Calcium and magnesium in drinking water and risk of death from cerebrovascular disease

The impacts of reduction in ambient fine particulate air pollution on natural-cause mortality in Taiwan

Many epidemiologic studies have reported an association between high concentrations of fine particulate matter (PM2.5) and increased mortality rates. Concurrently an association between decreased concentration of these airborne PM2.5 pollutants and a decline in mortality frequency was noted in certain investigations globally; however, only a very few of these studies were conducted in Asia. Taiwan was found to exhibit a 30% decline in ambient PM2.5 levels over the last 20 years. The aim of this ecological investigation was to examine the contribution of annual reductions in ambient PM2.5 to changes in age-standardized natural-cause mortality rates (ASRs) in 65 townships in Taiwan from 2006 to 2020 controlling for lung cancer mortality rate, physician density, and annual household income. Data demonstrated a 0.9/105 fall in adjusted ASR for every 10 ug/m3 reduction in mean annual PM2.5 level in Taiwan during this 14-year period, suggesting a significant association between reductions in ambient PM2.5 levels and decreases in natural-cause mortality rates.

Effects of long-term exposure to ambient fine particulate air pollution on all-cause mortality in Taiwan

According to the US Environmental Protection Agency's Integrated Science Assessment (ISA), there is a causal relationship between fine particulate matter (PM2.5) exposure and increased mortality rates. A similar association was also reported by the International Agency for Research on Cancer (IARC). While many studies are available on this relationship between PM exposure and elevated mortality frequency in Europe and North America, there are limited investigations in Asia. Thus, the aim of this study was to perform an ecological investigation to determine the relationship between exposure to ambient PM2.5 levels and all-cause mortality in 66 in Taiwan municipalities. To undertake this investigation, annual PM2.5 levels and age-standardized all-cause mortality rates were calculated for male and female residents of these areas from 2010 to 2020. Weighted-multiple regression analyses were used to obtain adjusted risk ratio (RR) controlling for possible confounding by urbanization level, physician density, and annual mean household income. Annual PM2.5 levels of each municipality were divided into tertiles. Data demonstrated that men residing in areas with intermediate tertile PM2.5 levels (21.06 to 27.29 µg/m3) and the highest tertiles levels (27.30-33.11 µg/m3) exhibited adjusted RRs of 1.06 (95% CI = 1.03-1.08) and 1.13 (95% CI = 1.10-1.16), respectively. Women in these locations displayed a similar risk, 1.03 (0.99-1.06) and 1.07 (1.04-1.11), respectively. These findings indicate that ambient exposure to PM2.5 increased risk for all-cause mortality rates in both men and women in Taiwan during this time period.

Health benefits of reducing ambient levels of fine particulate matter: a mortality impact assessment in Taiwan

While numerous studies have found a relationship between long-term exposure to airborne fine particulate matter (PM2.5) and higher risk of death, few investigations examined the contribution that a reduction of exposure to ambient PM2.5 levels might exert on mortality rates. This study aimed to collect data on changes in annual average ambient levels of PM2.5 from 2006 to 2020 and consequent health impact in public health in 65 municipalities in Taiwan. Avoidable premature mortality was used here as an indicator of adverse health impact or health benefits. Annual PM2.5 levels were averaged for the years 2006, 2010, and 2020. In accordance with World Health Organization (WHO) methodology, differences were estimated in the number of deaths attributed to ambient PM2.5 exposure which were derived from concentration-response data from prior epidemiological studies. PM2.5 concentrations were found to have been decreased markedly throughout Taiwan over the two-decade study. As the PM2.5 concentrations fell, so was the health burden as evidenced by number of deaths concomitantly reduced from 22.4% in 2006 to 8.47% in 2020. Data demonstrated that reducing annual mean levels of PM2.5 to PM10 ug/m3 was associated with decrease in the total burden of mortality, with a 2.22-13.18% fall in estimated number of PM2.5-related deaths between 2006 and 2020. Based upon these results, these declines in ambient PM2.5 levels were correlated with significant improvement in public health (health benefits) and diminished number of deaths in Taiwan.

Relationship between Regional Distribution of Centenarians and Drinking Water Hardness in the Amami Islands, Kagoshima Prefecture, Japan

People who drink naturally hardened water may experience longevity-enhancing effects. In this study, we investigated water hardness and longevity from both geological and epidemiological perspectives in Japan’s Amami islands, where drinking water is drawn from coralline or non-coralline bedrock. We investigated drinking water hardness, limestone bedrock occupancy, and the centenarian rate (number per 10,000 population) by municipality across four adjacent islands (Amami-Oshima (non-coralline), Tokunoshima, Okinoerabu, and Yoron (predominantly coralline)). Limestone was strongly correlated with water hardness (r = 0.99; p < 0.01), occupying more than 80% of the bedrock where the water was the hardest (Tokunoshima’s Isen municipality: 86.5%; Yoron: 82.9%) and being scarcely detectable in Amami-Oshima (0.0 to 0.2%), where the water was the least hard. The centenarian rate was also strongly correlated with water hardness (r = 0.84, p < 0.01), with the highest figures in Yoron (29.7) and Isen (29.2), and the lowest in Amami-Oshima (0.0 to 12.2). Therefore, we hypothesize a potentially beneficial effect of hard water on longevity when that water is drawn from coralline limestone. Water hardness is determined by the water content of calcium and magnesium and may plausibly influence life expectancy through a preventative effect against cardiovascular disease. Our findings are of interest to current debates about future global access to drinking water and its quality.

Risk of death from liver cancer in relation to long-term exposure to fine particulate air pollution in Taiwan

According to the International Agency for Research on Cancer (IARC), airborne fine particulate matter (PM_2.5), which is categorized as a Group I carcinogen, was found to lead to predominantly lung as well as other cancer types in humans. Hepatocellular carcinoma (HCC) is endemic in Taiwan where it is the second and fourth foremost cause of cancer deaths in men and women, respectively. Taiwan's mortality rates for liver cancer vary considerably from one region to another, suggesting that the environment may exert some influence on deaths attributed to liver cancer. The aim of this investigation was to perform an ecologic study to examine the possible link between ambient PM_2.5 levels and risk of liver cancer in 66 in Taiwan municipalities. To undertake this investigation, annual PM_2.5 levels and age-standardized liver cancer mortality rates were calculated for male and female residents of these areas from 2010 to 2019. Data were tested using weighted-multiple regression analyses to compute adjusted risk ratio (RR) controlling for urbanization level and physician density. Annual PM_2.5 levels of each municipality were divided into tertiles. The adjusted RRs for males residing in those areas with intermediate tertile levels (21.85 to 28.21 ug/m³) and the highest tertiles levels (28.22-31.23 ug/m³) of PM_2.5 were 1.29 (95% CI = 1.25-1.46) and 1.41 (95% CI = 1.36-1.46), respectively. Women in these locations shared a similar risk, 1.32 (1.25-1.4) and 1.41 (1.34-1.49), respectively. Evidence indicated that PM_2.5 increased risk of mortality rates attributed to liver cancer in both men and women in Taiwan.

