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Comparison of the mineral content of tap water and bottled waters

Abstract

OBJECTIVES: Because of growing concern that constituents of drinking water may have adverse health effects, consumption of tap water in North America has decreased and consumption of bottled water has increased. Our objectives were to 1) determine whether North American tap water contains clinically important levels of calcium (Ca2+), magnesium (Mg2+), and sodium (Na+) and 2) determine whether differences in mineral content of tap water and commercially available bottled waters are clinically important.

DESIGN: We obtained mineral analysis reports from municipal water authorities of 21 major North American cities. Mineral content of tap water was compared with published data regarding commercially available bottled waters and with dietary reference intakes (DRIs).

MEASUREMENTS AND MAIN RESULTS: Mineral levels varied among tap water sources in North America and among bottled waters. European bottled waters generally contained higher mineral levels than North American tap water sources and North American bottled waters. For half of the tap water sources we examined, adults may fulfill between 8% and 16% of their Ca2+ DRI and between 6% and 31% of their Mg2+ DRI by drinking 2 liters per day. One liter of most moderate mineralization European bottled waters contained between 20% and 58% of the Ca2+ DRI and between 16% and 41% of the Mg2+ DRI in adults. High mineralization bottled waters often contained up to half of the maximum recommended daily intake of Na+.

CONCLUSION: Drinking water sources available to North Americans may contain high levels of Ca2+, Mg2+, and Na+ and may provide clinically important portions of the recommended dietary intake of these minerals. Physicians should encourage patients to check the mineral content of their drinking water, whether tap or bottled, and choose water most appropriate for their needs.

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References

  1. Aschengrau A, Zierler S, Cohen A. Quality of community drinking water and the occurrence of spontaneous abortion. Arch Environ Health. 1989; 44:283–90.

    PubMed  CAS  Article  Google Scholar 

  2. Shy CM, Stroba RJ. Air and water pollution. In: Schottenfeld D, Fraumeni JF, eds. Cancer epidemiology and prevention. Philadelphia, Pa: W.B. Saunders; 1982:336–63.

    Google Scholar 

  3. Morton MS, Elwood PC, Abernathy M. Trace elements in water and congenital malformations of the central nervous system in South Wales. Br J Prev Soc Med. 1976; 30:36–9.

    PubMed  CAS  Google Scholar 

  4. Lowe CR, Roberts CL, Lloyd S. Malformations of the central nervous system and softness of local water supplies. Br Med J. 1971; 2:357–61.

    PubMed  CAS  Google Scholar 

  5. St. Leger AS, Elwood PC. Neural tube malformations and trace elements in water. J Epidemiol Community Health. 1980; 34:186–7.

    Article  Google Scholar 

  6. Arbuckle TE, Sherman GJ, Corey PN, Walters D, Lo B. Water nitrates and CNS birth defects: a population-based case-control study. Arch Environ Health. 1988; 43:162–7.

    PubMed  CAS  Article  Google Scholar 

  7. Morris JN, Crawford MD, Heady JA. Hardness of local water supplies and mortality from cardiovascular disease. Lancet. 1961; 1:860–2.

    PubMed  Article  CAS  Google Scholar 

  8. Crawford MD, Gardner MJ. Mortality and hardness of local water supplies. Lancet. 1968; 1:860–2.

    Google Scholar 

  9. Schroeder HA. Municipal drinking water and cardiovascular death rates. JAMA. 1966; 95:125–9.

    Google Scholar 

  10. Anderson TW, LeRiche WH. Sudden death from ischemic heart disease in Ontario and its correlation with water hardness and other factors. Can Med Assoc J. 1971; 105:155–60.

    CAS  PubMed  Google Scholar 

  11. Schroeder HA, Kraemer LA. Cardiovascular mortality, municipal water, and corrosion. Arch Environ Health. 1974; 28:303–11.

    PubMed  CAS  Google Scholar 

  12. Eisenberg MJ. Magnesium deficiency and sudden death. Am Heart J. 1992; 124:544–9.

    PubMed  Article  CAS  Google Scholar 

  13. Eisenberg MJ. Magnesium deficiency and cardiac arrhythmias. NY State J Med. 1986; 86:133–6.

    CAS  Google Scholar 

  14. Gibson RS, Vanderkooy PS, McLennan CE, Mercer NM. Contribution of tap water to mineral intakes of Canadian preschool children. Arch Environ Health. 1987; 42:165–9.

    PubMed  CAS  Article  Google Scholar 

  15. Heany RP, Dowell MS. Absorbality of the calcium in a high-calcium mineral water. Osteoporos Int. 1994; 4:323–4.

    Article  Google Scholar 

  16. Neri LC, Johansen HL, Hewitt D, Marier J, Langer N. Magnesium and certain other elements and cardiovascular disease. Sci Total Environ. 1985; 42:49–75.

    PubMed  Article  CAS  Google Scholar 

  17. Heany RP. Nutritional factors in osteoporosis. Annu Rev Nutr. 1993; 13:287–316.

    Article  Google Scholar 

  18. Consensus Development Conference. Diagnosis, prophylaxis, and treatment of osteoporosis. Am J Med. 1993; 94:646–50.

    Article  Google Scholar 

  19. Garzon P, Eisenberg MJ. Variation in the mineral content of commercially available bottled waters: implications for health and disease. Am J Med. 1998; 105:125–30.

