Review: +Nuun – Electrolyte enhanced drinks tabs

by Bikeboyslim | Aug 7, 2012

With the recent BBC Panorama documentary in mind about the research that underpins sales and marketing of sports drinks in the UK, I have become some what sceptical about the claims made by manufacturers relating to the performance enhancement that the general population of active sports people and in our case active cyclists can gain from the use of sports drinks and nutrition products. People believe it super effective during their workouts, having even become famous as the joe rogan diet included drinking sports drinks in his workout routine. And that’s what the researcher is trying to analyze.

For those who did not see the programme, in a nutshell, the BBC had linked up with a group of researchers at Oxford University who wanted to test the validity of the research and data that is currently being used to sell Lucozade Sport and Powerade.

As we may know all research findings are based on statistical analysis and we all know about statistics, ‘there are lies, damn lies and statistics’! I should know I used to use research findings and materials data to sell a specific engineering product. In the past making claims that our product out performed the competition. Well it did in certain areas but not always the one the customer wanted to use it in, but who was I to enlighten them to that fact!

The outcome of the team at Oxford appeared to suggest that sports drinks offer no significant advantage to the average population vs drinking water. In fact they went even further and suggested the the ingestion of 23 grammes of sugar per 500ml of fluid could be detrimental to the target audience, children!

But perhaps this is where Nuun is different as the name might suggest it has nuun of the ‘nasty’ calories found in sugar, although this does mean the drink does not provide an energy source but then it is does not claim to do this.

So what does the American manufacturer actually claim? Well here is their promotional information on the company website:-

Other then the reference to the American College of Sports Medicine no specific references appear to be easily found on the company website. The marketing blurb continues with:-

WHY IS HYDRATION IMPORTANT?
Hydration is important for your overall health, regardless of your daily activity level. A large percentage of your body is made up of water, and proper hydration means ensuring that your body maintains that level of water, as we are constantly losing water. Water helps your body regulate temperature, transport nutrients to organs and tissues, transport oxygen to cells, remove waste, and protect your joins and organs.
Hydration, however, is more than just drinking water. Proper hydration is essential for concentration and attention to detail, whether you’re running a marathon, or a marathon of errands. Even a small decline in dehydration levels can result in a decrease of mental and physical performance.

HOW CAN I STAY HYDRATED WITHOUT THE UNNECESSARY SUGARS?
Nuun is hydration, without the sugar – a refreshing alternative to many of the options in the beverage market today. On average, Americans consume 130 pounds of sugar per person, per year. Sugar has been directly related to heart disease, metabolic syndrome and diabetes.
Beverages containing large amounts of sugar can accelerate the dehydration process. Sugar requires water from the body in order to be digested, leaving less water to properly fuel muscle and brain function. With zero sugars and only 8 calories in each 16oz. bottle, Nuun is a smart choice for hydration.

All very interesting, but wait what is this about sugar causing dehydration, this a new one to me. I always thought that the key to rehydration was to drink water with the addition of salt and sugar. Well that is certainly what I remember being told would save lives in third world countries, if only they could have clean water, salt and sugar!
But wait please remember that this product was developed for the American market and the key words to pick up on are:-

On average, Americans consume 130 pounds of sugar per person, per year. Sugar has been directly related to heart disease, metabolic syndrome and diabetes.

A quick internet search revealed via the Livestrong website that sugar can dehydrate you if you get very high levels in you blood, this can happen if you are, guess what, yes you guessed it Diabetic! (Read more: www.livestrong.com)
So with all this in mind and one over riding memory of the Panorama programme, Graeme Obree describing his feed and hydration regime for his hour records, water and jam butties!

So down to the testing; how does Nuun perform out on the road?

