Magnesium deficiency and chronic diseases

Most people probably know magnesium deficiency in connection with muscular cramps. But its potential role in the development of chronic diseases hasn't received much attention from medical researchers: It may in fact have been underestimated for a long time. In the following you will learn more about potential risk factors and how to prevent a deficiency.



Daily requirement of magnesium


Each food contains a certain quantity of magnesium. The highest concentrations occur in wholemeal grains, legumes and nuts (see screenshot 1). The mineral plays an important role in hundreds of different enzymatic reactions in the body, e.g. in the synthesis of DNA and proteins, nerve signaling and muscular contraction. Because of its great significance, shortage can have severe consequences. The body can't work properly without adequate magnesium supply and therefore developed a sophisticated mechanism to protect itself from a deficiency. Magnesium is stored in the bone mass and in body cells and can be released if required. When the intake of this vital mineral falls below a critical threshold, the body tries to increase the absorption rate from nutrition and simultaneously minimizes the urinary excretion. Through this mechanism the magnesium levels can remain in a stable range for a long time.

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Screenshot 1: Magnesium content of various foods (Source: Oox)


Difficulties in determining the daily requirements


The buffer capacity of the body made it very difficult to find out how much magnesium one actually needs. In contrast to many vitamins and other minerals, there isn't one clear parameter that determines a state of deficiency with one simple test, precisely because the body can keep the level constant despite insufficient intake.

The current guidelines had to be determined in complex studies from indirect parameters. The findings of these studies were that a person with about 70 kg bodyweight needs approximately 250 mg magnesium. The requirements depend on the bodyweight – lighter people need less, heavier people more. With 100 kg bodyweight the requirement is 355 mg. The difficulties in determining the appropriate intake resulted in slightly different recommendations around the world. The Food and Nutrition Board (FNB) at the Institute of Medicine of the National Academies currently proposes a recommended dietary allowance (RDA) of 400 mg for male adults and 310 mg for female adults.


Factors that influence magnesium requirements


The dietary recommendations refer to the intake of healthy individuals under ideal nutrictional conditions. By nature, very tall and very heavy individuals, athletically active people and pregnant women have higher requirements. But there are other factors that interfere with adequate supply:
  • Unbalanced nutrition as a result of dieting
  • Insufficient food intake
  • Heavy perspiration (e.g. strong physical activity)
  • Chronic disease (e.g. diabetes)
  • Strong oxidative stress (e.g. through smoking)
  • Inflammatory processes in the body
  • Increased excretion of magnesium (e.g. because of alcohol or diuretics)
  • Decreased absorption of magnesium (e.g. protone pump inhibitors)
  • Inhibited absorption through food compounds (e.g. high fiber intake or certain antinutrients like phytates and oxalates)
  • Mineral loss through diarrhea


Potential side-effects of long-term magnesium deficiency


The actual consequences of acute magnesium deficiency were mainly observed in animal experiments. Restricting the intake of mice to only 10 % of the daily requirements resulted in significantly increased inflammatory processes and extreme oxidative stress. Acute magnesium deficiency may therefore promote diseases or amplify pre-existing symptoms.

However, even with the unhealthiest diet it is almost impossible to reach such low levels of magnesium intake. It is much more likely that the body suffers from a subliminal magnesium deficiency that wears out the body's depots in the long term. An unhealthy and unbalanced diet with a high percentage of processed foods (e.g. white flour products) results in a suboptimal daily intake in the range of 50–99 % of the recommended value, which has no permanent side-effects in the short term.

In the course of several months or years, however, this latent magnesium deficiency might have drastic consequences. Several animal studies showed side-effects after several months of suboptimal magnesium intake that point to a relation to many chronic diseases, e.g. hypertension, cardiovascular disease, metabolic syndrome, type 2 diabetes, chronic kidney disease, osteoporosis and neurological disorders.

Overweight persons are especially affected by this state of deficiency, because they have an above the ordinary requirement. According to latest estimations, around 10–20 % of the population are not adequately supplied with the essential mineral.


Magnesium and food sensitivities


Individuals who suffer from food sensitivities are at high risk of magnesium deficiency – up to 42 % of those affected have low magnesium levels. The body often reacts with inflammatory reactions to unsuitable foods which leads to an increased need for magnesium. At the same time, however, the intake can be severely impacted by dietary restrictions. In the worst case, the body loses even more minerals as a consequence of loose stools or diarrhea.

Magnesium supplementation improves the health condition in many cases. So far, it's not yet entirely clear what is responsible for this effect. One possible explanation is that magnesium is needed for the transformation of linoleic acid and α-linolenic acid into the essential long-chain omega-3 fatty acids EPA and DHA. These fats down-regulate the formation of pro-inflammatory mediators. A deficiency of magnesium could therefore trigger or enhance inflammatory processes. Besides, magnesium also has a stabilizing effect on mast cells: It decreases the release of histamine, which modulates immune responses and acts as a pro-inflammatory factor.

Several smaller studies showed promising results for the intravenous administration of magnesium in asthmatics. Proper supply improves the course of the disease and causes a relaxation of the cramped muscles in the bronchi.


Conclusion


Latent magnesium deficiency is an important risk factor for all diseases where inflammatory processes are involved. There are numerous risk factors for inadequate intake. As magnesium has such an important role in the metabolism you should definitely evaluate your magnesium intake and switch to a more balanced diet with a high proportion of unprocessed foods to meet your requirements naturally. Should this not be possible, e.g. because of a severely restricted diet, magnesium needs to be supplemented.

Healthy people with normal weight most likely won't be affected by a treatable state of deficiency. In most cases calf cramps are a consequence of muscular overloading and don't require the use of expensive magnesium supplements.


Sources:
F. Nielsen, Dietary Magnesium and Chronic Disease, Adv Chronic Kidney Dis. 25:3 (2018), 230–235
R. Jones et al., Electrolyte disturbance secondary to proton pump inhibitors, European Journal of Internal Medicine 24 (2013), e157–e159
M. Mazidi et al., Effect of magnesium supplements on serum C-reactive protein: a systematic review and meta-analysis, Arch Med Sci 14:4 (2018), 707–716
A. Cantani, Pediatric Allergy, Asthma and Immunology, Springer, 2008
U. Das, Beneficial action of magnesium sulfate in bronchial asthma: how and why?, Correspondence / American Journal of Emergency Medicine 34 (2016), 1673–1730
https://de.wikipedia.org/wiki/Magnesiummangel (02/2019)