Magnesium in Drinking Water, LDL Cholesterol and Atherosclerosis: What Does the Science Say?

Could the mineral composition of the water we drink influence the health of our arteries? Decades of research have revealed intriguing connections between magnesium, cholesterol metabolism and cardiovascular health.

When we think about cardiovascular health, we usually think about cholesterol, exercise, diet and blood pressure. Rarely do we consider the mineral composition of our drinking water.

Yet scientists have been investigating this relationship for more than half a century. Some epidemiological studies have found that populations consuming naturally mineral-rich water experience lower cardiovascular mortality than populations drinking softer, less mineralized water.

Magnesium, in particular, has attracted considerable scientific interest.

Could this essential mineral influence the development of atherosclerosis, the gradual accumulation of cholesterol-rich plaques in our arteries? And could drinking water contribute to this process?

The answers are not yet definitive, but the research is worth exploring.

LDL cholesterol: a major driver of atherosclerosis

LDL, often described as bad cholesterol, plays a central role in atherosclerosis.

When LDL particles enter and become retained in the arterial wall, they can trigger inflammatory processes that contribute to plaque formation. Over time, these plaques may narrow arteries or become unstable, increasing the risk of heart attacks and strokes.

The causal relationship between LDL cholesterol and atherosclerotic cardiovascular disease is firmly established. Lowering elevated LDL cholesterol remains one of the most effective strategies for reducing cardiovascular risk.

But LDL is not the only factor involved in arterial health. Inflammation, blood pressure, metabolic regulation and mineral balance also contribute to cardiovascular physiology.

This is where magnesium becomes particularly interesting.

Magnesium and arterial health

Magnesium is involved in hundreds of biochemical reactions and contributes to normal muscle function, energy metabolism and electrolyte balance.

Within the cardiovascular system, it participates in cellular processes involving calcium regulation, vascular tone and normal muscle contraction.

Researchers have therefore investigated whether magnesium intake might also influence vascular calcification, arterial stiffness and the biological processes involved in atherosclerosis.

The evidence comes from several directions: experimental research, epidemiological observations and a smaller number of clinical intervention studies.

A remarkable experiment: magnesium-enriched water and arterial plaques

In 2002, researchers from the Sheba Medical Center and Tel Aviv University published an intriguing study in Biological Trace Element Research.

The investigators studied mice genetically predisposed to developing atherosclerosis. They compared animals receiving ordinary drinking water with animals receiving water enriched with magnesium chloride.

The results were remarkable.

In the group receiving the higher magnesium concentration, the area of atherosclerotic lesions measured at the aortic sinus was approximately 64% smaller than in the control group.

Interestingly, this difference was observed without a sustained significant increase in circulating magnesium levels or consistent changes in blood lipids at the end of the experiment.

The results suggested that magnesium might influence processes involved in plaque formation independently of its effects on circulating cholesterol.

However, this was an animal experiment using unusually high magnesium concentrations. It investigated the development of lesions, not the reversal of established plaques.

It would therefore be incorrect to conclude that drinking magnesium-rich water can reverse atherosclerosis in humans.

Nevertheless, the findings raised an interesting scientific question that deserves further investigation.

What do human studies tell us?

Research involving human populations provides additional clues, although the findings are more nuanced.

A study from the Framingham Heart Study, published in 2014, examined magnesium intake and arterial calcification in approximately 2,700 participants.

Researchers found that higher reported magnesium intake was associated with lower coronary artery calcification, a marker of atherosclerotic disease.

In their statistical model, each additional 50 mg of daily magnesium intake was associated with approximately 22% lower coronary artery calcium scores.

This is an interesting association, but it does not mean that adding 50 mg of magnesium to someone's daily intake will reduce existing arterial calcium by 22%. The study was observational and assessed magnesium intake from food and supplements rather than specifically from drinking water.

A broader systematic review published in Foods in 2023 examined 25 studies exploring the relationship between drinking water hardness and cardiovascular mortality.

Seventeen reported statistically significant associations between harder drinking water and lower cardiovascular mortality. The authors nevertheless emphasized the substantial variability among studies and the possibility of confounding factors.

Together, these findings suggest that the mineral composition of drinking water may be relevant to cardiovascular health. They do not establish that magnesium-enriched water prevents cardiovascular disease.

Could mineral water influence LDL cholesterol?

Beyond the potential relationship between magnesium and arterial physiology, researchers have investigated whether mineral waters might directly influence cholesterol metabolism.

In 1999, Italian researchers led by Capurso studied the effects of a salt-rich mineral water from Montecatini in individuals with elevated cholesterol.

During the mineral-water treatment period, LDL cholesterol decreased by approximately 12.5%. The researchers also observed a substantial increase in the excretion of bile acids through the intestine.

This is interesting because bile acids are produced from cholesterol in the liver. Their elimination through the digestive tract can influence cholesterol metabolism.

The study suggested a possible mechanism by which certain mineral waters could affect circulating cholesterol. However, its small, sequential treatment design prevents firm conclusions, and the results cannot be attributed to magnesium alone.

Other clinical investigations have produced mixed results.

In 2014, researchers in Iran conducted a randomized study involving 69 adults with elevated blood lipids. One group consumed mineral water rich in calcium, magnesium and bicarbonate, while another received a water with a much lower mineral content.

Both groups experienced reductions in total cholesterol and LDL cholesterol after one month. However, the difference between the groups was not statistically significant.

A later study published in 2019 examined 41 hypertensive men consuming either Damavand mineral water or Tehran municipal water for eight weeks. The researchers reported reductions in LDL cholesterol in the mineral-water group compared with the control group.

