Health Benefits of Mineral Water: For Heart, Constipation, Hypertension, and More

Mineral water is a natural, healthy beverage. The Oxford Dictionary defines mineral water as “water from a spring in the ground that contains mineral salts or gasses”. Mineral water usually refers to bottled mineral water and can be sparkling (naturally or artificially carbonated) or still, meaning uncarbonated. Regulations in some countries require a minimum total level of minerals, referred to as Total Dissolved Solids or TDS, measured in milligrams per liter.

There is a large variation among brands in both the total amount of minerals and the specific minerals present due to the widely varied geologic sources of mineral waters. People sometimes confuse any natural source bottled water as mineral water, or sometimes even any bottled water at all. Such usage is incorrect.

Legal definitions of mineral water vary by country. The definitions of mineral water for different countries are listed below.

• The European Union’s Mineral Water Definition: The EU Mineral Water Directive defines Natural Mineral Water as “microbiologically wholesome water, originating in an underground water table or deposit and emerging from a spring tapped at one or more natural or bore exits.” It must be obtained from a protected underground source, be free from impurities (physical, microbiological, chemical, and radiological), have a stable mineral composition, be bottled near the source, and the only treatments allowed are removal of unstable components such as iron and sulfides or the addition of carbon dioxide for sparkling versions. The EU notably does not set a minimum TDS level.
• The USA’s Mineral Water Definition: The US Food and Drug Administration (FDA) defines mineral water as water that “comes from an underground source and contains at least 250 parts per million total dissolved solids. Minerals and trace elements must come from the source of the underground water. They cannot be added later.” The underground source can be “one or more boreholes or springs”.
• The Codex Alimentarius Mineral Water Definition The Codex Alimentarius is a set of food standard guidelines written by the UN Food and Agriculture Organization (FAO) and the World Health Organization (WHO) which countries often use as a basis for writing local regulations. The Codex Alimentarius definition of natural mineral water is virtually the same as the EU definition.

Spring water is a broader and often vaguely defined term that simply means any water which comes from a natural spring that emerges at the surface. Spring waters are sometimes tapped via a borehole below the surface to avoid exposure to impurities. This means that many mineral waters are spring waters since they are sourced from springs.

Actual mineral water is appreciated for the therapeutic health effects arising from the combinations of dissolved compounds in it. Minerals are essential for the functioning of the human body but cannot be produced by it because they are inorganic compounds. Mineral water is a particularly good source of minerals as it is present in the form of ions that can be easily absorbed by the body.

What are the main minerals that mineral water supplies for human health? These are the most common ones.

• Calcium in Mineral Water: Essential for bone development, regulation of muscle contraction, and transmission of nerve impulses.
• Magnesium in Mineral Water: Essential for bone formation and protection from cardiovascular diseases.
• Bicarbonate in Mineral Water: Promotes digestion by neutralizing gastric acidity.
• Potassium in Mineral Water: Regulates muscles and acid-base balance.
• Silica in Mineral Water: Possesses bone-strengthening properties.
• Sodium in Mineral Water: Essential for fundamental regulation of body fluids.
• Sulfate in Mineral Water:Possesses laxative properties and regulates intestinal peristalsis.
• Chloride in Mineral Water: Essential in the formation of digestive juices in the stomach (hydrochloric acid).

The following diagram shows the contributions of these key minerals to the functioning of the body.

Thanks to the presence of these and other trace minerals, depending on the specific composition of a brand, mineral water provides the following health benefits.

1. Improves heart health by lowering cholesterol
2. Helps for digestion
3. Lowers blood pressure by preventing hypertension
4. Treats constipation
5. Increases bone density

Scientific research into mineral water benefits continues to turn up supporting such benefits. As a 2021 study on the San Martino brand of mineral water published in the journal Biomedicine & Pharmacotherapy pointed out, “Hypermineral waters may enhance bowel movements, gastric emptying, [and] gallbladder kinetics.”

1. Heart Benefits of Mineral Water

Research has shown that mineral waters rich in magnesium, calcium, sulfur, sodium, bicarbonate, and chloride contribute to heart health.

