Calcium Supplementation with Calcium-Rich Mineral Waters: A Systematic Review and Meta-analysis of its Bioavailability

Abstract

The relevance of calcium (Ca2+), an essential bone mineral, to the prevention and treatment of osteoporosis is well established. However, a good deal of evidence casts doubt on the validity of current RDAs (recommended daily allowance), i.e., 800-1000 mg/day. New guidelines consistently advocate higher daily intakes (up to 1500 mg/day), a goal that may be difficult to achieve for many patients. Environmental as well as individual behavioral factors may limit the consumption of dairy products, whereas calcium supplements require a high level of compliance and cause additional costs. Calcium-rich mineral waters may offer a promising alternative. A systematic literature search was performed (Medline, years 1966-1998) to identify experimental studies on the bioavailability of calcium-rich mineral waters. First, all publications on calcium absorption from mineral waters were identified, and, in a second step, studies comparing calcium absorption from mineral waters with that from dairy products. Four studies fulfilled all inclusion criteria. A meta-analysis based on published p values indicated calcium absorption from mineral waters was significantly higher (p = 0.03) than that from dairy products. Although only few studies with a relatively small number of subjects are available to date, the bioavailability of calcium from calcium-rich mineral waters thus seems to be at least comparable to, and possibly better than, that from dairy products. These results are in keeping with the assumption that calcium-rich mineral water is a useful calcium source to achieve new, higher recommended daily allowances of calcium.

Natural mineral waters: chemical characteristics and health effects

“…Skeletal health and bone mineralization need a regular calcium intake and calcic mineral waters represent an important dietary source of calcium and should be recognized as good low-calorie nutritional calcium supplements (43). The calcium bioavailability of mineral waters has been investigated by different Authors and it is demonstrated that calcium from mineral waters is bioavailable as dairy products, sometimes also more than milk (37,42). Moreover, calcium-rich mineral waters increase bone mineralization, considering both femoral and spinal bone mineral density after calcic waters intake (44,45).…”

“…A systematic review and a meta-analysis on five studies shows that, although only a few studies with a relatively small number of subjects are available, the calcium bioavailability of mineral waters is at least comparable to, and possibly better than, that from dairy products or pharmaceutical preparations (42). Because of calcium bioavailability, high-calcium mineral waters represent an important dietary source of calcium and should be recognized as good low-calorie nutritional calcium supplements (43).…”

Balneoprevention: new approaches

“…Therapeutic, low volume consumption of highly mineralized waters has a great influence on the activity of the gastrointestinal system, ionic balance of the organism, and excretion. A series of clinical trials has been published on the preventive action of mineralized waters in several diseases (Worwood et al 1996;Rodgers 1997;Bohmer et al 2000). The everyday mineral water consumption of the population, however, can also be viewed as a preventive measure.…”

Gesundheitliche Bedeutung natürlicher Mineralwässer

“…In den meisten Studien wird die Bioverfügbarkeit von Calcium aus Mineralwässern mit jener aus Milch verglichen und festgestellt, dass die Werte der Bioverfügbarkeit aus beiden Getränken vergleichbar sind [2][3][4]. Böhmer et al fanden in einer Meta-Analyse 6 Studien die sich mit der Problematik der Calciumresorption aus Mineralwasser befassten [3].…”