Calcium and magnesium in drinking water and risk of death from colon cancer

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.

Association between exposure to desalinated sea water and ischemic heart disease, diabetes mellitus and colorectal cancer; A population-based study in Israel

BACKGROUND

Drinking water (DW) is an important dietary source of magnesium. Recently, Israel has increased its use of desalinated seawater (DSW) as DW country-wide. Its negligible magnesium content, however, raises concern that consumption of DSW may be associated with hypomagnesemia and increase the risk of ischemic heart disease (IHD), diabetes mellitus (DM), and colorectal cancer (CRC).

OBJECTIVES

We tested whether there was a change in incidence of negative health outcomes (IHD, DM, and CRC) following the introduction of DSW supply in a population-based ecologic study in Israel.

METHODS

A historical prospective analysis was applied to members aged 25-76 during 2004-2013 of Clalit Health Services (Clalit), the largest healthcare provider in Israel, using its electronic medical record database. Multivariable analyses were adjusted for age, sex, socioeconomic status, smoking status, and body mass index.

RESULTS

An increased odds ratio was found for IHD (0.96, 95% CI 0.93-0.99 at baseline and 1.06, 95% CI 1.02-1.11 at the end of the follow-up period), but no time trend was observed.

CONCLUSIONS

We found that the risk for IHD increased during the study period. The risks for DM and CRC were unchanged. Long term studies are needed for assessing the risk for CRC due to the long latency. The higher risk for IHD has practical public health implications and raise the need to add magnesium to DSW.

Impact of Calcium and Magnesium in Groundwater and Drinking Water on the Health of Inhabitants of the Slovak Republic

This work aims to evaluate the impact of the chemical composition of groundwater/drinking water on the health of inhabitants of the Slovak Republic. Primary data consists of 20,339 chemical analyses of groundwater (34 chemical elements and compounds) and data on the health of the Slovak population expressed in the form of health indicators (HI). Fourteen HIs were evaluated including life expectancy, potential years of lost life, relative/standardized mortality for cardiovascular and oncological diseases, and diseases of the gastrointestinal and respiratory systems. The chemical and health data were expressed as the mean values for each of the 2883 Slovak municipalities. Artificial neural network (ANN) was the method used for environmental and health data analysis. The most significant relationship between HI and chemical composition of groundwater was documented as Ca + Mg (mmol·L⁻¹), Ca and Mg. The following limit values were set for these most significant groundwater chemical parameters: Ca + Mg 2.9–6.1 mmol·L⁻¹, Ca 78–155 mg·L⁻¹ and Mg 28–54 mg·L⁻¹. At these concentration ranges, the health of the Slovak population is the most favorable and the life expectancy is the highest. These limit values are about twice as high in comparison to the current Slovak valid guideline values for drinking water.

Chemical composition of groundwater/drinking water and oncological disease mortality in Slovak Republic

This study deals with the analysis of relationship between chemical composition of the groundwater/drinking water and the data on mortality from oncological diseases (MOD) in the Slovak Republic. Primary data consist of the Slovak national database of groundwater analyses (20,339 chemical analyses, 34 chemical elements/compounds) and data on MOD (17 health indicators) collected for the 10-year period (1994-2003). The chemical and health data were unified in the same form and expressed as the mean values for each of 2883 municipalities within the Slovak Republic. Pearson and Spearman correlation as well as artificial neural network (ANN) methods were used for analysis of the relationship between chemical composition of groundwater/drinking water and MOD. The most significant chemical elements having influence on MOD were identified together with their limit values (limit and optimal contents). Based on the results of calculations, made through the neural networks, the following eight chemical elements/parameters in the groundwater were defined as the most significant for MOD: Ca + Mg (mmol l^-1), Ca, Mg, TDS, Cl, HCO₃, SO₄ and NO₃. The results document the highest relationship between MOD and groundwater contents of Ca + Mg (mmol l^-1), Ca and Mg. We observe increased MOD with low (deficit) contents of these three parameters of groundwater/drinking water. The following limit values were set for the most significant groundwater chemicals/parameters: Ca + Mg 1.73-5.85 mmol l^-1, Ca 60.5-196.8 mg l^-1 and Mg 25.6-35.8 mg l^-1. At these concentration ranges, the mortality for oncological diseases in the Slovak Republic is at the lowest levels. These limit values are about twice higher in comparison with the current Slovak valid guideline values for the drinking water.