Calcium and magnesium in drinking water and risk of myocardial infarction and stroke-a population-based cohort study

BACKGROUND

The implication of calcium and magnesium in drinking water for cardiovascular disease is unclear.

OBJECTIVES

To assess the association of the concentration of calcium and magnesium in drinking water with incidence of myocardial infarction and stroke, accounting for dietary mineral intake.

METHODS

We linked drinking water monitoring data to residential information of 26,733 women from the population-based Swedish Mammography Cohort, who completed a 96-item FFQ at baseline. Drinking water was categorized into low (magnesium <10 mg/L and calcium <50 mg/L) or high (magnesium ≥10 mg/L or calcium ≥50 mg/L) mineral concentration. Incident cases of myocardial infarction and stroke types were ascertained 1998-2019 using the National Patient Register.

RESULTS

The mean ± SD concentration of calcium and magnesium in drinking water was 29 ± 7 mg/L and 5 ± 1 mg/L in the low-exposed area and 52 ± 20 mg/L and 10 ± 3 mg/L in the high-exposed area, respectively. During 16 years of follow-up, we ascertained 2023, 2279, and 452 cases of myocardial infarction, ischemic stroke, and hemorrhagic stroke, respectively. High drinking water calcium and magnesium was associated with lower risk of ischemic and hemorrhagic stroke HRs of 0.87 (95% CI: 0.80, 0.95) and 0.78 (95% CI: 0.65, 0.95), whereas the HR for myocardial infarction was 0.93 (95% CI: 0.85, 1.02). In separate analyses, only drinking water magnesium, not calcium, remained associated with ischemic stroke (HR: 0.69; 95% CI: 0.54, 0.88).

CONCLUSIONS

Drinking water with a high concentration of calcium and magnesium, particularly magnesium, may lower the risk of stroke in postmenopausal women.

Drinking water magnesium and cardiovascular mortality: A cohort study in Denmark, 2005-2016

INTRODUCTION

Cardiovascular diseases are globally a major cause of death. Magnesium deficiency is associated with several diseases including cardiovascular diseases.

OBJECTIVE

To examine if a low concentration of magnesium in drinking water is associated with increased cardiovascular mortality and mortality due to acute myocardial infarction and stroke.

METHODS

A nationwide population-based cohort study using national health registries was used. A total of 4,274,132 individuals aged 30 years or more were included. Magnesium concentration in drinking water was estimated by linkage of residential addresses in the period 2005-2016 with the national drinking water quality monitoring database. The association between magnesium concentration in drinking water and cardiovascular mortality and mortality due to acute myocardial infarction and stroke was examined using a Poisson regression of number of deaths and logarithmic transformation of follow-up time as offset. The incidence rate ratio (IRR) was adjusted for differences in age, sex, calendar year, cohabitation, country of origin, and socioeconomic status.

RESULTS

Median magnesium concentration in drinking water at inclusion was 12.4 mg/L (range: 1.37-54.2 mg/L). The adjusted IRR for cardiovascular mortality was 0.96 (95% CI: 0.94; 0.97) for the lowest magnesium quintile (<6.5 mg/L) as compared to the highest magnesium quintile (>21.9 mg/L). The adjusted IRR for mortality due to acute myocardial infarction and stroke was 1.22 (1.17; 1.27) and 0.96 (0.93; 0.99), respectively, for the lowest magnesium quintile as compared to the highest quintile A decreasing mortality due to acute myocardial infarction was seen with an increasing magnesium concentration in a dose-response manner.

CONCLUSION

Low concentrations of magnesium in drinking water were associated with an increased mortality due to acute myocardial infarction. Low concentrations of magnesium in drinking water were associated with decreased cardiovascular mortality, and mortality due to stroke.

Association between fine particulate air pollution and the risk of death from lung cancer in Taiwan

Airborne fine particulate matter (PM_2.5) has been classified as a Group I carcinogen leading to lung cancer in humans by the International Agency for Research on Cancer (IARC). In Taiwan, where there is a growing incidence of this disease, lung cancer is currently the leading cause of cancer-associated deaths in women and second leading cause of deaths in men. Because tobacco use is rare in Taiwan, especially amongst women, the high incidence of this type of cancer was suggested to be attributed to the other external contaminants, including airborne PM₂ pollution. In this ecologic study, a possible association between ambient air PM_2.5 exposure and likelihood of death attributed to lung cancer was examined in Taiwan in 66 municipalities. Annual PM_2.5 levels and age-standardized lung cancer mortality rates for male and female residents were calculated for years 2010 to 2019. Weighted-multiple regression was applied to analyze our data, adjusting for level of urbanization and physician density. For males, the adjusted risk ratios (RRs) for lung cancer mortality were 1.01 for municipalities with PM_2.5 levels 21.85-28.21 ug/m3 and 1.07 for municipalities with 28.22-31.23 ug/m3, compared to those with the lowest PM_2.5 levels. For females, these adjusted RRs were 0.99 and 1.06, respectively. Data demonstrated an association between chronic exposure to high levels of PM_2.5 and increased likelihood of death attributed to lung cancer for both men and women in Taiwan. Further studies are needed to explore the relationship between PM_2.5 air pollution exposure and risk of lung cancer histologic subtype.

Populations in Low-Magnesium Areas Were Associated with Higher Risk of Infection in COVID-19's Early Transmission: A Nationwide Retrospective Cohort Study in the United States

Many studies have confirmed the important roles of nutritional status and micronutrients in the COVID-19 pandemic. Magnesium is a vital essential trace element that is involved in oxidative stress, inflammation, and many other immunological functions and has been shown to be associated with the outcome of COVID-19 infection. Here, we conducted a nationwide retrospective cohort study in the United States involving 1150 counties, 287,326,503 individuals, and 5,401,483 COVID-19 confirmed cases as of 30 September 2020 to reveal the infection risk of the populations distributed in low-magnesium areas in the early transmission of COVID-19. Our results indicate that the average county-level COVID-19 cumulative incidence in low-magnesium areas was significantly higher than in the control areas. Additionally, a significant negative nonlinear association was found between environmental magnesium concentration and the county-level COVID-19 cumulative incidence. Furthermore, the populations distributed in low environmental magnesium areas faced a higher COVID-19 infection risk (RR: 1.066; CI: 1.063–1.068), among which females (RR: 1.07; CI: 1.067–1.073), the 0–17 years subgroup (RR: 1.125; CI: 1.117–1.134), the 65+ years subgroup (RR: 1.093; CI: 1.087–1.098), black people (RR: 1.975; CI: 1.963–1.986), populations outside metro areas, and counties with a smaller population experienced higher risk of infection by COVID-19 than other subgroups. Considering that the magnesium intake of about half the population of the United States is below the daily required dose, our study will contribute to the creation of long-term public health strategies to help protect against COVID-19.