The first thing to comment on is the Nuun bottle that came with the test product, it is very good, and continues to be a favourite of mine after two weeks of daily rides. It has an easy to use soft mouth piece, wide mouth to allow for easy cleaning and is made of a soft plastic that allows easy squeeze to get a good squirt of hydration product.
The test arena for the hydration tabs is the sunny Vendee (Atlantic Coast France) and the region that is one of the key sponsors of the Europcar Team. Testing has been conducted on medium paced rides of over 60 minutes in temperature approaching and in excess of 30oC! Prime weather for dehydration and salt imbalance, the type of weather that can easily promote post ride cramp.
The three flavours on test were, Strawberry, Lemon and Lime and the main sample of Grape. Nuun recommended dosage is one tab per 500ml bottle, but being a tight Yorkshireman, I typically only use one tab (habit was developed using High 5 Zero) so my initial test rides are all based on a single tab.
The tabs are incredibly easy to use, drop one into the bottle and add water. Step back and watch them fizz away to their hearts content. With a little agitation they dissolve very quickly, so much easier then a powder mix and no mess. The tab format also means that will be easy to carry on a long ride and mix on route. Nice. This as far as I am concerned is an absolutely major benefit to using tabs vs powders. They are really easy to transport anywhere in the world and better still take up less cupboard space, this means less hassle from the one who is to be obeyed (aka the wife)!

Ride 1 Strawberry.
72 mins early morning start 7.30am temperature 22oC and climbing.
Initial reaction was that the flavour would probably be the bottom of my list, a little insipid to say the least but I would never normally drink anything strawberry flavoured so a little harsh maybe and especially as I am using a half dose.
The product seemed to work during and post ride and I would certainly say that it was more palatable then plain water.

Ride 2 Lemon and Lime.
78 mins fast paced afternoon ride 4pm temperature 32oC
This was a much better flavour for my taste even at half strength a very smooth taste and no after taste of bicarb (can sometimes get this with other tab products) over all quite impressed. No issues with cramp during the ride.

Further rides using Grape
A range of easy and hard rides across similar temperatures to the first two tests.
At half strength the grape did not taste very strong so I took the plunge and used the recommended one tabs per 500ml. Bingo! the taste was great and more importantly no cramp during or post rides. The biggest benefit for me, from past experience, is the fluids were good to drink even when the bottle temperature had risen during the ride. I normally find it unpleasant to drink warm water mid to end of a long warm ride. Adding Nuun changes this and the tepid fluid stays pleasant to drink and actually encourage you to maintain fluid balance.

So much for the use now for the science behind the product or at least the labeling and list of ingredients. Now be honest after all the hype, advertising and endorsements listed for the product you use how many of you actually read the ingredients and find out what they do or are used for? I confess I have never done so, but in view of the TV documentary I thought it might be enlightening!

On each packet is found the following:-
Nuun turns water into a refreshing sports hydration drink (hmm this smacks of the Apprentice style sales pitch!!)
According to the label Nuun are electrolyte enhanced drinks tabs with zero sugar and only 8 calories per tab.
The full nutrition data is listed for a tab in 240ml as:-
Fat 0g

Sodium 173mg (2%)

Potassium 50mg (1%)

Total Carbs <1g
Sugar 0g
Vitamin C 19mg (31%)
Riboflavin 250mg (15%)
Calcium 6.5mg (1%)
Magnesium 12.5mg (3%)

 (percentages based on a 2000 calorie diet)

Ingredients: citric acid, sorbitol, sodium bicarbonate, sodium carbonate, sodium benzonate, natural flavours, polyethylene glycol, magnesium oxide, sodium acetate, ascorbic acid, acesulfame potassium, calcium carbonate, natural colour, riboflavin 5-phosphate.

Hmm that all sounds very tasty, if not a little industrial!

A couple of the ingredients leapt out at me immediately:
Sorbitol is that not a laxative? I seem to remember in my childhood falling foul of eating too many sorbitol mints, hmm not a pleasant memory.
Sodium Bicarbonate (baking soda), is this not the active ingredient in popular Plink Plink fizz pick me up and headache tablet? I remember a science experiment at school where our teacher demonstrated that over 50% of the Alka Salksa was actually Bicarb and was only added to give the good old fizz for branding!
Sodium Benzonate, is that not related to benzene and is that not found in petrol and is it a cancer causing chemical?
Well that is what got me thinking about what all these chemical actually are and you can find out too my reading the ingredients appendix. (data sourced from Wikipedia so reader beware).