Potential health impacts of consuming desalinated bottled water

This study compared physicochemical properties, anion and carbon content and major and trace elements in desalinated and non-desalinated bottled water available in Qatar, and assessed the potential health risks associated with prolonged consumption of desalinated water. Results indicate that Qatar's population is not at elevated risk of dietary exposure to As (mean = 666 ng/L), Ba (48.0 μg/L), Be (9.27 ng/L), Cd (20.1 ng/L), Cr (874 ng/L), Pb (258 ng/L), Sb (475 ng/L) and U (533 ng/L) from consumption of both desalinated and non-desalinated bottled water types available in the country. Consumers who primarily consume desalinated water brands further minimize risk of exposure to heavy metals as levels were significantly lower than in non-desalinated bottled water. Desalinated bottled water was not a significant contributor to recommended daily intakes for Ca, Mg and F(-) for adults and children and may increase risk of deficiencies. Desalinated bottled water accounted for only 3% of the Institute of Medicine (IOM) adequate intake (AI) for Ca, 5-6% of the recommended daily allowance for Mg and 4% of the AI for F among adults. For children desalinated water contributed 2-3% of the IOM AICa, 3-10% of the RDA(Mg) and 3-9% of the AIF.

Nonlinear association between magnesium intake and the risk of colorectal cancer

OBJECTIVES

The association between dietary magnesium intake and the risk of colorectal cancer has been examined by many prospective studies, but remains controversial because of inconsistent results. We aimed to carry out a meta-analysis to investigate this.

MATERIALS AND METHODS

We assessed this association with categorical and dose-response meta-analysis of data from prospective cohort studies. Relevant studies were identified by searching MEDLINE, EMBASE, and OVID for studies published before 9 June 2012, with no restrictions. Relative risks (RRs) and 95% confidence intervals (CIs) for the highest versus lowest and dose-response association were estimated using random-effects models. Heterogeneity and publication bias was investigated, and subgroup, sensitivity, and meta-regression analyses were carried out.

RESULTS

The analysis included 333 510 participants with 7435 colorectal cancers from seven prospective cohort studies. The summary RR for the highest versus the lowest intake of dietary magnesium was 0.81 (95% CI: 0.70-0.92) for colorectal cancer, 0.76 (95% CI: 0.64-0.88) for colon cancer, and 0.82 (95% CI: 0.58-1.06) for rectal cancer. For men and women, the pooled RR was 0.76 (95% CI: 0.51-1.01) and 0.81 (95% CI: 0.68-0.94), respectively. Significant inverse associations of colorectal cancer and dietary magnesium emerged in nonlinear models (p nonlinearity=0.03). The greatest risk reduction was observed when dietary magnesium intake increased from very low levels.

CONCLUSION

Dietary magnesium intake has a statistically significant nonlinear inverse association with the risk of colorectal cancer. The greatest reduction for magnesium intake is 200-270 mg/day. Whether the association is causal or because of confounding warrants further investigation.

Magnesium in drinking water modifies the association between nitrate ingestion and risk of death from esophageal cancer

The objective of this study was to explore whether magnesium (Mg) levels in drinking water modified the effects of nitrate on esophageal cancer risk occurrence. A matched cancer case-control study was used to investigate the relationship between the risk of death from esophageal cancer and exposure to nitrate in drinking water in Taiwan. All esophageal cancer deaths of Taiwan residents from 2006 through 2010 were obtained from the Bureau of Vital Statistics of the Taiwan Provincial Department of Health. Controls were deaths from other causes and were pair-matched to cancer cases by gender, year of birth, and year of death. Information on the levels of nitrate-nitrogen (NO(3)-N) and Mg in drinking water were collected from Taiwan Water Supply Corporation (TWSC). The municipality of residence for cancer cases and controls was presumed to be the source of the subject's NO(3)-N and Mg exposure via drinking water. Evidence of an interaction was noted between drinking water NO(3)-N and Mg intake. This is the first study to report effect modification by Mg intake originating from drinking water on an association between NO(3)-N exposure and increased risk mortality attributed to esophageal cancer.

