Are you missing a key mineral in your diet?

Are you missing a key mineral in your diet?

I hope your summer is off to a great start. It’s definitely going to be a different kind of summer given the landscape of the pandemic. A good reason to make sure our bodies are fueled with proper nutritious foods and that we correct any nutrient depletions we may be experiencing. I get a lot of questions about magnesium, it’s such a powerful mineral in the body and one that unfortunately is depleted in our soil with modern farming practices. This post was written by Dr. Kristina Burban, PharmD who was an intern with us in April. We will be sharing part 2 later this week where we will discuss various forms of magnesium.

Magnesium is an essential mineral that plays a role in healthy cell function and bone structure. Sources of dietary magnesium include legumes, whole grains, vegetables, nuts, dark chocolate, fish, and beef.¹ Magnesium deficiency is common in the United States; one study found that 68% of Americans do not consume the recommended amount (310-420 mg) of magnesium daily.² Signs and symptoms of magnesium deficiency include muscle cramps, headaches, fatigue, mood changes, and irregular heartbeat¹. Your provider can test blood magnesium level through a simple blood draw. Problems with absorbing magnesium or not enough intake of magnesium have been associated with developing osteoporosis, high blood pressure, diabetes, and heart disease.¹ People commonly use magnesium for constipation or heartburn, but it can be useful for other reasons as well.

Benefits of Magnesium:

Heart health:

• Having enough magnesium is important for heart health. Studies have shown various cardiac benefits with either dietary or supplemental magnesium. Magnesium intake has been shown to decrease stroke risk. Most of these studies looked at magnesium from dietary sources.^3-8  In heart disease patients with low magnesium levels, taking magnesium supplements reduced heart pain. Also, heart disease patients with low magnesium levels had worse outcomes than heart disease patients with normal magnesium levels.⁹  Supplementing magnesium in coronary artery disease may help reduce blood clots.¹⁰  Patients who took 800-1200 mg magnesium oxide daily for 3 months had 35% less clots than patients who did not take magnesium.

 Diabetes:

• Multiple studies show that increasing dietary magnesium reduces the risk of developing type 2 diabetes.^11-14  A review combined and analyzed existing data about type 2 diabetes and magnesium in 2016. It found that more magnesium intake corresponded to less risk for developing type 2 diabetes. This study also found that increasing dietary magnesium by 100mg/day reduced the risk of developing type 2 diabetes by 8-13%.¹⁵ In people who have diabetes, there is evidence that taking magnesium can increase insulin sensitivity.¹⁶ 

Metabolism:

• Magnesium helps support a healthy metabolism. There is evidence that supplementing magnesium can reduce the risk of developing metabolic syndrome¹⁷, a combination of conditions including high blood pressure, blood sugar, body fat, and cholesterol. People with metabolic syndrome are more likely to have low magnesium levels.¹⁸  Studies have shown that taking supplementing magnesium can have slight benefits on blood pressure and cholesterol.^19-23 A study of adults in the United States found that 68% consumed less than the recommended daily amount of 310-420 mg magnesium daily. Also, it found that people who didn’t consume enough magnesium were more likely to have inflammation. C-reactive protein, a marker of the body’s inflammation, was more likely to be elevated in those patients.²

Mental Health:

• Through what we know about brain function, magnesium has a potential role in altering mood. GABA, a calming neurotransmitter, needs magnesium to be able to function properly in the brain. Magnesium can also change how glutamate, a neurotransmitter that excites, functions in the brain. Therefore, it must be important to have enough magnesium. 
• Research suggests that magnesium could have benefits in anxiety.  One study tested a preparation of 300mg magnesium with hawthorn and poppy plant extracts in patients with anxiety disorders.  The group that took the magnesium preparation showed clinical improvement. ²⁴ In a 2017 review of existing data, researchers found that 4 out of the 8 total clinical studies about magnesium and anxiety reported positive effects on anxiety outcomes.²⁵ However, all of the studies tested a combination of ingredients, not magnesium by itself. More research is needed to establish the effectiveness of magnesium on reducing anxiety.
• Clinical research about magnesium’s effects on depression are also promising, but limited. In animal studies, magnesium seems to have an antidepressant effect, but there is less evidence in humans. One study tested 2,000 mg magnesium daily for 6 weeks in patients with symptoms of depression. The study showed improvement in depression symptoms, but there was no placebo group and the patients knew they were taking magnesium, which could have affected the results.²⁶  Another study tested supplementing 500 mg magnesium versus placebo in patients with depression and low magnesium levels. After 8 weeks, the patients taking magnesium showed improvement in depression status.²⁷ Again, more research is needed to see how effective magnesium is in improving depression.
• A national health and nutrition survey showed that people who report under 7 hours of sleep have lower intake of calcium, magnesium, and vitamin D.²⁸ This reinforces how important it is to have enough mineral and vitamin intake, whether through dietary sources or supplementation. Overall, having enough magnesium is likely to help improve rest, relaxation, and mood. 
• Magnesium is also helpful for sleep. In one particular study of insomnia in the elderly statistically significant increases in sleep time, sleep efficiency, and melatonin, and also resulted in significant decrease in time to sleep onset and serum cortisol concentration.²⁹

References:

