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Biology and the properties of water

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Water consumption and disease prevention

Water consumption and disease prevention

It is known that many diseases have environmental or nutritional components in their etiology.  It is known also that organ function diminishes with age. Environmental and nutritional components cause alterations in tissue physiology which predispose to disease progression, particularly with aging.  Diseases with environmental or nutritional components include the main causes of death and debility in Western societies - atherosclerosis, cerebrovascular disease, ischemic heart disease, Type 2 diabetes, multiple sclerosis, osteoporosis, osteoarthritis, some kidney diseases and some cancers.

Water is essential for life processes and for the structural formation of intracellular biological molecules that support life.  In water, non polar molecules associate with each other(1).  In addition, the hydrophobic surfaces of biological molecules attract one another in water.  In body cells, this hydrophobic interaction is one of the key stabilizing forces of protein folding and of multi-subunit assemblies(2).  Despite the central role of water in life processes and biological structures, and water's ability to form hydrogen bonds and hydration complexes, it is open to debate whether drinking extra water, or drinking water with specific constituents, would assist in preventing the abovementioned diseases.  Nevertheless, the diseases share similar risk factors which include aberrations in tissue blood supply, oxygen supply and fluid balance.

What is irrefutable is that the polar nature of water molecules affects the structure and function of intracellular biomolecules such as proteins and nucleic acids.  The structure and function of intracellular biomolecules often define differences between health and disease.  Indeed, whilst it has been recognized for decades that protein structure and function depends on appropriate hydration, it has been overlooked that the famous double-helical structure of DNA is not intrinsic to that molecule but relies on appropriate hydration.  Without water, and possibly other counter ions, to screen the electrostatic repulsion between phosphate groups, the classic orderly helix of DNA is no longer viable.  At low hydration, the most biologically relevant B form of DNA undergoes conformational transitions to other forms(3).  It is feasible that inappropriate hydration of DNA may be associated with diseases - particularly diseases of inappropriate DNA expression or DNA mutation such as cancer.

Several epidemiological studies have demonstrated an association between extra water consumption and the prevention of disease.  In the Adventist Health Study, a prospective cohort study involving approximately 20,000 people, extra water consumption was correlated significantly to a decrease in fatal coronary heart disease(4).  In a case control study of approximately 400 people with colon cancer, there was a strong inverse association between extra water consumption and risk of colon cancer among women(5).  In a prospective study of 47,000 men, the consumption of 1500ml of water per day decreased the incidence of bladder cancer(6).

A small, hospital-based, case-control study of 44 women with newly diagnosed histologically confirmed breast cancer in England showed a strong, inverse, significant association between daily water consumption and breast cancer(7).  The drinking of water conferred a beneficial effect on cancer risk.

In 2003, the World Health Organization (WHO) gathered a group of experts to assess 80 observational epidemiological studies which related the constituents of drinking water to health and disease.  The majority, but certainly not all, of the studies found a protective association between the calcium and magnesium constituents of water and the risk of death from cardiovascular disease(8,9). Other studies have further supported the inverse association between magnesium levels in drinking water and cardiovascular mortality (reviewed in 10). A major review of epidemiological studies on drinking water concluded that a low intake of magnesium in drinking water increased the risk of dying from, and possibly developing, both cardiovascular disease and stroke.

Abstract in European Journal of Cardiovascular Prevention and Rehabilitation:

http://www.escardiocontent.org/periodicals/ejcpr/article/S1741-8267%2803%2913404-4/abstract

Following a meta-analysis of high quality case control studies, a statistically significant (p < 0.001) effect was found between low magnesium levels in drinking water and cardiovascular mortality.

Abstract in Journal of Water and Health:

http://www.ncbi.nlm.nih.gov/pubmed/18401109

A large case control study (17,133 and 17,133 controls) found a significant protective effect of moderate to high magnesium concentrations in drinking water on the risk of death from cerebrovascular disease (stroke).

Abstract in Stroke:

http://www.ncbi.nlm.nih.gov/pubmed/9472882

Drinking waters often contain calcium and magnesium ions that have arisen from natural geological processes involving rain water reacting with rocks and soils.