Magnesium in drinking water modifies the association between trihalomethanes and the risk of death from colon cancer

The objectives of this study were to (1) examine the relationship between total trihalomethanes (TTHM) levels in public water supplies and death attributed to colon cancer and (2) determine whether magnesium (Mg) levels in drinking water modify the effects of TTHM on risk of colon cancer development. A matched case-control study was used to investigate the relationship between the risk of death attributed to colon cancer and exposure to total trihalomethanes (TTHM) in drinking water in 53 municipalities in Taiwan. All colon cancer deaths of the 53 municipalities from 1998 through 2007 were obtained from the Bureau of Vital Statistics of the Taiwan Provincial Department of Health. Controls were deaths from other causes and were pair-matched to the cancer cases by gender, year of birth, and year of death. Each matched control was selected randomly from the set of possible controls for each cancer case. Data on TTHM levels in drinking water were collected from Taiwan Environmental Protection Administration. Information on the levels of Mg in drinking water was obtained from the Taiwan Water Supply Corporation. The municipality of residence for cancer cases and controls was presumed to be the source of the subject's TTHM and Mg exposure via drinking water. Relative to individuals whose TTHM exposure levels were <4.9 ppb, the adjusted odds ration (OR) (with 95% confidence interval [CI]) for colon cancer was 1.14 (1.01-1.28) for individuals who had resided in municipalities served by drinking water with a TTHM exposure≥4.9 ppb. Evidence of an interaction between drinking-water TTHM and Mg intake via drinking water was noted. This is the first study to report an effect modification by Mg intake from drinking water in association between TTHM exposure and risk of colon cancer occurrence. Better knowledge of this modifying factor will help in public policymaking and setting health standards.

Calcium and magnesium in drinking water and risk of death from kidney cancer

The possible association between the risk of kidney cancer development and the levels of calcium and magnesium in drinking water from municipal supplies was investigated in a matched cancer case-control study in Taiwan. All eligible kidney cancer deaths (1778 cases) of Taiwan residents from 1999 through 2008 were compared with deaths from other causes (1778 controls), and the levels of calcium and magnesium in drinking water of these residents were determined. Data on calcium and magnesium levels in drinking water throughout Taiwan were obtained from the Taiwan Water Supply Corporation (TWSC). The control group consisted of individuals who died from other causes, and the controls were pair-matched to the cancer cases by gender, year of birth, and year of death. The adjusted odd ratios for death attributed to kidney cancer for individuals with higher calcium levels in their drinking water, as compared to the lowest tertile, were 0.89 (95% CI = 0.72-1.11) and 0.78 (95% CI = 0.62-0.98), respectively. The adjusted odd ratios were not statistically significant for the relationship between magnesium levels in drinking water and kidney cancer development. The results of the present study demonstrate that there may be a significant protective effect of calcium intake from drinking water against the risk of death due to kidney cancer.

Nitrates in drinking water and the risk of death from brain cancer: does hardness in drinking water matter?

The objectives of this study were to (1) examine the relationship between nitrate levels in public water supplies and risk of death from brain cancer and (2) determine whether calcium (Ca) and magnesium (Mg) levels in drinking water might modify the influence of nitrates on development of brain cancer. A matched cancer case-control study was used to investigate the relationship between the risk of death from brain cancer and exposure to nitrates in drinking water in Taiwan. All brain cancer deaths of Taiwan residents from 2003 through 2008 were obtained from the Bureau of Vital Statistics of the Taiwan Provincial Department of Health. Controls were deaths from other causes and were pair-matched to cancer cases by gender, year of birth, and year of death. Information on the levels of nitrate-nitrogen (NO₃-N), Ca, and Mg in drinking water was obtained from Taiwan Water Supply Corporation (TWSC). The municipality of residence for cancer cases and controls was presumed to be the source of the subject's NO₃-N, Ca, and Mg exposure via drinking water. Relative to individuals whose NO₃-N exposure level was <0.38 ppm, the adjusted OR (95% CI) for brain cancer occurrence was 1.04 (0.85-1.27) for individuals who resided in municipalities served by drinking water with a NO₃-N exposure ≥ 0.38 ppm. No marked effect modification was observed due to Ca and Mg intake via drinking water on brain cancer occurrence.