Nanoscale insight into the relation between pressure solution of calcite and interfacial friction

Pressure solution of carbonate-based rocks participates in many geophysical and geochemical processes, but fundamental knowledge of the interfacial processes is still lacking. By concurrently pressing and sliding two single calcite crystals past each other, the pressure solution rate and the friction force between the crystals were concurrently measured in calcium-carbonate saturated water with an extended surface forces apparatus. These studies reveal that both a decrease and an increase in frictional strength can originate from the pressure-solution of calcite single crystals. By conducting nanoscale force measurements with an atomic force microscope, ion specific effects were unveiled at the level of a single asperity. Pressure solution is promoted when the interfacial water layers of calcite remain undisturbed under stress (e.g. with Ca(II)) and the dissolved ions and water lubricate the interface - a phenomenon called pressure-solution facilitated slip. The mechanically induced disruption of the hydration layers of the calcite surface (e.g. with Mg(II) and low Ni(II) concentration) correlates with the more fluid-like and lubricious behavior of the confined fluid in the absence of pressure solution. Charge neutralization of the calcite surface leads to an abrupt change of calcite's hydration layers, which promotes pressure-solution facilitated slip. This work advances the fundamental understanding of physicochemical interactions occurring at confined surfaces of stressed calcite.

A Simple Approach of Groundwater Quality Analysis, Classification, and Mapping in Peshawar, Pakistan

Groundwater is an important source of water for drinking, agriculture, and other household purposes, but high population growth, industrialization, and lack of oversight on environmental policies and implementation have not only degraded the quality but also stressed the quantity of this precious source of water. Many options existed, but this study evaluated, classified, and mapped the quality of groundwater used for potable consumption with a simple approach in an urban area (Peshawar valley) of Pakistan. More than 100 groundwater samples were collected and analyzed for physio-chemical parameters in a laboratory. Hierarchal clustering analysis (HCA) and classification and regression tree (CART) analysis were sequentially applied to produce potential clusters/groups (groundwater quality classes), extract the threshold values of the clusters, classify and map the groundwater quality data into meaningful classes, and identify the most critical parameters in the classification. The HCA produced six distinct potential clusters. We found a high correlation of electrical conductivity with t o t a l   h a r d n e s s ( R 2 =   0.72 ), a l k a l i n i t y ( R 2 =   0.59 ) and c h l o r i d e   ( R 2 =   0.64 ) , and, t o t a l   h a r d n e s s with c h l o r i d e ( R 2 = 0.62), and a l k a l i n i t y ( R 2 = 0.51). The CART analysis conclusively identified the threshold values of the six classes and showed that t o t a l   h a r d n e s s was the most critical parameter in the classification. The majority of the groundwater was either with worse quality or good quality, and only a few areas had the worst groundwater quality. This study presents a simple tool for the classification of groundwater quality based on several aesthetic constituents and can assist decision makers develop and support policies and/or regulations to manage groundwater resources.

Seasonal quality variation and environmental risks associated with the consumption of surface water: implication from the Landzun Stream, Bida Nigeria

Water constitutes a major environmental and public health concerns worldwide. A large proportion of global water consumption is sourced from surface water. The dependency level on surface water is higher in developing countries, especially in rural-to-semi-urban areas, where subsurface water is not accessible. Presented in this paper is a spatiotemporal and hydrochemical quality assessment of the spring-originated Landzun Stream in Bida, Nigeria; which is usually consumed in its untreated state. Water samples were systematically collected in eighteen locations along the stream channel in both rainy and dry seasons at an equidistance interval of 500m. On-site and laboratory measurement of important physical and hydrochemical parameters were carried out using standard procedures. Water temperature in the rainy season (34–37 °C) slightly exceeds measured values in the dry season (29–33 °C). 72.22% (rainy) and 83.33% (dry) of collected samples did not meet the odourless requirement for drinking water. Similarly, estimated percentages of 66.67 and 94.44 of collected samples in rainy and dry seasons respectively have a taste. Contrary to data in the rainy season, 89%, 11%, 67% and 56% of the dry season's samples were enriched in magnesium (Mg), lead (Pb), potassium (K) and iron (Fe) respectively above the 2018 World Health Organisation guidelines for drinking water. This study further established that seasonal variation plays a major role in altering the aesthetic surface water quality. The intake of untreated surface water is a vehicle for potential water-borne diseases and allergies, hence alternative sources of drinking water for the populace dependent on the Landzun Stream is recommended to reduce risks and possible dangers of consuming the stream water.

Intake of Molecular Hydrogen in Drinking Water Increases Membrane Transporters, p-Glycoprotein, and Multidrug Resistance-Associated Protein 2 without Affecting Xenobiotic-Metabolizing Enzymes in Rat Liver

Molecular hydrogen (H2) has been shown to have antioxidant and anti-inflammatory activities that may reduce the development and progression of many diseases. In this study, hydrogen-rich water (HRW) was obtained by reacting hybrid magnesium-carbon hydrogen storage materials with water. Then, the effects of intake of HRW on the activities of xenobiotic-metabolizing enzymes, membrane transporters, and oxidative stress in rats were investigated. Rats were given HRW ad libitum for four weeks. The results showed that intake of HRW had no significant effect on the activities of various cytochrome P450 (CYP) enzymes (CYP1A1, 1A2, 2B, 2C, 2D, 2E1, 3A, and 4A), glutathione-S-transferase, and Uridine 5'-diphospho (UDP)-glucuronosyltransferase. Except for a mild lower plasma glucose concentration, intake of HRW had no effect on other plasma biochemical parameters in rats. p-Glycoprotein and multidrug resistance-associated protein (Mrp) 2 protein expressions in liver were elevated after intake of HRW. However, HRW had no significant effects on glutathione, glutathione peroxidase, or lipid peroxidation in liver. The results from this study suggest that consumption of HRW may not affect xenobiotic metabolism or oxidative stress in liver. However, intake of HRW may increase the efflux of xenobiotics or toxic substances from the liver into bile by enhancing p-glycoprotein and Mrp2 protein expressions.

