As an old year fades into its final days and a new year approaches, I always wonder what new quackery will make an appearance. I know, of course, that all the old quackeries, antivaccine pseudoscience, homeopathy, naturopathy, reflexology, cancer quackery,and the huge number of other variations on self-deception will still be there. I also know that, when it comes to pseudoscience, there is rarely anything truly new under the sun, but I do like to contemplate what previously neglected bit of nonsense will come to prominence in 2018.

Thanks to The New York Times the other day, I might know. It’s variant of many forms of pseudoscience based on the fallacy of an appeal to nature (i.e., that if it’s “natural” it must be better, safer, and healthier, and that many of humanity’s health most intractable health issues are due to the products of modernity, such as industry and pesky public health measures that protect against disease, such as vaccines, pure water, and pasteurization), but it’s also yet another variety of a common form of nonsense that I like to refer to as water woo. Over the years here at SBM, we’ve written about alkaline water, oxygen water, Kangan water, and water cluster quackery. And of course we’ve written extensively about the pseudoscience and conspiracy theories demonizing water fluoridation more times than I care to remember. It’s not for nothing that I like to make frequent Dr. Strangelove references.

Think of this particular form of fashionable nonsense as being the ultimate in water woo. Basically, the idea is that any treatment of water is bad, that you must drink the water untreated and unfiltered from the source, whatever that “natural” source might be:

At Rainbow Grocery, a cooperative in this city’s Mission District, one brand of water is so popular that it’s often out of stock. But one recent evening, there was a glittering rack of it: glass orbs containing 2.5 gallons of what is billed as “raw water” — unfiltered, untreated, unsterilized spring water, $36.99 each and $14.99 per refill, bottled and marketed by a small company called Live Water.

“It has a vaguely mild sweetness, a nice smooth mouth feel, nothing that overwhelms the flavor profile,” said Kevin Freeman, a shift manager at the store. “Bottled water’s controversial. We’ve curtailed our water selection. But this is totally outside that whole realm.”

Here on the West Coast and in other pockets around the country, many people are looking to get off the water grid.

Start-ups like Live Water in Oregon and Tourmaline Spring in Maine have emerged in the last few years to deliver untreated water on demand. An Arizona company, Zero Mass Water, which installs systems allowing people to collect water directly from the atmosphere around their homes, began taking orders in November from across the United States. It has raised $24 million in venture capital.

Reading about this new craze, I couldn’t help but think of two things. My first thought was: Damn, is that water expensive at $14.80 a gallon for the first “orb” and $6.00 a gallon for a refill! Yes, I know that bottled water can be more expensive on a per-gallon basis than a refill of Live Water, depending upon where you buy it (e.g., a sports stadium or concert hall), but this is still some expensive water. My second thought was that this reminded me very much of “raw milk.” As regular readers probably know, the same sorts of arguments are used for raw milk, namely that the usual treatment of milk used to decrease the risk of milk-borne infections to nearly zero (Pasteurization) somehow robs the milk of its taste, nutrition, and “vitality.” Whether raw milk “tastes better” or not, I do not know, never having tried it, but I do know that drinking raw milk increases the risk of potentially serious food-borne illness, as has been extensively documented. Personally, I always wondered if these same people also eat uncooked pork and chicken.

Let’s leave aside the issue of fluoridation and concentrate just on the claims for “raw water” for a moment. Fluoridation is a subset of “contamination” fear that we’ve written about extensively, particularly how fluoridation as practiced today is both safe and effective as a public health means to decrease the risk of dental caries but has been the subject of conspiracy theories at least since the time of Dr. Strangelove over 50 years ago. Let’s see what sort of health claims are made for raw water:

What adherents share is a wariness of tap water, particularly the fluoride added to it and the lead pipes that some of it passes through. They contend that the wrong kind of filtration removes beneficial minerals. Even traditional bottled spring water is treated with ultraviolet light or ozone gas and passed through filters to remove algae. That, they say, kills healthful bacteria — “probiotics” in raw-water parlance.

Yes, when water is improperly treated, the lead pipes still found in some older cities can lead to the leeching of lead into the water. Flint, a city in my own state, made national headlines for that very problem less than two years ago, and the problem still hasn’t been resolved. Of course, what the NYT article lists as health claims for this water are a bit less…extravagant…than what the actual sellers of this water claim. For instance, I wandered over to the Live Water website, and one of the first claims that greeted me was this:

The earth constantly offers the purest substance on the planet as spring water. We celebrate this ancient life source that humanity flourished from, since the beginning of our existance. [sic] We trust it’s perfect just the way it is.

