Acid-Base Balance in Healthy Adults: Beneficial Effects of Bicarbonate and Sodium-Rich Mineral Water in a Randomized Controlled Trial: The BicarboWater Study.

Background: Noncommunicable diseases (NCDs) are a global health challenge. The complex etiology of NCDs involves genetic, environmental, and lifestyle factors, including dietary habits. Chronic latent metabolic acidosis has been associated with an increased risk of NCDs. Alkalizing diets and mineral water consumption have shown promise in improving acid-base balance and potentially impacting NCDs. Methods: In this randomized controlled intervention study, the effect of drinking 1,500-2,000 mL of mineral water daily on acid-base balance was evaluated. Ninety-four healthy participants were divided into two groups: one consumed mineral water with a high bicarbonate and sodium content (HBS, n = 49) and the other consumed mineral water with a low bicarbonate and sodium content (LBS, n = 45). Changes in venous blood gas and urinary acid-base parameters were measured over a short-term (3 days) and long-term (28 days) intervention period. Potential renal acid load (PRAL) and nutrient intake were calculated at baseline and after 28 days. Results: HBS water consumption led to increased urinary pH (24-hour urine and spontaneous urine, both p < 0.001) and bicarbonate levels (p < 0.001), accompanied by reduced titratable acids (p < 0.001) and ammonium (p < 0.001), resulting in a lower renal net acid excretion (p < 0.001). These changes occurred in the short term and persisted until the end of the study. LBS consumption showed no significant effects on urinary pH but led to a slight decrease in bicarbonate (p < 0.001) and NH4 + (p < 0.001), resulting in a slight decrease in NAE (p=0.011). Blood gas changes were modest in both groups. Mineral water consumption in the HBS group altered dietary intake of sodium and chloride, contributing to changes in PRAL values. Conclusion: The study demonstrates that the consumption of mineral water high in bicarbonate and sodium (1,500 mL-2,000 mL/day) can positively influence urinary acid-base parameters and reduce NAE, suggesting potential benefits in maintaining acid-base balance without adverse effects on human health. These findings highlight the importance of mineral water composition in acid-base regulation. This trial is registered with DRKS00025341.

A micronutrient supplement modulates homocysteine levels regardless of vitamin B biostatus in elderly subjects.

Elevated homocysteine (Hcy) levels (≥15 µmol/L) in the elderly are frequently associated with a higher risk of cardiovascular disease and cognitive decline. Several studies have already shown an Hcy-lowering effect of B vitamin supplementation in cohorts deficient in these nutrients. The aim of this randomized, double-blinded 12-week intervention study was to investigate whether Hcy levels in healthy elderly subjects (75.4±4.5 years, n=133) could be lowered with a micronutrient supplement (i.e., 400 µg folic acid, 100 µg cobalamin). Difference in mean initial Hcy levels between intervention (17.6±7.1 µmol/L, n=65) and placebo group (18.9±6.1 µmol/L, n=68) was not significant. The prevalence of cobalamin and folate deficiency in the total study population was low: 27% had serum-cobalamin levels ≤150 pmol/L, 12% holo-transcobalamin (Holo-TC) levels ≤50 pmol/L, 13% low cobalamin status using the aggregated cobalamin marker 4cB12 and 10% red blood cell (RBC) folate ≤570 nmol/L. Nevertheless, the treated subjects still showed improved cobalamin and folate biostatus (serum cobalamin Δt12-t0: 63±48 pmol/L; Holo-TC Δt12-t0: 17±19 pmol/L; RBC folate Δt12-t0: 326±253 nmol/L) and Hcy levels (Δt12-t0: -3.6±5.7 µmol/L). The effects were statistically significant compared to the placebo group with p=0.005 (serum cobalamin), p=0.021 (Holo-TC), p=0.014 (RBC-folate) and p<0.001 (Hcy). The Hcy-lowering effect was dependent on the initial Hcy levels (p<0.001). Our findings suggest that elevated Hcy levels in elderly subjects can be lowered regardless of the initial cobalamin and folate biostatus.

Peripheral blood derived endothelial colony forming cells as suitable cell source for pre-endothelialization of arterial vascular grafts under dynamic flow conditions.

In regenerative medicine, autologous peripheral blood derived endothelial colony forming cells (PB-derived ECFC) represent a promising source of endothelial cells (EC) for pre-endothelialization of arterial tissue engineered vascular grafts (TEVG) since they are readily attainable, can easily be isolated and possess a high proliferation potential. The aim of this study was to compare the phenotype of PB-derived ECFC with arterial and venous model cells such as human aortic endothelial cells (HAEC) and human umbilical vein endothelial cells (HUVEC) under dynamic cell culture conditions to find a suitable cell source of EC for pre-endothelialization. In this study PB-derived ECFC were cultivated over 24 h under a high pulsatile shear stress (20 dyn/cm2, 1 Hz) and subsequently analyzed. ECFC oriented and elongated in the direction of flow and expressed similar anti-thrombotic and endothelial differentiation markers compared to HAEC. There were significant differences observable in gene expression levels of CD31, CD34 and NOTCH4 between ECFC and HUVEC. These results therefore suggest an arterial phenotype for PB-derived ECFC both under static and flow conditions, and this was supported by NOTCH4 protein expression profiles. ECFC also significantly up-regulated gene expression levels of anti-thrombotic genes such as krueppel-like factor 2, endothelial nitric oxide synthase 3 and thrombomodulin under shear stress cultivation as compared to static conditions. Dynamically cultured PB-derived ECFC therefore may be a promising cell source for pre-endothelialization of arterial TEVGs.