Intended for healthcare professionals


Getting well from water

BMJ 2004; 329 doi: (Published 16 December 2004) Cite this as: BMJ 2004;329:1417
  1. Keith J Petrie, professor (kj.petrie{at},
  2. Simon Wessely, professor (S.Wessely{at}
  1. Health Psychology Department, Faculty of Medicine and Health Sciences, University of Auckland, Private Bag 92019, New Zealand
  2. Academic Department of Psychological Medicine, Guy's, King's, and St Thomas' School of Medicine, Institute of Psychiatry, London SE5 8AF

    Bottled water exploits our worries about what affects health in the modern world

    Water is now everywhere. It has become a modern fashion and health accessory, as ubiquitous as the mobile phone. Students have a bottle in their bags or in front of them during lectures, people are jogging with water, and office workers have a bottle within easy reach of their desk. The rise of water as a health product is underpinned by people's worries about modern life. Bottled water is seen as a natural antidote to what the consumer sees wrong with modernity and bad for their health—chemicals and technologies full of risk and hazard, genetically engineered food, low level radiation, harmful medications, and sinister viruses.1

    Sales figures confirm that bottled water is the world's fastest selling drink. In the United Kingdom, consumers spent £1bn ($1.9bn; €1.4bn) on bottled water last year, a 70-fold increase from 20 years ago. In the United States, consumption of bottled water has risen from 2.5bn gallons (9.5bn litres) in 1992 to almost 6bn gallons in 2002. Advertisers conjure up a thousand variations on the same theme—the theme of pure, clean, fresh, and unspoiled water. Drinking “pure” water restores energy and ensures health. Samuel Hahneman, the inventor of homoeopathy, knew this well. His product was also nothing but the purest of pure water, in which the deliberately added substances had been diluted away beyond Avogadro's number, leaving nothing behind but their memory. The homoeopathic version of bottled water, which has had negative memories removed and replaced with beneficial energy patterns, is called “Blue Water” and sells for £11 a litre.

    But consumers can only take so much purity. Bottled water has also become an “aquaceutical,” the ultimate health food. It is now fortified with additives and produced using special processes claimed to improve health. Nestlé, the maker of Contrex bottled water, says its product contains traces of calcium and magnesium that help reduce weight, eliminate toxins, and reduce fatigue. Penta H2O is claimed to have a unique structure with smaller clusters of H2O molecules that ensures more efficient absorption of its health giving properties. Superoxygenated waters claim to increase energy levels and concentration by increasing the concentration of oxygen in the blood. Lakeland Willow Spring water, voted best designer water in 2003, contains traces of salicin, which is claimed by the company to be useful for “eliminating toxins.” In California, a company is now selling chemical-free bottled water specifically designed for pets.

    Water can also make people feel very vulnerable when they think it has been tampered with. Water contamination incidents are associated with particular disruption and morbidity, which cannot be explained on toxicological grounds.2 General Jack Ripper, who believed that fluoridation was a communist plot to poison our “vital body fluids,” was a product of Stanley Kubrick's imagination, but his views are only an exaggeration of a widespread concern. The continuing fluoridation controversy confirms that adding anything to public supplies of water causes anxiety.

    The public is particularly unforgiving when companies produce water that is less than pure. When high concentrations of benzene were found in Perrier, sales plummeted and the company has struggled to regain its market share. The example of Coca Cola is instructive. Bottled Coca Cola was associated with a health scare in Belgium, which was almost certainly an example of mass hysteria.3 The brand was temporarily withdrawn, but sales eventually recovered and the company has not been affected in the long term. On the other hand, when Coca Cola's Dansani water, produced through a process labelled as reverse osmosis developed by NASA, was found to contain concentrations of bromate above the legal limit, the company faced hostility from consumers. Despite the multi-million pound marketing campaign, the company withdrew the product completely from the market.

    Bottled water is another of the modern paradoxes of health—a product born out of our success at reducing waterborne disease. In the developing world such diseases cause over two million deaths a year, most of them among children aged under 5.4 In these countries, adding chlorine to water is viewed as a health intervention with the potential to save a huge number of lives. In the developed world, bottled water owes part of its popularity to the view that tap water is impure, contaminated, and hence risky. Bottled water is seen as natural, clean, fat-free, and with traces of health giving minerals. In fact tap water is as safe as bottled water and about 1000 times cheaper. The marketing of bottled water exploits people's worries about what affects their health in the modern world. There is a message in that bottle.


    • Competing interests None declared.


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