Calcium bioavailability from a calcium-rich mineral water, with some observations on method

Role of Nutrition in the Management of Patients with Multiple Endocrine Neoplasia Type 1

Multiple endocrine neoplasia type 1 (MEN1) is a rare syndrome caused by inactivating mutations in the MEN1 tumor suppressor gene. The three main clinical manifestations of MEN1 are primary hyperparathyroidism (PHPT), duodenal-pancreatic neuroendocrine tumors (DP-NETs) and anterior pituitary tumors. Endocrine tumors in patients with MEN1 differ from sporadic tumors because of their younger age at onset, common multiple presentations and the different clinical course. MEN1 is characterized by a complex clinical phenotype; thus, patients should be followed by a multidisciplinary team of experts that includes an endocrinologist, a surgeon, a oncologist, a radiotherapist, and not least, a nutritionist. It is important to remember the fundamental role that diet plays as a primary prevention tool, together with a healthy and active lifestyle in preventing osteoporosis/osteopenia and reducing the risk of developing kidney stones due to hypercalciuria, two frequent clinical complications in MEN1 patients. Is very important for MEN1 patients to have an adequate intake of calcium, vitamin D, magnesium and phosphate to maintain good bone health. The intake of foods containing oxalates must also be kept under control because in combination with calcium they concur to form calcium oxalate crystals, increasing the risk of nephrolithiasis. Another aspect to consider is the management of patients with pancreatic neuroendocrine tumors undergoing major surgical resections of the pancreas that can lead to alterations in digestion and absorption mechanisms due to partial or total reduction in pancreatic enzymes such as amylase, lipase, and protease, resulting in malabsorption and malnutrition. Therefore, the nutritionist's aim should be to devise a dietary plan that takes into consideration each single patient, educating them about a healthy and active lifestyle, and accompanying them through various life stages by implementing strategies that can enhance their quality of life.

Replacement of Milk and Dairy Products with Soy-Based Alternatives-How to Avoid Nutrient Deficiencies in a Milk-Free Diet?

BACKGROUND

In Germany, milk and dairy products are increasingly replaced by their plant-based alternatives. Although they can be used as substitutes, they differ significantly in their nutrient composition; thus, substitution could lead to nutrient deficiencies. So far, there are no food-based dietary recommendations that show which foods can replace milk and dairy products in a healthy way when switching to a plant-based substitute.

OBJECTIVES

Against this background, the question arises as to how to ensure adequate intake of critical nutrients when plant-based alternatives are consumed instead of milk and dairy products. To answer this question, this study aims to analyze what dietary changes would be required to avoid possible nutrient deficiencies and what types of foods can be consumed instead.

METHODS

To answer the research question, 3 different models are compared using the linear programming method: healthy diets with 1) milk and dairy products, 2) nonfortified plant-based alternatives, and 3) fortified plant-based alternatives. The models are applied to omnivorous, pescatarian, and vegetarian diet types.

RESULTS

The results show that when consuming nonfortified soy alternatives, an adequate supply of calcium and, in the case of a vegetarian diet, vitamin B12 can only be achieved if significant dietary changes are made compared to the average diet. This includes a significantly higher consumption of fruit and vegetables, whereby within the groups, calcium-rich varieties should be chosen (e.g., green leafy vegetables). When consuming fortified soy-based alternatives instead, the absence of milk and dairy products can be well compensated by the nutrients currently added to commercially available products.

CONCLUSIONS

Given the trend to consume less milk and dairy products or to abstain from them altogether, public health measures should point out possible nutrient deficiencies as well as necessary dietary changes, especially because in Germany, many plant-based alternatives are not fortified.

Supplementing Low-Sodium Bicarbonate-Calcic (Lete)® Water: Effects in Women on Bone and Systemic Metabolism

