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bbc.com

Is sparkling water really bad for you?

Claudia Hammond

We all know by now that drinking sweet, fizzy drinks all day isnt a
good idea. The combination of a high sugar content coupled with
acidity caused by the carbonisation that makes it fizzy, isnt good.
Anyone who has tried leaving coins in a glass of cola overnight
knows that they come up shiny and clean. The reason is that
phosphoric acid in the drink removes the oxide coating that has built
up on the coin. So one alternative is to drink water. Still or
sparkling? they say to you in restaurants. If youre not brave
enough to say tap then sparkling can seem like a nice change.
The chances are though, that if youre in a group at least one person
will say sparkling water is bad for you, but is there any evidence for
that claim?
Lets start with the stomach. Fizzy water is made by adding carbon
dioxide under pressure. The result is that water contains the weak
acid, carbonic acid. If you gulp it down it can of course give you
hiccups or indigestion. But what if you drink it at a more measured
pace? Is there any truth in the idea that it harms your stomach?
Quite the reverse, it appears. In a small but double-blinded
randomised trial, patients with frequent dyspepsia or constipation

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were assigned to drink either still or sparkling water for 15 days.

Then they were given a series of tests. Both conditions improved in
the people drinking sparkling water and showed no improvement in
those drinking tap water.
If you drink a lot of sparkling water you might find you feel bloated,
but researchers in Japan have found that this side-effect could be
put to good use. They had a group of women fast overnight and then
slowly drink either still or sparkling water. They found that 900ml of
gas was released from just 250ml of water, so not surprisingly the
womens stomachs distended slightly and the had the perception of
feeling full, even though they hadnt eaten. They didnt feel
uncomfortable and so fizzy water has been suggested as a way of
avoiding overeating, because it makes you feel fuller.
Bone problems?
And you might have heard people deliberately letting fizzy drinks go
flat and then drinking them if theyre dehydrated after a stomach
upset or vomiting or even a hangover. But a review of this practice in
children with acute gastroenteritis found theres little evidence that it
works and that compared with rehydration powders specifically
constituted to contain replacement salts and sugars in the right
proportions such drinks contain far lower levels of sodium and
potassium than youd find in rehydration drinks. So its better to stick
to the real thing.
Surely any acid, even a weak one, is going to erode the enamel on
our teeth?

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But if sparkling water doesnt damage your stomach, how about your
bones? Does it weaken them? Again, the evidence so far suggests
not. A small, Canadian study published in 2001 found that
teenagers who drank lots of fizzy drinks (not sparkling water) had
less calcium in their bones, but they couldnt tell whether this was a
problem with the drinks themselves or that it was because people
who drank them might favour them instead of milk.
The Framingham Heart study began in 1948 and followed a group
of people over many years to discover more about the risk factors for
heart disease. Now some of their offspring are taking part in the
Framingham Osteoporosis Study which involves extensive testing
every four years by researchers from Tufts University in Boston. In
2006, the team examined the relationship between bone density and
fizzy drinks. They looked in detail at the different types of drink
consumed by more 2,500 taking part in the study.
They found that the women (but not men) who drank cola-flavoured
fizzy drinks three times a week had hip bones with a lower average
bone mineral density. Other carbonated drinks made no difference.
The authors hypothesise that the effect is probably down to caffeine
and to the actions of phosphoric acid (not found in sparkling water)
that are not yet well understood. Its possible that it might somehow
block calcium absorption but no one yet knows how. Ten years
later there is still disagreement over how diet affects bone health.
So as far as bones and stomachs go, so far drinking sparkling water
seems to be fine. But how about teeth? Surely any acid, even a
weak one, is going to erode the enamel on our teeth? Maybe not.
Very little research has been done on sparkling water in particular,

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but much more has been done on other fizzy drinks. Barry Owens
from the University of Tennessee College of Dentistry, Memphis,
USA conducted a study back in 2007 comparing different fizzy
drinks. In his study, cola-based drinks came out as most acidic,
followed by diet-based cola drinks, followed by coffee.
Cumulative effect
He argues that its not just the initial pH of a drink that matters, but
how strongly the drink retains that acidity in the presence of other
substances, because in a real-life mouth saliva is present, as well as
other foods which might affect the levels of acidity. This is known as
the buffering capacity. A review of different drinks puts them in the
following order for their buffering capacity. Non fruit-based
carbonated drinks such as cola came out as the most acidic (with
diet versions doing slightly better), followed by fruit-based fizzy
drinks, fruit juice and then coffee. In other words, some fizzy drinks
can damage the hardness of the enamel.
By taking slices of enamel and immersing them in different soft
drinks for six, 24 and 48 hours, Poonam Jain at Southern Illinois
University School of Dental Medicine demonstrated that the enamel
does begin to erode. Some argue that this isnt very like real life
because we dont keep a drink in our mouth for that length of time.
But over the course of many years, even a few seconds each slurp
adds up.
A case study published in 2009 of a 25-year-old bank worker whose
front teeth wore out after four years of drinking half a litre of cola a
day, followed by three years where he upped that to a litre-and-a-half

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each day and added in some fruit juice, is enough to frighten

anyone. But it also depends on how you drink it. This man was
described as holding the drink in the mouth for several seconds
and tasting before swallowing. In Sweden researchers compared
short-sipping, long-sipping, gulping, nipping (whatever that might
be) and sucking. They found that the longer a drink stayed in the
mouth, the more noticeable the drop in pH in that persons mouth. In
other words, the more acidic the mouth becomes. But if you drink
through a straw the drink goes straight to the back of your mouth
and theres less opportunity for damage.
But what about sparkling mineral water? At the University of
Birmingham, Catriona Brown put extracted human teeth without
signs of erosion into jars for 30 minutes with different kinds of
flavoured sparkling water to see what happened. The teeth had
been coated in varnish, apart from a half-a-centimetre-diameter test
area which was left unvarnished. They found the effect of the drinks
on the teeth was the same and sometimes greater than the effect of
orange juice, a drink which is already known to soften tooth enamel.
Lemon and lime, and grapefruit were the most acidic flavours,
probably because they use citric acid to give the nice taste.
So flavoured mineral waters shouldnt be considered as harmless as
water, but how about sparkling water with no added flavours?
Studies on this are few and far between. But in 2001, the
Birmingham team examined seven different brands of mineral water,
again pouring them over extracted teeth to see what happened.
They found sparkling waters had a pH of between 5 and 6 (so not as
acidic as some cola drinks which can be as high as 2.5), compared
with still water which was neutral at 7. In other words, they are a

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weak acid, as suspected. But when it came to the erosive potential

of that weak acid on the teeth, the effect was 100-times less than
that of some other kinds of fizzy drinks. Of course the mouth itself is
a different environment from a jar, but so far the evidence for harm
doesnt seem to be very strong.
So if you want a change from plain old water, then although its
mildly acidic, so far there isnt strong evidence to suggest that its
harmful to your bones, your stomach or your teeth. But if you want to
play safe and keep it away from your teeth, when you answer the
question still or sparkling, perhaps you should also ask for a straw.
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