Exploring the Potential Benefits of Natural Calcium-Rich Mineral Waters for Health and Wellness: A Systematic Review
Abstract
:1. Introduction
2. Methods
3. Natural Calcium-Rich Mineral Waters Worldwide
- Vittel (France, https://www.vittel.com/water-life (accessed on 20 June 2023)): Originating from the Vosges region of France, Vittel is known for its high calcium content. It contains approximately 240 milligrams of calcium per liter (mg/L). Alongside calcium, it also contains magnesium (about 42 mg/L) and bicarbonates.
- Contrex (France, https://www.fonsapor.com/products/contrex-500ml-natural-mineral-water-pet (accessed on 20 June 2023)): Another renowned mineral water from the French region of Vosges, Contrex stands out with one of the highest calcium contents among mineral waters, boasting about 468 mg/L. It also contains significant magnesium levels and is low in sodium.
- Gerolsteiner (Germany, https://www.gerolsteiner.de/fileadmin/Contentbilder/UnsereProdukte/Mineralwasser/Dokumente/gerolsteiner-sparkling-mineral-water-analysis.pdf (accessed on 20 June 2023)): Originating from the Volcanic Eifel region in Germany, Gerolsteiner mineral water offers a balanced mineral profile. It contains about 348 mg/L of calcium, 108 mg/L of magnesium, and a high bicarbonate content.
- AQUA Carpatica (Romania, https://aquacarpatica.com/products/ (accessed on 20 June 2023)): Sourced from the springs of the Carpathian Mountains, AQUA Carpatica contains about 260 mg/L of calcium. It also has a balanced magnesium level [31,43].
- Borsec (Romania, https://romaqua-group.ro/en/brands/borsec/ (accessed on 20 June 2023)): Known since ancient times, Borsec mineral water has approximately 195 mg/L of calcium. It is also characterized by a high content of bicarbonates [31,43].
- San Pellegrino (Italy, https://www.sanpellegrino.com/files/usa/2021_SP_WAR_EN.pdf (accessed on 20 June 2023)): San Pellegrino, sourced from the Italian Alps, is famous worldwide. It contains around 160 mg/L of calcium and is rich in bicarbonate and sulphate ions.
- Mountain Valley Spring Water (USA, https://www.mountainvalleyspring.com/pages/our-water (accessed on 20 June 2023)): Originating from the Ouachita Mountains in Arkansas, this water is balanced in mineral content, offering around 67 mg/L of calcium. It also contains other minerals like magnesium and potassium [44].
- Spa Reine (Belgium, https://mineralwaterfit.com/spa-reine-mineral-water-p-1828/ (accessed on 20 June 2023)): Spa Reine mineral water comes from the Ardennes in Belgium and has a lower, but still notable, calcium content of about 33 mg/L. Its unique mineral composition includes very low sodium levels, making it suitable for low-sodium diets [45].
- Health-Conscious Consumers: As the importance of dietary calcium becomes more widely known, health-conscious consumers are actively seeking out beverages that can contribute to their daily mineral intake. Calcium-rich mineral waters fit this trend perfectly, offering a natural, calorie-free source of this vital mineral. The clear labelling of calcium content on packaging often influences purchasing decisions for these consumers [46].
- Natural and Organic Trend: Consumers today are increasingly seeking natural and organic products, driven by the perception that these are healthier and more environmentally friendly. Natural mineral waters, sourced directly from springs and untouched by human processing, are well-aligned with this trend. This preference for natural products has contributed to the growing popularity of natural mineral waters over other processed beverages [47].
- Sustainability and Eco-Friendliness: Sustainability is another significant trend in consumer attitudes. Consumers are becoming more aware of the environmental impact of their choices and are looking for products with sustainable packaging and sourcing. Mineral water companies that prioritize sustainable practices, from water sourcing to packaging, are more likely to gain favor with these eco-conscious consumers [48,49].
- Fitness and Hydration: With the growing popularity of fitness and outdoor activities, there is an increasing demand for hydrating beverages [50]. Mineral water, particularly calcium-rich mineral water, is perceived as a healthy hydrating choice providing essential minerals lost during physical exertion [51,52].
