TY - JOUR

T1 - Effects of mineral waters on acid–base status in healthy adults:

T2 - Results of a randomized trial

AU - Wasserfurth, Paulina

AU - Schneider, Inga

AU - Ströhle, A.

AU - Nebl, Josefine

AU - Bitterlich, Norman

AU - Hahn, Andreas

N1 - Funding information: The authors would like to thank Heike Kohrs for technical assistance in the laboratory and all the subjects who took part in this study. The publication of this article was funded by the Open Access Fund of the Leibniz Universität Hannover. The authors declare no potential conflicts of interest. This study was funded in parts by the Association of German Mineral Water Bottlers (VDM). Study realization, data analysis, and reporting were undertaken independently from the sponsor.

PY - 2019/12/3

Y1 - 2019/12/3

N2 - 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.

AB - 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.

KW - Acid

KW - Base status

KW - Dietary acid load

KW - Mineral water

KW - Net acid excretion

UR - http://www.scopus.com/inward/record.url?scp=85078065293&partnerID=8YFLogxK

U2 - 10.29219/fnr.v63.3515

DO - 10.29219/fnr.v63.3515

M3 - Article

C2 - 31839789

VL - 63

JO - Food & nutrition research

JF - Food & nutrition research

SN - 1654-661X

M1 - 3515

ER -