10 More Scientific Reasons to Drink Lemon Water

  • May
    11

    ALTHOUGH WATER IS NOT A MAGICAL CURE for cancer, world hunger or childhood diseases, it does hold a top position in a healthy lifestyle and it’s ESSENTIAL for life!

    Water is quantitatively the most important nutrient for life [24].

    Along with a healthy balanced diet, exercise routine, sunshine, and good quality sleep is hydration. Water is critical to all living creatures and an absence will be lethal to humans within days, as we are made up of 55-75% H2O [24].

    Many people have a hard time drinking enough pure H2O (including myself), but adding a little citrus to your water can make a big difference to the taste and health benefits.

    Lemon water is an ideal way to start your morning with energy, hydration, and endurance. Simply squeeze the juice of an 1/8- 1/4 wedge of lemon into a glass of room temperature or slightly cool water.

    Citrus fruits contain bioactive compounds such as phenolics, flavonoids, vitamins, terpenoids, reducing sugars and essential oils, which have a large range of protective health benefits including antioxidative, anti‐inflammatory, antitumor, and antimicrobial activities [22].

    Lemon is part of the citrus family. Its Latin name is Citrus limon. Lemon juice contain citrus flavonoids including hesperedin, hesperetin, naringin, naringenin, as well as bioactive components such as citric acid, polyphenol, and ascorbic acid (reduced form of Vitamin C) [3, 9, 15].

    Let’s take a closer look…

    Here are 11 benefits of staying hydrated throughout the day with lemon water.

    Please note: the amount of lemon juice in your water may not be enough to have the following therapeutic effects. Drinking lemon water should be an added practice on top of your primary treatment plan.

    1. Gently Detoxifies

    Many people hear the word “detox” they get defensive and sometimes aggressive. And I get it. There are lots of fad supplements, diets and juice plans that market the word “detox” as a cure-all treatment for a lifetime of eating poorly and partying.

    So is “detox” just a fad? Well, maybe, but more than that it’s actually a physiological medical process of the body. Detox stands for detoxification.

    Look up “detoxification” in PubMed and you’ll find 31,127 articles:

    PubmedDetox

    Detoxification is your body’s natural way of protecting itself from potentially harmful toxins. It works to store, then safely excrete waste at a regulated interval. The liver is one of the primary detoxification organs and follows 2 steps to safely remove chemicals from the body [12].

    • Phase I: Reduction and Hydrolysis into a lipophilic-fat soluble molecule (active and storage form)
    • Phase II: Conjugation into a hydrophilic-water soluble molecule (excretion via bowels and kidneys)

    Your body is built to maintain homeostasis and balance. Therefore, taking a pill or manually forcing the body to speed up this process can be dangerous.

    “Forcing the body’s natural detoxification pathways can be dangerous.”

    Drinking lemon water is one of many gentle detoxification technique that supports the organs of detoxification to work optimally. It doesn’t speed up the natural process.

    The acidity of lemon in the mouth and gut (not blood), stimulates gastric acid secretions from the pancreas and bile flow from the gall bladder and liver. This supports the natural removal of toxins stored in the liver and fat cells to help excrete them safely [30].

    Drinking water by itself will support other organs of detoxification, such as the kidneys, lungs and skin.

    The kidneys are the main organ for water balance in the body. When we drink more water our urine get progressively lighter in color. This is because we are eliminated excess fluids as well as nutrients, electrolytes, urobilirubin and chemicals out of the blood after Phase II liver detoxification to maintain fluid balance [18].

    Chronic low fluid intake can lead to several urinary system conditions including [18]:

    • Urolithiasis (kidney stones)
    • Urinary tract infection
    • Chronic kidney disease
    • Bladder cancer
    • as well as non-urinary system conditions such as disruptions in mood and cognitive functioning

     

    2. Cardiovascular Protection – Hypercholesterolemia and Hypertension

    Cardiovascular disease (CVD) is still the leading cause of death around the world [5]. Arteriosclerosis is a common and potentially life-threatening disease predominantly found in the Western population.

