1.
Association of bacterial load in drinking water and allergic diseases in childhood.
Turkalj, M, Drkulec, V, Haider, S, Plavec, D, Banić, I, Malev, O, Erceg, D, Woodcock, A, Nogalo, B, Custovic, A
Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology. 2020;(6):733-740
Abstract
BACKGROUND Treatment of drinking water may decrease microbial exposure. OBJECTIVE To investigate whether bacterial load in drinking water is associated with altered risk of allergic diseases. METHODS We recruited 1,110 schoolchildren aged 6-16 years between 2011 and 2013 in Požega-Slavonia County in Croatia, where we capitalized on a natural experiment whereby individuals receive drinking water through public mains supply or individual wells. We obtained data on microbial content of drinking water for all participants; 585 children were randomly selected for more detailed assessments, including skin prick testing. Since water supply was highly correlated with rural residence, we compared clinical outcomes across four groups (Rural/Individual, Rural/Public, Urban/Individual and Urban/Public). For each child, we derived quantitative index of microbial exposure (bacterial load in the drinking water measured during the child's first year of life). RESULTS Cumulative bacterial load in drinking water was higher (median [IQR]: 6390 [4190-9550] vs 0 [0-0]; P < .0001), and lifetime prevalence of allergic diseases was significantly lower among children with individual supply (5.5% vs 2.3%, P = .01; 14.4% vs 6.7%, P < .001; 25.2% vs 15.1%, P < .001; asthma, atopic dermatitis [AD] and rhinitis, respectively). Compared with the reference group (Urban/Public), there was a significant reduction in the risk of ever asthma, AD and rhinitis amongst rural children with individual supply: OR [95% CI]: 0.14 [0.03,0.67], P = .013; 0.20 [0.09,0.43], P < .001; 0.17 [0.10,0.32], P < .001. Protection was also observed in the Rural/Public group, but the effect was consistently highest among Rural/Individual children. In the quantitative analysis, the risk of allergic diseases decreased significantly with increasing bacterial load in drinking water in the first year of life (0.79 [0.70,0.88], P < .001; 0.90 [0.83,0.99], P = .025; 0.80 [0.74,0.86], P < .001; current wheeze, AD and rhinitis). CONCLUSIONS AND CLINICAL RELEVANCE High commensal bacterial content in drinking water may protect against allergic diseases.
2.
How Trace Element Levels of Public Drinking Water Affect Body Composition in Turkey.
Cetin, I, Nalbantcilar, MT, Tosun, K, Nazik, A
Biological trace element research. 2017;(2):263-270
Abstract
Since waterborne minerals appear in ionic form and are readily absorbed by the gastrointestinal tract, drinking water could be a crucial source of mineral intake. However, no comprehensive research has yet determined how trace elements in drinking water relate to body composition. We aimed to assess the relationship between clinically important trace elements in public drinking water and body composition in average, overweight and obese individuals in Turkey. The study's population consisted of 423 participants: 143 overweight, 138 obese and 142 healthy control individuals, grouped according to clinical cutoff points of body mass index (BMI). We measured levels of lithium (Li), nickel (Ni), lead (Pb), silicon (Si), tin (Sn), strontium (Sr), boron (B), aluminium (Al), barium (Ba) and rubidium (Rb) in samples from wells of municipal water by using inductively coupled plasma mass spectrometry. We gauged all the participants' body composition measurements with a BC-418 body composition analyser. In all the participants, body weight values showed significant positive correlations with Ni levels in drinking water, as did BMI values with Al levels and percentage of obesity with Ni, Si and B levels. In particular, Ni levels showed significant positive correlations with the basal metabolic rate, activity calories, and total activity of participants. Giving findings showing correlations between obesity-related parameters and Al, Si, B and Ni content in drinking water, we hope that these associations will be clarified with further studies including cellular, experimental and clinical studies. Hence, medical practitioners must be aware of trace element levels in drinking water for overweight and obese patients.
3.
Efficacy of highly bioavailable zinc from fortified water: a randomized controlled trial in rural Beninese children.
Galetti, V, Kujinga, P, Mitchikpè, CE, Zeder, C, Tay, F, Tossou, F, Hounhouigan, JD, Zimmermann, MB, Moretti, D
The American journal of clinical nutrition. 2015;(5):1238-48
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Abstract
BACKGROUND Zinc deficiency and contaminated water are major contributors to diarrhea in developing countries. Food fortification with zinc has not shown clear benefits, possibly because of low zinc absorption from inhibitory food matrices. We used a novel point-of-use water ultrafiltration device configured with glass zinc plates to produce zinc-fortified, potable water. OBJECTIVE The objective was to determine zinc bioavailability from filtered water and the efficacy of zinc-fortified water in improving zinc status. DESIGN In a crossover balanced study, we measured fractional zinc absorption (FAZ) from the zinc-fortified water in 18 healthy Swiss adults using zinc stable isotopes and compared it with zinc-fortified maize porridge. We conducted a 20-wk double-blind randomized controlled trial (RCT) in 277 Beninese school children from rural settings who were randomly assigned to receive a daily portion of zinc-fortified filtered water delivering 2.8 mg Zn (Zn+filter), nonfortified filtered water (Filter), or nonfortified nonfiltered water (Pump) from the local improved supply, acting as the control group. The main outcome was plasma zinc concentration (PZn), and the 3 groups were compared by using mixed-effects models. Secondary outcomes were prevalence of zinc deficiency, diarrhea prevalence, and growth. RESULTS Geometric mean (-SD, +SD) FAZ was 7-fold higher from fortified water (65.9%; 42.2, 102.4) than from fortified maize (9.1%; 6.0, 13.7; P < 0.001). In the RCT, a significant time-by-treatment effect on PZn (P = 0.026) and on zinc deficiency (P = 0.032) was found; PZn in the Zn+filter group was significantly higher than in the Filter (P = 0.006) and Pump (P = 0.025) groups. We detected no effect on diarrhea or growth, but our study did not have the duration and power to detect such effects. CONCLUSIONS Consumption of filtered water fortified with a low dose of highly bioavailable zinc is an effective intervention in children from rural African settings. Large community-based trials are needed to assess the effectiveness of zinc-fortified filtered water on diarrhea and growth. These trials were registered at clinicaltrials.gov as NCT01636583 and NCT01790321.