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This article is part of our special May 2021 issue. Download the full issue here.
Relation
Sim M, Kim CS, Shon WJ, Lee YK, Choi EY, Shin DM. Hydrogen-rich water reduces inflammatory responses and prevents peripheral blood cell apoptosis in healthy adults: a randomized, double-blind, controlled trial.Scientific Rep. 2020;10(1):12130.
Study objective
To determine whether hydrogen water increases antioxidant capacity, reduces oxidative stress, and improves immune function in healthy adults compared to pure water
Participant
A total of 38 healthy adults aged 20 to 59 years completed the study and were randomly assigned to the pure water group (n=18) or the hydrogen water group (n=20). At the start of the study, there was no statistical difference in age, height, weight, body mass index (BMI), and daily water intake between the two groups (P>0.05).
Draft
Randomized, double-blind, controlled trial
intervention
For 4 weeks, each group drank 1.5 liters (approximately 51 ounces) of either pure or hydrogen water daily. The hydrogen water was normal water with hydrogen (H2) Gas added. The researchers provided the water in 3 different bottles and instructed all participants to drink the water bottle within 1 hour of opening it to minimize the loss of dissolved hydrogen from the bottles containing it.
Measured results
The researchers measured the following outcomes:
- Antioxidative Kapazität, angezeigt durch das biologische Antioxidanspotential im Serum (BAP)
- Oxidativer Stress über den Gehalt an Serumderivaten reaktiver Sauerstoffmetaboliten (d-ROMs)
- Apoptose über die Anzahl der apoptotischen Zellen im Blut
- Profile peripherer mononukleärer Blutzellen (PBMCs) für Zelloberflächenmarker, einschließlich CD4, CD8, CD14, CD20 und CD11b
- Entzündung über Toll-like-Rezeptor (TLR) NF-κB (nuclear factor kappa-light-chain-enhancer of enabled B cells)-Signalisierung sowie proinflammatorische Zytokinexpression
Key insights
The following findings were observed:
- Teilnehmer der Wasserstoffwassergruppe, die über 30 Jahre alt waren, zeigten einen signifikanten Anstieg des BAP im Vergleich zur Gruppe mit reinem Wasser (P=0,028), aber es gab keine signifikante Wirkung auf BAP bei jüngeren Personen in der Wasserstoffwassergruppe im Vergleich zu reinem Wasser.
- Ein Marker für DNA-Schäden durch oxidativen Stress (8-Oxo-2′-desoxyguanosin) nahm in beiden Gruppen signifikant ab (Δ=− 0,94 ± 1,44 ng/mL, P<0,05 in der Reinwassergruppe; Δ=-1,32 ± 1,05 ng/ml, P<0,001 in der Wasserstoffwassergruppe).
- Nach den 4 Wochen zeigte die Gruppe mit Wasserstoffwasser einen signifikant geringeren Prozentsatz an PBMC-Apoptose im Vergleich zur Gruppe mit reinem Wasser (P=0,036).
- Die Häufigkeit von CD14+-Zellen stieg in der Gruppe mit Wasserstoffwasser an und nahm in der Gruppe mit klarem Wasser ab, und dieser Unterschied erreichte statistische Signifikanz (P=0,039).
- Die Wasserstoff-Wasser-Gruppe hatte signifikant niedrigere Expressionsniveaus mehrerer Zytokine: Interleukin 1 beta (IL1B), Interleukin 8 (IL8), Interleukin-6-Rezeptor (IL6R) und Tumor-Nekrose-Faktor-Rezeptor-Superfamilie Mitglied 10B (TNFRSF10B) im Vergleich zur Gruppe mit normalem Wasser .
Practice implications
Immune activation and inflammation go hand in hand as reactive oxygen species stimulate immune cells that trigger the subsequent inflammatory response. Reducing underlying oxidative stress is an ongoing clinical goal in many patients, and it is appealing to find safe, effective interventions that can do this consistently. One such tool can be the use of therapeutic hydrogen gas.
In addition to hydrogen-rich water, hydrogen therapies include injecting hydrogen saline, inhaling hydrogen gas, using hydrogen eye drops, and taking hydrogen-rich water baths.1The scientific community is uncovering the diverse mechanisms of action of hydrogen therapy. They include:2
- Steigerung der antioxidativen Aktivität,
- Hemmung von Apoptose und Entzündung,
- Modulation der Immunregulation und
- Regulierung der Autophagie, des zirkadianen Rhythmus und der Mitochondrien.