    Arteriosclerosis is the hardening of arteries due to plaque formation. These plaques start out as minor injuries to the inner lining of the arteries, which allow lipids (apo-B lipids mainly found in LDL cholesterol) to enter those cells. These lipids get oxidized and are consumed by macrophages, creating a “fatty streak”, which can be found as early as teenage years [28].

    The lipid containing macrophages then die, creates a plaque and begins to undergo necrosis and calcification [28]. If the plaque progresses it can block blood flow and be potentially life-threatening in major arteries.

    There are 4 modifiable causes for arteriosclerosis:

    1. Hypertension
    2. Diabetes
    3. Smoking
    4. Hypercholesterolemia

    NOTE: Despite common belief, eating foods high in cholesterol and saturated fats do not increase the cholesterol levels on your lab report. A meta-analysis showed that there is no significant evidence for concluding that dietary saturated fat is associated with an increased risk for cardiovascular disease [31]. However, there are other reasons to limit saturated fat intake that you can read about here.

    Proper hydration is associated a reduction in hypertension, fatal coronary heart disease, venous thrombo-embolism, and cerebral infarct [24].

    Meanwhile, consuming the juice of citrus fruits shows a decrease of plasma cholesterol and triglycerides levels, liver cholesterol and circulating LDL:HDL [7, 27]. Recent studies suggest an important role of citrus flavonoids in the treatment of dyslipidemia and atherosclerosis [3].

    Getting rid of cholesterol happens primarily by liver metabolism and via feces. The acidity of lemon helps to simulate digestive enzyme and bile secretions to promote cholesterol breakdown. Cholesterol is converted into bile acids by the liver and becomes water soluble so it can be removed from the body [20, 31].

    Animal studies show naringin supplementation improved hypertension in high-carbohydrate/high-fat-diet–fed obese rats and stroke-prone hypertensive rats [1].

    Lemon juice, its crude flavonoid and the water extract of lemon peel can lower blood pressure in healthy women, while citric acid levels were correlated with benefits to the systolic blood pressure, pulse pressure, and red blood cell count [15]. As well, the intake of citric acid increases the absorption of magnesium and calcium from foods, which also supports optimal blood pressure [15].

    Ironically, studies show the intake of lemon is highly correlated with the activity level of individuals. One guess is that people who are health consciousness eat lemons and move more often, among other healthy habits [15].

     

    3. Fat Loss Promoter

    Having a high percentage of body fat increases your risk of developing diseases such as diabetes, hyperlipidemia (high cholesterol), and hypertension (high blood pressure), which can lead to arteriosclerosis, type 2 diabetes (T2DM), metabolic syndrome and certain cancers [1, 25].

    In animal models, consumption of lemon constituents suppressed body weight gain, fat accumulation, hyperlipidemia, hyperglycemia and insulin resistance [25].

    When you gain body fat, it’s a combination of growth in fat cell size and the formation of new adipocytes (aka fat cells) through a process called adipogenesis, or adipocyte differentiation [13]. Currently, it is thought that disruption of adipocyte differentiation limits fat expansion, which is linked to the development of insulin sensitivity, resistance and T2DM [25].

    Studies found naringenin has the ability to inhibit adipogenesis and impair mature fat cell function [25]. Although lemons only contain small amounts of naringenin, other citrus fruits such as grapefruit and oranges are excellent sources.

    “In metabolic syndrome, obesity, and related cardiovascular complications, naringin influences AMPK-, PPARα–, and CPT-1–mediated fat utilization and preserves mitochondrial function.

    Moreover, naringin also prevents the TNF-α–mediated inflammatory process and tissue damage in liver and vasculature.” [1]

    Naringin and naringenin supplementation has proven to be effective for the treatment of metabolic syndrome and obesity in animal models [1]. However, more research needs to be conducted on the effects of naringin and naringenin on humans.

     

    4. Blood Sugar Regulator

    Studies show that citrus flavonoids regulate blood sugar levels with a similar mechanism to Metformin, the main pharmaceutical drug to control diabetes and insulin resistance [8].