Back to the product itself and the burning question Does it work? and would I buy it?

Does it work? yes it does create a very palatable hydration drink with the benefit of no added sugar. Does it keep cramp at bay and provide good salt balance. Used at full strength Nuun works very well and does what it says on the Tin (or plastic tube in Nuun’s case) Would I buy it? Yes. It really does turn water into a great flavoured hydration drink. I would recommend you try Nuun for yourself, you might just find you like it and that it suits your needs well.
Tablets RRP: £6.00 for a pack of 12 Tablets.
Nuun Bottle RRP:£4.00
Flavours: Banana, Tropical, Lemon Tea, Citrus Fruit, Fruit Punch, Strawberry Lemonade, Kona Kola, Orange, Grape & Tri-Berry.

Enter our competition to win nuun goodies by clicking here!

To find out more about nuun and their products visit their website by clicking here.

Ingredients appendix

Citric acid is a weak organic acid. It is a natural preservative/conservative and is also used to add an acidic, or sour, taste to foods and soft drinks. In biochemistry, the conjugate base of citric acid, citrate, is important as an intermediate in the citric acid cycle, and therefore occurs in the metabolism of virtually all living things. Citric acid is a commodity chemical, and more than a million tonnes are produced every year by fermentation. It is used mainly as an acidifier, as a flavoring, and as a chelating agent.

Sorbitol, also known as glucitol, is a sugar alcohol, which the human body metabolizes slowly. It can be obtained by reduction of glucose, changing the aldehyde group to a hydroxyl group. Sorbitol is found in apples, pears, peaches, and prunes. It is synthesized by sorbitol-6-phosphate dehydrogenase, and converted to fructose by succinate dehydrogenase and sorbitol dehydrogenase. Succinate dehydrogenase is an enzyme complex that participates in the citric acid cycle.
Sweetener
Sorbitol is a sugar substitute. It may be listed under the inactive ingredients listed for some foods and products. Sorbitol is referred to as a nutritive sweetener because it provides dietary energy: 2.6 kilocalories (11 kilojoules) per gram versus the average 4 kilocalories (17 kilojoules) for carbohydrates. It is often used in diet foods (including diet drinks and ice cream), mints, cough syrups, and sugar-free chewing gum.[citation needed]
It also occurs naturally in many stone fruits and berries from trees of the genus Sorbus.

Laxative
Sorbitol can be used as a non-stimulant laxative via an oral suspension or enema. As with other sugar alcohols, gastrointestinal distress may result when food products that contain sorbitol are consumed. Sorbitol exerts its laxative effect by drawing water into the large intestine, thereby stimulating bowel movements. Sorbitol has been determined safe for use by the elderly, although it is not recommended without consultation with a clinician. Sorbitol is found in some dried fruits and may contribute to the laxative effects of prunes.

Sodium bicarbonate
Sodium bicarbonate or sodium hydrogen carbonate is the chemical compound with the formula NaHCO3. Sodium bicarbonate is a white solid that is crystalline but often appears as a fine powder. It has a slightly salty, alkaline taste resembling that of washing soda (sodium carbonate). The natural mineral form is nahcolite. It is a component of the mineral natron and is found dissolved in many mineral springs.
Since it has long been known and is widely used, the salt has many related names such as baking soda, bread soda, cooking soda, and bicarbonate of soda. In colloquial usage, its name is shortened to sodium bicarb, bicarb soda, or simply bicarb. The word saleratus, from Latin sal æratus meaning aerated salt, was widely used in the 19th century for both sodium bicarbonate and potassium bicarbonate. The term has now fallen out of common usage.
Baking soda in sports
Small amounts of sodium bicarbonate have been shown to be useful as a supplement for athletes in speed-based events, like middle distance running, lasting from about one to seven minutes. But overdose is a serious risk because sodium bicarbonate is slightly toxic and in particular gastrointestinal irritation is of concern. Additionally this practice causes a significant increase in dietary sodium.

