Sparkling or Still Water for Stomach Upset and Constipation?

“Natural bubbling or sparkling mineral waters have been popular for thousands of years,” but manufactured sparkling water was first “‘invented’ in the mid to late 1700s” when a clergyman suspended water over a vat of fermenting beer. “For centuries, carbonated water has been considered capable of relieving gastrointestinal symptoms, including dyspepsia,” or tummy aches. But we didn’t have good data until a study was published in 2002, which I discuss in my video Club Soda for Stomach Pain and Constipation. Twenty-one people with dyspepsia, which was defined in the study as “pain or discomfort located in the upper abdomen” including bloating, nausea, and constipation were randomized to drink one and a half quarts of either carbonated or tap water every day for two weeks.

Carbonated water improved both dyspepsia and constipation compared to tap water. “Drink more water” is a common recommendation for constipation, but researchers didn’t observe a clear benefit of the added tap water. It seems you need to increase fiber and water rather than just water alone, but sparkling water did appear to help on its own. The study used a sparkling mineral water, though, so we can’t tell whether these effects were due to the bubbles or the minerals.

There’s been a concern that carbonated beverages may increase heartburn and GERD, acid reflux disease, but that was based on studies that compared water to Pepsi cola. Soda may put the pepsi in dyspepsia and contribute to heartburn, but so may tea and coffee in those who suffer from heartburn. That may be partly from the cream and sugar, though, since milk is another common contributor to heartburn. Carbonated water alone, though, shouldn’t be a problem.

Similarly, while flavored sparkling drinks can erode our enamel, it’s not the carbonation, but the added juices and acids. Sparkling water alone appears 100 times less erosive than citrus or soda. So, a sparkling mineral water may successfully help treat a stomach ache and constipation without adverse effects, unless you’re the teenage boy who opened a bottle of sparkling wine with his teeth or the nine-year-old boy who tried to do so on a hot day after he’d shaken it up, actions placing them at risk for a pneumatic rupture of the esophagus.

For more on combating acid reflux, see Diet and GERD Acid Reflux Heartburn and Diet and Hiatal Hernia.

Some of my other videos on beverages include:

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

How to Avoid BPA

The purported link between obesity and hormone-disrupting plastics chemicals like bisphenol A (BPA) was initially based in part on observations that the rise in chemical exposure seemed to coincide with the rise of the obesity epidemic, but that may only be a coincidence. Many other changes over the last half century, like an increase in fast-food consumption and watching TV, would seem to be simpler explanations. But why are our pets getting fatter, too? Fido isn’t drinking more fries or drinking more soda. Of course, the more we watch Seinfeld reruns, the less we may walk the dog, but what about our cats? They’re also getting fatter. Are we giving both them and our kids a few too many treats? That would seem to be an easier explanation than some pervasive obesity-causing chemical in the environment building up in the pet and person food chains.

How then do we explain the results of a study of more than 20,000 animals from 24 populations, showing they are all getting fatter? The odds that this could happen just by chance is about 1 in 10 million. The study’s “findings reveal that large and sustained population increases in body weight” are occurring across the board, even in those without access to vending machines or getting less physical education in schools. Perhaps some environmental pollutant is involved. I discuss this in my video How to Avoid the Obesity-Related Plastic Chemical BPA.

We’re exposed to a whole cocktail of new chemicals besides BPA, but the reason researchers have zeroed in on it is because of experiments showing that BPA can accelerate the production of new fat cells, at least in a petri dish. This was at more than a thousand times the concentration found in most people’s bloodstream, though. We didn’t know if the same thing happened at typical levels…until now. Most people have between 1 and 20 nanomoles of BPA in their blood, but even 1 nanomole may significantly boost human fat cell production. So, even low levels may be a problem, but that’s in a petri dish. What about in people?

Why not just measure the body weights of a population exposed to the chemical compared to a population not exposed to the chemical? There is virtually no unexposed population: BPA is everywhere. In that case, how about those with higher levels compared to those with lower levels? This is what researchers at New York University did, and the amount of BPA flowing through the bodies of children and adolescents “was significantly associated with obesity.” However, since it was a cross-sectional study, a snapshot in time, we don’t know which came first. Maybe instead of the high BPA levels leading to obesity, the obesity led to high BPA levels, since the chemical is stored in fat. Or, perhaps BPA is a marker for the same kinds of processed foods that can make you fat. What we need are prospective studies that measure exposure and then follow people over time. We never had anything like that…until now! And indeed, researchers found that higher levels of BPA and some other plastics chemicals were significantly associated with faster weight gain over the subsequent decade. So, how can we stay away from the stuff?

Though we inhale some from dust and get some through our skin touching BPA-laden receipts, 90 percent of exposure is from our diet. How can we tell? When we have people fast and drink water only out of glass bottles for a few days, their BPA levels drop as much as tenfold.

Fasting isn’t very sustainable, though.

What happens with a three-day fresh foods intervention, where families switch away from canned and packaged foods for a few days? A significant drop in BPA exposure. If we do the experiment the other way, adding a serving of canned soup to people’s daily diet, we see a thousand percent rise in BPA levels in their urine compared to a serving of soup prepared with fresh ingredients. That study used a ready-to-serve canned soup, which, in the largest survey of North American canned foods, was found to have about 85 percent less BPA than condensed soups, but the worst was canned tuna.