    As surprising as this is, hesperidin, hesperetin, naringin and naringenin have been shown to decrease hepatic gluconeogenesis [8]. Hepatic gluconeogenesis is the production of glucose by the liver, which is released into the blood stream for energy use. In a person with impaired insulin function, gluconeogenesis results in high levels of blood sugar and initiates tissue damage associated with T2DM (type 2 diabetes) [4, 8].

    Therefore:

    “inhibition of the gluconeogenic pathway by citrus flavanones, which was similar to that of the drug metformin, may represent an attractive novel treatment strategy for type 2 diabetes” [8].

    Recent investigations of naringin suggests hypoglycemic activity mediated via uptake of glucose in the skeletal muscle [1].

    And an animal study found naringin supplementation (0.2 g/kg of diet) improved glucose intolerance and insulin resistance in a model of high-fat-diet–fed mice, as high fat diets have been shown to increased inflammatory cytokines and caused insulin resistance and hyperglycemia [1, 6].

    In rat studies, naringin also has the potential to retard as well as improve diabetic complications by improved glucose intolerance, plasma lipid concentrations, and liver mitochondrial dysfunction [6]. More research is required on humans to see the potential for diabetic patients.

    NOTE: Never discontinue or alter your medication without permission and supervision of a qualified medical doctor.

     

    5. Energy Boost

    Three common causes of fatigue are:

    1. Dehydration and hypo-tension
    2. Stress and anxiety leading to poor sleep
    3. Iron deficiency anemia

    Lemon water targets all 3 with hydration, nourishing the HPA axis (hypothalamus-pituitary-adrenal) and aiding in iron absorption [17, 24, 34].

    DEHYDRATION and HYPO-TENSION

    When you get your blood pressure taken, do you often see 80/60 mmHg?

    If so, you probably have hypo-tension (aka. low blood pressure) and the most common reason is dehydration, but it could also indicate a serious medical condition.

    Dehydration can also appear as [24]:

    • dizziness, fainting, black outs
    • poor concentration and delirium
    • extreme thirst
    • constipation
    • cold, clammy skin
    • nausea
    • headaches
    • fatigue

    Have you ever felt dizzy from standing up suddenly?

    If so, this is called postural hypo-tension (or orthostatic hypo-tension) and can be treated by drinking 300–500 ml of water [24].

    So, keep count of how many glasses of water (or lemon water) you drink per day and if it is less than 8, try increasing your hydration one glass at a time.

    STRESS and ANXIETY

    Hypo-tension, hypo-volemia (low blood volume) and sodium depletion simulates the RAAS (renin-angiotenin-aldosterone system) to stabilize blood pressure and volume [32].

    However, the RAAS also has an affect on the hypothalamus, which influences the neuroendocrine and limbic system leading to heightened stress response and anxiety [32].

    Exaggerated levels of stress and anxiety can lead to poor sleep, difficulty concentrating, and fatigue. Chronic and poorly managed stress is often the root of physical, mental and emotional illness.

    IRON DEFICIENCY ANEMIA

    For those with iron deficiency, it is ideal to consume vitamin C (aka ascorbic acid) with an iron-rich meal or supplement [17]. The reasons for its action are two-fold:

    1. Prevents conversion of iron into an insoluble and unabsorbable iron compound.
    2. Reduction of ferric to ferrous iron, which appears to be required for iron uptake into mucosal cells.

    A study of young Indian women with iron deficiency anemia showed the addition of ascorbic acid to iron supplementation (4:1 molar ratio) increased iron absorption by ∼3.5-fold [33].

     

    6. Skin Rejuvenation

    The skin contains approximately 30% water, which contributes to plumpness, elasticity, and resiliency [24]. However…

    “One of the more pervasive myths regarding water intake is the improvement of the skin or complexion. By improvement, it is generally understood that individuals are seeking to have a more “moisturized” look to the surface skin, or to minimize acne or other skin conditions.

    Numerous lay sources such as beauty and health magazines as well as the Internet suggest that drinking 8–10 glasses of water a day will “flush toxins from the skin” and “give a glowing complexion” despite a general lack of evidence94, 95 to support these proposals. The skin, however, is important in maintaining body water levels and preventing water loss into the environment.”