• The risk of cardiovascular diseases (or stroke) can be minimized with the optimal consumption of magnesium and calcium content. A study published by Marque et al. in the European Journal of Epidemiology in 2003 found a statistically significant protective effect for cardiovascular mortality at calcium levels of 94-146 mg/l and magnesium levels of 4-11 mg/l. Optimal intake of magnesium may decrease blood triglycerides and increase HDL-cholesterol levels.
• Atherosclerosis (build-up of fats, cholesterol, and other substances in the artery walls) can be prevented by the consumption of Magnesium-rich mineral waters. Galan et al. have shown in their 2002 study published in the Journal of the American Dietary Association that up to 6-17% of the daily magnesium intake can be obtained from mineral water (depending on the brand).
• Cardiac fibrosis, which refers to an abnormal thickening of the heart valves and can be a primary cause of end-stage heart failure can be managed by sulfurous mineral water according to a study published in the Archives of Biochemistry and Biophysics in 2011.
• Post-menopausal women who are at a higher risk of cardiovascular diseases benefit from carbonated mineral water rich in sodium, bicarbonate, and chloride. According to clinical trials published in the Journal of Nutrition and British Journal of Nutrition in 2004 and 2005, 17-34 ounces (0.5-1 liter) of daily carbonated water intake decreased total cholesterol and LDL-cholesterol levels by 6.8% and 14.8%, while HDL-cholesterol (“good cholesterol”) rose 8.7%. These changes in LDS cholesterol and HDL cholesterol significantly reduced indexes measuring cardiovascular disease risk.

ROI mineral water sourced from Rogaska Slatina, Slovenia is one brand that could support many of these benefits as it has 1300 mg/l of Magnesium, 610 mg/l of Calcium, has 7700 mg/l of bicarbonate, 2100 mg/l of sulfate, 1600mg/l of sodium, and 83 mg/l of chloride.

2. Digestion Benefits of Mineral Water

Mineral water helps with neutralizing acid secretions, increasing the pH level in gastric lumen (i.e the contents of the stomach), accelerating digestive emptying, and enhancing the release of gastric peptides (small molecules essential for digestive function) if it is rich in bicarbonates.

In the cases of higher acidity in the digestive tract of those suffering from chronic conditions such as GERD (gastro-esophageal reflux disease), drinking mineral water benefits the alleviation of symptoms if it is bicarbonate-rich. In 2002 clinical trials published by Michele et al. in Pharmacology Research, a 27.4% enhancement in gastric emptying was observed in patients who consumed 1.5 liters per day of bicarbonate-alkaline mineral water (Uliveto) for 30 days.

These are some mineral water brands with healthy bicarbonate levels to provide digestion benefits.

Brand	Source Country	TDS (mg/l)	Bicarbonate (mg/l)
ROI	Slovenia	7481	8449
Vichy Catalan	Spain	2900	2081
Chateldon	France	1882	2075
Vidago	Portugal	2853	1995
Pedras	Portugal	2807	1983
Gerolsteiner	Germany	2527	1817
Socosani	Peru	1392	1239
Crazy Water No. 4	USA	2763	758
Perrier	France	475	390
Mountain Valley Spring	USA	221	176

3. Blood Pressure Benefits of Mineral Water

The number of individuals with metabolic syndromes such as high blood pressure has been on the rise owing to genetic and environmental factors such as the quality of diet and a lack of physical activity. Some minerals such as calcium, magnesium, potassium have been found to be deficient in such individuals (Feldeisen and Tucker, 2007).

Mineral water rich in potassium, calcium, and magnesium helps manage cases of high blood pressure in communities with high consumption of sodium in their diets. Natural mineral water rich in calcium, bicarbonate, magnesium, and sulfate reduced systolic and diastolic blood pressure in individuals aged 45-64 years with borderline hypertension in a 2004 study by Rylander et al. Mineral water benefits included a significant reduction in blood pressure at 4 weeks after drinking at least 1 liter of natural mineral water with a magnesium concentration of 84 mg/l. Badoit sparkling mineral water from France perfectly fits this requirement with 85 mg/l.