Calcium (Ca) represents about 40% of the total mineral mass, mainly in the bone, providing mechanical strength to the skeleton and teeth. An adequate Ca intake is necessary for bone growth and development in children and adolescents and for maintaining bone mineral loss in elderly age. Ca deficiency predisposes to osteopenia and osteoporosis. Healthy nutrition, including an adequate intake of Ca-rich food, is paramount to prevent and cure osteoporosis. Recently, several clinical studies have demonstrated that, in conditions of Ca dysmetabolism, Ca-rich mineral water is beneficial as a valuable source of Ca to be used as an alternative to caloric Ca-rich dairy products. Although promising, these data have been collected from small groups of participants. Moreover, they mainly regard the effect of Ca-rich mineral water on bone metabolism. In contrast, an investigation of the effect of Ca supplementation on systemic metabolism is needed to address the spreading of systemic metabolic dysfunction often associated with Ca dysmetabolism. In the present study, we analyzed urine and blood sera of 120 women in perimenopausal condition who were subjected for six months to 2l daily consumption of bicarbonate-calcium mineral water marketed under ®Lete. Remarkably, this water, in addition to being rich in calcium and bicarbonate, is also low in sodium. A complete set of laboratory tests was carried out to investigate whether the specific water composition was such to confirm the known therapeutic effects on bone metabolism. Second, but not least, urine and blood sera were analyzed using NMR-based metabolomic procedures to investigate, other than the action on Ca metabolism, potential system-wide metabolic effects. Our data show that Lete water is a valid supplement for compensating for Ca dysmetabolism and preserving bone health and integrity.

Exploring the Potential Benefits of Natural Calcium-Rich Mineral Waters for Health and Wellness: A Systematic Review

This systematic review investigates the potential health and wellness benefits of natural calcium-rich mineral waters. It emphasizes the importance of dietary calcium sourced from natural mineral waters in promoting bone health, maintaining cardiovascular function, aiding in weight management, and enhancing overall well-being. The review process involved the comprehensive analysis of peer-reviewed articles, clinical trials, and experimental studies published within the last decade. Findings reveal that consuming calcium-rich mineral water can contribute significantly to daily calcium intake, particularly for those with lactose intolerance or individuals adhering to plant-based diets. The unique bioavailability of calcium from such waters also appears to enhance absorption, thus potentially offering an advantage over other calcium sources. The potential benefits extend to the cardiovascular system, with some studies indicating a reduction in blood pressure and the prevalence of cardiovascular diseases. Emerging evidence suggests that calcium-rich mineral water might have a role in body weight management, though further research is needed. The review identifies several areas requiring additional research, such as the potential interaction between calcium-rich mineral water and other dietary components, the effects on populations with specific health conditions, and the long-term effects of consumption. In conclusion, natural calcium-rich mineral waters show promise as a readily accessible and bioavailable sources of dietary calcium, potentially beneficial for a broad range of individuals. However, further investigation is required to fully understand its range of health impacts and define optimal intake levels.

East-Greenland traditional nutrition: a reanalysis of the Høygaard et al. nutritional data (1936-1937)

Greenlandic traditional nutrition was unique in the arctic environment. The aim of the present study was to reanalyse the Høygaard et al. data, focusing on two micronutrients object of discussion, i.e. Ca and vitamin C. Høygaard et al. left Copenhagen in August 1936 and stayed in East-Greenland until August 1937. The members of the expedition recorded nutritional intake whilst residing in families. However, the nutritional intake was analysed on a household level. In total, thirty-five adults and fourty-one children participated. Median total energy expenditure in kcal per d was estimated at 2978 and 2627 for male and female adults, respectively, and 1997 for children and adolescents. Median (IQR) energy consumption in kcal per d was 3881 (1568) for male and 2910 (882) for female adults. This was 2442 (857) and 2023 (1122) for male and female children and adolescents. Median (IQR) Ca intake in mg.d^-1 was 555 (1110) for male and 484 (883) for female adults. This was 458 (747) and 358 (838) for male and female children and adolescents. Median (IQR) vitamin C intake in mg.d^-1 was 79 (77) for male and 59 (56) for female adults. This was 44 (47) and 60 (52) for male and female children and adolescents. In this study, the importance of traditional foods in reaching an acceptable energy balance was emphasised, together with the confirmation of a low Ca intake in East-Greenland traditional dietary pattern, and the important role of algae consumption in Inuit traditional dietary pattern to avoid scurvy.

