Bicarbonate-Rich Mineral Water and Human Health

Background and aim: Nutrition plays a crucial role in both subjective well-being and maintaining optimal health. A substantial body of research has demonstrated that the contemporary Western diet, characterized by a high proportion of animal protein, highly processed foods, and a low proportion of fruit and vegetables, is associated with an increased risk of lifestyle diseases. This diet induces an excess of acid, which must be counterbalanced to maintain the normal functioning of the organism. Bicarbonate plays a key role in these processes as a buffer base. Therefore, the objective of this thesis was to provide a comprehensive overview of the current state of research on the effects of bicarbonate-rich mineral water and to critically evaluate potential areas of application concerning the prevention and treatment of diseases and symptoms. To obtain more detailed insights into the effects on the acid-base balance, a human study was also conducted, taking into account both short-term and long-term effects. Given the tendency of mineral water with high bicarbonate levels to exhibit elevated sodium concentrations, particular emphasis was placed on investigating its effects on blood pressure. Methods: Reviews: A comprehensive literature search was conducted for intervention studies that evaluated the effects of bicarbonate-rich mineral water on human health. Due to the substantial amount of data obtained, the results of the literature search were critically summarized in two distinct narrative reviews. Intervention study: The monocentric, placebo-controlled, randomized clinical study included healthy men and women aged 30-65 years who were not taking any antihypertensive medication and adhered to an omnivorous diet. The participants consumed either 1.5-2 liters/day of mineral water with low mineral content or mineral water with high bicarbonate and sodium levels. The effects of the intervention were assessed by evaluating various blood and urine parameters, both after three days of water consumption and at the end of the four-week intervention period. Furthermore, blood pressure measurements were performed at the study center. Results: Reviews: The initial review provides a summary of the effects on the buffer capacity of the organism. The findings indicate that the consumption of bicarbonate-rich mineral water results in a decrease in renal net acid excretion (NAE), accompanied by an increase in bicarbonate (HCO3-) levels and a rise in base excess (BE) in the blood. Furthermore, the beneficial effects regarding the prevention of kidney stones are outlined, and evidence of reduced bone resorption is demonstrated. The second review focuses on metabolic changes. The findings indicate that cardiovascular risk factors, including parameters of glucose and lipid metabolism, are positively impacted, and no adverse effects on blood pressure are anticipated. The manuscript also describes positive effects regarding complaints in the upper gastrointestinal tract. Potential benefits for liver health are also highlighted. Intervention study: In the context of acid-base balance regulation, the consumption of bicarbonate-rich mineral water has been demonstrated to be more efficacious than mineral water with a low mineral content. The intervention study demonstrated an increase in urine pH and a decrease in NAE in urine. Furthermore, alterations in blood were detected, suggesting an enhancement in buffer capacity. The effects were already apparent after a short period of consumption (three days) and persisted until the end of the intervention period. Conclusion: The available data suggest that mineral water with high bicarbonate content has the potential to enhance the body's buffering capacity, thereby contributing to the stabilization of the acid-base balance. This has a favorable impact on metabolism and a wide range of health aspects. In addition, the consumption of mineral water with a high bicarbonate and sodium content does not appear to pose a risk of increasing blood pressure.