The results of the 2004 Rylander study regarding blood pressure, and the mineral composition of the waters involved, are shown in the graphs below.

4. Constipation Related Benefits of Mineral Water

Sulfate-rich mineral water is a good first-line solution in functional constipation before the initiation of laxatives or other drug treatments.

• Digestive troubles (or pain) arising from functional disorders involving the gallbladder are treatable using mineral water. Mennuni et al. (La Clinica Terapeutica 2014), found that the mineral combination of sulfate-bicarbonate-calcium-magnesium can stimulate the release and modulation of the regulators needed for optimal functioning of the gallbladder and decreased digestive pains.
• Dupont et al. in their study published in Clinical Gastroenterology and Hepatology in 2014, assessed the effect of Hépar bottled water (produced by Nestlé Waters, Issy-les-Moulineaux, France) on gastrointestinal movement in constipated women. This magnesium and sulfate-rich natural mineral water (119 mg/l magnesium and 1530 mg/l sulfate) when consumed at 1L per day was found to reduce constipation by 37.5% within 2 weeks.

Extremely high sulfate mineral water brands that can help with constipation (obstruction) to the same degree as Hépar are fairly rare, with the median natural water of the brands profiled by the Fine Water Society having only 10 mg/l. But a close comparable to Hépar is Contrex mineral water from France at 1121 mg/l of sulfate. Crazy Water No.4 in the United States is another at 1170 mg/l of sulfate.

These are some mineral water brands with healthy sulfate levels to provide help with constipation problems.

Brand	Source Country	TDS (mg/l)	Sulfate (mg/l)
ROI	Slovenia	7481	2100
Crazy Water No. 4	USA	2763	1170
Contrex	France	2078	1121
Vytautas	Lithuania	7320	989
San Pellegrino	Italy	1109	549
SwissMountain	Switzerland	988	480
22 Artesian Water	Spain	663	288
Sierra da Graciosa	Brazil	180	250
American Summits	USA	380	170
Starkey Spring Water	USA	240	150

5. Bone Related Health Benefits of Mineral Water

Calcium-rich mineral water benefits bone health. Studies show that drinking mineral water helps with skeletal health if it is rich in calcium. In mineral waters, calcium is usually found associated with bicarbonate and sulfate.

• A 2008 study conducted by Wynn et al. published in The British Journal of Nutrition revealed that bicarbonate-rich calcic mineral waters had an alkalizing power which created an optimal environment for bone mineralization.
• In post-menopausal women, drinking calcium-rich mineral water helps with their calcium requirement (at least 1200mg/day). A 2005 study published in Osteoporosis International showed that post-menopausal women who consumed 1 liter per day of high calcium mineral waters (596mg/l) were found to show lower indices of bone remodeling (i.e a reduction in age-related bone loss).
• Mineral water benefits by being a highly bioavailable source of calcium - i.e., a high amount of the calcium contained in the water is able to enter circulation in the body and have an active effect. Bohmer et al. in their study published in Osteoporosis International in 2000, it was shown that the bioavailability of calcium sourced from mineral waters was comparable and sometimes even better than dairy and pharmaceutical sources. Thus proving that mineral water is a good low-calorie source for achieving the recommended calcium intake of 1000 mg/day.
• The alkali load in bicarbonate-rich mineral water benefits the decrease of bone resorption (in this case referring to a loss of bone density with age) according to a study published in the Journal of Nutrition in 2008.
• Mineral waters with fluoride may be indicated for children because they can help reduce the incidence of tooth decay and promote bone mineralization.

2 liters per day of ROI mineral water with its 610 mg/l of calcium would more than meet the daily recommended intake, but it is not really daily drinking water as it is both expensive and a “challenging” taste that the Netflix show Down to Earth with Zac Efron described as “it tastes like there’s a coin in there” due to its high magnesium content. A widely available choice would be German Gerolsteiner sparkling mineral water with 347 mg/l of calcium that could meet a large portion of one’s daily calcium needs at a more modest cost.