1. Magnesium. In: Natural Medicines Comprehensive Database. Stockton, CA: Therapeutic Research Faculty. [Updated January 23, 2020]. 
2. King DE, Mainous AG 3rd, Geesey ME, Woolson RF. Dietary magnesium and C-reactive protein levels. J Am Coll Nutr 2005;24:166-71.
3. Adebamowo SN, Spiegelman D, Willett WC, Rexrode KM. Association between intakes of magnesium, potassium, and calcium and risk of stroke: 2 cohorts of US women and updated meta-analysis. Am J Clin Nutr. 2015;101(6):1269-77. 
4. Suter PM. The effects of potassium, magnesium, calcium, and fiber on risk of stroke. Nutr Rev 1999;57:84-8.
5. Ascherio A, Rimm EB, Hernan MA, et al. Intake of potassium, magnesium, calcium, and fiber and risk of stroke among US men. Circulation 1998;98:1198-204.
6. Nie ZL, Wang ZM, Zhou B, Tang ZP, Wang SK. Magnesium intake and incidence of stroke: meta-analysis of cohort studies. Nutr Metab Cardiovasc Dis 2013;23(3):169-76.
7. Xu T, Sun Y, Xu T, Zhang Y. Magnesium intake and cardiovascular disease mortality: a meta-analysis of prospective cohort studies. Int J Cardiol 2013;167(6):3044-7. 
8. Zhang W, Iso H, Ohira T, Date C, Tamakoshi A; JACC Study Group. Associations of dietary magnesium intake with mortality from cardiovascular disease: the JACC study. Atherosclerosis 2012;221(2):587-95.
9. Lasserre B, Spoerri M, Moullet V, et al. Should magnesium therapy be considered for the treatment of coronary heart disease? II. Epidemiological evidence in outpatients with and without coronary heart disease. Magnes Res 1994;7:145-53. 
10. Shechter, M., Merz, C. N., Paul-Labrador, M., Meisel, S. R., Rude, R. K., Molloy, M. D., Dwyer, J. H., Shah, P. K., and Kaul, S. Beneficial antithrombotic effects of the association of pharmacological oral magnesium therapy with aspirin in coronary heart disease patients. Magnes.Res. 2000;13(4):275-284.
11. Meyer KA, Kushi LH, Jacobs DR, et al. Carbohydrates, dietary fiber, and incident type 2 diabetes in older women. Am J Clin Nutr 2000;71:921-30.
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13. Fung TT, Manson JE, Solomon CG, et al. The association between magnesium intake and fasting insulin concentration in healthy middle-aged women. J Am Coll Nutr 2003;22:533-8. 
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15. Fang X, Han H, Li M, et al. Dose-Response Relationship between Dietary Magnesium Intake and Risk of Type 2 Diabetes Mellitus: A Systematic Review and Meta-Regression Analysis of Prospective Cohort Studies. Nutrients. 2016;8(11)
16. Barbagallo M, Dominguez LJ. Magnesium and type 2 diabetes. World J Diabetes. 2015;6(10):1152‐1157. doi:10.4239/wjd.v6.i10.1152
17. He K, Liu K, Daviglus ML, et al. Magnesium intake and incidence of metabolic syndrome among young adults. Circulation 2006;113:1675-82.
18. Guerrero-Romero F, Rodriguez-Moran M. Low serum magnesium levels and metabolic syndrome. Acta Diabetol 2002;39:209-13. 
19. Hoogerbrugge N, Cobbaert C, de Heide L, et al. Oral physiological magnesium supplementation for 6 weeks with 1 g/d magnesium oxide does not affect increased Lp(a) levels in hypercholesterolaemic subjects. Magnes Res 1996;9:129-32.
20. Jee SH, Miller ER 3rd, Guallar E, et al. The effect of magnesium supplementation on blood pressure: a meta-analysis of randomized clinical trials. Am J Hypertens 2002;15:691-6.
21. Dickinson HO, Nicolson DJ, Campbell F, et al. Magnesium supplementation for the management of essential hypertension in adults. Cochrane Database Syst Rev 2006;3:CD004640.
22. Kass L, Weekes J, Carpenter L. Effect of magnesium supplementation on blood pressure: a meta-analysis. Eur J Clin Nutr 2012;66:411-8.
23. Zhang X, Li Y, Del Gobbo LC, et al. Effects of magnesium supplementation on blood pressure: a meta-analysis of randomized double-blind placebo-controlled trials. Hypertension. 2016 Aug;68(2):324-33. 
24. Hanus M, Lafon J, Mathieu M. Double-blind, randomised, placebo-controlled study to evaluate the efficacy and safety of a fixed combination containing two plant extracts (Crataegus oxyacantha and Eschscholtzia californica) and magnesium in mild-to-moderate anxiety disorders. Curr Med Res Opin 2004;20:63-71.
25. Boyle NB, Lawton C, Dye L. The Effects of Magnesium Supplementation on Subjective Anxiety and Stress-A Systematic Review. Nutrients. 2017;9(5):429. Published 2017 Apr 26. doi:10.3390/nu9050429
26. Tarleton EK, Littenberg B, MacLean CD, Kennedy AG, Daley C. Role of magnesium supplementation in the treatment of depression: a randomized clinical trial. PLoS One. 2017 Jun 27;12(6):e0180067. 
27. Rajizadeh A, Mozaffari-Khosravi H, Yassini-Ardakani M, Dehghani A. Effect of magnesium supplementation on depression status in depressed patients with magnesium deficiency: A randomized, double-blind, placebo-controlled trial. Nutrition. 2017 Mar;35:56-60. doi: 10.1016/j.nut.2016.10.014. Epub 2016 Nov 9.
28. Ikonte CJ, Mun JG, Reider CA, Grant RW, Mitmesser SH. Micronutrient Inadequacy in Short Sleep: Analysis of the NHANES 2005-2016. Nutrients. 2019 Oct 1;11(10). pii: E2335. doi: 10.3390/nu11102335. 
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