The role of water in fault lubrication

The friction between two adjacent tectonic plates under shear loading may dictate seismic activities. To advance the understanding of mechanisms underlying fault strength, we investigate the frictional characteristics of calcite in an aqueous environment. By conducting single-asperity friction experiments using an atomic force microscope, here we show three pathways of energy dissipation with increasing contact stresses: viscous shear of a lubricious solution film at low normal stresses; shear-promoted thermally activated slip, similar to dry friction but influenced by the hydrated ions localized at the interface; and pressure-solution facilitated slip at sufficiently high stresses and slow sliding velocities, which leads to a prominent decrease in friction. It is also shown that the composition of the aqueous solution affects the frictional response. We use this nanoscale evidence to scrutinize the role of brines on fault behavior and argue that pressure solution provides a weakening mechanism of the fault strength at the level of single-asperity contacts.

Present-day monitoring underestimates the risk of exposure to pathogenic bacteria from cold water storage tanks

Water-borne bacteria, found in cold water storage tanks, are causative agents for various human infections and diseases including Legionnaires’ disease. Consequently, regular microbiological monitoring of tank water is undertaken as part of the regulatory framework used to control pathogenic bacteria. A key assumption is that a small volume of water taken from under the ball valve (where there is easy access to the stored water) will be representative of the entire tank. To test the reliability of this measure, domestic water samples taken from different locations of selected tanks in London properties between November 2015 and July 2016 were analysed for TVCs, Pseudomonas and Legionella at an accredited laboratory, according to regulatory requirements. Out of ~6000 tanks surveyed, only 15 were selected based on the ability to take a water sample from the normal sampling hatch (located above the ball valve) and from the far end of the tank (usually requiring disassembly of the tank lid with risk of structural damage), and permission being granted by the site manager to undertake the additional investigation and sampling. Despite seasonal differences in water temperature, we found 100% compliance at the ball valve end. In contrast, 40% of the tanks exceeded the regulatory threshold for temperature at the far end of the tank in the summer months. Consequently, 20% of the tanks surveyed failed to trigger appropriate regulatory action based on microbiological analyses of the water sample taken under the ball valve compared to the far end sample using present-day standards. These data show that typical water samples collected for routine monitoring may often underestimate the microbiological status of the water entering the building, thereby increasing the risk of exposure to water bourne pathogens with potential public health implications. We propose that water storage tanks should be redesigned to allow access to the far end of tanks for routine monitoring purposes, and that water samples used to ascertain the regulatory compliance of stored water in tanks should be taken at the point at which water is abstracted for use in the building.

Association between trace elements in the environment and stroke risk: The reasons for geographic and racial differences in stroke (REGARDS) study

The disparities in stroke mortality between blacks and whites, as well as the increased stroke mortality in the "stroke belt" have long been noted. The reasons for these disparities have yet to be fully explained. The association between trace element status and cardiovascular diseases, including stroke, has been suggested as a possible contributor to the disparities in stroke mortality but has not been fully explored. The purpose of this study is to investigate distributions of four trace elements (arsenic, mercury, magnesium, and selenium) in the environment in relation to stroke risk. The study population (N=27,770) is drawn from the Reasons for Geographic and Racial Disparities in Stroke (REGARDS) cohort. Environmental distribution of each trace element was determined using data from the United States Geological Survey (USGS) and was categorized in quartiles. A proportional hazards model, adjusted for demographic data and stroke risk factors, was used to examine the association of interest. The results showed that higher selenium levels in the environment were associated with increased stroke risk, and the hazard ratio for the 4th quartile compared to the 1st quartile was 1.33 (95% CI: 1.09, 1.62). However, there was no statistically significant relationship between environmental arsenic, mercury or magnesium and the risk of stroke. Because of dietary and non-dietary exposure as well as bioavailability, further research using biomarkers is warranted to examine the association between these trace elements and the risk of stroke.

Review of epidemiological studies on drinking water hardness and cardiovascular diseases

BACKGROUND

Major risk factors do not entirely explain the worldwide variability of morbidity and mortality due to cardiovascular disease. Environmental exposures, including drinking water minerals may affect cardiovascular disease risks.

METHOD

We conducted a qualitative review of the epidemiological studies of cardiovascular disease and drinking water hardness and calcium and magnesium levels.

RESULTS

Many but not all ecological studies found an inverse (i.e., protective) association between cardiovascular disease mortality and water hardness, calcium, or magnesium levels; but results are not consistent. Some case-control studies and one cohort study found either a reduced cardiovascular disease mortality risk with increased drinking water magnesium levels or an increased risk with low magnesium levels. However, the analytical studies provide little evidence that cardiovascular risks are associated with drinking water hardness or calcium levels.

CONCLUSION

Information from epidemiological and other studies supports the hypothesis that a low intake of magnesium may increase the risk of dying from, and possibly developing, cardiovascular disease or stroke. Thus, not removing magnesium from drinking water, or in certain situations increasing the magnesium intake from water, may be beneficial, especially for populations with an insufficient dietary intake of the mineral.

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.

Hydrophobic Gating of Ion Permeation in Magnesium Channel CorA

Ion channels catalyze ionic permeation across membranes via water-filled pores. To understand how changes in intracellular magnesium concentration regulate the influx of Mg²⁺ into cells, we examine early events in the relaxation of Mg²⁺ channel CorA toward its open state using massively-repeated molecular dynamics simulations conducted either with or without regulatory ions. The pore of CorA contains a 2-nm-long hydrophobic bottleneck which remained dehydrated in most simulations. However, rapid hydration or “wetting” events concurrent with small-amplitude fluctuations in pore diameter occurred spontaneously and reversibly. In the absence of regulatory ions, wetting transitions are more likely and include a wet state that is significantly more stable and more hydrated. The free energy profile for Mg²⁺ permeation presents a barrier whose magnitude is anticorrelated to pore diameter and the extent of hydrophobic hydration. These findings support an allosteric mechanism whereby wetting of a hydrophobic gate couples changes in intracellular magnesium concentration to the onset of ionic conduction.

This study shows how rapid wetting/dewetting transitions in the pores of ion channels participate in the control of biological ion permeation. Ion channels catalyze ionic permeation across non-polar membranes via water-filled pores. However, non-polar stretches or hydrophobic bottlenecks are present in the pores of many ion channels. To clarify the relationship between channel regulation, pore hydration, and ion permeation, we examine how the slow relaxation of magnesium channel CorA from its closed state towards its open state modulates wetting of its hydrophobic bottleneck. Results provide a quantitative description of wetting and dewetting probabilities and kinetics and a quantitative relationship between the extent of pore hydration and the energetics of ion permeation, consistent with a mechanism of hydrophobic gating.