These are some mineral water brands with good calcium levels to help with bone health.

Brand	Source Country	TDS (mg/l)	Calcium (mg/l)
ROI	Slovenia	7481	610
Contrex	France	2078	468
Chateldon	France	1882	383
Manantiales Sureños	Paraguay	305	361
Gerolsteiner	Germany	2527	347
Cana Royal	Slovenia	1572	340
Aqua Carpatica	Romania	1000	260
San Pellegrino	Italy	1109	208
Badoit	France	1200	190
Perrier	France	475	147

To support bone health, calcium-rich bottled water brands are useful. ROI is the highest calcium content bottled water brand among Fine Water Society members.

What Are the Possible Risks of Drinking Mineral Water?

Minerals like iron and sodium easily turn harmful when consumed beyond the safe levels. An excess of iron levels in the body leads to a gradual build-up as the body’s regulatory system fails to keep up and as a result gets stored in the organs such as the liver, heart, and pancreas. Over the course of many years, this potentially leads to life-threatening conditions such as liver disease and some heart ailments.

Excess sodium holds fluid in the body and thereby increases blood pressure and raises the risk of stroke, heart failure, osteoporosis, stomach cancer, and kidney disease. People at risk of cardiovascular diseases and metabolic syndromes should stay away from sodium-rich mineral waters.

There are concerns about high fluoride intake and its toxic effects (carcinogenic, dental fluorosis, skeletal fluorosis, etc.), so the consumption of fluoride mineral water should be kept low. The European Food Safety Agency established the upper limit of exposure to Fluoride as 1.5 mg/l a day. This value is confirmed by the WHO.

In addition to the build-up of minerals that are toxic to the human body in higher concentrations, some of the other risks involving overconsumption of mineral water are water intoxication, GERD, and microplastic effects.

1. Water Intoxication

Water intoxication is the opposite of dehydration and refers to a medical condition where excess water is consumed in a short time span. The standard advice is that eight glasses of eight ounces of water (so 64 fluid ounces per day or 1.9 liters) is a healthy amount of daily water intake. Drinking water without necessity may cause water intoxication if a person rapidly drinks more than 3-4 liters (100-135 fluid ounces). This is dangerous as it can dilute the body’s salt and electrolyte levels and can lead to a homeostatic imbalance (i.e., in this case, depletion of necessary salts due to excess fluids). Clinically, this condition can result in disruption of the kidney’s normal functioning.

Water intoxication usually occurs in scenarios where a high energy strenuous physical activity (athletics and high-intensity workouts) has been undertaken. While certain high-TDS mineral waters can be helpful to athletes and sportspeople for restoring electrolytes, it is of little to no help once the condition of water intoxication has proceeded to a dangerous level and any amount of excess water (mineral or not) from then on can be detrimental. Thankfully, the solution is simple. Stop drinking water until symptoms subside.

A 2007 contest titled ‘Hold Your Wee for a Wii’, hosted by a California radio show, resulted in the death of a woman from water intoxication. The 28-year-old mother consumed around 7.6 liters of water (nearly two gallons) in a bid to win a Nintendo Wii console for her children, and subsequently died after being admitted to hospital. The following video recounts this tragic story from a medical perspective.

2. GERD

The repeated backflow of acid from the stomach into the esophagus is called gastroesophageal reflux disorder (GERD). There is a theory that consuming excessive carbonated mineral water can exacerbate this condition in individuals who suffer from frequent acid reflux. Gastric distension (enlargement of the stomach) caused by the bubbling of CO2 can decrease the pressure of the lower esophageal sphincter at the entrance to the stomach, which could consequently promote acid reflux. Opting for non-carbonated still mineral water is frequently given as advice for those with GERD conditions.

Despite the seemingly sound logic of such suggestions, a 2010 review of scientific studies by the Neuroenteric Clinical Research Group of the Southern Arizona VA Health Care System looked into the impact of carbonated beverages on GERD and found that “Based on the currently available literature, it appears that there is no direct evidence that carbonated beverages promote or exacerbate GERD.” No specific volume in liters or ounces was mentioned in the review.

