Dr. Ron’s Research Review – May 21, 2014

© 2014

This week’s research review focuses on mineral water and gallstones.

High sodium chloride (NaCl) intake can induce low-grade metabolic acidosis (LGMA) and may thus influence bone and protein metabolism.  Oral potassium bicarbonate supplementation may compensate by inducing a postprandial shift to a more alkaline state. This leads to decreased bone resorption and protein degradation, which in turn might initiate an anti-catabolic state for the musculoskeletal system in the long run. Eight healthy male subjects participated in a randomized trial with a crossover design. The study group showed a 14% reduction in urinary free cortisol and cortisone. Urinary excretion of calcium and bone resorption marker N-terminal telopeptide of type I collagen was reduced by 12 and 8%. (Buehlmeier, Frings-Meuthen et al. 2012)

A recent study examined the effects of sulphate-bicarbonate-calcium water on gallstone risk. Subjects drank 500 mL of “Acqua Santa of Chianciano Terme” sulphate-bicarbonate-calcium water every day in the morning in the fasted state, over a 30 min period for 12 days. Fasting gallbladder volume was significantly (P < 0.005) smaller. Serum bile acid concentration was significantly (P < 0.05) higher, mainly by glycochenodeoxycholic acid. The number of pasta (P < 0.001), meat (P < 0.001) and vegetable (P < 0.005) portions consumed during the study and of bowel movements per day (P < 0.05) were significantly higher. (Corradini, Ferri et al. 2012)

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Articles

 

Alkaline salts to counteract bone resorption and protein wasting induced by high salt intake: results of a randomized controlled trial
         (Buehlmeier, Frings-Meuthen et al. 2012) Download
High sodium chloride (NaCl) intake can induce low-grade metabolic acidosis (LGMA) and may thus influence bone and protein metabolism. We hypothesized that oral potassium bicarbonate (KHCO(3)) supplementation may compensate for NaCl-induced, LGMA-associated bone resorption and protein losses. Eight healthy male subjects participated in a randomized trial with a crossover design. Each of two study campaigns consisted of 5 d of dietary and environmental adaptation followed by 10 d of intervention and 1.5 d of recovery. In one study campaign, 90 mmol KHCO(3)/d were supplemented to counteract NaCl-induced LGMA, whereas the other campaign served as a control with only high NaCl intake. When KHCO(3) was ingested during high NaCl intake, postprandial buffer capacity ([HCO(3)(-)]) increased (P = 0.002). Concomitantly, urinary excretion of free potentially bioactive glucocorticoids [urinary free cortisol (UFF) and urinary free cortisone (UFE)] was reduced by 14% [ summation operator(UFF,UFE); P = 0.024]. Urinary excretion of calcium and bone resorption marker N-terminal telopeptide of type I collagen was reduced by 12 and 8%, respectively (calcium, P = 0.047; N-terminal bone collagen telopeptide, P = 0.044). There was a trend of declining net protein catabolism when high NaCl was combined with KHCO(3) (P = 0.052). We conclude that during high salt intake, the KHCO(3)-induced postprandial shift to a more alkaline state reduces metabolic stress. This leads to decreased bone resorption and protein degradation, which in turn might initiate an anticatabolic state for the musculoskeletal system in the long run.

Beneficial effect of sulphate-bicarbonate-calcium water on gallstone risk and weight control
         (Corradini, Ferri et al. 2012) Download
AIM: To investigate the effect of drinking sulphate-bicarbonate-calcium thermal water (TW) on risk factors for atherosclerosis and cholesterol gallstone disease. METHODS: Postmenopausal women with functional dyspepsia and/or constipation underwent a 12 d cycle of thermal (n = 20) or tap (n = 20) water controlled drinking. Gallbladder fasting volume at ultrasound, blood vitamin E, oxysterols (7-beta-hydroxycholesterol and 7-ketocholesterol), bile acid (BA), triglycerides, total/low density lipoprotein and high density lipoprotein cholesterol were measured at baseline and at the end of the study. Food consumption, stool frequency and body weight were recorded daily. RESULTS: Blood lipids, oxysterols and vitamin E were not affected by either thermal or tap water consumption. Fasting gallbladder volume was significantly (P < 0.005) smaller at the end of the study than at baseline in the TW (15.7 +/- 1.1 mL vs 20.1 +/- 1.7 mL) but not in the tap water group (19.0 +/- 1.4 mL vs 19.4 +/- 1.5 mL). Total serum BA concentration was significantly (P < 0.05) higher at the end of the study than at baseline in the TW (5.83 +/- 1.24 mumol vs 4.25 +/- 1.00 mumol) but not in the tap water group (3.41 +/- 0.46 mumol vs 2.91 +/- 0.56 mumol). The increased BA concentration after TW consumption was mainly accounted for by glycochenodeoxycholic acid. The number of pasta (P < 0.001), meat (P < 0.001) and vegetable (P < 0.005) portions consumed during the study and of bowel movements per day (P < 0.05) were significantly higher in the TW than in the tap water group. Body weight did not change at the end of the study as compared to baseline in both groups. CONCLUSION: Sulphate-bicarbonate-calcium water consumption has a positive effect on lithogenic risk and intestinal transit and allows maintenance of a stable body weight despite a high food intake.

References

Buehlmeier, J., P. Frings-Meuthen, et al. (2012). "Alkaline salts to counteract bone resorption and protein wasting induced by high salt intake: results of a randomized controlled trial." J Clin Endocrinol Metab 97(12): 4789-97. [PMID: 23027921]
Corradini, S. G., F. Ferri, et al. (2012). "Beneficial effect of sulphate-bicarbonate-calcium water on gallstone risk and weight control." World J Gastroenterol 18(9): 930-7. [PMID: 22408352]