Visual detection of Ca2+based on aggregation-induced emission of Au(i)–Cys complexes with superb selectivity

An interesting Au(i)–Cys complex was employed for the optical detection of Ca²⁺based on an aggregation-induced emission phenomenon. This AIE property of Au(i)–thiol complexes may provide a universal sensing strategy by employing different mercapto-appended ligands.

The high heart health value of drinking-water magnesium

Universal drinking water and beverages containing moderate to high levels of magnesium (10–100 ppm) could potentially prevent 4.5 million heart disease and stroke deaths per year, worldwide. This potential is calculated with 2010 global mortality figures combined with a recent quantification of water-magnesium’s inverse association with heart disease and stroke mortality. The modern processed food diet, low in magnesium and spreading globally, makes this well-researched potential of drinking-water magnesium worth serious consideration, especially in areas where insufficient dietary intake of magnesium is prevalent.

Magnesium and the risk of cardiovascular events: a meta-analysis of prospective cohort studies

BACKGROUND

Prospective studies that have examined the association between dietary magnesium intake and serum magnesium concentrations and the risk of cardiovascular disease (CVD) events have reported conflicting findings. We undertook a meta-analysis to evaluate the association between dietary magnesium intake and serum magnesium concentrations and the risk of total CVD events.

METHODOLOGY/PRINCIPAL FINDINGS

We performed systematic searches on MEDLINE, EMBASE, and OVID up to February 1, 2012 without limits. Categorical, linear, and nonlinear, dose-response, heterogeneity, publication bias, subgroup, and meta-regression analysis were performed. The analysis included 532,979 participants from 19 studies (11 studies on dietary magnesium intake, 6 studies on serum magnesium concentrations, and 2 studies on both) with 19,926 CVD events. The pooled relative risks of total CVD events for the highest vs. lowest category of dietary magnesium intake and serum magnesium concentrations were 0.85 (95% confidence interval 0.78 to 0.92) and 0.77 (0.66 to 0.87), respectively. In linear dose-response analysis, only serum magnesium concentrations ranging from 1.44 to 1.8 mEq/L were significantly associated with total CVD events risk (0.91, 0.85 to 0.97) per 0.1 mEq/L (P(nonlinearity)= 0.465). However, significant inverse associations emerged in nonlinear models for dietary magnesium intake (P(nonlinearity)= 0.024). The greatest risk reduction occurred when intake increased from 150 to 400 mg/d. There was no evidence of publication bias.

CONCLUSIONS/SIGNIFICANCE

There is a statistically significant nonlinear inverse association between dietary magnesium intake and total CVD events risk. Serum magnesium concentrations are linearly and inversely associated with the risk of total CVD events.

Trihalomethanes in drinking water and the risk of death from esophageal cancer: does hardness in drinking water matter?

The objectives of this study were to (1) examine the relationship between total trihalomethanes (TTHM) levels in public water supplies and risk of esophageal cancer occurrence and (2) determine whether calcium (Ca) and magnesium (Mg) levels in drinking water modify the effects of TTHM on risk to develop esophageal cancer. A matched case-control study was used to investigate the relationship between the risk of death attributed to esophageal cancer and exposure to TTHM in drinking water in 53 municipalities in Taiwan. All esophageal cancer deaths in the 53 municipalities 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 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 Ca and 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, Ca, and Mg exposure via drinking water. Relative to individuals whose TTHM exposure level <4.9 ppb, the adjusted odds ratio (OR) with 95% confidence interval (CI) for esophageal cancer was 1.02 (0.84-1.23) for individuals who resided in municipalities served by drinking water with a TTHM exposure ≥4.9 ppb. There was evidence of an interaction between drinking-water TTHM levels and low Ca and Mg intake. Our findings showed that the correlation between TTHM exposure and risk of esophageal cancer development was influenced by Ca and Mg levels in drinking water. This is the first study to report effect modification by Ca and Mg intake from drinking water on the correlation between TTHM exposure and risk of esophageal cancer occurrence. Increased knowledge of the interaction between Ca, Mg, and TTHM in reducing risk of esophageal cancer development will aid in public policymaking and standard setting for drinking water.

Environmental characteristics and oxidative stress of inhabitants and patients with amyotrophic lateral sclerosis in a high-incidence area on the Kii Peninsula, Japan

OBJECTIVE

Although Oshima, in the Kii Peninsula of Japan, is located within a high incidence area of amyotrophic lateral sclerosis (ALS) (Koza/Kozagawa/Kushimoto area, K area), no patients with ALS were detected between 1960 and 1999. However, the incidence recently increased between 2000 and 2009. On Oshima, the source of drinking water was changed from a regional river/wells to the Kozagawa River in the K area in 1975. We speculate that this change in water source may have played a role in the recent increase in the incidence of ALS. The aim of this study is to find contributing factors that may have triggered the locally high incidence of ALS.

METHODS

We investigated a possible association between the mineral content of drinking water and serum and oxidative stress markers among patients with ALS in the K area (K-ALS), residents of Oshima and controls.

RESULTS

We found that the levels of Ca and Zn in the recent drinking water in Oshima are low and that the serum levels of Ca and Zn in the Oshima residents and patients with K-ALS were significantly lower, while the oxidative stress markers were significantly higher, than those of the controls. The serum Zn and urinary 8-OHdG/creatinine levels explained 60% and 58% of the variations among the three groups, respectively. The serum Zn levels were negatively correlated with the serum Cu levels in the patients with K-ALS, and the serum Cu levels exhibited a tendency to be positively correlated with the 8-OHdG/creatinine levels in both the patients with K-ALS (r: 0.64) and the residents free from K-ALS (r: 0.32, p<0.01).

CONCLUSION

Taken together, we suggest that the low levels of Ca and Zn in the drinking water are possibly associated with an imbalance of metal metabolism in Oshima residents and an increase in oxidative stress markers in patients with K-ALS, although the causative relationship is not clear. This is a cross-sectional study, and a prospective study is needed in the future.

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.

Parity, age at first birth, and risk of death from brain cancer: a population-based cohort study in Taiwan

Background

This study was undertaken to examine whether there is an association between parity and age at first birth and risk of death from brain cancer.