Calcium and Magnesium

in Drinking Water

The Australian Government National Health and Medical Research Council (NHMRC) has stated in its guidelines for drinking water that the consumption of soft water (water relatively low in calcium or magnesium ions) may adversely affect mineral balance in the body(11).  Many international governmental health authorities make similar statements.

The National Academy of Sciences (USA) and the associated National Research Council (USA) have published evidence that groups of people demonstrate increased longevity (a low death rate) if they reside in areas of the United States that have relatively high levels of calcium, magnesium and bicarbonate ions in drinking water, particularly high levels of magnesium.  In contrast, groups of people demonstrate decreased longevity (a high death rate) if they reside in areas of the United States that have relatively low levels of calcium, magnesium and bicarbonate ions in drinking water, particularly low levels of magnesium(12). 

Recent clinical evidence may help to explain some of the epidemiological results cited above. It has been demonstrated that optimal hydration, optimal kidney function and optimal magnesium status may help to prevent atherosclerosis. Atherosclerosis (a specific type of arteriosclerosis or 'hardening of the arteries') is the main contributor to death in Western and industrialized societies. See below*.

1. Dill KA and Bromberg S.  Molecular Driving Forces, Statistical Thermodynamics in Chemistry and Biology. 2003. Garland Science, New York.

2. Ball P.  2003.  How to keep dry in water.  Nature 423: 25-26.

3. Ball P.  2008.  Water as an Active Constituent in Cell Biology.  Chem Rev 108: 74-108.

4. Chan J, et al.  2002.  Water, Other Fluids, and Fatal Coronary Heart Disease.  Am J Epidemiol 155(9): 827-833.

5. Shannon J, et al.  1996.  Relationship of Food Groups and Water Intake to Colon Cancer Risk.  Cancer Epidemiology, Biomarkers & Prevention 5: 495-502.

6. Michaud DS, et al.  1999.  Fluid intake and the risk of bladder cancer in men.  N Engl J Med 340: 1390-1397.

7. Stookey JD, et al.  1997.  Correspondence re: J. Shannon et al., Relationship of Food Groups and Water Intake to Colon Cancer Risk. Cancer Epidemiol., Biomarkers & Prev., 5: 495-502. Cancer Epidemiol Biomarkers & Prev 6: 657-658.

8. World Health Organization Nutrients in Drinking Water, Expert Consensus, World Health Organization Meeting Group Report 2005.

9. Drinking Water Hardness and Cardiovascular Diseases:  A review of the epidemiological studies 1979-2004, Chapter 11, pages 127-134 in World Health Organization Nutrients in Drinking Water, World Health Organization meeting Group Report 2005.

10. Day RO, et al.  2010.  A double-blind, placebo-controlled study of the short term effects of a spring water supplemented with magnesium bicarbonate on acid/base balance, bone metabolism and cardiovascular risk factors in postmenopausal women.  BMC Research Notes 3: 180.

11. Australian Government, Australian Drinking Water Guidelines 6, 2004; NHMRC, 2003.

12. Feder GL. 1981. Contrasts in drinking-water quality between the increased-longevity low-death-rate area and the decreased-longevity high-death-rate area in the United States. In Aging and the Geochemical Environment (Panel on Aging and the Geochemical Environment). 92-103. National Research Council. National Academy Press, Washington, D.C.

Water consumption and disease prevention

Water consumption and disease prevention

*Atherosclerosis overwhelmingly contributes to more mortality and more serious morbidity in the Western world than any other disorder. Atherosclerosis is responsible for over half of all deaths in the Western world. In the USA alone, over one million people die each year from the consequences of atherosclerosis. The diagnoses and treatments of atherosclerosis and diseases resulting from, or related to, atherosclerosis consume the majority of monies allocated to national health budgets.

Atherosclerosis is a disease of the intimal layer of arteries. It primarily affects the aorta, carotid, iliac, and coronary arteries. The major consequences of atherosclerosis are ischemic heart disease (coronary heart disease), myocardial infarction (heart attack), cerebral infarction (stroke), aortic aneurysms, and gangrene of the extremities. It is considered also that atherosclerosis may contribute to dementia, Alzheimer's disease and other diseases of the brain related to ischemia. At the very least, atherosclerosis, dementia and Alzheimer's disease are heterogeneous disease processes sharing similar risk factors.

For more information visit the Prevent Atherosclerosis information website - www.preventatherosclerosis.info.