    Dry skin is typically associated with [24]:

    • Moderate dehydration
    • Exposure to dry air
    • Prolonged contact with hot water
    • Excessive scrubbing with soap (strip oils from the skin)
    • Certain medical conditions
    • Specific medications

    While more serious levels of dehydration will show reduced skin turgor or “tenting of the skin” when pinched.

    So what does drinking water do for the skin?

    Improvements in skin thickness and density can be seen with increased water intake, particularly in people who consume low amounts of water [24]. However, adequate skin hydration is NOT sufficient to prevent wrinkles or other signs of aging, which are related to sun exposure, genetics and environmental damages [24].

    The ascorbic acid and vitamin C content from lemons is also an effective vulnerary, which nourishes the skin and connective tissue (tendons, ligaments, and muscles) to speed up healing for wounds and injuries [27].

     

    7. Anti-Oxidant and Cancer Prevention

    Two main areas of research of Citrus flavonoids have been inflammation and cancer, as the mechanisms of action are not completely known [21]. The anti-oxidant properties from lemons and other citrus fruits act to protect the body from cancer growth and carcinogen exposure [6, 21].

    There are 3 main agents that attempt to stop cancer [21]:

    1. Suppressing agents prevent pro-carcinogens from becoming new cancers.
    2. Blocking agents prevent carcinogenic compounds from reaching critical initiation sites.
    3. Transformation agents act to encourage metabolism of carcinogenic components into less toxic materials or prevent their biological actions.

    Citrus flavonoids can act as all three types of agent, with naringin, naringenin and ascorbic acid shown to be strong antioxidants [1, 21].

    Naringin and naringenin possess numerous health properties such as antioxidant, anti-inflammatory, and anti-apoptotic (stopping self-destruction of a cell) activities [6]. The gut microflora breaks down naringin to its aglycon form naringenin in the intestine, where it is then absorbed from the gut and has a stronger anti-oxidant effect than naringin itself [1].

    In vitro and in vivo studies have established the usefulness of naringin in various pre-clinical models of [6]:

    • atherosclerosis
    • cardiovascular disorders
    • diabetes mellitus
    • neurodegenerative disorders
    • osteoporosis
    • rheumatological disorders

    As well, naringin possesses chemopreventive and anticancer attributes in various studies of oral, breast, colon, genito-urinary, liver, lung, ovarian, and skin cancer [6]. However, further clinical research is necessary to understand the mechanisms underlying the effects of naringin in humans [6].

    Ascorbic acid is involved in the first line of antioxidant defense, protecting lipid membranes and proteins from oxidative damage. Humans require a constant supply of ascorbic acid from fruits and vegetables as we are unable to fully synthesize it ourselves [9].

    Various research shows a toxic effect of ascorbic acid on a variety of cancer cell lines. The main anti-tumour effect of ascorbic acid is due to its production of cytotoxic hydrogen peroxide [16].

    Ascorbic acid given in pharmacological concentrations shows that most cancer cells, but not normal cells, are affected by 20 mmol/L ascorbic acid. However, this concentration is greater than what could be obtained orally, but is easily met with intravenous injection [16].

    In another study, 11 human cancer cell lines (carcinomas and glioblastomas) were exposed to ascorbic acid in which 55% of the cell lines were more susceptible (EC50 ≤ 20 mmol/L) and 45% were more resistant (EC50 >20 mmol/L) to incubation. This means that half of the cancer cell lines did not thrive in 20 mmol/L of ascorbic acid, while another half were more resistant and required a higher dose to effectively reduce the population by 50% (EC50) [16]. More research is warranted, however there is some anti-cancer potential with Citrus flavonoids.

     

    8. Natural Antimicrobial and Immune Booster

    “The problem of resistance of microorganisms to antimicrobial drugs is one of the world’s current challenges.

    On the other hand, plant‐based antimicrobials are attractive as they are often devoid of the many side effects associated with synthetic antimicrobials.” [22]

    In vitro research has been studied with lemon juice as effective in the growth of S. aureus, E. faecalis, and Salmonella spp. [6, 14, 22].