“We trust it’s perfect just the way it is” basically because it’s “natural.” Also notice the distinct tinge of primitive vitalism in the claims made for this water, which is portrayed as an “ancient life source.” That vitalism is made even more explicit in multiple Instagram posts like this one:

“Our earth provides us this ancient source of #medicine in a complex cycle, far greater than anything we can ever fully comprehend”? This sounds more like magic and mysticism than anything scientific, as does this:

Also, you don’t need to refrigerate it, just to keep it cool and consume it within one lunar cycle:

Common question- Why don’t we offer 5 gallon glass jugs anymore? 🧐 After a handful of customers reported heavy and hard to handle 5 gallon jugs busting in kitchens, switching to 2.5 gallon glass jugs was the only safe solution🚰 Our #custom #leadfree #floweroflife jugs just happen to be easier to maneuver and stackable as well ⏳ Common question- Why do we refrigerate our #livespringwater from the moment it goes into glass till it’s delivered? 🤔 Since our water isn’t sterilized like all other spring water companies, the naturally occurring probiotic microbes in our water, would go green in hot storage conditions🍵 Common question- Does the water need to get refrigerated after delivery? ❄️ Most homes don’t reach the 110 degrees Fahrenheit most trucks and warehouses do in summer. 🔥 Store your #livewater in a cool dark space and enjoy it within one lunar cycle for super freshness ⛈

A post shared by Līve Water (@livespringwater) on

Then there’s the sorts of things Mukhande Singh, founder of Live Water, says, as in this quote from the NYT article:

Pure water can be obtained by using a reverse osmosis filter, the gold standard of home water treatment, but for Mr. Singh, the goal is not pristine water, per se. “You’re going to get 99 percent of the bad stuff out,” he said. “But now you have dead water.”

He said “real water” should expire after a few months. His does. “It stays most fresh within one lunar cycle of delivery,” he said. “If it sits around too long, it’ll turn green. People don’t even realize that because all their water’s dead, so they never see it turn green.”

See what I mean? To people like Singh, if you treat the water you’re “killing” it. You’re robbing it of its “vital essence.” Of course, I don’t want my water to turn green; that rather suggests to me that there are too many organisms in it.

I will admit that the bottles are quite pretty, although I could do without photos of Singh that look like this:

A post shared by Līve Water (@livespringwater) on

Note the flowing locks, the levitating nakedness, the concentrated woo. At least he kept most of his clothes on for the photo in the NYT article.

Next up:

Shocking but true– All other filtered and even bottled spring waters are sterilized with UV light, ozone gas, and a sub micron filter. This is similar to how most juice and dairy products are pasteurized for shelf stability. Unfortunately this sterilization destroys beneficial sources of minerals and probiotics.

I can’t help but notice a dig at a potential competitor, as the first link goes to a page on the Mountain Valley Spring Water Company website discussing how its water complies with FDA regulations for filtering and purification. The second link goes to a page on David Williams’ website that claims that chlorinated drinking water is “toxic” to gut bacteria, as are “sterilized” (i.e., pasteurized) foods and a wide variety of other “unnatural” things, including vaccinations. I also note that “Dr.” David Williams is not a physician. He is a chiropractor with “multiple bachelor’s degrees, a Doctor of Chiropractic from Texas Chiropractic College, and research projects at the University of Houston, University of Texas at San Antonio, and Rice University.” There’s not a lot about vaccines on his website, but he does clearly believe that vaccines somehow “damage” the gut bacteria, with detrimental health consequences to infants and children. He also thinks that you should not get the flu shot every year, claiming:

Vaccines deliver either live or dead viruses directly into your body tissue, short-circuiting your body’s normal front-line immune defense system in your respiratory passageways and mucous membrane linings. If your immune system is weak or out of balance when the virus is introduced this way, you could have serious health consequences.

Also, there are controversial additives that have been used for years in seasonal flu shots. The most well known is thimerosal, a mercury-based preservative that has been associated with brain and immune system dysfunction. The majority of flu shots each contain 25 mcg of this toxin.

Yes, Dr. Williams is not only a chiroquack, but he is antivaccine, claiming that “about the only thing flu vaccines are truly good for is lining the pockets of bio-pharmaceutical companies.” Let’s just put it this way. If Live Water thinks Mr. Williams is a good source of medical information about anything, it makes me question its other claims, and there are quite a few.