Sodium carbonate (also known as washing soda or soda ash), Na2CO3 is a sodium salt of carbonic acid. It most commonly occurs as a crystalline heptahydrate, which readily effloresces to form a white powder, the monohydrate. Sodium carbonate is domestically well known for its everyday use as a water softener. It can be extracted from the ashes of many plants. It is synthetically produced in large quantities from salt (sodium chloride) and limestone in a process known as the Solvay process.

Sodium carbonate is also used in the production of sherbet powder. The cooling and fizzing sensation results from the endothermic reaction between sodium carbonate and a weak acid, commonly citric acid, releasing carbon dioxide gas, which occurs when the sherbet is moistened by saliva.
Sodium benzoate has the chemical formula NaC6H5CO2; it is a widely used food preservative, with E number E211. It is the sodium salt of benzoic acid and exists in this form when dissolved in water. It can be produced by reacting sodium hydroxide with benzoic acid. 

Sodium benzoate is a preservative. It is bacteriostatic and fungistatic under acidic conditions. It is most widely used in acidic foods such as salad dressings (vinegar), carbonated drinks (carbonic acid), jams and fruit juices (citric acid), pickles (vinegar), and condiments. It is also used as a preservative in medicines and cosmetics. As a food additive, sodium benzoate has the E number E211.

It is also used in fireworks as a fuel in whistle mix, a powder that emits a whistling noise when compressed into a tube and ignited. The fuel is also one of the fastest burning rocket fuels and provides a lot of thrust and smoke. It does have its downsides: there is a high danger of explosion when the fuel is sharply compressed because of the fuel’s sensitivity to impact.
Sodium benzoate is produced by the neutralization of benzoic acid with sodium hydroxide. Benzoic acid is detectable at low levels in cranberries, prunes, greengage plums, cinnamon, ripe cloves, and apples. Though benzoic acid is a more effective preservative, sodium benzoate is more commonly used as a food additive because benzoic acid does not dissolve well in water. Concentration as a preservative is limited by the FDA in the U.S. to 0.1% by weight. The International Programme on Chemical Safety found no adverse effects in humans at doses of 647–825 mg/kg of body weight per day.
Cats have a significantly lower tolerance against benzoic acid and its salts than rats and mice. Sodium benzoate is, however, allowed as an animal food additive at up to 0.1%, according to AFCO‘s official publication.
Safety and health
Main article: Benzene in soft drinks
In combination with ascorbic acid (vitamin C, E300), sodium benzoate and potassium benzoate form benzene, a known carcinogen. However, in most beverages that contain both, the benzene levels are below those considered dangerous for consumption. Heat, light and shelf life can affect the rate at which benzene is formed.
Professor Peter W. Piper of the University of Sheffield claims that sodium benzoate by itself can damage and inactivate vital parts of DNA in a cell’s mitochondria. Mitochondria consume oxygen to generate ATP, the body’s energy currency. If they are damaged due to disease, the cell malfunctions and may enter apoptosis.[citation needed]

Polyethylene glycol (PEG) is a polyether compound with many applications from industrial manufacturing to medicine. The structure of PEG is (note the repeated element in parentheses):
HO-CH2-(CH2-O-CH2-)n-CH2-OH
PEG is also known as polyethylene oxide (PEO) or polyoxyethylene (POE), depending on its molecular weight, and under the tradename Carbowax.

Biological uses

• PEG is commonly used as a precipitant for plasmid DNA isolation and protein crystallisation. X-ray diffraction of protein crystals can reveal the atomic structure of proteins.
• Polymer segments derived from PEG polyols impart flexibility to polyurethanes for applications such as elastomeric fibres (spandex) and foam cushions.
• In microbiology, PEG precipitation is used to concentrate viruses. PEG is also used to induce complete fusion (mixing of both inner and outer leaflets) in liposomes reconstituted in vitro.
• Gene therapy vectors (such as viruses) can be PEG-coated to shield them from inactivation by the immune system and to de-target them from organs where they may build up and have a toxic effect. The size of the PEG polymer has been shown to be important, with large polymers achieving the best immune protection.
• PEG is a component of stable nucleic acid lipid particles (SNALPs) used to package siRNA for use in vivo.
• In blood banking, PEG is used as a potentiator to enhance detection of antigens or antibodies.
• When working with phenol in a laboratory situation, PEG 300 can be used on phenol skin burns to deactivate any residual phenol.