    • Staphylococcus aureus is one of the most common bacteria in food poisoning with lemon juice concentrates showing inhibitory and bacteriocidal properties.
    • Lemon juice concentrates significantly inhibited the growth of P. aeruginosa, which is among the most difficult to treat with conventional antibiotics.
    • Candida albicans growth was significantly inhibited by lemon juice concentrates and is important due to resistant Candida species to existing antifungal drugs.
    • Inhibition of Penicillum spp. growth was observed with lemon juice concentrates and certain citral essential oils.

    Ascorbic acid is a superoxide anion scavenger and has shown to inhibit the influenza virus in cell cultures [34]. In hospitalized patients, studies show that inhaled and oral supplementation of ascorbic acid can prevent influenza virus infections, such as pneumonia, and reduce hospital stays [34].

    Dietary supplementation with naringin in experimental animals has shown significant beneficial effects on dental development and as an anti-septic on oral bacteria, which is the most common contributor to bad breath [6, 14].

    Meanwhile, the citrus essential oil (ie. limonene, citral, linaloo) has shown potential as a bacteriacidal (kills bacteria) against mould, yeast, spore-forming bacteria and food poisoning bacteria [14].

    At lower concentrations lemon displayed bacteriostatic activity (slow bacterial growth), but bacteriocidal activity (kill bacteria) at higher concentrations [22].

     

    9. Alkalize Your Body

    Despite its acidity, lemon juice actually has a slight alkalizing effect in the body, which can help decrease chronic pain, digestive issues, cancer risks and unexplained frequent illnesses, especially in the elderly and those with kidney disease [10, 19, 29].

    There has been a lot of hype about an alkaline diet having protective effects on the body, specifically bone health and unfortunately the research is conflicting.

    Several studies show the “Acid Ash Diet” or “Alkaline Diet” do not have substantiated evidence to show protective characteristics for bone health or osteoporosis, despite changes to urine pH and calcium levels [10]. Many “Alkaline Diet” fads use urine pH as an indicator for health and although there are changes to urine pH, acidic urine does not reflect blood pH, metabolic acidosis or adverse health conditions [10].

    So why does urine pH change but not blood pH?

    The pH of blood is a tightly controlled process. The human body requires a pH serum level of ~ 7.4 (a slightly alkaline range of 7.35 to 7.45) to survive [29].

    However, a highly regulated blood pH doesn’t mean that your diet has no affect on your body. Studies show an alkaline diet potentially reducing morbidity and mortality from chronic diseases but further research is warranted [29].

    Since the blood is so well managed, there is constant exchange of electrolytes to maintain a balanced pH of ~7.4. This means, when you eat a more acidic diet (ie. lots of meat and little vegetables) your body compensates to regulate your blood pH. So while your blood pH doesn’t change much, there are potentially negative shift happening in the body to compensate and regulate the body.

    An acid-forming diet can causes very small decreases in blood pH and plasma bicarbonate (HCO3-) [19].

    Even small shifts in pH can have significant effect. For example, in the past 100 years the pH of the ocean has dropped from 8.2 to 8.1 due to increased CO2 emission from industrialization. This has had a negative impact on the coral reef system [29]. Even the pH of soil has had an influence of the nutrient content of the produce we consume as minerals maintain pH as a buffer. Acidic soils have reduced calcium and magnesium content, while highly alkaline soils affect iron, manganese, copper and zinc availability [29].

    “It is generally accepted that agricultural humans today have a diet poor in magnesium and potassium as well as fiber and rich in saturated fat, simple sugars, sodium, and chloride as compared to the preagricultural period.” [29]

    A modern day diet may lead to metabolic acidosis especially with the aging population or people with kidney disease. As a person ages, there is a gradual loss of acid-base regulation by the kidneys and can increase the chances of a diet-induced metabolic acidosis [29].

    Chronic low-grade acidosis is thought to be due to 2 main factors [19]:

    1. Advancing age, with a consequent decline in renal function
    2. Diet

    An acidic diet may not affect the blood pH much, but can decrease urinary magnesium levels, urinary citrate and pH, while increasing urinary calcium, undissociated uric acid, and phosphate. All of these factors increases the risk for kidney stones [29].