    PubMed  Article  CAS  Google Scholar 

  20. Heany RP, Gallagher JC, Johnston CC, et al. Calcium nutrition and bone health in the elderly. Am J Clin Nutr. 1982; 36:986–1013.

    Google Scholar 

  21. The Surgeon General’s Report on Nutrition and Health. Summary and recommendations. Washington, DC: DHHS (PHS), Publication No. 88-50211; 1988.

  22. McDowell LR. Minerals in Animal and Human Nutrition. San Diego, Ca: Academic Press; 1992:26–73, 78–95, 98–137.

    Google Scholar 

  23. Whitney EN, Corinne BC, Sharon RR. Understanding normal and clinical nutrition. 3rd ed. St. Paul, Minn: West Publishing Company; 1991:271–313, 853–92.

    Google Scholar 

  24. Marx A, Neutra RR. Magnesium in drinking water and ischemic heart disease. Epidemiol Rev. 1999; 19:258–72.

    Google Scholar 

  25. Rubenowitz E, Axelsson G, Rylander R. Magnesium in drinking water and death from acute myocardial infarction. Am J Epidemiol. 1996; 143:456–62.

    PubMed  CAS  Google Scholar 

  26. Löwik MR, Grrot EH, Binnerts WT. Magnesium and public health: the impact of drinking water. In: Trace substances in environmental health, XVI: Proceedings of the University of Missouri’s 16th Annual Conference on Trace Substances in Environmental health. Columbia, Mo: University of Missouri-Columbia; 1982:189–95.

    Google Scholar 

  27. Alfonso JF, De Alvarez RR. Effects of mercury on human gestation. Am J Obstet Gynecol. 1984; 75:18–24.

    Google Scholar 

  28. Durlach J. Recommended dietary amounts of magnesium: Mg RDA. Magnesium Res. 1989; 2:195–203.

    CAS  Google Scholar 

  29. Allen HAJ. An investigation of water hardness, calcium, and magnesium in relation to mortality in Ontario. PhD Thesis. University of Waterloo, Ontario, Canada; 1972.

    Google Scholar 

  30. Karppanen H. Epidemiological studies on the relationship between magnesium intake and cardiovascular disease. Artery. 1981; 9:190–9.

    PubMed  CAS  Google Scholar 

  31. Prior LAM, Evans JG, Harvey HPB, et al. Sodium intake and blood pressure in two Polynesian populations. N Engl J Med. 1968; 279:515–20.

    PubMed  CAS  Article  Google Scholar 

  32. MacGregor GA. Sodium is more important than calcium in essential hypertension. Hypertension. 1985; 7:628–37.

    PubMed  CAS  Google Scholar 

  33. Kinney JM, Jeejeebhoy DJ, Hill GL, Owen OE. Nutrition and metabolism in patient care. 1st ed. Philadelphia, Pa: WB Saunders; 1988:61–88, 445–464, 701–726.

    Google Scholar 

  34. Beverage Marketing Corporation. Bottled Water in the U.S. 1995 ed.

  35. Prince GW. Smoke on the water. Beverage World. 1996; (March):50–4.

  36. Population Estimates Program, Population Division, U.S. Bureau of the Census, Washington, DC.

  37. Draft Ground Water Disinfection Rule, Office of Drinking Water, U.S. Environmental Protection Agency, Washington, DC, 1992.

  38. von Wiesenberger A. The Pocket Guide to Bottled Water. 1st ed. Chicago, Ill: Contemporary Books; 1991.

    Google Scholar 

  39. Green T, Green M. The Good Water Guide. London, England: Rosendale Press; 1994.

    Google Scholar 

  40. Hammer MJ. Water and Wastewater Technology. 3rd ed. Englewood Cliffs, NJ: Prentice Hall; 1996:21.

    Google Scholar 

  41. Committee on Dietary Reference Intakes. Dietary Reference Intakes for Calcium, Phosphorous, Magnesium, Vitamin D, and Fluoride. Washington, DC: National Academy Press; 1997.

    Google Scholar 

  42. De Planter A. Bowes & Church’s food values of portions commonly used. Pennington JAT, ed. Philadelphi, Pa: Lippincott; 1994.

    Google Scholar 

  43. Recommended Dietary Allowances. 10th ed. Washington, DC: National Academy Press; 1989:253.

  44. Cavallo G. Water, water everywhere...but how much is safe to drink? Cardiac Alert. 1987; 9:4–6.

    Google Scholar 

  45. Shils ME, Olson JA, Shike M, Ross AC, eds. Modern Nutrition in Health and Disease. Baltimore, Md: Williams & Wilkins; 1999.

    Google Scholar 

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Correspondence to Mark J. Eisenberg MD, MPH.

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Dr. Eisenberg is a research scholar of the Heart and Stroke Foundation of Canada.

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Azoulay, A., Garzon, P. & Eisenberg, M.J. Comparison of the mineral content of tap water and bottled waters. J GEN INTERN MED 16, 168–175 (2001). https://doi.org/10.1111/j.1525-1497.2001.04189.x

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  • DOI: https://doi.org/10.1111/j.1525-1497.2001.04189.x

Key words

  • tap water
  • bottled water
  • calcium
  • magnesium
  • sodium