Calcium availability from yogurt by itself or yogurt-cereal-containing products

Dairy products are the basic source of calcium (Ca) for many nations. The aim of this study was to determine the influence of addition of cereal products to yogurt on the ability of subsequent release of Ca present in yogurt. This was conducted in vitro by the process of enzymatic digestion simulating digestion in the human gastrointestinal tract (GIT). Calcium content was determined in commercial yogurts containing cereal and in yogurt meals with subsequent addition of cereal products or bread. Only 3 samples contained more Ca than 100 mg/100 g. Only about 45% (from 28.5 to 77.9%) of Ca was released from the samples with cereals. Innovations in yogurt production technologies actually result in less Ca being released to humans, which may be a problem for individuals with low daily Ca intake.

Does calcium in drinking water modify the association between trihalomethanes and the risk of death from colon cancer?

The objectives of this study were (1) to examine the relationship between total trihalomethanes (TTHM) levels in public water supplies and mortality attributed to colon cancer and (2) to determine whether calcium levels (Ca) in drinking water modify the effects of TTHM on risk to develop colon cancer. A matched cancer case-control study was used to investigate the relationship between the risk of death attributed to colon cancer and exposure to TTHM in drinking water in 53 municipalities in Taiwan. All colon cancer deaths in the 53 municipalities from 1998 through 2007 were obtained from the Bureau of Vital Statistics of the Taiwan Provincial Department of Health. Controls were deaths from other causes and were pair-matched to the cancer cases by gender, year of birth, and year of death. Each matched control was selected randomly from the set of possible controls for each cancer case. Data on TTHM levels in drinking water were collected from the Taiwan Environmental Protection Administration. Information on the levels of Ca in drinking water was obtained from the Taiwan Water Supply Corporation. The municipality of residence for cancer cases and controls was presumed to be the source of the subject's TTHM and Ca exposure via drinking water. Relative to individuals whose TTHM exposure level was <4.9 ppb, the adjusted OR (95% CI) for colon cancer was 1.14 (1.01-1.28) for individuals who resided in municipalities served by drinking water with a TTHM exposure > or =4.9 ppb. Data demonstrated evidence of an interaction between drinking-water TTHM concentrations and Ca intake via drinking water. Our findings showed that the correlation between TTHM exposure and risk of colon cancer development is influenced by Ca in drinking water. Increased knowledge of the interaction between Ca and TTHM in reducing colon cancer risk will aid in public policymaking and standard setting.

Nitrates in drinking water and the risk of death from rectal cancer: does hardness in drinking water matter?

The objectives of this study were to (1) examine the relationship between nitrate levels in public water supplies and increased risk of death from rectal cancer and (2) determine whether calcium (Ca) and magnesium (Mg) levels in drinking water might modify the effects of nitrate on development of rectal cancer. A matched case-control study was used to investigate the relationship between the risk of death from rectal cancer and exposure to nitrate in drinking water in Taiwan. All rectal cancer deaths of Taiwan residents from 2003 through 2007 were obtained from the Bureau of Vital Statistics of the Taiwan Provincial Department of Health. Controls were deaths from other causes and were pair-matched to the cases by gender, year of birth, and year of death. Information on the levels of nitrate-nitrogen (NO(3)-N), Ca, and Mg in drinking water was collected from Taiwan Water Supply Corporation (TWSC). The municipality of residence for cancer cases and controls was presumed to be the source of the subject's NO(3)-N, Ca, and Mg exposure via drinking water. Relative to individuals whose NO(3)-N exposure level was <0.38 ppm, the adjusted odds ratio (OR) (95% CI) for rectal cancer occurrence was 1.15 (1.01-1.32) for individuals who resided in municipalities served by drinking water with a NO(3)-N exposure > or =0.38 ppm. There was no apparent evidence of an interaction between drinking water NO(3)-N levels with low Mg intake via drinking water. However, evidence of a significant interaction was noted between drinking-water NO(3)-N concentrations and Ca intake via drinking water. Our findings showed that the correlation between NO(3)-N exposure and risk of rectal cancer development was influenced by Ca in drinking water. This is the first study to report effect modification by Ca intake from drinking water on the association between NO(3)-N exposure and risk of rectal cancer occurrence. Increased knowledge of the mechanistic interaction between Ca and NO(3)-N in reducing rectal cancer risk will aid in public policymaking and setting threshold standards.