    Deficiency of potassium alkali salts (K-base) from a low plant-based diet can increase the risk for chronic metabolic acidosis. This can have a deleterious effects on the body, including growth retardation in children, decreased muscle and bone mass in adults, and kidney stone formation [11].

    An alkaline diet may prevent a number of diseases and result in significant health benefits, although there is no substantial evidence that it improves bone health or protects from osteoporosis. However, alkaline diets may result in a number of health benefits as outlined below [29]:

    1. Increased fruits and vegetables would improve the potassium (K)/ sodium (Na) ratio and may benefit bone health, reduce muscle wasting, as well as mitigate other chronic diseases such as hypertension and strokes.
    2. The increase in growth hormone with an alkaline diet may improve many conditions from cardiovascular health to memory and cognition.
    3. An increase in available magnesium, required to activate vitamin D, would result in numerous added benefits in the vitamin D apocrine/exocrine systems.
    4. Alkalinity may result in added benefit for some chemotherapeutic agents that require a higher pH.

    It’s important to consider an alkaline diet (aka. lots of fruits and veggies) in the aging population, but also for the general population even if it doesn’t directly affect blood alkalinity [29].

    Evidence has shown that…

    “consumption of abundant alkaline-forming foods can result in improvement in bone mineral density (BMD) and muscle mass, protection from chronic illnesses, reduced tumor-cell invasion and metastasis, and effective excretion of toxins from the body.

    In addition, a large number of studies showing the benefits of alkaline water (mineral water) have revealed that people consuming water with a high level of total dissolved solids (TDS) (ie, with a high mineral content) have shown a lower incidence of coronary heart disease (CHD), cardiovascular disease (CVD), and cancer and lower total mortality rates.

    Consumption of alkaline water also may prevent osteoporosis and protect pancreatic beta cells with its antioxidant effects. In addition, this article discusses the literature that shows that reducing digestive-tract bacterial load can play an important role in increasing blood alkalinity toward the normal upper limit.” [19]

    The specifics of eating an alkaline diet is not as important as eating lots of colorful fruits and veggies, leafy greens and water for overall health and wellness.

     

    10. Mental and Cognitive Health

    The anti-oxidant and anti-inflammatory properties of Citrus flavonoids can play a key role against several degenerative and brain diseases [21].

    The anti-inflammatory properties of Citrus flavonoids are largely due to its affect on pro-inflammatory mediators, mainly the arachidonic acid derivatives, prostaglandins E2, F2, and thromboxane A2 [21].

    While vitamin C has more research, naringin has shown substancial evidence in animal studies on Alzheimerʼs disease [6].

    NOTE: Ascorbic acid is a reduced form of vitamin C with important antioxidant properties. It is essential to humans because of our inability to synthesize the final conversion into a usable form, leaving us dependent on dietary and supplementary sources of ascorbic acid [9].

    Ascorbic acid is highly concentrated in the brain and a key antioxidant of the central nervous system (CNS). Imbalance of ascorbic acid levels can lead to neurodegenerative disorders, as seen with a clear link between ascorbic acid deficiency and oxidative-induced neuronal death [9].

    The brain is vulnerable to oxidative damage because of its high oxygen consuming metabolic rate. Increased reactive oxygen species (ROS) levels have been observed in post-mortem brain tissue from patients with neurodegenerative disorders, including [9]:

    • Amyotrophic lateral sclerosis (ALS)
    • Alzheimer’s disease (AD)
    • Huntington’s disease (HD)
    • Parkinson’s disease (PD)

    Multiple studies links oxidative stress in the brain with neurodegeneration, making ascorbic acid an effective supplement to regain redox balance.

     

     

    References:

    These references were taken from PubMed. If you have any concerns about the validity and quality of these studies, please email the PMC Help Desk at pubmedcentral@ncbi.nlm.nih.gov.