Natural Mineral Waters and Metabolic Syndrome: Insights From Obese Male and Female C57BL/6 Mice on Caloric Restriction

Metabolic syndrome (MetS) represents one of the greatest challenges to public health given its serious consequences on cardiovascular diseases and type 2 diabetes. A carbohydrate-restricted, low-fat diet is the current therapy for MetS. Natural mineral waters (NMWs) are known to exert beneficial effects on human health. Our primary objective was to shed light on the potential therapeutic properties of NMWs in MetS. A total of 125 C57BL/6 male and female mice were included in the study. Of these, 10 were left untreated. They were fed a standard diet with tap water throughout the study period, and stayed healthy. The remaining 115 mice were initially fed a high-calorie diet (HCD) consisting of a high-fat feed (60% of energy from fat) with 10% fructose in tap water, served ad libitum over a period of 4 months to induce MetS (the MetS induction phase). Mice were then randomly divided into six treatment groups and a control group, all of which received a low-calorie diet (LCD), but with a different kind of drinking water, for 2 months (the treatment phase). Five groups were each treated with a different kind of NMW, one group by alternating the five NMWs, and one group – the control group – was given tap water. Body weight and blood biochemistry were monitored over the 6-month trial. After 4 months, male and female mice on HCD developed obesity, hypercholesterolaemia and hyperglycaemia, although gains in body weight, total cholesterol, and blood glucose in males were greater than those observed in females (P < 0.0001). When combined with an LCD, the NMWs rich in sulphate, magnesium and bicarbonate, and the minimally mineralised one were the most effective in reducing the blood levels of total cholesterol, high-density lipoprotein (HDL) cholesterol, and glucose. Sex differences emerged during both the MetS induction phase and the treatment phase. These results suggest that NMWs rich in specific macronutrients, such as bicarbonate, sulphate and magnesium, and minimally mineralised water, in combination with an LCD, may contribute to controlling blood lipid and glucose levels in subjects with MetS. Further studies are needed to confirm these results and to extend them to humans.

Differences in health status of Slovak municipalities supplied with drinking water of different hardness values

This epidemiological study of ecological type deals with the analysis of relationship between drinking water hardness and health status of inhabitants of the Slovak Republic. This relationship was investigated in two groups of more than 50,000 inhabitants living in 53 different municipalities. The first group was supplied with drinking water with low hardness, and the second group was supplied with drinking water with increased hardness. The health status of the population of both groups was monitored by means of health indicators, which represented 15-year average values, for 1994-2008. We investigated four major causes of death, namely cardiovascular, oncological, gastrointestinal and respiratory tract mortality, and evaluated the average life expectancy. The health status of inhabitants supplied with drinking water with increased hardness was significantly better than the health status of people supplied with drinking water with low hardness. For example, the relative mortality for cardiovascular diseases, oncological diseases, digestive tract diseases and respiratory diseases was 56%, 62%, 128% and 121% higher in the population supplied with soft drinking water compared to the population supplied with hard water, respectively. In addition, life expectancy was more than 4.5 years higher in the population supplied with hard drinking water. Our observation confirms the findings of previous studies on relationship between the water hardness and human health.

Calcium daily intake and the efficacy of a training intervention on optimizing calcium supplementation therapy: A clinical audit

BACKGROUND AND AIMS

Calcium is an essential element for human health, with key roles in the prevention and therapy of multifactorial conditions. Calcium dietary intake is often insufficient in the general population. The aim of this study was to perform a clinical audit for general practitioners (GPs) to understand the efficacy of training intervention on doctors' awareness about dietary calcium and supplements.

METHODS AND RESULTS

General practice outpatients were enrolled (Before Clinical Audit, BCA) from the same sanitary district, and calcium dietary intake was evaluated with a validated questionnaire, also collecting information about the consumption of calcium and vitamin D supplements. Then, a training intervention with a frontal lesson and discussion with GPs involved was performed. After one month of this intervention, a second outpatient enrolment was performed (Post Clinical Audit, PCA) in the same general practices to evaluate differences in nutritional suggestions and supplement prescription by GPs. In BCA, the calcium dietary intake was low, with nobody reaching 1000 mg as suggested by the guidelines. Only 6.6% and 24.5% took calcium and vitamin D supplements, respectively; in the PCA, these percentages increased to 28% and 78% for calcium and vitamin D supplements, respectively (p < 0.01 PCA vs BCA). There were no differences in calcium dietary intake between BCA and PCA.

CONCLUSION

Training intervention on GPs was successful to sensitize them regarding calcium intake problems; GPs tended to increase the prescription of supplements but not to suggest changes in dietary habits.