The results are intriguing, but the study was small, the differences in magnesium content between the waters were modest, and some aspects of the reported lipid data require caution.

These findings suggest that certain mineral waters may influence lipid metabolism, but the available clinical evidence is not sufficiently consistent to establish a reliable LDL-lowering effect.

What about magnesium bicarbonate?

In natural groundwater, magnesium is frequently present alongside bicarbonate ions, reflecting the interaction of water, carbon dioxide and geological minerals.

At Aqvita, magnesium bicarbonate is central to our work because it allows us to introduce dissolved magnesium into purified water through a chemistry inspired by natural mineral waters.

But does this particular form of magnesium offer cardiovascular advantages?

A double-blind clinical study published in 2010 investigated magnesium bicarbonate-enriched spring water in 67 postmenopausal women.

Participants consumed approximately 1.5–1.8 litres of water daily for 84 days. The supplemented water contained 120 mg/L magnesium and 650 mg/L bicarbonate.

The researchers observed a significant increase in serum magnesium, demonstrating that the enriched water provided magnesium available to the body.

However, the study did not demonstrate significant improvements in LDL cholesterol, other blood lipids or blood pressure.

This is an important distinction. Magnesium bicarbonate-enriched water can contribute to magnesium intake, but there is currently insufficient clinical evidence to claim that it prevents or treats atherosclerosis or lowers LDL cholesterol.

Why the minerals in everyday drinking water matter

The nutritional importance of magnesium is well established. Adequate intake is necessary for normal physiological function, and food remains its primary source.

Drinking water can nevertheless provide a useful additional contribution.

Consider a simple example: drinking 1.5 litres of water containing 25 mg/L magnesium provides approximately 38 mg of magnesium daily.

That contribution may appear modest compared with total dietary requirements. But drinking water is consumed regularly, throughout the day and over a lifetime.

Its mineral composition therefore deserves attention.

Modern purification technologies, particularly reverse osmosis and desalination, can remove naturally occurring minerals alongside unwanted substances.

These technologies are highly effective for water treatment, but the resulting water may contain very little magnesium or calcium unless these minerals are deliberately reintroduced.

At Aqvita, we believe the mineral composition of purified drinking water should no longer be left to chance.

Our patented technology enables us to stabilize concentrated magnesium bicarbonate formulations and add precisely measured quantities to purified water.

The objective is straightforward: make it easier to obtain drinking water with a carefully selected mineral composition, without relying exclusively on bottled natural mineral waters.

What can we conclude?

The research connecting magnesium, LDL cholesterol and atherosclerosis is scientifically interesting, but important questions remain.

Experimental studies suggest that magnesium may influence processes involved in arterial plaque formation. Epidemiological studies have identified associations between magnesium intake, drinking water hardness and cardiovascular outcomes. Some small clinical studies have also reported changes in cholesterol metabolism following consumption of particular mineral waters.

However, it has not been demonstrated that magnesium-enriched drinking water prevents, stabilizes or reverses atherosclerosis in humans. Nor has magnesium bicarbonate water been established as an LDL-lowering treatment.

Adequate magnesium intake is part of good nutrition, but it cannot replace established cardiovascular prevention measures, including LDL cholesterol management, physical activity, healthy eating and appropriate medical care.

For Aqvita, the scientific interest is broader than any single health claim.

Water is something we consume every day. Its mineral composition influences its taste, nutritional contribution and chemical characteristics. Understanding these properties—and making them available in purified water—is the reason we developed our technology.

Nature gave us the model. We developed a way to recreate its mineral chemistry instantly.

Scientific references

1. Cohen H. et al. (2002). Atherogenesis Inhibition Induced by Magnesium-Chloride Fortification of Drinking Water. Biological Trace Element Research, 90, 251–259. Read study.

2. Hruby A. et al. (2014). Magnesium Intake Is Inversely Associated With Coronary Artery Calcification: The Framingham Heart Study. JACC: Cardiovascular Imaging, 7, 59–69. Read study.

3. Bykowska-Derda A. et al. (2023). The Relationship between Mortality from Cardiovascular Diseases and Total Drinking Water Hardness: Systematic Review with Meta-Analysis. Foods, 12, 3255. Read study.

4. Capurso A. et al. (1999). Increased Bile Acid Excretion and Reduction of Serum Cholesterol after Crenotherapy with Salt-Rich Mineral Water. Aging, 11, 273–276. Read study.

5. Aslanabadi N. et al. (2014). Hypolipidemic Activity of a Natural Mineral Water Rich in Calcium, Magnesium, and Bicarbonate in Hyperlipidemic Adults. Advanced Pharmaceutical Bulletin, 4, 303–307. Read study.

6. Kooshki A. et al. (2019). The Effect of Consuming Mineral Water and Piped Water on Blood Pressure and Lipid Profiles of Hypertensive Men. Journal of Nutrition and Food Security, 4, 101–106. Read study.

7. Day R.O. et al. (2010). A Double-Blind, Placebo-Controlled Study of the Short-Term Effects of a Spring Water Supplemented with Magnesium Bicarbonate. BMC Research Notes, 3, 180. Read study.

8. Ference B.A. et al. (2017). Low-Density Lipoproteins Cause Atherosclerotic Cardiovascular Disease. European Heart Journal, 38, 2459–2472. Read study.

This article is provided for scientific and educational purposes. It does not constitute medical advice. Aqvita's magnesium products are not intended to diagnose, treat or prevent cardiovascular disease.