    1.     Alam MA, Subhan N, Rahman MM, Uddin SJ, Reza HM, Sarker SD. Effect of Citrus Flavonoids, Naringin and Naringenin, on Metabolic Syndrome and Their Mechanisms of Action. Advances in Nutrition. 2014;5(4):404-417. doi:10.3945/an.113.005603.
    2.     Amorim JL, Simas DL, Pinheiro MM, Moreno DS, Alviano CS, da Silva AJ, Dias Fernandes P. Anti-Inflammatory Properties and Chemical Characterization of the Essential Oils of Four Citrus Species. PLoS One. 2016 Apr 18;11(4)
    3.     Assini JM, Mulvihill EE, Huff MW. Citrus flavonoids and lipid metabolism. Curr Opin Lipidol. 2013 Feb;24(1):34-40.
    4.     Barthel A, Schmoll D. Novel concepts in insulin regulation of hepatic gluconeogenesis. Am J Physiol Endocrinol Metab. 2003 Oct;285(4):E685-92.
    5.     Bentzon JF, Otsuka F, Virmani R, Falk E. Mechanisms of plaque formation and rupture. Circ Res. 2014 Jun 6;114(12):1852-66.
    6.     Bharti S, Rani N, Krishnamurthy B, Arya DS. Preclinical Evidence for the Pharmacological Actions of Naringin: A Review. Planta Med. 2014 Apr 7.
    7.     Bharti S, Rani N, Krishnamurthy B, Arya DS. Preclinical evidence for the pharmacological actions of naringin: a review. Planta Med. 2014 Apr;80(6):437-51.
    8.     Constantin RP, Constantin RP, Bracht A, Yamamoto NS, Ishii-Iwamoto EL, Constantin J. Molecular mechanisms of citrus flavanones on hepatic gluconeogenesis. Fitoterapia. 2014 Jan;92:148-62.
    9.     Covarrubias-Pinto A, Acuña AI, Beltrán FA, Torres-Díaz L, Castro MA. Old Things New View: Ascorbic Acid Protects the Brain in Neurodegenerative Disorders. Int J Mol Sci. 2015 Nov 27;16(12):28194-217.
    10.  Fenton TR, Tough SC, Lyon AW, Eliasziw M, Hanley DA. Causal assessment of dietary acid load and bone disease: a systematic review & meta-analysis applying Hill’s epidemiologic criteria for causality. Nutrition Journal. 2011;10:41. doi:10.1186/1475-2891-10-41.
    11.  Frassetto L, Morris RC Jr, Sellmeyer DE, Todd K, Sebastian A. Diet, evolution and aging–the pathophysiologic effects of the post-agricultural inversion of the potassium-to-sodium and base-to-chloride ratios in the human diet. Eur J Nutr. 2001 Oct;40(5):200-13. Review.
    12.  Grant DM. Detoxification pathways in the liver. J Inherit Metab Dis. 1991;14(4):421-30. Review.
    13.  Gregoire FM, Smas CM, Sul HS. Understanding adipocyte differentiation. Physiol Rev. 1998 Jul;78(3):783-809.
    14.  K. Fisher and C.A. Phillips. The effect of lemon, orange and bergamot essential oils and their components on the survival of Campylobacter jejuni, Escherichia coli O157, Listeria monocytogenes, Bacillus cereus and Staphylococcus aureus in vitro and in food systems. Journal of Applied Microbiology. Volume 101, Issue 6, pages 1232–1240, December 2006
    15.  Kato Y, Domoto T, Hiramitsu M, et al. Effect on Blood Pressure of Daily Lemon Ingestion and Walking. Journal of Nutrition and Metabolism. 2014;2014:912684. doi:10.1155/2014/912684.
    16.  Klingelhoeffer C, Kämmerer U, Koospal M, et al. Natural resistance to ascorbic acid induced oxidative stress is mainly mediated by catalase activity in human cancer cells and catalase-silencing sensitizes to oxidative stress. BMC Complementary and Alternative Medicine. 2012;12:61. doi:10.1186/1472-6882-12-61.
    17.  L Hallberg, M Brune, and L Rossander. The role of vitamin C in iron absorption. International Journal for Vitamin and Nutrition Research. Supplement = Internationale Zeitschrift fur Vitamin- und Ernahrungsforschung. Supplement [1989, 30:103-108], (PMID:2507689)
