Access: Open)