4. Dietary Calcium from Natural Mineral Waters
5. Impact on Bone Health
6. Cardiovascular Implications
7. Role in Weight Management
8. Other Potential Health Benefits
9. Conclusions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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No. | Article | Year | Main Details |
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1 | Vannucci L, Fossi C, Quattrini S, Guasti L, Pampaloni B, Gronchi G et al. Calcium Intake in bone health: A focus on calcium-rich mineral waters. Nutrients | 2018 | The study investigates the crucial role of calcium in human bone health, particularly in bone mineralization. It further delves into the significance of calcium-rich mineral waters, focusing on the high bioavailability of calcium they provide. |
2 | Flynn A. The role of dietary calcium in bone health. Proc Nutr Soc | 2003 | Calcium, predominantly found in bones, is crucial for their development and maintenance. Its dietary intake varies across life stages, with disagreements on optimal amounts. Insufficiency can impair bone health and potentially lead to osteoporosis. |
3 | Tandoǧan B, Ulusu NN. Importance of calcium. Turkish J Med Sci. | 2005 | Calcium, the body’s most abundant mineral, regulates numerous processes, including muscle function, fibrin polymerisation, and nervous impulses. Managed by calcium-transporting systems, its balance is vital as fluctuations can prompt varied responses, including apoptosis. |
4 | Rusoff LL. Calcium–Osteoporosis and Blood Pressure. J Dairy Sci. | 1987 | Optimum calcium intake throughout life, primarily through dairy, is vital for peak bone mass development and preventing osteoporosis. Unfortunately, many, particularly older females, fall short of the recommended intake, risking bone diseases and high blood pressure. |
5 | Shkembi B, Huppertz T. Calcium absorption from food products: Food matrix effects. Nutrients. | 2022 | Calcium absorption from food varies significantly due to interactions with other food components and factors like fermentation and gastrointestinal conditions. Absorption requires calcium to be ionized, facilitated by the stomach’s low pH. |
6 | Quattrini S, Pampaloni B, Brandi ML. Natural mineral waters: Chemical characteristics and health effects. Clin Cases Miner Bone Metab. | 2016 | Drinking 1.5–2 L of water daily is vital for maintaining body water equilibrium. Despite concerns over plastic containers, natural mineral waters’ unique mineral compositions can offer numerous health benefits, impacting various physiological and pathological conditions. |
7 | Albertini MC, Dachà M, Teodori L, Conti ME. Drinking mineral waters: Biochemical effects and health implica-tions—The state-of-the-art. Int J Environ Heal. | 2007 | While the health benefits of mineral waters have been shown to have significant biochemical implications, adverse effects must also be considered. This review underscores the need for further research to ensure public health safety and avoid mineral water misuse. |
8 | Heaney RP. Absorbability and utility of calcium in mineral waters. Am J Clin Nutr. | 2006 | This research investigates the potential of high-calcium mineral waters to address calcium deficiency in North America. The absorbability of calcium from high-mineral waters was measured in human volunteers and compared to calcium from milk. |
9 | Bacciottini L, Tanini A, Falchetti A, Masi L, Franceschelli F, Pampaloni B et al. Calcium bioavailability from a calcium-rich mineral water, with some observations on method. J Clin Gastroenterol. | 2004 | This study compares the bioavailability of calcium from high-calcium mineral water and milk in 27 healthy subjects. Results indicate that the calcium from the mineral water is highly bioavailable, comparable to milk calcium. The research underscores mineral water as a potential significant source of dietary calcium. |
10 | Bourassa MW, Abrams SA, Belizán JM, Boy E, Cormick G, Quijano CD et al. Interventions to improve calcium intake through foods in populations with low intake. Ann N Y Acad Sci. | 2022 | In countries with low calcium intake, food-based solutions can enhance calcium consumption and bioavailability. Strategies include promoting calcium-rich animal-source foods and plant foods, improving calcium content via food processing techniques, fortifying staple foods with calcium, and exploring biofortification. |
11 | Weaver CM, Proulx WR, Heaney R. Choices for achieving adequate dietary calcium with a vegetarian diet. Am J Clin Nutr. | 1999 | While dairy is common in America, certain plants also provide calcium. Yet, a purely plant-based diet may need fortified foods or supplements for sufficient calcium. |
12 | Pampaloni B, Brandi ML. Mineral water as food for bone: an overview. Int J Bone Fragility. | 2022 | Natural mineral waters, particularly calcium-rich ones (>150 mg/L), provide bioavailable calcium and other micronutrients beneficial for bone health. Despite the potential negative effects from plasticizers in bottled waters, their consumption is common. |
