You’ve seen those bottles on the grocery shelves. What are the pros and cons of alkaline water? Does it have benefits for bone health?
In this article I clear up some of the confusion around alkaline water. Read on to find out whether mineral water can be part of a plan to help strengthen your bones.
What is Alkaline Water?
Alkaline water has a pH above 7.0. See this other post to refresh your memory on pH.
The pH of Different Types of Water
Still water generally has a higher (more alkaline) pH than sparkling water. Sparkling water is more acidic because of the dissolved carbon dioxide.
For example, one study found bottled still water (not carbonated) from various sources had a pH 7.0-7.5. Bottled carbonated (sparkling) water had a more acidic pH of around 5.5 (1).
Distilled water has a low pH, around 5.5. This is because the minerals have been removed.
In the US, the EPA sets a secondary standard for the pH of drinking water. This means it is non-enforceable, or more of a suggestion. The “suggestion” is that drinking water has a pH between 6.5 and 8.5 (2).
The pH of tap water is variable across the US. You can test the pH of your own tap water at home.
How Is Alkaline Water Made?
Some types of alkaline water, or mineral water, are made naturally when ground water runs over rocks and absorbs minerals. Icelandic Glacial is one of these brands, with a natural pH of 8.4.
Evian has a natural mineral water sourced from the French Alps with a pH of 7.2.
Waiākea is a natural mineral water that comes from Hawaii. It has a pH of 7.6-8.2.
Ten Alkaline Spring Water (with a pH of 10) lists the pH of many brands of bottled water on their web site.
Some manufacturers create alkaline water by ionizing regular (often tap) water with electrolysis. This artificial process breaks down the molecules and separates and removes the acidic properties.
Manufacturers remove minerals from the water before electrolysis. However, they do not always add all the minerals back. So even though your water is at an alkaline pH, it might be missing the minerals that are beneficial for your bones.
The WHO has even cautioned that it might be harmful to drink demineralized water on a long term basis (3).
Bottom line is that it is healthier to choose a natural alkaline water rather than one that is artificially made. If you drink alkaline water produced by electrolysis, make sure that minerals have been added back.
Pros of Alkaline Water For Your Bones
Research supports the idea that drinking alkaline water can improve bone health.
In 2021, Fasihi et al studied the effects of alkaline drinking water on 100 postmenopausal women. After 3 months, the spinal T scores for the women drinking the alkaline water were significantly improved.
In the study they dissolved calcium and magnesium ions into water to get a pH of 7.8–8.2. The women consumed 1.5 liters of alkaline water, which is about 6 ½ cups (4).
Getting Your Calcium From Water
Besides the effects of alkalinity, the extra minerals in some water can supplement your diet. You can actually absorb calcium, magnesium, silica, sodium, potassium, and more. You body will absorb calcium in mineral water just as easily as calcium in milk.
Tap water has a wide variability depending on where you live. A 2006 study of cities across the USA and Canada found amounts from less than 2 mg all the way up to 125 mg per liter. When you run your tap water through a filter you lose most of that calcium.
The study also tested bottled mineral waters in North America and Europe. Bottled spring waters from the USA had less calcium, with an average around 20 mg/liter. However some European mineral waters had a substantial amount of calcium.
The average content of calcium in European mineral waters was 208 mg/liter, which is about 20% of the RDA for calcium for a postmenopausal woman drinking six 8-ounce glasses per day (5).
Cons of Alkaline Water For Your Bones
If you have a condition where you have to monitor intake of minerals, like chronic kidney disease, check with your doctor to see whether you should be drinking mineralized water.
Do not drink mineral water with any medication that should not be taken with calcium. Levothyroxine and bisphosphonates are two examples where calcium will interfere with their absorption.
Buying alkaline water might be bad for your pocketbook. It is usually more expensive than other bottled water, and definitely more than tap water.
You can find many different kinds of alkaline water in the stores and online. All of these products aren’t necessarily going to have benefits for your bones.
A study back in 2008 looked at the composition of European and North American mineral waters with respect to bone health. They measured the amount of different minerals in each water, and the PRAL (potential renal acid load) value.
The study found a wide variation in the types of minerals and the alkalinizing properties of these natural waters. They even found that some waters, those containing sulfur, had an acidic pH (6).
Most of the alkaline water research uses specially engineered water, or alkaline supplements such potassium citrate or bicarbonate. It is hard to extrapolate this to the water you can buy in the grocery store.
This makes it confusing to know which brands of alkaline water can actually help strengthen your bones. Investigate a company by visiting their website to see what information is available about their brand. What is the pH of their water? Do they tell you the mineral content? Is it from a natural source, or do they produce it artificially?
Putting It All Together
There is evidence that drinking at least 1.5 liters of alkaline water each day can improve bone density in postmenopausal women.
However, there are so many kinds of alkaline water out there, it is difficult to know which ones will have this benefit.
Mineral water from natural sources has the alkalizing elements that help your body to neutralize acids, and you are also getting extra minerals to supplement your diet. European mineral water contains more calcium, and can provide up to 20% of your daily requirement if you drink 6 glasses a day.
Be sure to do your homework on a specific brand of mineral water if you plan to use it as a dietary source of calcium.
Alkaline water is not going to save you from a poor diet and lifestyle choices that are bad for your bones. It should not be the only method you use to strengthen your bones. However, it can be an important part of your overall best bones diet and lifestyle.
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