One example is this:

Microbes outnumber human cells in the body 10 fold. There are more nerve endings in our bellies than in our brains and there’s a constant battle between good and bad bacteria. The micro biome of our gut produces about 95% of the serotonin and 50% of the dopamine in our brains. Anxiety, weight gain, fatigue, and countless other ailments are linked to an imbalance of proper gut bacteria. Living spring water is the key to unlocking a perfect micro-biome balance.

The probiotics listed here are exclusive to our unsterilized water. There could be countless other benificial [sic] microbes present, scientists just haven’t discovered yet. They are imperative for optimal physical and mental health. Without these probiotics we’re not able to fully assimilate all the nutrients in our food. Beneficial bacteria are also proven to have abilities to transform harmful bacteria. Here is a published medical report proving raw spring water has vast healing abilities.

I don’t know about you, but there’s nothing like a link to Pinterest showing all sorts of microbiome memes maintained by the company to persuade me. As for the report, I was struck at one result not reported that is generally considered critical to determining if water is pure: The level of coliform bacteria (E. coli, and other bacteria commonly found in feces, certain strains of which can cause disease). As for the rest, Live Water reports levels of bacteria ranging from 1,310 CFU/mL for Pseudomonas putida to 11,640 CFU/mL for Pseudomonas oleovorans. (CFU=colony forming unit, which is a measure of the number of viable bacteria per volume of water.) This struck me as rather high, and indeed the maximal bacterial level for potable drinking water as regulated by the U.S. Environmental Protection Agency Drinking Water Safety Act is 50,000 CFU/100 mL or 500 CFU/mL. Granted, these bacteria are generally nonpathogenic, but one has to wonder how careful Live Water is with regards to preventing fecal coliforms to creep in during the bottling process. Also, as the World Health Organization points out, bacterial counts can increase even at 5° C.

As for the purported health benefits of the bacteria found in a spring, Live Water cites a study that is—shall we say?—far more speculative than it is informative. Yes, the authors found a variety of bacteria in a spring near Comano, Italy, but the evidence for the health effects of these bacteria is basically a lot of handwaving. As for the bit about beneficial bacteria “transforming” harmful bacteria, let’s just say that a link to the Wikipedia entry on phage therapy is not a convincing argument. Yes, viruses known as bacteriophages can transform and, in some cases, kill bacteria, but this is not an argument that Live Water has health benefits.

Regarding one of the other water sellers mentioned, I can’t help but note that Zero Mass is a system costing “$4,000 plus tax, delivery and installation” that isolates water by condensing water from the humidity in the air using solar power. Its makers claim it can work in areas of low humidity. There’s nothing wrong with this, as far as I’m concerned, but it’s also silly to lump this system in with purveyors of “natural” water. Given that this system runs the water through a cartridge that adds magnesium, calcium, and other minerals to the water, as well as filtering out pollutants, I fail to see how this water is any more “natural” than standard treated water.

I’ve concentrated mainly on bacteria, of course, because that’s the most obvious problem with the raw water movement, that untreated water can harbor disease. However, they are not the only problems with raw water. I also can’t help but note that one big booster of the “raw water” movement is Doug Evans, who moved rapidly to raw water after his business selling a $400 raw juicer Juicero shut down.

I can’t help but think that those of us living in developed nations are so wrapped up in our little cocoons of technology that we forget that in much of the world potable water is not a given—nowhere near it. Waterborne disease is still very common, with waterborne diarrheal diseases responsible for 2 million deaths each year, with the majority occurring in children under 5. As for those advocates claiming that raw water is more “natural” and “alive,” I like to point out that Giardia, amoebic dysentery, cholera, salmonella and shigella, E. coli, and a whole host of other waterborne diseases that used to regularly cause outbreaks that would kill humans in large numbers before the advent of sewage and water treatment systems (and still do in undeveloped countries) are very much “natural” and “alive” as well.

It would be one thing if there were demonstrable health benefits to “Live Water” and other “raw water” products compared to tap water or even bottled water. In such a case one could discuss the risk of disease versus the documented health benefits. Sadly, however, there are no such health benefits yet demonstrated. Raw water is all high (and expensive) risk for no scientifically demonstrable benefit.

Posted by David Gorski

Dr. Gorski's full information can be found here, along with information for patients. David H. Gorski, MD, PhD, FACS is a surgical oncologist at the Barbara Ann Karmanos Cancer Institute specializing in breast cancer surgery, where he also serves as the American College of Surgeons Committee on Cancer Liaison Physician as well as an Associate Professor of Surgery and member of the faculty of the Graduate Program in Cancer Biology at Wayne State University. If you are a potential patient and found this page through a Google search, please check out Dr. Gorski's biographical information, disclaimers regarding his writings, and notice to patients here.