13 | Burckhardt P. The effect of the alkali load of mineral water on bone metabolism: Interventional studies. J Nutr. | 2008 | Alkali supplements and diets reduce bone resorption and increase bone mineral density. Bicarbonate-rich alkali mineral waters with low acid load effectively lower bone resorption markers and parathyroid hormone levels, surpassing acidic calcium-rich mineral waters, regardless of sufficient calcium intake. |
14 | Guillemant J, Le HT, Accarie C, Du Montcel ST, Delabroise AM, Arnaud MJ et al. Mineral water as a source of dietary calcium: Acute effects on parathyroid function and bone resorption in young men. Am J Clin Nutr. | 2000 | The study aimed to investigate the effectiveness of high-calcium mineral water as an additional source of dietary calcium. Results showed that intake of high-calcium water significantly reduced parathyroid hormone secretion and bone resorption markers, indicating its potential in inhibiting bone resorption. |
15 | Wynn E, Krieg MA, Aeschlimann JM, Burckhardt P. Alkaline mineral water lowers bone resorption even in calcium sufficiency: Alkaline mineral water and bone metabolism. Bone. | 2009 | In this study, the effects of an alkaline mineral water rich in bicarbonate and an acid mineral water rich in calcium were compared in young women with normal calcium intake. The alkaline water led to a significant decrease in parathyroid hormone and bone resorption markers, while the acid water had no effect on bone resorption. |
16 | Meunier PJ, Jenvrin C, Munoz F, De La Gueronnière V, Garnero P, Menz M. Consumption of a high calcium mineral water lowers biochemical indices of bone remodeling in postmenopausal women with low calcium intake. Osteoporos Int. | 2005 | In a 6-month trial, postmenopausal women with low calcium intake were given a high-calcium mineral water (HCaMW) or a low-calcium placebo water. The HCaMW group experienced significant decreases in serum parathyroid hormone and biochemical markers of bone remodeling, indicating the potential benefits in repairing calcium deficiency and reducing age-related bone loss. |
17 | Y, Xu A, Qiu Z, Wang L, Wang J, Luo J et al. Drinking Natural Mineral Water Maintains Bone Health in Young Rats With Metabolic Acidosis. Front Nutr. | 2022 | The rats drinking bicarbonate-rich natural mineral water showed improved bone health, including higher bone mineral density, greater bone microstructure, and increased bone strength. Drinking natural mineral water, especially bicarbonate-rich water, can effectively improve bone health in individuals with metabolic acidosis. |
18 | Wang L, Manson JAE, Sesso HD. Calcium intake and risk of cardiovascular disease: A review of prospective studies and randomized clinical trials. Am J Cardiovasc Drugs. | 2012 | Adequate calcium intake is crucial for bone health and has potential effects on cardiovascular disease (CVD). Experimental studies suggest calcium’s involvement in cardiovascular processes. Epidemiological studies show mixed results |
19 | Myung SK, Kim HB, Lee YJ, Choi YJ, Oh SW. Calcium supplements and risk of cardiovascular disease: A me-ta-analysis of clinical trials. Nutrients. | 2021 | This meta-analysis of double-blind, placebo-controlled trials found that calcium supplements increased the risk of CVD and coronary heart disease (CHD) by approximately 15% in healthy postmenopausal women. Subgroup analysis showed that both dietary and supplementary calcium intake were associated with increased CVD and CHD risk. |
20 | Tankeu AT, Ndip Agbor V, Noubiap JJ. Calcium supplementation and cardiovascular risk: A rising concern. J Clin Hypertens. | 2017 | The use of calcium supplementation has increased globally, driven by its established role in osteoporosis prevention and treatment. However, emerging evidence suggests potential adverse cardiovascular effects. |
21 | Böhmer H, Müller H, Resch KL. Calcium supplementation with calcium-rich mineral waters: A systematic review and meta-analysis of its bioavailability. Osteoporos Int. | 2000 | The relevance of calcium in preventing and treating osteoporosis is well established. Higher daily calcium intake is recommended, but achieving it can be challenging. Calcium-rich mineral waters may offer a promising alternative, as they have shown comparable or better calcium bioavailability than dairy products. |
22 | Nerbrand C, Agréus L, Lenner RA, Nyberg P, Svärdsudd K. The influence of calcium and magnesium in drinking water and diet on cardiovascular risk factors in individuals living in hard and soft water areas with differences in cardiovascular mortality. BMC Public Health. | 2003 | Current recommendations for daily calcium intake are being questioned, with new guidelines suggesting higher levels that may be challenging to meet through traditional sources like dairy products or supplements. Calcium-rich mineral waters could provide a promising alternative. A systematic review and meta-analysis found that calcium absorption from mineral waters was significantly higher than from dairy products. |