Eight Days of Water-Only Fasting Promotes Favorable Changes in the Functioning of the Urogenital System of Middle-Aged Healthy Men

The aim of this study was to determine whether, after 8 days of water-only fasting, there are changes in the efficiency of the lower urinary tract, the concentration of sex hormones, and the symptoms of prostate diseases in a group of middle-aged men (n = 14). For this purpose, before and after 8 days of water-only fasting (subjects drank ad libitum moderately mineralized water), and the following somatic and blood concentration measurements were made: total prostate specific antigen (PSA-T), free prostate specific antigen (PSA-F), follicle stimulating hormone (FSH), luteotropic hormone (LH), prolactin (Pr), total testosterone (T-T), free testosterone (T-F), dehydroepiandrosterone (DHEA), sex hormone globulin binding (SHGB), total cholesterol (Ch-T), β-hydroxybutyrate (β-HB). In addition, prostate volume (PV), volume of each testis (TV), total volume of both testes (TTV), maximal urinary flow rate (Qmax), and International Prostate Symptom Score (IPSS) values were determined. The results showed that after 8 days of water-only fasting, Qmax and IPSS improved but PV and TTV decreased significantly. There was also a decrease in blood levels of PSA-T, FSH, P, T-T, T-F, and DHEA, but SHGB concentration increased significantly. These results indicate that 8 days of water-only fasting improved lower urinary tract functions without negative health effects.

Proposal of New Health Risk Assessment Method for Deficient Essential Elements in Drinking Water-Case Study of the Slovak Republic

The US EPA health risk assessment method is currently widely used to assess human health risks for many environmental constituents. It is used for risk assessment from the exposure to various contaminants exceeding tolerable or safe reference doses, determined e.g., for drinking water, soil, air and food. It accepts widely that excess contents of non-essential elements (e.g., As, Pb or Sb) in environmental compartments represent a general risk to human health. However, contrary to toxic trace elements, deficient contents of essential (biogenic) elements e.g., F, I, Se, Zn, Fe, Ca or Mg may represent even higher health risk. Therefore, we propose to extend the human health risk assessment by calculating the health risk for deficient content and intake of essential elements, and to introduce the terms Average Daily Missing Dose (ADMD), Average Daily Required Dose (ADRD) and Average Daily Accepted Dose (ADAD). We propose the following equation to calculate the Hazard Quotient (HQ) of health risk from deficient elements: HQd = ADRD/ADAD. At present, there are no reference concentrations or doses of essential elements in each environmental compartment in world databases (Integrated Risk Information System IRIS, The Risk Assessment Information System RAIS). ADRD and ADMD can be derived from different regulatory standards or guidelines (if they exist) or calculated from actual regional data on the state of population health and content of essential elements in the environment, e.g., in groundwater or soil. This methodology was elaborated and tested on inhabitants of the Slovak Republic supplied with soft drinking water with an average Mg content of 5.66 mg·L-1. The calculated ADMD of Mg for these inhabitants is 0.314 mg·kg-1·day-1 and HQd is equal to 2.94, indicating medium risk of chronic diseases. This method extending traditional health risk assessment is the first attempt to quantify deficient content of essential elements in drinking water. It still has some limitations but also has potential to be further developed and refined through its testing in other countries.

Metabolic Syndrome Features: Is There a Modulation Role by Mineral Water Consumption? A Review

Metabolic syndrome (MetSyn) promotes, among others, the development of atherosclerotic cardiovascular disease and diabetes. Its prevalence increases with age, highlighting the relevance of promoting precocious MetSyn primary prevention and treatment with easy-to-implement lifestyle interventions. MetSyn features modulation through mineral water consumption was reviewed on Pubmed, Scopus and Google Scholar databases, using the following keywords: metabolic syndrome, hypertension, blood pressure (BP), cholesterol, triglycerides, apolipoprotein, chylomicron, very low-density lipoprotein, low-density lipoprotein, high-density lipoprotein (HDL), glucose, insulin, body weight, body mass index, waist circumference (WC), obesity and mineral(-rich) water. Twenty studies were selected: 12 evaluated BP, 13 assessed total-triglycerides and/or HDL-cholesterol, 10 analysed glucose and/or 3 measured WC. Mineral waters were tested in diverse protocols regarding type and composition of water, amount consumed, diet and type and duration of the study. Human and animal studies were performed in populations with different sizes and characteristics. Distinct sets of five studies showed beneficial effects upon BP, total-triglycerides, HDL-cholesterol and glucose. WC modulation was not reported. Minerals/elements and active ions/molecules present in mineral waters (and their pH) are crucial to counterbalance their inadequate intake and body status as well as metabolic dysfunction and increased diet-induced acid-load observed in MetSyn. Study characteristics and molecular/physiologic mechanisms that could explain the different effects observed are discussed. Further studies are warranted for determining the mechanisms involved in the putative protective action of mineral water consumption against MetSyn features.