3. Microplastic Effects

Microplastic contamination from plastic water bottles and other sources is a pressing issue being researched all over the world, with health impacts still uncertain. Some studies suggest links to cancer, disruption of stomach functions, inflammation, obesity, neurological damage, induced oxidative stress, cardiovascular disorders, and immunological responses. research in this field is still in its early stages and it is not clear if these harmful links can be substantiated. The WHO’s take has been much more sanguine, seeing little impact.

Barbera et al. showed in their 2018 study published in Water Research 2018 that mineral water from reusable bottles was found to contain higher amounts of microplastics than from single-use bottles. In water from single-use PET bottles, pigmented particles were less than 4500 particles/liter (133 particles/fluid ounce). Whereas in reusable PET bottles, higher amounts of 18000 to 62000 particles/liter (532 to 1834 particles/fluid ounce) were detected. In water from PET bottles, the predominant polymer found is PET indicating that the contamination arises from the bottle material itself.

In the water from glass bottles, in addition to 3.6% of PET particles, polymers such as PE, PP, and styrene-butadiene-copolymer were found. Possible contamination sources for glass bottles are the water bottle cap, washing equipment, and filing processes. The aging of the bottle material increased the concentration of microplastics in the water.

Solutions in the short term can only come from mineral water producers. Their choice of packaging materials (aluminum or glass versus plastic), filtration methodologies, and the cleanliness of plants and processes all impact the level of microplastics in the water. In the long term, only a world that moves beyond plastic and cleans up the plastic already in the environment can fix the problem in all water types.

Which Minerals in Mineral Water Are More Important?

The minerals in mineral water that are more important are calcium for bone development, magnesium for protection from cardiovascular risks, and potassium for muscles and acid-base balance. The recommended daily allowances for these minerals are as follows.

• Calcium: 1000 mg for adults (1200 mg for women over 51).
• Magnesium: 400-420 mg for men and 310-320 mg for women
• Potassium: 3000-3400 mg for men and 2300-2600 mg for women.

Are The Benefits of Carbonated Mineral Water Different from Still Mineral Water?

The benefits of carbonated mineral water are not different from still water in that if they have the same mineral content as still water, then the same mineral benefits will occur. On the positive side for sparkling water, carbonated mineral waters tend to have higher mineral levels than still waters. Out of the 247 mineral water brands which the Fine Water Society has profiles for, the TDS of the average still water is only 321 mg/l, compared to 813 mg/l for sparkling waters.

On the negative side, carbonated water has a lower pH than still water which may exacerbate acid reflux and GERD because carbonation lowers the pH of water when the CO2 forms carbonic acid. The Fine Water Society’s brand profiles show sparkling mineral waters with an average pH of 6 compared to 7.5 for still waters. In the case of individuals suffering from acid reflux and GERD, opting for still mineral water can be beneficial.

This chart shows the percentage of bottled water brands with Fine Water Society profiles that are in each 0.5-wide pH range, arranged by still water versus sparkling water.

What Are the Other Water Types That Benefit Health?

The other water types that benefit health include the following.

• Tap water
• Lemon water
• Spring water
• Iceberg water

Tap water can be of any quality or mineral content depending on how your local utility sources, treats, and distributes it. But in most parts of the world it is healthy, clean, and cheap. Sometimes it has just as many minerals as bottled mineral water and it does not require any packaging, greatly reducing its environmental footprint for everyday hydration. It is good practice to contact your local water company for a copy of the annual water quality report and check it against the Environmental Working Group’s (EWG) standards.

Lemon water adds the benefits of vitamin C and increased amounts of healthy minerals and can be made from any kind of water including mineral water. Spring waters that are not technically mineral waters still benefit from many of the same regulations as mineral water for assuring purity. Iceberg water such as Svalbarði Polar Iceberg Water has few of the minerals found in mineral water but has an extreme natural purity having been preserved as ice for thousands of years since it first fell from the sky as snow before modern pollution.