Commercial uses

• It is the basis of many skin creams, as cetomacrogol, and sexual lubricants, frequently combined with glycerin.
• PEG is used in a number of toothpastes as a dispersant; it binds water and helps keep xanthan gum uniformly distributed throughout the toothpaste. It is also under investigation for use in body armour and tattoos to monitor diabetes.
• Low-molecular-weight (PEG 400) is used in Hewlett-Packard designjet printers as an ink solvent and lubricant for the print heads.
• PEG is also one of the main ingredients in paintball fill because it is thick and flexible. However, as early as 2006, some Paintball manufacturers have been substituting cheaper alternatives for PEG.[citation needed]
• PEG is a major ingredient in e-liquid, used in e-cigarettes. It is generally used as a 30%-50% proportion of the liquid that is vaporized. Its use is designed to give a smoother effect to the vaping action.[citation needed]
• PEG is also as a food additive used as an anti-foaming agent; its INS number is 1521 or E1521 in the EU.

Magnesium oxide (MgO), or magnesia, is a white hygroscopic solid mineral that occurs naturally as periclase and is a source of magnesium (see also oxide). It has an empirical formula of MgO and consists of a lattice of Mg2+ ions and O2− ions held together by ionic bonds. Magnesium hydroxide forms in the presence of water (MgO + H2O → Mg(OH)2), but it can be reversed by heating it to separate moisture.
Magnesium oxide was historically known as magnesia alba (literally, the white mineral from Magnesia), to differentiate it from magnesia negra, a black mineral containing what is now known as manganese.

Medical
In medicine, magnesium oxide is used for relief of heartburn and sore stomach, as an antacid, magnesium supplement, and as a short-term laxative. It is also used to improve symptoms of indigestion. Side effects of magnesium oxide may include nausea and cramping. In quantities sufficient to obtain a laxative effect, side effects of long-term use include enteroliths resulting in bowel obstruction.

Sodium acetate, CH3COONa, also abbreviated NaOAc, also sodium ethanoate, is the sodium salt of acetic acid. This colourless salt has a wide range of uses.

Sodium acetate may be added to foods as a seasoning. It may be used in the form of sodium diacetate — a 1:1 complex of sodium acetate and acetic acid, given the E-number E262. A frequent use of this form is in salt and vinegar chips in the United States. Many US brands, including national manufacturer Frito-Lay, sell “salt and vinegar flavoured” chips that use this chemical, with lactose and smaller percentages of other chemicals, in lieu of a real salt and vinegar preparation.

Ascorbic acid is a naturally occurring organic compound with antioxidant properties. It is a white solid, but impure samples can appear yellowish. It dissolves well in water to give mildly acidic solutions. Ascorbic acid is one form (“vitamer“) of vitamin C. It was originally called L-hexuronic acid, but when it was found to have vitamin C activity in animals (“vitamin C” being defined as a vitamin activity, not then a specific substance), the suggestion was made to rename L-hexuronic acid. The new name for L-hexuronic acid is derived from a- (meaning “no”) and scorbutus (scurvy), the disease caused by a deficiency of vitamin C. Because it is derived from glucose, many animals are able to produce it, but humans require it as part of their nutrition. Other vertebrates lacking the ability to produce ascorbic acid include other primates, guinea pigs, teleost fishes, bats, and birds, all of which require it as a dietary micronutrient (that is, a vitamin).
Chemically, there exists a D-ascorbic acid which does not occur in nature. It may be synthesized artificially. It has identical antioxidant properties to L-ascorbic acid, yet has far less vitamin C activity (although not quite zero). This fact is taken as evidence that the antioxidant properties of ascorbic acid are only a small part of its effective vitamin activity. Specifically, L-ascorbate is known to participate in many specific enzyme reactions which require the correct epimer (L-ascorbate and not D-ascorbate).