Calcium Intake in Bone Health: A Focus on Calcium-Rich Mineral Waters

Calcium is an essential element that plays numerous biological functions in the human body, of which one of the most important is skeleton mineralization. Bone is a mineralized connective tissue in which calcium represents the major component, conferring bone strength and structure. Proper dietary calcium intake is important for bone development and metabolism, and its requirement can vary throughout life. The mineral composition of drinking water is becoming relevant in the modulation of calcium homeostasis. In fact, calcium present in mineral drinking waters is an important quantitative source of calcium intake. This, together with its excellent bioavailability, contributes to the maintenance of the bone health. This article aims to examine studies that assessed the bioavailability of the calcium contained in calcium-rich mineral waters and their impact on bone health, including original data collected in a recent study in humans.

Calcium Bioavailability from Mineral Waters with Different Mineralization in Comparison to Milk and a Supplement

OBJECTIVE

The aim of the present study was to compare the bioavailability of calcium from 3 mineral waters with different concentrations of minerals with that of milk and a calcium supplement.

METHODS

A single-center, randomized controlled trial with a crossover design with 21 healthy men and women was conducted at the Institute of Food Science and Human Nutrition, Leibniz University Hannover. The participants consumed the 5 test products providing 300 mg of calcium each on 5 examination days with 1-week wash-out phases in between. Primary outcome variables were the area under the curve of serum calcium levels for 10-hour (AUC_0-10h) and 24-hour urinary calcium excretion.

RESULTS

In all groups, no significant differences in the AUC_0-10h of serum calcium levels as well as in the 24-hour urinary calcium excretion were observed. Likewise, mean changes in serum phosphate and urinary phosphate, as well as serum parathormone, showed no differences between the groups.

CONCLUSION

Given an equivalent bioavailability of calcium in all test products, neither a high concentration of SO₄^2- or of HCO₃ influenced the bioavailability of calcium. Accordingly, the use of mineral water with high concentrations of calcium constitutes a calorie-free calcium source that can improve calcium supply.

Natural mineral waters: chemical characteristics and health effects

Water contributes significantly to health and a daily intake of 1.5 to 2 liters of water should be guaranteed, because a good hydration is essential to maintain the body water equilibrium, although needs may vary among people. However, worldwide population is far from the Recommended Allowance for water intake. Among the waters for human uses, there are 'waters (treated or not), intended for drinking, used for the food and beverages preparation or for other domestic purposes' and natural mineral waters, that are 'originated from an aquifer or underground reservoir, spring from one or more natural or bore sources and have specific hygienic features and, eventually, healthy properties'. According to the European Legislation (2009/54/EC Directive), physical and chemical characterization is used to make a classification of the different mineral waters, basing on the analysis of main parameters. Mineral composition enables to classify natural mineral waters as bicarbonate mineral waters, sulphate mineral waters, chloride mineral waters, calcic mineral waters, magnesiac mineral waters, fluorurate mineral waters, ferrous mineral waters and sodium-rich mineral waters. Although the concerns about bottled mineral waters (due to plasticizers and endocrine disruptors), many are the health effects of natural mineral waters and several studies explored their properties and their role in different physiological and pathological conditions.

Interventions to prevent and treat corticosteroid-induced osteoporosis and prevent osteoporotic fractures in Duchenne muscular dystrophy

BACKGROUND

Corticosteroid treatment is considered the 'gold standard' for Duchenne muscular dystrophy (DMD); however, it is also known to induce osteoporosis and thus increase the risk of vertebral fragility fractures. Good practice in the care of those with DMD requires prevention of these adverse effects. Treatments to increase bone mineral density include bisphosphonates and vitamin D and calcium supplements, and in adolescents with pubertal delay, testosterone. Bone health management is an important part of lifelong care for patients with DMD.