23 | Anderson JJB, Klemmer PJ. Risk of high dietary calcium for arterial calcification in older adults. Nutrients. | 2013 | As the kidneys have limited capacity to eliminate excess calcium, the risk of soft-tissue calcification may increase, especially in older adults with reduced renal function. While maintaining bone health remains important, policy recommendations for calcium intake in adults should also consider the potential risks of cardiovascular diseases associated with excessive calcium intake. |
24 | Phillips-Eakley AK, McKenney-Drake ML, Bahls M, Newcomer SC, Radcliffe JS, Wastney ME et al. Effect of High-Calcium Diet on Coronary Artery Disease in Ossabaw Miniature Swine With Metabolic Syndrome. J Am Heart Assoc. | 2015 | This study aimed to investigate the impact of high calcium intake on coronary artery calcification using innovative calcium tracer kinetic modeling in pigs with diet-induced metabolic syndrome. The results showed no detectable effect of high calcium diets on coronary artery calcium deposition. Secondary endpoints also demonstrated no treatment differences in coronary artery disease or function. |
25 | Anderson JJB, Kruszka B, Delaney JAC, He K, Burke GL, Alonso A et al. Calcium intake from diet and sup-plements and the risk of coronary artery calcification and its progression among older adults: 10-year follow-up of the multi-ethnic study of atherosclerosis (MESA). J Am Heart Assoc. | 2016 | In a longitudinal cohort study, the relationship between calcium intake (from both foods and supplements) and coronary artery calcification (CAC) was assessed. The study included 5448 adults without clinically diagnosed CVD. Results showed that high total calcium intake, obtained from dietary sources, was associated with a decreased risk of incident atherosclerosis over long-term follow-up. |
26 | Aptel I, Cance-Rouzaud A, Grandjean H. Association between calcium ingested from drinking water and femoral bone density in elderly women: Evidence from the EPIDOS cohort. J Bone Miner Res. | 1999 | In the EPIDOS multicenter study, data from 4434 women over 75 years old were analyzed to examine the relationship between dietary calcium, calcium from drinking water, and bone density at the femoral neck. Total calcium intake showed a significant correlation with bone density. Specifically, a 100 mg/day increase in calcium from drinking water was associated with a 0.5% increase in femoral bone density. |
27 | Teegarden D, Gunther CW. Can the controversial relationship between dietary calcium and body weight be mechanistically explained by alterations in appetite and food intake? Nutr Rev. | 2008 | Studies have suggested that calcium or dairy products may affect body weight and fat by influencing appetite and food intake. However, recent research has found no evidence of complete compensation for increased energy intake from dairy products, indicating that a short-term increase in dairy intake does not affect appetite. Additionally, altering the calcium content of a meal has shown no impact on appetite-related hormones or energy intake from subsequent meals. |
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Pop, M.S.; Cheregi, D.C.; Onose, G.; Munteanu, C.; Popescu, C.; Rotariu, M.; Turnea, M.-A.; Dogaru, G.; Ionescu, E.V.; Oprea, D.; et al. Exploring the Potential Benefits of Natural Calcium-Rich Mineral Waters for Health and Wellness: A Systematic Review. Nutrients 2023, 15, 3126. https://doi.org/10.3390/nu15143126
Pop MS, Cheregi DC, Onose G, Munteanu C, Popescu C, Rotariu M, Turnea M-A, Dogaru G, Ionescu EV, Oprea D, et al. Exploring the Potential Benefits of Natural Calcium-Rich Mineral Waters for Health and Wellness: A Systematic Review. Nutrients. 2023; 15(14):3126. https://doi.org/10.3390/nu15143126
Chicago/Turabian StylePop, Manuela Simona, Dragoș Cornel Cheregi, Gelu Onose, Constantin Munteanu, Cristina Popescu, Mariana Rotariu, Marius-Alexandru Turnea, Gabriela Dogaru, Elena Valentina Ionescu, Doinița Oprea, and et al. 2023. "Exploring the Potential Benefits of Natural Calcium-Rich Mineral Waters for Health and Wellness: A Systematic Review" Nutrients 15, no. 14: 3126. https://doi.org/10.3390/nu15143126
APA StylePop, M. S., Cheregi, D. C., Onose, G., Munteanu, C., Popescu, C., Rotariu, M., Turnea, M. -A., Dogaru, G., Ionescu, E. V., Oprea, D., Iliescu, M. G., Minea, M., Stanciu, L. E., Silișteanu, S. C., & Oprea, C. (2023). Exploring the Potential Benefits of Natural Calcium-Rich Mineral Waters for Health and Wellness: A Systematic Review. Nutrients, 15(14), 3126. https://doi.org/10.3390/nu15143126