Most individuals would assume that due to the low number of calories and artificial additives, sparkling water and seltzer water are considerably healthier alternatives to soda. The low sugar content pushes it above many juices and recovery drinks such as Gatorade or Powerade. However, Sophie Egan’s article in the New York Times, Does Sparkling Water Have a Downside, questions this healthy alternative1. The first question posed is the risks of sparkling water contributing to low bone mineral density (BMD) and osteoporosis. In Tucker et al.’s study on the effects of coca cola and other carbonated beverages on low BMD, results showed only coca cola – regular, diet and non-caffeinated (albeit lower for the latter two types) – was associated with a decrease BMD in men and women who consumed more than one coca cola per month3. Other carbonated beverages, such as the essentially carbonated water that is seltzer and sparkling, showed no effects on bone mineral density or association with osteoporosis development3.
However, this leads to the second question. Sparkling water may not be correlated with detrimental effects on bone, but does its low pH (acidity) lead to a degradation of tooth enamel? Reddy et al., in a study on 379 United States beverages and their pH levels, established three classifications for beverage acidity (extremely erosive, erosive, and minimally erosive)2. Sparkling water, plain without any additions, has a pH level of 5, which classifies it as minimally erosive, and hence not a danger to tooth enamel erosion1. Yet, where individuals need to be careful is with adding citric flavors, such as lemon or lime, to their sparkling water. The natural acidity in these fruits can increase the pH levels and consequently decrease the healthy benefits of drinking a sparkling water over a carbonated soda.
Two additional comments Egan makes on the downside of sparkling water involve essential minerals. Drinking bottled sparkling water eliminates the benefits of the fluoridation process of tap water. Also, avoid making the mistake of confusing seltzer and sparkling water with club soda. These are not the same, as the latter includes a large amount of added sodium, which is already consumed in a larger than healthy amount among most Americans.
All in all, Egan utilizes two decently coordinated studies to effectively, and accurately, provide a better-rounded view on the health benefits, and risks, of consuming sparkling water. This media piece provides useful information that many individuals may have been unaware of, as they chose sparkling water with fruit flavorings over sodas in an attempt to make a healthier beverage selection.
1Egan, S. (16 September 2016). Does Sparkling Water Have a Downside? New York Times. Retrieved September 18, 2016 from http://well.blogs.nytimes.com/2016/09/16/does-sparkling-water-have-a-downside/?rref=collection%2Fsectioncollection%2Fhealth&action=click&contentCollection=health®ion=rank&module=package&version=highlights&contentPlacement=9&pgtype=sectionfront.
2Reddy, A., et al. (2016). The pH of Beverages in the United States. American Dental Association. Retrieved September 18, 2016 from http://www.ada.org/en/~/media/ADA/Public%20Programs/Files/JADA_The%20pH%20of%20beverages%20in%20the%20United%20States.
3Tucker, K., et al. (2006). Colas, but not other carbonated beverages, are associated with low bone mineral density in older women: The Framingham Osteoporosis Study. American Society for Clinical Nutrition. Retrieved September 18, 2016 from http://ajcn.nutrition.org/content/84/4/936.
Well, this is actually my worst nightmare, as I *live* for La Croix. I’ve heard these sentiments before, and I can see how the carbonation could affect tooth enamel. I was intrigued to see the effect on BMD, as that is my area of research here at UGA. I took a look at the article and it was interesting to see they proposed phosphoric acid as potentially contributing to some of the negative effect due to the potential stimulation of parathyroid hormone, which will lead to bone breakdown. I would be curious to see if the lifestyle patterns of the soda versus non-soda drinkers differed. Bone status, especially when you get older, has a lot to do with physical activity, calcium and vitamin D intake and estrogen levels (and even what age a woman reached menarche!). Though they said cola was not displacing milk consumption, I still wonder how the nutrition and lifestyle habits differed. In terms of the effects on teeth, maybe it would be worthwhile to have a study done in Italy, they primarily drink “fizzante” water!
Interesting article. I knew Staci would get to the comments first, with her main interests being in bone and La Croix.
My major question for this article would be on the assumption that people are using sparkling water to replace fluoridated tap water. Typically, it is considered a “healthier” option for soda drinkers, and as you outlined it is less detrimental to BMD than cola drinks. Even if sparkling water was replacing tap water that had added fluoride, how detrimental would that be? Fluoride can be found in many foods including spinach, tomatoes, even celery. With a varied diet it is possible to reach the Adequate Intake of 10 mg a day through food. I would be interested to see a study on fluoride intakes of those who do consumed beverages other than water.
I second Staci’s comment about this article being one of my worst nightmares. I am not a fan of the sweetness of soda so therefore I am an avid sparkling water/seltzer drinker. That being said, there were two major points in this post that I found interesting. I would be curious to know how their fluoride worry would change if they studied someone like me who truly uses the sparkling water in place of soda and still drinks large amounts of “normal” water, instead of someone who is using the sparkling water to replace their “normal” water intake. I was also curious about the additive flavor portion of this post, especially the citric flavors. I would be curious to find out if there was any difference (whether good or bad) of adding fresh lemon/lime juice to plain sparkling water compared to the artificially flavored option.
I also thought it was extremely important and beneficial that Egan pointed out that sparkling water/ seltzer is actually very different from club soda. Working in different restaurants as a bartender for the past few years, it has always surprised me how many people do not realize the difference. As a side note for avid seltzer drinkers like myself, be aware that many times most restaurant “soda guns” spit out club soda rather than seltzer, and most servers do not know the difference. So make sure you are specific when you are ordering out!!