OBJECTIVES

To assess the effects of interventions to prevent or treat osteoporosis in children and adults with DMD taking long-term corticosteroids; to assess the effects of these interventions on the frequency of vertebral fragility fractures and long-bone fractures, and on quality of life; and to assess adverse events.

SEARCH METHODS

On 12 September 2016, we searched the Cochrane Neuromuscular Specialised Register, CENTRAL, MEDLINE, Embase, and CINAHL Plus to identify potentially eligible trials. We also searched the Web of Science ISI Proceedings (2001 to September 2016) and three clinical trials registries to identify unpublished studies and ongoing trials. We contacted correspondence authors of the included studies in the review to obtain information on unpublished studies or work in progress.

SELECTION CRITERIA

We considered for inclusion in the review randomised controlled trials (RCTs) and quasi-RCTs involving any bone health intervention for corticosteroid-induced osteoporosis and fragility fractures in children, adolescents, and adults with a confirmed diagnosis of DMD. The interventions might have included oral and intravenous bisphosphonates, vitamin D supplements, calcium supplements, dietary calcium, testosterone, and weight-bearing activity.

DATA COLLECTION AND ANALYSIS

Two review authors independently assessed reports and selected potential studies for inclusion, following standard Cochrane methodology. We contacted study authors to obtain further information for clarification on published work, unpublished studies, and work in progress.

MAIN RESULTS

We identified 18 potential studies, of which two, currently reported only as abstracts, met the inclusion criteria for this review. Too little information was available for us to present full results or adequately assess risk of bias. The participants were children aged five to 15 years with DMD, ambulant and non-ambulant. The interventions were risedronate versus no treatment in one trial (13 participants) and whole-body vibration versus a placebo device in the second (21 participants). Both studies reported improved bone mineral density with the active treatments, with no improvement in the control groups, but the abstracts did not compare treatment and control conditions. All children tolerated whole-body vibration treatment. No study provided information on adverse events. Two studies are ongoing: one investigating whole-body vibration, the other investigating zoledronic acid.

AUTHORS' CONCLUSIONS

We know of no high-quality evidence from RCTs to guide use of treatments to prevent or treat corticosteroid-induced osteoporosis and reduce the risk of fragility fractures in children and adults with DMD; only limited results from two trials reported in abstracts were available. We await formal trial reports. Findings from two ongoing relevant studies and two trials, for which only abstracts are available, will be important in future updates of this review.

Types and characteristics of drinking water for hydration in the elderly

The role of hydration in the maintenance of health is increasingly recognized. Hydration requirements vary for each person, depending on physical activity, environmental conditions, dietary patterns, alcohol intake, health problems, and age. Elderly individuals have higher risk of developing dehydration than adults. Diminution of liquid intake and increase in liquid losses are both involved in causing dehydration in the elderly. The water used for drinking is provided through regular public water supply and the official sanitary controls ensure their quality and hygiene, granting a range of variation for most of its physical and chemical characteristics, being sometimes these differences, though apparently small, responsible for some disorders in sensitive individuals. Hence, the advantages of using bottled water, either natural mineral water or spring water, are required by law to specify their composition, their major components, and other specific parameters. It is essential to take this into account to understand the diversity of indications and favorable effects on health that certain waters can offer.

The effect of probiotics (Lactobacillus rhamnosus HN001, Lactobacillus paracasei LPC-37, and Lactobacillus acidophilus NCFM) on the availability of minerals from Dutch-type cheese

The use of probiotic cultures in the production of Dutch-type cheeses did not lead to significant changes in their chemical composition but it lowered their acidity. The availability of calcium and magnesium analyzed by in vitro enzymatic hydrolysis was 19 and 35%, respectively; the availability of phosphorus was significantly higher, at >90%. The use of probiotic cultures significantly increased the availability of calcium (~2.5%), phosphorus (~6%), and magnesium (~18%). The in vitro method supports accurate determination of the effect of the Lactobacillus spp. cultures on the availability of mineral compounds ingested with Dutch-type cheese.