Methods

The study cohort consisted of 1,292,462 women who had a first and singleton childbirth between Jan. 1, 1978 and Dec. 31, 1987. We tracked each woman from the time of their first childbirth to December 31, 2009, and their vital status was ascertained by linking records with the computerized mortality database. Cox proportional hazard regression models were used to estimate the hazard ratios (HR) of death from brain cancer associated with parity and age at first birth.

Results

There were 316 brain cancer deaths during 34,980,246 person-years of follow-up. The mortality rate of brain cancer was 0.90 cases per 100,000 person-years. The adjusted HR was 1.35 (95% CI= 0.91-2.01) for women who gave birth between 21 and 25, 1.61 (95% CI=1.05-2.45) for women who gave birth after 25 years of age, respectively, when compared with women who gave birth less than 20 years. A trend of increasing risk of brain cancer was seen with increasing age at first birth. The adjusted HR were 0.73 (95% CI= 0.53-0.99) for women who had 2 children, and 0.60 (95% CI =0.43-0.83) for women with 3 or more births, respectively, when compared with women who had given birth to only 1 child. There was a significant decreasing trend in the HRs of brain cancer with increasing parity.

Conclusions

This study provides evidence that reproductive factors (parity and early age at first birth) may confer a protective effect on the risk of death from brain cancer.

Evaluation of the intravenous magnesium sulfate effect in clinical improvement of patients with acute ischemic stroke

BACKGROUND

Evidence is mounting that magnesium may play a critical role in the development of strokes and the healing process during and after a stroke. Magnesium is an N-methyl-D-aspartate (NMDA) glutamate receptor antagonist that has been shown to be neuroprotective in many preclinical models of ischemic and excitotoxic brain injury. This study was performed to evaluate the intravenous magnesium sulfate effect in clinical improvement of patients with acute ischemic stroke.

METHODS

One hundred and seven patients with acute ischemic stroke signs and symptoms lasting less than 12 hours were included in the study and were divided into two groups, 55 patients received 4 g of MgSO(4) over 15 minutes and then 16 g over the next 24 hours, and 52 patients were received matching placebo. The study primary end point was stroke related neurologic deficit evaluation by the national institute of stroke scale (NIHSS).

RESULTS

Patients receiving MgSO(4) showed significant recovery compared with the group of patients receiving placebo.

CONCLUSION

This study suggests that magnesium sulfate can be used as a safe and useful neuroprotective agent in acute ischemic stroke and lacunar stroke patients may represent a relevant and practical target population for agents with biological activity in white matter.

Imipramine inhibition of TRPM-like plasmalemmal Mg2+ transport in vascular smooth muscle cells

Depression is associated with vascular disease, such as myocardial infarction and stroke. Pharmacological treatments may contribute to this association. On the other hand, Mg²⁺ deficiency is also known to be a risk factor for the same category of diseases. In the present study, we examined the effect of imipramine on Mg²⁺ homeostasis in vascular smooth muscle, especially via melastatin-type transient receptor potential (TRPM)-like Mg²⁺-permeable channels. The intracellular free Mg²⁺ concentration ([Mg²⁺]_i) was measured using ³¹P-nuclear magnetic resonance (NMR) in porcine carotid arteries that express both TRPM6 and TRPM7, the latter being predominant. pH_i and intracellular phosphorus compounds were simultaneously monitored. To rule out Na⁺-dependent Mg²⁺ transport, and to facilitate the activity of Mg²⁺-permeable channels, experiments were carried out in the absence of Na⁺ and Ca²⁺. Changing the extracellular Mg²⁺ concentration to 0 and 6 mM significantly decreased and increased [Mg²⁺]_i, respectively, in a time-dependent manner. Imipramine statistically significantly attenuated both of the bi-directional [Mg²⁺]_i changes under the Na⁺- and Ca²⁺-free conditions. This inhibitory effect was comparable in influx, and much more potent in efflux to that of 2-aminoethoxydiphenyl borate, a well-known blocker of TRPM7, a channel that plays a major role in cellular Mg²⁺ homeostasis. Neither [ATP]_i nor pH_i correlated with changes in [Mg²⁺]_i. The results indicate that imipramine suppresses Mg²⁺-permeable channels presumably through a direct effect on the channel domain. This inhibitory effect appears to contribute, at least partially, to the link between antidepressants and the risk of vascular diseases.

Parity, age at first birth, and risk of death from liver cancer: Evidence from a cohort in Taiwan

BACKGROUND AND AIM

The present study was undertaken to examine whether there is an association between parity and age at first birth and risk of liver cancer.

METHODS

The study cohort consisted of 1,292,462 women who had a first and singleton childbirth between 1 January 1978 and 31 December 1987. We tracked each woman from the time of their first childbirth to 31 December 2007, and their vital status was ascertained by linking records with the computerized mortality database. Cox proportional hazard regression models were used to estimate the relative risks (RR) of death from liver cancer associated with parity and age at first birth.

RESULTS

There were 826 liver cancer deaths during 32,464,186.58 person-years of follow-up. The mortality rate of liver cancer was 2.54 cases per 100,000 person-years. The adjusted RR was 1.59 (95% confidence interval [CI] = 1.36-1.86) for women who gave birth between 26 and 30, 2.41 (95% CI = 1.81-3.20) for women who gave birth between 31 and 35, and 6.26 (95% CI = 4.27-9.19) for women who gave birth after 35 years of age, respectively, when compared with women who gave birth at less than 25 years of age. The adjusted RR was 0.72 (95% CI = 0.59-0.87) for women who had two to three children, and 0.63 (95% CI = 0.47-0.84) for women with four or more births, respectively, when compared with women who had given birth to only one child.

CONCLUSIONS

The present study suggests that reproductive factors (parity and early age at first birth) may confer a protective effect on the risk of liver 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.

Nitrates in drinking water and the risk of death from childhood brain tumors in Taiwan

The objective of this study was to (1) examine the relationship between nitrate (NO₃-N) levels in public water supplies and risk of death from childhood brain tumors (CBT) and (2) determine whether calcium (Ca) and magnesium (Mg) levels in drinking water might modify the effects of NO₃-N on development of CBT. A matched cancer case-control study was used to investigate the relationship between the risk of death attributed to CBT and exposure to NO₃-N in drinking water in Taiwan. All CBT deaths of Taiwan residents from 1999 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 the 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 were collected from Taiwan Water Supply Corporation. The municipality of residence for CBT 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 ≤ 0.31 ppm, and the adjusted odds ration (OR) (95% confidence interval [CI]) for CBT occurrence was 1.4 (1.07-1.84) for individuals who resided in municipalities served by drinking water with a NO₃-N exposure > 0.31 ppm. No significant effect modification was observed by Ca and Mg intake via drinking water. Data suggest that exposure to NO₃-N in drinking water is associated with a higher risk of CBT development in Taiwan.