Food chemistry
Ascorbic acid and its sodium, potassium, and calcium salts are commonly used as antioxidantfood additives. These compounds are water-soluble and thus cannot protect fats from oxidation: For this purpose, the fat-solubleesters of ascorbic acid with long-chain fatty acids (ascorbyl palmitate or ascorbyl stearate) can be used as food antioxidants. Eighty percent of the world’s supply of ascorbic acid is produced in China.
The relevant European food additive E numbers are

• E300 ascorbic acid (approved for use as a food additive in the EU, USA and Australia and New Zealand)
• E301 sodium ascorbate (approved for use as a food additive in the EU, USA and Australia and New Zealand)
• E302 calcium ascorbate (approved for use as a food additive in the EU, USA and Australia and New Zealand)
• E303 potassium ascorbate
• E304 fatty acid esters of ascorbic acid (i) ascorbyl palmitate (ii) ascorbyl stearate.

It creates volatile compounds when mixed with glucose and amino acids in 90 Celsius.
It is a cofactor in tyrosineoxidation.

Acesulfame potassium (ay-see-SUHL-faym) is a calorie-free artificial sweetener, also known as Acesulfame K or Ace K (K being the symbol for potassium), and marketed under the trade names Sunett and Sweet One. In the European Union, it is known under the E number (additive code) E950. It was discovered accidentally in 1967 by German chemist Karl Clauss at Hoechst AG (now Nutrinova). In chemical structure, acesulfame potassium is the potassium salt of 6-methyl-1,2,3-oxathiazine-4(3H)-one 2,2-dioxide. It is a white crystalline powder with molecular formula C4H4KNO4S and a molecular weight of 201.24 g/mol.

Acesulfame K is 200 times sweeter than sucrose (table sugar), as sweet as aspartame, about 2/3 as sweet as saccharin, and 1/3 as sweet as sucralose. Like saccharin, it has a slightly bitter aftertaste, especially at high concentrations. Kraft Foods has patented the use of sodium ferulate to mask acesulfame’s aftertaste. Acesulfame K is often blended with other sweeteners (usually sucralose or aspartame). These blends are reputed to give a more sugar-like taste whereby each sweetener masks the other’s aftertaste, and/or exhibits a synergistic effect by which the blend is sweeter than its components.
Unlike aspartame, acesulfame K is stable under heat, even under moderately acidic or basic conditions, allowing it to be used in baking, or in products that require a long shelf life. In carbonated drinks, it is almost always used in conjunction with another sweetener, such as aspartame or sucralose. It is also used as a sweetener in protein shakes and pharmaceutical products, especially chewable and liquid medications, where it can make the active ingredients more palatable.

Safety
As with other artificial sweeteners, there is concern over the safety of acesulfame potassium. Although studies of these sweeteners show varying and controversial degrees of dietary safety,[citation needed] the United States Food and Drug Administration (US FDA) has approved their general use. Critics say acesulfame potassium has not been studied adequately and may be carcinogenic, although these claims have been dismissed by the US FDA and by equivalent authorities in the European Union.
Some potential effects associated with Acesulfame K have appeared in animal studies. Acesulfame K has been shown to stimulate dose-dependent insulin secretion in rats, though no hypoglycemia was observed.
One rodent study showed no increased incidence of tumors in response to administration of acesulfame K. In this study, conducted by the National Toxicology Program, 60 rats were given acesulfame K for 40 weeks, making up as much as 3% of their total diet (which would be equivalent to a human consuming 1,343 12-oz cans of artificially sweetened soda every day). There was no sign that these (or lower) levels of acesulfame K increased the rats’ risk of cancer or other neoplasms. However, a similar study conducted with p53 haploinsufficient mice showed signs of carcinogenicity in males but not females. Further research in terms of food safety has been recommended.
Research suggests that acesulfame K may affect prenatal development. One study appeared to show that acesulfame K is ingested by mice through their mother’s amniotic fluid or breast milk, and that this influences the adult mouse’s sweet preference.