Relevance of a Hypersaline Sodium-Rich Naturally Sparkling Mineral Water to the Protection against Metabolic Syndrome Induction in Fructose-Fed Sprague-Dawley Rats: A Biochemical, Metabolic, and Redox Approach

The Metabolic Syndrome increases the risk for atherosclerotic cardiovascular disease and type 2 Diabetes Mellitus. Increased fructose consumption and/or mineral deficiency have been associated with Metabolic Syndrome development. This study aimed to investigate the effects of 8 weeks consumption of a hypersaline sodium-rich naturally sparkling mineral water on 10% fructose-fed Sprague-Dawley rats (Metabolic Syndrome animal model). The ingestion of the mineral water (rich in sodium bicarbonate and with higher potassium, calcium, and magnesium content than the tap water used as control) reduced/prevented not only the fructose-induced increase of heart rate, plasma triacylglycerols, insulin and leptin levels, hepatic catalase activity, and organ weight to body weight ratios (for liver and both kidneys) but also the decrease of hepatic glutathione peroxidase activity and oxidized glutathione content. This mineral-rich water seems to have potential to prevent Metabolic Syndrome induction by fructose. We hypothesize that its regular intake in the context of modern diets, which have a general acidic character interfering with mineral homeostasis and are poor in micronutrients, namely potassium, calcium, and magnesium, could add surplus value and attenuate imbalances, thus contributing to metabolic and redox health and, consequently, decreasing the risk for atherosclerotic cardiovascular disease.

Acute Calcium Assimilation from Fresh or Pasteurized Yoghurt Depending on the Lactose Digestibility Status

OBJECTIVE

The major aim of this trial was to evaluate the potential interaction of fresh or pasteurized yoghurt intake with lactose intolerance on calcium assimilation by means of the stable isotope 43Ca as a tracer.

METHODS

Forty volunteers (age: 32 +/- 7 years) participated in this parallel simple blind study (20 of them with moderate lactose intolerance). The protocol included the intake of a test meal consisting on 43Ca-labelled fresh or pasteurized yoghurt. Volunteers, in whom the calcium status was assessed, collected the 24-h urine before and after the test meal to measure the stable isotope output. The intake-related 43Ca enrichment in urine was measured by isotopic rate mass spectrometry.

RESULTS

In lactose tolerant and intolerant volunteers taken together, the fresh yoghurt consumption resulted in a statistically higher circulating calcium levels (p = 0.028) and urinary 43Ca output (p = 0.017) than after the pasteurized yoghurt intake. The lactose maldigestion status resulted in higher urinary 43Ca excretion (p = 0.013) after the fermented milk consumption, regardless of the nature of ingested product (p = 0.887).

CONCLUSIONS

This novel and non-aggressive protocol allowed the in vivo comparison of calcium utilization from two different dairy sources, revealing a higher acute calcium assimilation from fresh as compared to the pasteurized yoghurt, in both lactose digesting and maldigesting subjects.

Higher calcium urinary loss induced by a calcium sulphate-rich mineral water intake than by milk in young women

It is well known that the intestinal availability of Ca from Ca-rich mineral waters is equivalent to that of milk Ca. However, the effect of associated anions on Ca urinary loss needs to be addressed. The aim of the current study was to compare, under ordinary conditions of consumption, milk and a SO4-rich mineral water as the Ca provider in a large number of subjects consuming the same quantity of Ca from the two sources in a crossover study lasting for an extended period. Thirty-seven healthy women completed a 12-week protocol, divided into four periods of 3 weeks (W). In the first (W1-3) and third (W6-9) periods, dietary Ca intake was restricted to 600 mg/d. In the second (W4-6) and final (W10-12) periods, either 400 ml/d medium-fat milk or 1 litre of a Ca- and SO4-rich mineral water, each providing about 480 mg Ca/d, was added to the diet in a random manner. Dietary evaluation, blood and urinary measures were performed during the last week (W6 and W12) of each Ca supplementation period. The urinary excretion of Ca was higher (0.5 mmol/d more) with water than with milk (P<0.001). An examination of all the dietary factors known to influence calciuria suggested that the acidogenic action of SO4 was responsible for this increased calciuria. Thus, despite an equal Ca intake and assuming an unchanged intestinal absorption, these results suggest that Ca balance is better with milk consumption than with CaSO4-rich water.