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.

Effect modification of the association between trihalomethanes and pancreatic cancer by drinking water hardness: evidence from an ecological study

The objective of this study was to examine the relationship between total trihalomethanes (TTHM) levels in public water supplies and risk of pancreatic cancer and to determine whether calcium (Ca) and magnesium (Mg) levels in drinking water modify the effects of TTHM on risk to develop pancreatic cancer. A matched case-control study was used to investigate the relationship between the risk of death attributed to pancreatic cancer and exposure to TTHM in drinking water in 53 municipalities in Taiwan. All pancreatic 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 Taiwan Environmental Protection Administration. Information on the levels of Ca and 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, Ca, and Mg exposure via drinking water. Relative to individuals whose TTHM exposure level < 4.9ppb, the adjusted OR (95% CI) for pancreatic cancer was 1.01 (0.85-1.21) for individuals who resided in municipalities served by drinking water with a TTHM exposure > 4.9ppb. There was no evidence of an interaction of drinking water TTHM levels with low Ca intake via drinking water. However, we observed evidence of an interaction between drinking water TTHM concentrations and Mg intake via drinking water. Our findings showed that the correlation between TTHM exposure and risk of pancreatic cancer is influenced by Mg in drinking water. Increased knowledge of the interaction between Mg and TTHM in reducing pancreatic cancer risk will aid in public policy making and standard setting.

Parity, age at first birth, and risk of death from pancreatic cancer: evidence from a cohort in Taiwan

OBJECTIVES

This study was undertaken to examine whether there is an association between parity and age at first birth and risk of pancreatic cancer.

METHODS

The study cohort consisted of all women with a record of a first and singleton childbirth in the Birth Registration System between 1978 and 1987. We tracked each woman from the time of their first childbirth and linked their vital status with mortality database. Cox proportional hazard regression models were used to estimate the relative risks (RRs) of death from pancreatic cancer associated with parity and age at first birth.

RESULTS

A trend of increasing risk of pancreatic cancer was seen with increasing age at first birth. The adjusted RR was 0.69 (95% confidence interval, 0.49-0.98) for women who born 2 children and 0.64 (95% confidence interval, 0.44-0.93) for women with 3 or more births, respectively, when compared with women who had given birth to only 1 child. There was a significant decreasing trend in the RR of pancreatic cancer with increasing parity.

CONCLUSIONS

This study provides evidence that reproductive factors (parity and early age at first birth) may confer a protective effect on the risk of pancreatic cancer.

Dietary calcium and magnesium intake and mortality: a prospective study of men

The authors examined the association of dietary calcium and magnesium intake with all-cause, cardiovascular disease (CVD), and cancer mortality among 23,366 Swedish men, aged 45-79 years, who did not use dietary supplements. Cox proportional hazards regression models were used to estimate the multivariate hazard ratios and 95% confidence intervals of mortality. From baseline 1998 through December 2007, 2,358 deaths from all causes were recorded in the Swedish population registry; through December 2006, 819 CVD and 738 cancer deaths were recorded in the Swedish cause-of-death registry. Dietary calcium was associated with a statistically significant lower rate of all-cause mortality (hazard ratio (HR) = 0.75, 95% confidence interval (CI): 0.63, 0.88; P(trend) < 0.001) and a nonsignificantly lower rate of CVD (HR = 0.77, 95% CI: 0.58, 1.01; P(trend) = 0.064) but not cancer mortality (HR = 0.87, 95% CI: 0.65, 1.17; P(trend) = 0.362) when the highest intake tertile (mean = 1,953 mg/day; standard deviation (SD), 334) was compared with the lowest (990 mg/day; SD, 187). Dietary magnesium intake (means of tertiles ranged from 387 mg/day (SD, 31) to 523 mg/day (SD, 38) was not associated with all-cause, CVD, or cancer mortality. This population-based, prospective study of men with relatively high intakes of dietary calcium and magnesium showed that intake of calcium above that recommended daily may reduce all-cause mortality.

Relationship between tap water hardness, magnesium, and calcium concentration and mortality due to ischemic heart disease or stroke in The Netherlands

BACKGROUND

Conflicting results on the relationship between the hardness of drinking water and mortality related to ischemic heart disease (IHD) or stroke have been reported.

OBJECTIVES

We investigated the possible association between tap water calcium or magnesium concentration and total hardness and IHD mortality or stroke mortality.

METHODS

In 1986, a cohort of 120,852 men and women aged 5569 years provided detailed information on dietary and other lifestyle habits. Follow-up for mortality until 1996 was established by linking data from the Central Bureau of Genealogy and Statistics Netherlands. We calculated tap water hardness for each postal code using information obtained from all pumping stations in the Netherlands. Tap water hardness was categorized as soft [< 1.5 mmol/L calcium carbonate (CaCO3)], medium hard (1.62.0 mmol/L CaCO3), and hard (> 2.0 mmol/L CaCO3). The multivariate case-cohort analysis was based on 1,944 IHD mortality and 779 stroke mortality cases and 4,114 subcohort members.

RESULTS

For both men and women, we observed no relationship between tap water hardness and IHD mortality [hard vs. soft water: hazard ratio (HR) = 1.03; 95% confidence interval (CI), 0.851.28 for men and HR = 0.93; 95% CI, 0.711.21 for women) and stroke mortality (hard vs. soft water HR = 0.90; 95% CI, 0.661.21 and HR = 0.86; 95% CI, 0.621.20, respectively). For men with the 20% lowest dietary magnesium intake, an inverse association was observed between tap water magnesium intake and stroke mortality (HR per 1 mg/L intake = 0.75; 95% CI, 0.610.91), whereas for women with the 20% lowest dietary magnesium intake, the opposite was observed.

CONCLUSIONS

We found no evidence for an overall significant association between tap water hardness, magnesium or calcium concentrations, and IHD mortality or stroke mortality. More research is needed to investigate the effect of tap water magnesium on IHD mortality or stroke mortality in subjects with low dietary magnesium intake.