Calcium carbonate is a chemical compound with the formula CaCO3. It is a common substance found in rocks in all parts of the world, and is the main component of shells of marine organisms, snails, coal balls, pearls, and eggshells. Calcium carbonate is the active ingredient in agricultural lime, and is usually the principal cause of hard water. It is commonly used medicinally as a calcium supplement or as an antacid, but excessive consumption can be hazardous.

Health and dietary applications

500-milligram calcium supplements made from calcium carbonate

Calcium carbonate is widely used medicinally as an inexpensive dietary calcium supplement or gastric antacid. It may be used as a phosphate binder for the treatment of hyperphosphatemia (primarily in patients with chronic renal failure). It is also used in the pharmaceutical industry as an inert filler for tablets and other pharmaceuticals.

Calcium carbonate is known among IBS sufferers to help reduce diarrhea[citation needed]. Some individuals report being symptom-free since starting supplementation. The process in which calcium carbonate reduces diarrhea is by binding water in the bowel, which creates a stool that is firmer and better formed. Calcium carbonate supplements are often combined with magnesium in various proportions. This should be taken into account as magnesium is known to cause diarrhea.
Calcium carbonate is used in the production of toothpaste and has seen a resurgence as a food preservative and color retainer, when used in or with products such as organic apples or food.
Excess calcium from supplements, fortified food and high-calcium diets, can cause the milk-alkali syndrome, which has serious toxicity and can be fatal. In 1915, Bertram Sippy introduced the “Sippy regimen” of hourly ingestion of milk and cream, and the gradual addition of eggs and cooked cereal, for 10 days, combined with alkaline powders, which provided symptomatic relief for peptic ulcer disease. Over the next several decades, the Sippy regimen resulted in renal failure, alkalosis, and hypercalcemia, mostly in men with peptic ulcer disease. These adverse effects were reversed when the regimen stopped, but it was fatal in some patients with protracted vomiting. Milk alkali syndrome declined in men after effective treatments for peptic ulcer disease arose. During the past 15 years, it has been reported in women taking calcium supplements above the recommended range of 1.2 to 1.5 g daily, for prevention and treatment of osteoporosis, and is exacerbated by dehydration. Calcium has been added to over-the-counter products, which contributes to inadvertent excessive intake. Excessive calcium intake can lead to hypercalcemia, complications of which include vomiting, abdominal pain and altered mental status.
As a food additive it is designated E170; INS number 170. Used as an acidity regulator, anticaking agent, stabiliser or colour it is approved for usage in the EU, USA and Australia and New Zealand. It is used in some soy milk products as a source of dietary calcium; one study suggests that calcium carbonate might be as bioavailable as the calcium in cow’s milk. Calcium carbonate is also used as a firming agent in many canned or bottled vegetable products.

Flavin mononucleotide (FMN), or riboflavin-5′-phosphate, is a biomolecule produced from riboflavin (vitamin B2) by the enzyme riboflavin kinase and functions as prosthetic group of various oxidoreductases including NADH dehydrogenase as well as cofactor in biological blue-light photo receptors. During catalytic cycle, the reversible interconversion of oxidized (FMN), semiquinone (FMNH•) and reduced (FMNH2) forms occurs in the various oxidoreductases. FMN is a stronger oxidizing agent than NADH and is particularly useful because it can take part in both one- and two-electron transfers. In its role as blue-light photo receptor, (oxidized) FMN stands out from the ‘conventional’ photo receptors as the signaling state and not an E/Z isomerization.
It is the principal form in which riboflavin is found in cells and tissues. It requires more energy to produce, but is more soluble than riboflavin.

Food additive
Flavin mononucleotide is also used as an orange-red food colour additive, designated in Europe as the E number E101a.
E106, a very closely related food dye, is riboflavin-5′-phosphate sodium salt, which consists mainly of the monosodium salt of the 5′-monophosphate ester of riboflavin. It is rapidly turned to free riboflavin after ingestion. It is found in many foods for babies and young children as well as jams, milk products, and sweets and sugar products.