Nitrate Levels in Tap Water May Raise Dementia Risk

Nitrate Levels in Tap Water May Raise Dementia Risk

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Nitrate levels in drinking water may increase the risk of dementia, even when levels fall far below current safety limits, research suggests—raising questions about regulatory standards in the United States and Europe.

The study published in December 2025 in the journal Alzheimer’s & Dementia observed a higher dementia risk at drinking water nitrate levels as low as 5 milligrams per liter (mg/L)—well below current regulatory limits of 50 mg/L in the European Union (EU) and Denmark, and 10 mg/L set by the Environmental Protection Agency (EPA) in the United States.
“This is the first time drinking water nitrate has been linked to dementia,” study author Nicola Bondonno, a postdoctoral research fellow at Edith Cowan University’s Nutrition & Health Innovation Research Institute, said in a social media post.
The findings also revealed a surprising paradox: While nitrate from drinking water and meat may increase dementia risk, nitrate from vegetables appears to protect against it.

Why Source Matters

The researchers tracked more than 54,000 Danish adults for up to 27 years to examine how nitrate and nitrite intake—nitrogen-oxygen compounds with different chemical structures—from various sources affected people’s dementia risk.

Although nitrates and nitrites from plants and water share identical chemical structures, the evidence suggests that the accompanying compounds associated with these substances influence whether they benefit or harm the brain.

“When we eat nitrate-rich vegetables, we are also eating vitamins and antioxidants which are thought to help nitrate form the beneficial compound, nitric oxide, while blocking it from forming N-nitrosamines, which are carcinogenic and potentially damaging to the brain,” Bondonno said in a press release.

Water doesn’t contain antioxidants that can block the formation of N-nitrosamines. Without these protective compounds, nitrate in drinking water may form N-nitrosamines in the body, according to the study.

About 80 percent of human nitrate exposure comes from vegetables, Hope Barkoukis, chair of the nutrition department at Case Western Reserve University, who was not involved in the study, told The Epoch Times. However, she noted that these sources are not toxic because, in foods, they predominantly convert to nitric oxide, which helps dilate (open) blood vessels and reduce the risk of chronic disease.

Barkoukis noted that vegetables contain antioxidants and vitamins that help convert nitrate into beneficial nitric oxide while limiting the formation of potentially harmful N-nitrosamines. She added that the stomach’s acidic environment typically neutralizes these compounds during digestion.

By contrast, nitrates in water originate from runoff or other contamination.

Nitrates in meat may also be problematic because they lack protective antioxidants and contain compounds such as heme iron, which may actually increase the formation of N-nitrosamines, the study found.

Current Nitrate Limits May Be Too High

The researchers found that even small amounts of nitrate in drinking water were linked to a higher risk of developing dementia later in life.

Specifically, people drinking water with about 5 mg/L of nitrate had about a 12 percent to 16 percent increased chance of developing dementia compared to those drinking water with very low nitrate levels. This is important because these levels are well below the safety limits set by regulations in many countries.

In simpler terms, drinking water with just a small amount of nitrate might raise your chances of developing dementia by about one-eighth compared with drinking water with very little or no nitrate.

Participants exposed to nitrate levels below current regulatory limits still had higher rates of dementia. However, Bondonno emphasized that more research is needed to confirm this association.

“Drinking water is much better for your health than sugary drinks like juices and soft drinks,” she said. “However, our findings do suggest that regulatory agencies should reexamine current limits and better understand how long-term, low-level exposure affects brain health.”

Bondonno and her team believe that nitrates from different sources may have opposite effects on brain health, but she noted that more laboratory studies are needed to understand the biological mechanisms. She also emphasized that the study was observational and cannot establish cause and effect.

The increase in dementia risk appears to be small at the individual level, and other dietary or lifestyle factors may have contributed to the association.

Still, the findings don’t mean people should stop drinking water, the researchers stressed.

“In adults, typically our [gastrointestinal] GI system (stomach) is so acidic that the overall risk is not as worrisome as [it is] for infants or young children,” Barkoukis said. “In those two categories, particularly infants, they lack the fully developed and strongly acidic stomach acid levels as adults, and so the breakdown can’t typically happen as easily.”

What You Can Do

Leafy greens, cauliflower, cucumber, and beets are among the best sources of nitrate and are also rich in vitamins and antioxidants, Emily Feivor, a registered dietitian nutritionist at Northwell Health in New York, who was not involved in the study, told The Epoch Times.
She also noted other research that found eating red and processed meats was associated with increased dementia risk, although the risk was reduced when participants replaced at least one serving of those foods with nuts or legumes.

“Eating more vegetables and less red meat and processed meat is a sensible approach based on our findings and decades of other research on diet and health,” Bondonno said in a statement.

For those worried about nitrate exposure from their drinking water, Feivor offered practical advice.

“Since nitrates cannot be destroyed by boiling, it is recommended that the water be tested for nitrates,” she said. “Especially if used in a baby’s formula.”

If nitrate levels exceed recommended levels, an alternative water source should be used to prepare infant formula and food, she noted. Feivor emphasized that nitrate levels are generally less concerning for adults, “as studies show an increased, but within normal level, number of nitrates [expelled] in urine after consumption.”

The most effective filtration systems for removing nitrate from water include anion exchange, reverse osmosis, and distillation. These systems remove nitrate by swapping it with harmless minerals, pushing water through a fine membrane to filter out contaminants, or boiling water and collecting the purified steam.

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