Nitrate in drinking water and risk of death from colon cancer in Taiwan

The relationship between nitrate levels in drinking water and colon cancer has been inconclusive. A matched case-control and a nitrate ecology study were used to investigate the association between colon cancer mortality and nitrate exposure from Taiwan's drinking water. All colon cancer deaths of Taiwan residents from 1999 through 2003 were obtained from the Bureau of Vital Statistics of the Taiwan Provincial Department of Health. Controls were deaths from other causes and were pair matched to the cases by sex, year-of-birth, and year-of-death. Each matched control was selected randomly from the set of possible controls for each case. Data on nitrate-nitrogen (NO3-N) level of drinking water throughout Taiwan have been collected from Taiwan Water Supply Corporation (TWSC). The municipality of residence for cases and controls was assumed to be the source of the subject's nitrate exposure via drinking water. The adjusted odds ratios for colon cancer death for those with high NO3-N levels in their drinking water, as compared to the lowest tertile, were 0.98 (0.84-1.14) and 0.98 (0.83-1.16), respectively. The results of the present study show that there was no statistically significant association between NO3-N in drinking water at levels in this study and risk of death from colon cancer.

Calcium and magnesium in drinking water and risk of death from acute myocardial infarction in Taiwan

Many studies have examined the association between cardiovascular disease mortality and water hardness. However, the results have not been consistent. This report examines whether calcium and magnesium in drinking water are protective against acute myocardial infarction (AMI). All eligible AMI deaths (10,094 cases) of Taiwan residents from 1994 to 2003 were compared with deaths from other causes (10,094 controls), and the levels of calcium and magnesium in drinking water of these residents were determined. Data on calcium and magnesium levels in drinking water throughout Taiwan have been obtained from the Taiwan Water Supply Corporation. The control group consisted of people who died from other causes and the controls were pair matched to the cases by sex, year of birth, and year of death. The adjusted odd ratios (95% confidence interval) were 0.79 (0.73-0.86) for the group with water calcium levels between 25.1 and 42.4 mg/L and 0.71 (0.65-0.77) for the group with calcium levels of 42.6 mg/L or more. After adjustment for calcium levels in drinking water, there was no difference between the groups with different levels of magnesium. The results of the present study show that there is a significant protective effect of calcium intake from drinking water on the risk of death from AMI.

Contribution of mineral waters to dietary calcium and magnesium intake in a French adult population

OBJECTIVE

To assess the contribution of mineral water containing different amounts of calcium and magnesium to the total dietary intakes of these minerals

DESIGN

Matched case control study using data issued from the Supplementation en Vitamines et Minéraux Antioxydants (SU.VI.MAX) cohort.

SUBJECTS

Subjects were water consumers-240 men and 424 women-divided into the following 4 groups (n=166 per group): regular drinkers of a calcium-rich and magnesium-rich mineral water (calcium, 486 mg/L; magnesium, 84 mg/ L), drinkers of a water classified as a moderately mineralized content (calcium, 202 mg/L; magnesium, 36 mg/L), drinkers of 2 low-mineralized waters (calcium, 9.9 to 67.6 mg/L and magnesium, 1.6 to 2 mg/L, respectively), and drinkers of tap waters.