Because of these diverse mechanisms of action, hydrogen gas is being investigated in the scientific literature as a therapeutic agent for a variety of diseases. But what exactly does research tell us about hydrogen water?
Similar to therapeutic hydrogen gas, hydrogen water has been studied in various patient populations and has shown positive effects on antioxidant status, immunity and inflammation.
For example, a 2017 randomized, placebo-controlled trial of colorectal cancer patients undergoing chemotherapy showed that hydrogen water helped protect against chemotherapy-induced liver damage compared to placebo.3This is consistent with a 2011 randomized, placebo-controlled trial in liver cancer patients, which showed that hydrogen water reduced radiation-induced oxidative stress without compromising antitumor effects compared to placebo.4In this study, quality of life scores were also significantly better in the hydrogen water group compared to placebo.
What's also interesting about this study is that the benefits of hydrogen water were more significant in people over 30 years old.
Metabolic syndrome is another area where the benefits of hydrogen water are being increasingly researched. In a 2010 pilot study involving people at risk of developing metabolic syndrome, the group that drank hydrogen water had a 39% increase in the antioxidant enzyme superoxide dismutase (SOD), an 8% increase in high-density lipoprotein cholesterol, and a 13% increase. Decrease in total cholesterol.5Similarly, a 2020 randomized, double-blind, placebo-controlled trial showed that the group that drank hydrogen water had significantly reduced blood cholesterol, glucose, and hemoglobin A1cand improved inflammatory markers and redox homeostasis compared to placebo.6
In a 2012 pilot study with patients with rheumatoid arthritis (RA), hydrogen water not only reduced markers of oxidative stress but also improved RA symptoms.7
A 2013 randomized, controlled trial in patients with hepatitis B showed that hydrogen water improved markers of oxidative stress and liver function compared to placebo.8
A 2017 double-blind, placebo-controlled study found that hydrogen water's anti-inflammatory and antioxidant activity may also affect the central nervous system. In this study, the group that drank the hydrogen water had an improvement in mood, anxiety, and overall quality of life compared to placebo.9
Preliminary research also shows that hydrogen water can positively influence the intestinal microbiome. In a study of teenage female soccer players, drinking hydrogen water for 2 months reduced IL1, IL2, and tumor necrosis factor; increased SOD, total antioxidant capacity and whole blood hemoglobin; and improves the diversity and abundance of the intestinal flora.10
As this paper shows, the US Food and Drug Administration has recognized hydrogen gas as a food additive with Generally Recognized as Safe (GRAS) status. Research confirms that hydrogen water is safe when consumed in recommended doses.
A commonly made argument regarding the hydrogen water studies is that simply increasing water consumption provides significant health benefits and that even mild dehydration can contribute to a variety of illnesses.11However, this argument does not hold in studies comparing hydrogen water with the same amount of pure water consumed.
This latest clinical study lends credence to the therapeutic effectiveness of hydrogen water, which has come under fire for being all hype and lacking substance. What's additionally interesting about this study is that the benefits of hydrogen water were more significant in people over 30 years old. Since aging is often accompanied by increased systemic oxidative stress and damage, it makes sense that as we age, the need for enhanced antioxidant defenses would also increase and therefore these individuals would derive more benefit from hydrogen water. This also applies to individuals dealing with dysregulated redox balance and systemic inflammation due to illness.
From a clinical perspective, research appears to support the use of hydrogen water for a variety of conditions that require immune regulation, increased antioxidant activity, and reduced inflammation. The biggest clinical problem with hydrogen water is cost. Individual cans or bottles cost between $2.50 and $3.00 per bottle versus about $0.60/bottle of spring water. In this particular study, participants drank 51 ounces per day, which is more than 6 8-ounce bottles, adding up to about $15 per day. Hydrogen water tablets and machines are also available, which can reduce the cost somewhat.
Hydrogen water packaging can also pose a problem. The type of packaging was not identified by the authors of this study; However, they instructed participants to drink the water within an hour to reduce hydrogen loss. Hydrogen dissolves quickly, and if hydrogen water is packaged in plastic or glass, it probably doesn't contain much hydrogen. Special packaging is required to maintain optimal hydrogen levels.
As with any procedure, there are advantages and disadvantages. While cost can be a disadvantage, patient compliance can be an advantage. Finally, asking patients to drink more water is something integrative practitioners do all the time in clinical practice. Asking to drink a certain type of water may be an easy solution for some patients who are not as compliant with supplement recommendations. Integrative practitioners excel at assessing the individual patient to select the appropriate intervention. In some cases, hydrogen water may be worth considering.