    18.  Lotan Y, Daudon M, Bruyère F, Talaska G, Strippoli G, Johnson RJ, Tack I. Impact of fluid intake in the prevention of urinary system diseases: a brief review. Curr Opin Nephrol Hypertens. 2013 May;22
    19.  Mousa HA. Health Effects of Alkaline Diet and Water, Reduction of Digestive-tract Bacterial Load, and Earthing. Altern Ther Health Med. 2016 Apr;22 Suppl 1:24-33.
    20.  Norlin M, Wikvall K. Enzymes in the conversion of cholesterol into bile acids. Curr Mol Med. 2007 Mar;7(2):199-218. Review.
    21.  O. Benavente-García and J. Castillo. Update on Uses and Properties of Citrus Flavonoids: New Findings in Anticancer, Cardiovascular, and Anti-inflammatory Activity. J. Agric. Food Chem., 2008, 56 (15), pp 6185–6205.
    22.  Oikeh EI, Omoregie ES, Oviasogie FE, Oriakhi K. Phytochemical, antimicrobial, and antioxidant activities of different citrus juice concentrates. Food Science & Nutrition. 2016;4(1):103-109. doi:10.1002/fsn3.268.
    23.  Payne AH, Hales DB. Overview of steroidogenic enzymes in the pathway from cholesterol to active steroid hormones. Endocr Rev. 2004 Dec;25(6):947-70.
    24.  Popkin BM, D’Anci KE, Rosenberg IH. Water, hydration, and health. Nutr Rev. 2010 Aug;68(8):439-58.
    25.  Richard AJ, Amini-Vaughan Z, Ribnicky DM, Stephens JM. Naringenin inhibits adipogenesis and reduces insulin sensitivity and adiponectin expression in adipocytes. Evid Based Complement Alternat Med. 2013;2013:549750. doi: 10.1155/2013/549750. Epub 2013 Jul 29. PubMed PMID: 23983791; PubMed Central PMCID: PMC3745873.
    26.  S.D. Turley, C.E. West, B.J. Horton. The role of ascorbic acid in the regulation of cholesterol metabolism and in the pathogenesis of atherosclerosis. Atherosclerosis. Volume 24, Issue 1-2, July-August 1976, p 1-18.
    27.  Sato K, Domoto T, Hiramitsu M, Katagiri T, Kato Y, Miyake Y, Ishihara K, Umei N, Takigawa A, Harada T, Aoi S, Ikeda H. [Effect of variation of lemon intake and walking in daily life on various indicators of muscle mass and blood biochemistry in menopausal middle-aged and elderly women]. Nihon Eiseigaku Zasshi. 2014;69(1):39-48. Japanese. PubMed PMID: 24476594
    28.  Sattar, Husain. Fundamentals of Pathology: Medical Course and Step 1 Review, 2016. Available at Pathoma.com
    29.  Schwalfenberg GK. The Alkaline Diet: Is There Evidence That an Alkaline pH Diet Benefits Health? Journal of Environmental and Public Health. 2012;2012:727630. doi:10.1155/2012/727630.
    30.  Shefalee K. Bhavsar, Paulomi Joshi, Mamta B. Shah and D.D. Santani. Investigation into Hepatoprotective Activity of Citrus limon. Pharmaceutical Biology, 2007, Vol. 45, No. 4 : Pages 303-311.
    31.  Siri-Tarino PW, Sun Q, Hu FB, Krauss RM. Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease. The American Journal of Clinical Nutrition. 2010;91(3):535-546. doi:10.3945/ajcn.2009.27725.
    32.  Smith JA, Pati D, Wang L, de Kloet AD, Frazier CJ, Krause EG. Hydration and beyond: neuropeptides as mediators of hydromineral balance, anxiety and stress-responsiveness. Front Syst Neurosci. 2015 Mar 31;9:46.
    33.  Thankachan P, Walczyk T, Muthayya S, Kurpad AV, Hurrell RF. Iron absorption in young Indian women: the interaction of iron status with the influence of tea and ascorbic acid. Am J Clin Nutr. 2008 Apr;87(4):881-6.
    34.  Uchide N, Toyoda H. Antioxidant therapy as a potential approach to severe influenza-associated complications. Molecules. 2011 Feb 28;16(3):2032-52.

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