STATISTICAL ANALYSES

Quantitative data were compared using student's t test. Mean comparisons were performed in multivariate analysis by analysis of variance.

RESULTS

Dietary calcium intake provided by the various food groups did not differ between the 4 consumer groups, except for calcium provided by mineral water. According to its calcium concentration, mineral water may contribute to one fourth of the total daily calcium intake. Subjects who regularly drink mineral-rich water have a calcium intake that is significantly higher (P< 10(-3)) than those drinking either low-mineral-content water or tap water. Dietary magnesium intake provided by the various food groups did not differ between the 4 consumer groups, except for magnesium provided by mineral water. Depending on the magnesium concentration of the mineral water, it contributed 6% to 17% of total daily magnesium intake. Drinkers of magnesium-rich mineral water and water with a moderate mineral content had magnesium intakes significantly (P< 10(-3)) higher than those of drinkers on low-mineralized or tap water.

APPLICATIONS

Mineral-rich water may provide an important supplementary contribution to total calcium and magnesium intake. For dietetics professionals, it may provide-in place of the usual recommendations concerning the consumption of dairy products-a good way to improve calcium and magnesium intakes, particularly in subjects who don't like dairy products.

Effects of lyophilized black raspberries on azoxymethane-induced colon cancer and 8-hydroxy-2'-deoxyguanosine levels in the Fischer 344 rat

This study examined the effects of lyophilized black raspberries (BRB) on azoxymethane (AOM)-induced aberrant crypt foci (ACF), colon tumors, and urinary 8-hydroxy-2'-deoxyguanosine (8-OHdG) levels in male Fischer 344 rats. AOM was injected (15 mg/kg body wt i.p.) once per week for 2 wk. At 24 h after the final injection, AOM-treated rats began consuming diets containing 0%, 2.5%, 5%, or 10% (wt/wt) BRB. Vehicle controls received 5% BRB or diet only. Rats were sacrificed after 9 and 33 wk of BRB feeding for ACF enumeration and tumor analysis. ACF multiplicity decreased 36%, 24%, and 21% (P < 0.01 for all groups) in the 2.5%, 5%, and 10% BRB groups, respectively, relative to the AOM-only group. Total tumor multiplicity declined 42%, 45%, and 71% (P < 0.05 for all groups). Although not significant, a decrease in tumor burden (28%, 42%, and 75%) was observed in all BRB groups. Adenocarcinoma multiplicity decreased 28%, 35%, and 80% (P < 0.01) in the same treatment groups. Urinary 8-OHdG levels were reduced by 73%, 81%, and 83% (P < 0.01 for all groups). These results indicate that BRB inhibit several measures of AOM-induced colon carcinogenesis and modulate an important marker of oxidative stress in the Fischer 344 rat.

Association of very low birth weight with calcium levels in drinking water

It has been hypothesized that calcium supplementation can reduce smooth muscle contractibility and tone and that this effect can be clinically manifested by a reduction in blood pressure and a reduction in the incidence of premature delivery. Calcium supplementation has been reported to reduce blood pressure in pregnant and nonpregnant women. We performed a study to examine the relationship between the levels of calcium in drinking water and the risk of delivering a child of very low birth weight (VLBW). The study population comprised 1781 women residing in 252 municipalities who had a first-parity singleton birth between January 1, 1993 and December 31, 1997 and for whom complete information on maternal age, education, gestational age, birth weight, and sex of the baby were available. Data on calcium levels were obtained from the Taiwan Water Supply Corporation. The results of our study provide evidence that there is significant protective effect of calcium intake from drinking water on the risk of delivering a VLBW baby. This is an important finding for the Taiwan water industry and human health.