I previously touched upon bisphenol A in BPA Plastic and Male Sexual Dysfunction. Some companies make canned foods without BPA, for example, Eden Foods. (See Do Eden Beans Have Too Much Iodine? for more information.) You can also buy aseptic packaged beans or boil your own. Personally, I like pressure-cooking them.

For more on BPA, see:

Phthalates are another concerning class of plastics chemicals. I covered those in Avoiding Adult Exposure to Phthalates and What Diet Best Lowers Phthalate Exposure?.

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

The Role of Pesticides in Parkinson’s Disease

In the original description of Parkinson’s disease by none other than Dr. James Parkinson himself, he described a characteristic feature of the disease: constipation, which may precede the diagnosis by many years. In fact, bowel movement frequency may be predictive. Men with less than one bowel movement a day were four times more like likely to develop Parkinson’s an average of 12 years later. This could be simply a really early symptom of the disease tied to decreased water intake, however. Many Parkinson’s patients report never really feeling very thirsty, and perhaps that led to the constipation. “Alternately, one may speculate that constipation also increases the risk of Parkinson’s disease as constipation results in a longer stay of the feces in the bowel and thus more absorption of neurotoxicants,” neurotoxins from the diet.

Two studies suggest an association between constipation and Parkinson’s, but, at the same time, 38 studies link the disease to pesticide exposure and by now more than 100 studies link pesticides to an increased risk of up to 80 percent.

Many of these studies are on occupational exposure, like that experienced by farmworkers, who may reduce their risk of Parkinson’s by wearing gloves and washing their clothes, but Parkinson’s has also been linked to ambient exposure. In the United States where approximately a billion pounds of pesticides are applied annually, just living or working in high-spray areas may increase Parkinson’s risk. It’s the same with using pesticides in the home. I didn’t realize how common household pesticide use was, and a study out of UCLA suggests it might not be such a good idea. 

Pesticides may cause DNA mutations that increase susceptibility for Parkinson’s or play a more direct role. Many neurodegenerative diseases appear to be caused by the buildup of misfolded proteins. In Alzheimer’s, it’s the protein amyloid beta; in Creutzfeldt-Jakob and mad cow disease, it’s prions; in Huntington’s, it’s a different protein; and in Parkinson’s disease, it’s a protein called alpha synuclein. A variety of pesticides—8 out of the 12 tested by researchers—were able to trigger synuclein accumulation in human nerve cells, at least in a petri dish, though the study has since been retracted so it’s unclear what the data actually showed.

The buildup of synuclein may play a role in killing off specialized nerve cells in the brain, 70 percent of which may be gone by the time the first symptoms arise. Pesticides are so good at killing these neurons that researchers use them to try to recreate Parkinson’s disease in animals. Is there any way to stop the process? As of this writing, there aren’t yet any drugs that can prevent this protein aggregation. What about flavonoid phytonutrients, natural compounds found in certain fruits and vegetables? Flavonoids can cross the blood-brain barrier and may have neuroprotective effects, so researchers tested 48 different plant compounds to see if any could stop the clumping of synuclein proteins into the little fibers that clog up the cell. And, indeed, they found a variety of flavonoids that can not only inhibit the spider web-like formation of synuclein fibers, but some could even break them up. It turns out flavonoids may actually bind to synuclein proteins and stabilize them.

In my video Berries vs. Pesticides in Parkinson’s Disease, you can see healthy nerve cells and the neurites, the arms they use to communicate to one another. After exposure to a pesticide, however, you can see how the cell is damaged and the arms are retracted. But, if you first incubate the nerve cells with a blueberry extract, the nerve cell appears better able to withstand the pesticide effects. So, this implies that flavonoids in our diet may be combating Parkinson’s disease as we speak, and healthy diets may be effective in preventing and even treating the disorder. However, these were all petri dish experiments in a laboratory. Is there any evidence that people eating berries are protected from Parkinson’s?

A study published quite a long time ago suggested the consumption of blueberries and strawberries was protective, but it was a tiny study and its results were not statistically significant. Nevertheless, that was the best we had…until now. In a more recent study, those eating a variety of phytonutrients were less likely to develop Parkinson’s disease. Specifically, higher intake of berries was associated with significantly lower risk. The accompanying editorial, “An Apple a Day to Prevent Parkinson Disease,” concluded that more research is necessary, but, until then, “an apple a day might be a good idea.” Of course, that’s coming from a man. Apples appeared protective against Parkinson’s for men, but not women. However, everyone appeared to benefit from the berries.

We may not want to have our berries with cream, though, as milk may be contaminated with the same kind of neurotoxic pesticide residues found in the brains of Parkinson’s disease victims.

I’ve produced other videos on Parkinson’s disease, including: 

Learn about other neurological muscular disorders, including essential tremor and ALS:

The same reason Parkinson’s may be related to constipation may also explain the breast cancer connection. For more on this, see my video Breast Cancer and Constipation.

What else can berries do?

But what about all the sugar in fruit? See my videos If Fructose Is Bad, What About Fruit? and How Much Fruit Is Too Much?.

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations: