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Is carbonated water as healthy as regular water?

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Is carbonated water as good for you as regular water? - National | Globalnews.ca

IMG via Global News 

Some say that carbonation in water may limit hydration, reduce gastrointestinal symptoms, and increase satiety. But let’s think twice about those claims.   

Regarding hydration, a randomized trial found no difference in urine volume after consumption of still water compared to sparkling water (1).  

Regarding gastrointestinal health, a small (21 subjects) double-blind randomized trial found fewer symptoms of indigestion with carbonated water compared to tap water (2). Another double-blind study of 40 elderly people found fewer symptoms of constipation among people who consumed carbonated water compared to those who drank still water (3). One question about both of these studies is how blinding was accomplished, since subjects can sense carbonation. The small number of study subjects decreases confidence in each experiment.  

It is also speculated that carbonated water can improve satiety, or sense of fullness. Two very small uncontrolled studies reported that people felt satiated after drinking carbonated water (4,5). But that might be the case for still water as well. There is also no good evidence that sparkling water can cause gas and bloating (6) and no evidence that it erodes tooth enamel, even though these symptoms have been reported anecdotally (7).  

While experimental evidence from randomized controlled trials is required to determine the relative health benefits of still and sparkling water, it is a good option for hydration, particularly compared to sugary drinks.  

References:

  1. Maughan RJ, Watson P, Cordery PA, et al. A randomized trial to assess the potential of different beverages to affect hydration status: development of a beverage hydration index. Am J Clin Nutr. 2016;103(3):717-723. doi:10.3945/ajcn.115.114769 
  2. Cuomo R, Grasso R, Sarnelli G, et al. Effects of carbonated water on functional dyspepsia and constipation. Eur J Gastroenterol Hepatol. 2002;14(9):991-999. doi:10.1097/00042737-200209000-00010 
  3. Mun JH, Jun SS. J Korean Acad Nurs. 2011;41(2):269-275. doi:10.4040/jkan.2011.41.2.269 
  4. Suzuki M, Mura E, Taniguchi A, Moritani T, Nagai N. Oral Carbonation Attenuates Feeling of Hunger and Gastric Myoelectrical Activity in Young Women. J Nutr Sci Vitaminol (Tokyo). 2017;63(3):186-192. doi:10.3177/jnsv.63.186 
  5. Wakisaka S, Nagai H, Mura E, Matsumoto T, Moritani T, Nagai N. The effects of carbonated water upon gastric and cardiac activities and fullness in healthy young women. J Nutr Sci Vitaminol (Tokyo). 2012;58(5):333-338. doi:10.3177/jnsv.58.333 
  6. Welstead L, Schuchmann C. Is sparkling water good for you? What about hard water? University of Chicago Medicine. 10 May 2023. 
  7. Parry J, Shaw L, Arnaud MJ, Smith AJ. Investigation of mineral waters and soft drinks in relation to dental erosion. J Oral Rehabil. 2001;28(8):766-772. doi:10.1046/j.1365-2842.2001.00795.x 
  8. https://globalnews.ca/news/4286475/is-carbonated-water-good-for-you/

 

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Is Dark Chocolate Good for You?

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bigstock-Delicious-dark-chocolate-bar-i-15054239

IMG via Moorings Park Communities 

Sweets are tasty, but refined sugar shouldn’t comprise a large part of our diet. Dark chocolate is promoted as a sweet with relative health benefits. Let’s think twice: what’s the evidence that dark chocolate is good for you? 

One of the potential benefits of dark chocolate is its relatively high content of antioxidants. Antioxidants can neutralize the free radicals (molecules that can damage cells) produced during natural metabolic processes, or when we are exposed to smoke, radiation, or other carcinogens (1). It is proposed that ingesting antioxidants can help protect against cardiovascular disease and cognitive decline (2,3).  

The idea that flavanols, the antioxidant agents in dark chocolate, reduce rates of cognitive decline has no support from adequately controlled and randomized experiments (4). The quality of the evidence used to support the claim that flavanols delay cognitive decline is low, such as uncontrolled cohort studies. For example, a study of just 17 participants claimed flavanols increase blood flow to the brain (an indirect outcome) (5).  

A large randomized trial with no placebo arm studied antioxidant supplementation beginning in 1998 and found that cognitive function was perhaps marginally improved over an 18-year period (6). But a placebo-controlled trial found that antioxidant-containing supplements did not protect against dementia (7). As is often the case, better quality evidence often contradicts the findings of less rigorous studies.   

Another claim for antioxidants is that they protect against cardiovascular disease. However, several large studies have shown no difference in cardiovascular outcomes between people taking antioxidant supplements and those taking placebos (8,9). After a careful look, it is questionable whether dark chocolate provides protection against cognitive decline or cardiovascular disease. However, that’s not to say it isn’t still a satisfying sweet! 

References:

  1. Lobo V, Patil A, Phatak A, Chandra N. Free radicals, antioxidants and functional foods: Impact on human health. Pharmacogn Rev. 2010;4(8):118-126. doi:10.4103/0973-7847.70902 
  2. A flavanol-rich diet may increase brain function. Harvard Health Publishing and Harvard Medical School. March 1, 2021. Accessed July 15, 2023. https://www.health.harvard.edu/mind-and-mood/a-flavanol-rich-diet-may-increase-brain-function 
  3. Lobo V, Patil A, Phatak A, Chandra N. Free radicals, antioxidants and functional foods: Impact on human health. Pharmacogn Rev. 2010;4(8):118-126. doi:10.4103/0973-7847.70902 
  4. A flavanol-rich diet may increase brain function. Harvard Health Publishing and Harvard Medical School. March 1, 2021. Accessed July 15, 2023. https://www.health.harvard.edu/mind-and-mood/a-flavanol-rich-diet-may-increase-brain-function 
  5. Ullah A, Munir S, Badshah SL, et al. Important Flavonoids and Their Role as a Therapeutic Agent. Molecules. 2020;25(22):5243. Published 2020 Nov 11. doi:10.3390/molecules25225243 
  6. Panche AN, Diwan AD, Chandra SR. Flavonoids: an overview. J Nutr Sci. 2016;5:e47. Published 2016 Dec 29. doi:10.1017/jns.2016.41 
  7. Gratton, G., Weaver, S.R., Burley, C.V. et al. Dietary flavanols improve cerebral cortical oxygenation and cognition in healthy adults. Sci Rep 10, 19409 (2020). https://doi.org/10.1038/s41598-020-76160-9 
  8. Grodstein F, Kang JH, Glynn RJ, Cook NR, Gaziano JM. A Randomized Trial of Beta Carotene Supplementation and Cognitive Function in Men: The Physicians’ Health Study II. Arch Intern Med. 2007;167(20):2184–2190. doi:10.1001/archinte.167.20.2184 
  9. Kryscio RJ, Abner EL, Caban-Holt A, et al. Association of Antioxidant Supplement Use and Dementia in the Prevention of Alzheimer’s Disease by Vitamin E and Selenium Trial (PREADViSE). JAMA Neurol. 2017;74(5):567–573. doi:10.1001/jamaneurol.2016.5778 
  10. Hennekens C., et al. Lack of Effect of Long-Term Supplementation with Beta Carotene on the Incidence of Malignant Neoplasms and Cardiovascular Disease. New England Journal of Medicine. 1996; 334:1145-1149. DOI: 10.1056/NEJM199605023341801 
  11. Lee I, Cook NR, Gaziano JM, et al. Vitamin E in the Primary Prevention of Cardiovascular Disease and Cancer: The Women’s Health Study: A Randomized Controlled Trial. JAMA. 2005;294(1):56–65. doi:10.1001/jama.294.1.56 
  12. https://www.mooringspark.org/news/the-health-benefits-of-dark-chocolate
All, Medicine, Recent posts, Women's Health

Does birth control cause infertility?

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Birth Control

IMG via MedlinePlus

Women take birth control for a multitude of reasons, from preventing pregnancy to regulating the menstrual cycle and reducing acne. Taken correctly, the pill can prevent 99% of pregnancies. This has made birth control a staple for generations of women. However, some women may wonder, What happens if I stop taking the pill? One misconception about the pill is that taken for years, it can reduce the ability to have children. The possibility of future infertility would deter many women from considering birth control pills. So, let’s think twice about it.  

The combination pill works by supplying two hormones, estrogen and progesterone, that work together to stop the ovaries from releasing an egg each month during menstruation. Other pills provide only progesterone; progestin-only pills prevent pregnancy primarily by thickening the cervical mucus. When you stop taking the pill, the hormones it supplies leave your system in a matter of days, and your body reverts to its natural cycle. Additionally, your body begins to produce estrogen and progesterone again. Therefore, barring underlying health issues, women can become pregnant right away after stopping the pill. 

There are several reasons behind the misconception that birth control causes infertility. One is that taking birth control can conceal symptoms of conditions associated with infertility, such as endometriosis, PCOS, and uterine fibroids. Birth control is sometimes used to manage these conditions, so stopping birth control might mistakenly associated with infertility. Another reason for this misconception might be that historically, the side effects of the pill were not well-researched or disclosed to users, so it was not clear whether infertility was a risk. Women often felt dismissed by clinicians and pharmaceutical companies when they experienced side effects of the pill, even for conditions as serious as blood clots and strokes. In the 1960s, despite reports of deaths related to the pill, the FDA maintained that the pill was safe. Additionally, drug companies failed to inform healthcare providers of the pill’s more severe side effects. Since then, the dosage of hormones provided by the pill was adjusted to improve its safety, but mistrust of the pill persists and worries about infertility have continued to the present day.  

However, there is good evidence that birth control users need not worry about their fertility. A 2018 review of twenty-two birth control studies including over 14,000 women showed that 83% of women became pregnant within 12 months of discontinuing contraception. Furthermore, a 2013 study of 3,727 women found that although birth control use was associated with a short delay before conception, overall fertility was not impacted. Additionally, longer-term use of the pill was associated with higher fertility compared to short-term use (less than 2 years). Therefore, even long-term users of the pill should not be concerned. Overall, the evidence suggests that worries about infertility should not stop women from taking the pill.  

Links:

https://my.clevelandclinic.org/health/drugs/3977-birth-control-the-pill#:~:text=Birth%20control%20pills%20are%20a,improve%20acne%20and%20treat%20endometriosis. 

https://my.clevelandclinic.org/health/drugs/3977-birth-control-the-pill 

https://health.clevelandclinic.org/can-birth-control-make-you-infertile/ 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6055351/ 

https://www.mayoclinic.org/healthy-lifestyle/birth-control/in-depth/birth-control-pill/art-20045136#:~:text=The%20pill%20prevents%20your%20body,you%20stop%20taking%20the%20pill. 

https://www.mayoclinic.org/healthy-lifestyle/birth-control/in-depth/best-birth-control-pill/art-20044807#:~:text=How%20do%20the%20different%20birth,sperm%20from%20joining%20the%20egg. 

https://health.clevelandclinic.org/6-things-that-can-happen-when-you-stop-taking-the-pill/ 

https://cham.org/HealthwiseArticle.aspx?id=te8132#:~:text=You%20can%20get%20pregnant%20right,months%20after%20stopping%20the%20pill. 

https://www.healthline.com/health/birth-control/can-birth-control-cause-infertility#misconceptions 

https://www.acog.org/womens-health/faqs/progestin-only-hormonal-birth-control-pill-and-injection#:~:text=It%20stops%20ovulation.,uterus%20and%20fertilize%20an%20egg. 

https://www.sciencedirect.com/science/article/pii/S0277953621005797#bib115 

https://medlineplus.gov/birthcontrol.html