Inhibitory effects of crude salts on the induction and development of colonic aberrant crypt foci in F-344 rats given azoxymethane

The present study was designed to investigate the modifying effects of dietary exposure to NaCl and four kinds of crude salts on the induction and development of aberrant crypt foci in Fischer 344 rats. A total of 57 male rats were divided into five groups at six weeks of age, and all were given weekly injections of azoxymethane (15 mg/kg body wt s.c.) for three weeks. Group 1 was fed a normal diet throughout the experiment as control group. Groups 2, 3, 4, and 5 were fed diets containing 4.4% pure NaCl, 4.4% cooking salt, 4.4% rock salt, and 4.4% beach salt, respectively, from one week before the first azoxymethane dosing. The mean numbers of aberrant crypt foci and aberrant crypts per colon were significantly lower in Groups 3-5 than in Group 1 (p < 0.01). The present results suggest that the other mineral components (e.g., calcium and magnesium) of these crude salts, rather than pure NaCl, may be chemopreventive agents for colonic tumorigenesis.

Trace element levels in drinking water and the incidence of colorectal cancer

We determined the levels of 15 elements in drinking water from 34 water treatment plants in Aomori Prefecture and studied how element levels relate to colorectal cancer incidence by district. Colorectal cancer incidence was calculated from the data of Aomori Colorectal Cancer Registry. Multiple regression analysis was performed by using age-adjusted incidences of rectal cancer and colon cancer by gender as object variables and each element level as an explanatory variable. The standardized partial regression coefficient was significant in gold (p < 0.01), magnesium (p < 0.01), selenium (p < 0.01) and tin (p < 0.05) for age-adjusted rectal cancer incidence in men as objective variable; in gold (p < 0.05), calcium (p < 0.01) and phosphorus (p < 0.01) with age-adjusted colon cancer incidence in men as the objective variable; and in sodium (p < 0.05), phosphorus (p < 0.05), tin (p < 0.05) and strontium (p < 0.01) with age-adjusted colon cancer incidence in women as the objective variable. These results confirm the need to further study trace elements in drinking water and food, and relationship to colorectal carcinogenesis.

Calcium and magnesium in drinking water and risk of death from rectal cancer

The possible association between the risk of rectal cancer and the levels of calcium and magnesium in drinking water from municipal supplies was investigated in a matched case-control study in Taiwan. All eligible rectal-cancer deaths (986 cases) of Taiwan residents from 1990 through 1994 were compared with a sample of deaths from other causes (986 controls), and the levels of calcium and magnesium in the drinking water of these residents were determined. Data on calcium and magnesium levels in drinking water throughout Taiwan were obtained from the Taiwan Water Supply Corporation (TWSC). The control group consisted of people who died from other causes, and the controls were pair-matched to the cases by gender, year of birth and year of death. Compared with those with calcium levels below 22.0 mg/liter, the adjusted odd ratios (95% confidence interval) were 0.72 (0.53-0.98) for the group with water calcium levels between 22.0 and 40.8 mg/liter and 0.63 (0.45-0.87) for the group with calcium levels of 40.9 mg/liter or more. The adjusted odd ratios were not statistically significant for the relationship between magnesium levels in drinking water and rectal cancer. The results of the present study show that there may be a significant protective effect of calcium intake from drinking water on the risk of rectal cancer.

Calcium, magnesium, and nitrate in drinking water and gastric cancer mortality

The possible association between the risk of gastric cancer and the levels of calcium, magnesium, and nitrate in drinking water from municipal supplies was investigated in a matched case-control study in Taiwan. Records of gastric cancer deaths among eligible residents in Taiwan from 1987 through 1991 were obtained from the Bureau of Vital Statistics of the Taiwan Provincial Department of Health. Controls were deaths from other causes and were pair-matched to the cases by sex, year-of-birth, and year-of-death. Each matched control was selected randomly from the set of possible controls for each case. Data on calcium, magnesium, and nitrate levels in drinking water throughout Taiwan were obtained from the Taiwan Water Supply Corporation. The municipality of residence of the cases and controls was assumed to be the source of the subject's calcium, magnesium, and nitrate exposure via drinking water. The subjects were divided into tertiles according to the levels of calcium, magnesium, and nitrate in their drinking water. The results of the present study show that there is a significant positive association between drinking water nitrate exposure and gastric cancer mortality. The present study also suggests that there was a significant protective effect of calcium intake from drinking water on the risk of gastric cancer. Magnesium also exerts a protective effect against gastric cancer, but only for the group with the highest levels.