Delay of cataract development in the Shumiya cataract rat by the administration of drinking water containing high concentration of magnesium ion

We discovered that the cataract development in the Shumiya cataract rat (SCR) can be prevented by the administration of deep-sea drinking water (DDW). A standard diet based on the American Institute of Nutrition guidelines (AIN-76) and DDW containing a high mineral concentration such as low, medium and high Mg2+ content (50, 200 and 1000 mg of Mg2+/l, respectively) were used in this study. SCRs were freely fed with combinations of the standard diet and purified water or DDW during 5-15 weeks of age. The opacities of SCR lenses were documented by anterior eye segment analysis system EAS-1000. The onset of opacification of cataractous SCR lenses administered a combination of standard diet and purified water started at 11 weeks of age, and mature cataracts had formed at 13 weeks of age. However, the supplementation of Mg2+ by administration with medium DDW showed the greatest effect of delay of cataract onset in SCR. In addition, even cataractous SCR lenses at 14 weeks of age showed differences in opacity level. The opacification and Ca2+ of the lenses in cataractous SCR administered medium DDW were lower than those administered purified water. In conclusion, the present study demonstrates that administration of DDW potently delays cataract development in SCR, and this may be caused by inhibiting the increase in Ca2+ levels in the lens.

Nitrates in municipal drinking water and non-Hodgkin lymphoma: an ecological cancer case-control study in Taiwan

The relationship between nitrate levels in drinking water and increased risk of non-Hodgkin lymphoma (NHL) development has been inconclusive. A matched cancer case-control and a nitrate ecology study was used to investigate the association between mortality attributed to NHL and nitrate exposure from Taiwan's drinking water. All deaths due to NHL in Taiwan residents from 2000 through 2006 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. Each matched control was selected randomly from the set of possible controls for each case. Data on nitrate-nitrogen (NO(3)-N) levels of drinking water throughout Taiwan were collected from the Taiwan Water Supply Corporation (TWSC). The municipality of residence for cancer cases and controls was presumed to be the source of the subject's nitrate exposure via drinking water. The adjusted odds ratios (OR) for NHL death for those with high nitrate levels in their drinking water, as compared to the lowest tertile, were 1.02 (0.87-1.2) and 1.05 (0.89-1.24), respectively. The results of the present study show that there was no statistically significant association between nitrates in drinking water at levels in this investigation and increased risk of death attributed to NHL.

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

The objectives of this study were (1) to examine the relationship between total trihalomethanes (TTHM) levels in public water supplies and risk of rectal cancer development and (2) to determine whether calcium (Ca) and magnesium (Mg) levels in drinking water might modify the effects of TTHM on risk of developing rectal cancer. A matched cancer case-control study was used to investigate the relationship between the risk of death attributed to rectal cancer and exposure to TTHM in drinking water in 53 municipalities in Taiwan. All rectal 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 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 and 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, Ca, and Mg exposure via drinking water. Relative to individuals whose TTHM exposure level was <4.9 ppb, the adjusted OR (95% CI) for rectal cancer occurrence was 1.04 (0.88-1.22) for individuals who resided in municipalities served by drinking water with a TTHM exposure >or=4.9 ppb. There was no evidence of an interaction of drinking-water TTHM levels with low Ca intake via drinking water. However, evidence of an interaction was noted between drinking-water TTHM concentrations and Mg intake via drinking water. Our findings showed that the correlation between TTHM exposure and risk of rectal cancer is influenced by Mg in drinking water. Increased knowledge of the interaction between Mg and TTHM in reducing rectal cancer risk will aid in public policymaking and standard setting.

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.

Survey of trace metals in drinking water supplied to rural populations in the eastern Llanos of Venezuela

To ascertain the water quality for human consumption, chemical parameters such as pH, conductivity and total dissolved calcium, magnesium, iron, aluminum, zinc, copper and manganese were measured during four sampling periods (November 2002; March, May and July 2003) in drinking water wells which supply several forest camps and rural populations located in the eastern Llanos of Venezuela. Copper levels in drinking water in November 2002 were found to be significantly higher (P<0.05) than the other assessed periods. Temporal variations of the other parameters considered were not statistically significant. Calcium and magnesium concentrations were found to be extremely low (mean concentration+/-S.D. of 0.27+/-0.25mg/l for Ca and 0.219+/-0.118 for Mg) during the four sampling periods, probably because of the carbonate bearing scarcity in the soils lithic component. The rest of the metals complied with the Venezuelan and International guidelines of quality criteria for drinking water.

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

The relationship between nitrate levels in drinking water and risk of pancreatic cancer development remains inconclusive. A matched case-control and nitrate ecology study was used to investigate the association between mortality attributed to pancreatic cancer and nitrate exposure from Taiwan's drinking water. All pancreatic cancer deaths of Taiwan residents from 2000 through 2006 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. Each matched control was selected randomly from the set of possible controls for each case. Data on nitrate-nitrogen (NO(3)-N) levels of drinking water throughout Taiwan were collected from Taiwan Water Supply Corporation (TWSC). The municipality of residence for cancer cases and controls was assumed to be the source of the subject's nitrate exposure via drinking water. The adjusted odds ratios and confidence limits for pancreatic cancer death for those with high nitrate levels in their drinking water, as compared to the lowest tertile, were 1.03 (0.9-1.18) and 1.1 (0.96-1.27), respectively. The results of the present study show that there was no statistically significant association between the levels of nitrate in drinking water and increased risk of death from pancreatic cancer.

Na(+)-independent Mg(2+) transport sensitive to 2-aminoethoxydiphenyl borate (2-APB) in vascular smooth muscle cells: involvement of TRPM-like channels

Magnesium is associated with several important cardiovascular diseases. There is an accumulating body of evidence verifying the important roles of Mg²⁺-permeable channels. In the present study, we estimated the intracellular free Mg²⁺ concentration ([Mg²⁺]_i) using ³¹P-nuclear magnetic resonance (³¹P-NMR) in porcine carotid arteries. pH_i and intracellular phosphorus compounds were simultaneously monitored. Removal of extracellular divalent cations (Ca²⁺ and Mg²⁺) in the absence of Na⁺ caused a gradual decrease in [Mg²⁺]_i to ∼60% of the control value after 125 min. On the other hand, the simultaneous removal of extracellular Ca²⁺ and Na⁺ in the presence of Mg²⁺ gradually increased [Mg²⁺]_i in an extracellular Mg²⁺-dependent manner. 2-aminoethoxydiphenyl borate (2-APB) attenuated both [Mg²⁺]_i load and depletion caused under Na⁺- and Ca²⁺-free conditions. Neither [ATP]_i nor pH_i correlated with changes in [Mg²⁺]_i. RT-PCR detected transcripts of both TRPM6 and TRPM7, although TRPM7 was predominant. In conclusion, the results suggest the presence of Mg²⁺-permeable channels of TRPM family that contribute to Mg²⁺ homeostasis in vascular smooth muscle cells. The low, basal [Mg²⁺]_i level in vascular smooth muscle cells is attributable to the relatively low activity of this Mg²⁺ entry pathway.