Magnesium and its Crucial Role in Human Well-Being: Unveiling Subclinical Deficiency in the UK

Magnesium (Mg) is a well-understood, essential mineral that plays a pivotal role in various physiological processes within the human body. While it often takes a backseat to well-known minerals like calcium and potassium, Magnesium is equally vital for maintaining overall health.

Magnesium is Crucial

Magnesium is also essential in plants where it is associated with chlorophyll pigments and serves as a cofactor of enzymes implicated in photosynthesis and metabolism. It is an equally essential nutrient for animals, involved in hundreds of metabolic reactions and is crucial for the biological activity of adenosine triphosphate (ATP). Not surprisingly, Magnesium deficiency is detrimental to the health of plants and animals as well as humans.

In humans, subclinical Mg deficiency is common and is understood to be a factor in the generation and perpetuation of chronic low-grade inflammation, which is the fundamental denominator of a wide range of mental and physical health problems from metabolic diseases to cognitive impairment, from osteopenia and sarcopenia to depression[1].

Our Soils

The primary source for dietary intake of Magnesium is derived from fruits and vegetables, but it is recognised that Mg content in fruits and vegetables has dropped in the last fifty years, and about 80% of this metal is also lost during food processing. Since the second half of the last century, the increase in food demand consequent to the impressive population growth has led to an exponential increase in the exploitation of fertile soil: it is the so-called Green Revolution. The related increased use of chemical fertilisers containing high levels of potash or potassium, phosphate, and nitrogen and little to no Magnesium further depletes the soils magnesium levels for root transfer. This mix also creates a progressive incapacity for the phytobiome and atmospheric pressures to enhance Mg uptake leading to plant depletion of this essential mineral[2].

Therefore, a large percentage of people all over the world do not meet the minimum daily Mg requirement. The ongoing changes in the Earth’s climate, which includes enhanced levels of Co2, has an impact on vegetation and crops, affecting plant growth, yield and productivity and as a result, significantly impacts the quantity and quality of some plant nutrients[3]. There is increasing evidence of the influence of climatic changes and elevated CO2 on crop plants’ mineral and starch concentrations[4]. It has been shown in multiple trials in different countries and continents that an elevated CO2 typically decreases the minerals N, Mg, Fe, and Zn, but not P, K, S, Cu, Mn concentrations in the edible part of vegetables and grain crops.

Magnesium Intake

Cereal grains are the most important source of calories for most of the world population. Rice is the single most important source of calories for humans, followed by wheat[5]. The results of a worldwide longitudinal study based on country-level data from 124 countries indicate that the major source of energy in the diet is represented by cereals (40.3%), followed by sugar and sweeteners (10.8%), vegetables (9.3%), meats (7.5%), starchy roots (6.4%), dairy products (6.3%), fruit (3.7%), animal fats (3.5%), legumes (2.1%) and vegetable oils (1.9%) a pattern of food production and consumption linked to the development of non-communicable disease[6].

Retrospective analysis of historical data has shown that in Palaeolithic times that daily Mg intake was about 600 mg, significantly higher than today⁷. However, we share the same homeostatic mechanisms with our Palaeolithic ancestors, thereby indicating that human metabolism is optimally tuned on a higher Mg intake than ours. Therefore, Mg should not remain the forgotten cation with the urgent aim of preventing subclinical Mg deficiency[7].

Subclinical Mg deficiency, which often goes unnoticed, is a serious concern in the United Kingdom and can have significant health impacts.

Subclinical Magnesium Deficiency in the UK

The human body contains around 25g of magnesium[8]. Mg is necessary for the functioning of over 300 enzymes in humans[9]. Although severe Mg deficiency is relatively rare in the UK due to dietary intake, subclinical Mg deficiency, characterised by low serum Mg levels that do not necessarily manifest as overt symptoms, is becoming more prevalent⁷. Several factors contribute to this trend, listed below are just some:

1. Dietary Habits: Modern diets often lack magnesium-rich foods, such as leafy green vegetables, nuts, seeds, and whole grains (that also contain less Mg than in prior generations). The consumption of processed and refined foods has further reduced Mg intake.
2. Stress: Chronic stress can lead to increased Mg excretion, potentially depleting the body’s Mg stores[10].
3. Alcohol, Soft Drinks and Caffeine Consumption: Alcohol, soft drinks, and caffeine intake can interfere with Mg absorption and promote its excretion[11]^,[12],[13].
4. Medications: Some medications, including diuretics, proton pump inhibitors, and certain antibiotics, can deplete Mg levels over time.
5. Aging: As individuals age, they may absorb and retain Mg less efficiently[14].
6. Adverse Health conditions: liver disease, gastrointestinal disease, heart failure etc.
7. Vitamin D: Excess or insufficiency[15]^,12.

Health Impacts of Subclinical Magnesium Deficiency

Subclinical Mg deficiency can have a range of health impacts, although they may not be immediately apparent. PubMed studies have highlighted the following associations:

1. Cardiovascular Health: Low Mg intake is linked to an increased risk of hypertension and cardiovascular disease, including heart attacks and strokes.
2. Type 2 Diabetes: Suboptimal Mg levels have been associated with insulin resistance and an elevated risk of type 2 diabetes.
3. Muscle and Nerve Function: Inadequate Mg can lead to muscle cramps, weakness, and neurological symptoms.
4. Bone Health: Mg deficiency may contribute to osteoporosis by affecting calcium metabolism and bone density.
5. Mood Disorders: Some research suggests a connection between low Mg levels and increased risk of depression and anxiety.

In Summary

Magnesium is a mineral essential for human well-being, yet subclinical deficiency is a growing concern in the United Kingdom and elsewhere. It is imperative that individuals become more mindful of their Mg intake and seek dietary sources rich in this vital mineral. Additionally, healthcare providers should consider assessing Mg status in patients with risk factors or symptoms of deficiency, ensuring that this silent health concern does not go unnoticed. Supplementation of oral Magnesium of between 100mg to 250mg and cofactor nutrients is a safe and effective way to ensure optimal Mg status is maintained in the face of increased pressures of food sources and lifestyle.

‘Abnormalities of serum Mg may be the most underdiagnosed serum electrolyte abnormality in clinical practice today. The incidence appears to range from 12.5% to 20% on routine determination’[16].

References

[1] de Baaij J.H.F., Hoenderop J.G.J., Bindels R.J.M. Mgin man: implications for health and disease. Physiol. Rev. 2015;95:1–46.

[2] Senbayram M., Gransee A., Wahle V., Thiel H. Role of Mgfertilisers in agriculture: plant–soil continuum. Crop Pasture Sci. 2015;66:1219.

[3] Cazzola R, Della Porta M, Manoni M, Iotti S, Pinotti L, Maier JA. Going to the roots of reduced Mgdietary intake: A tradeoff between climate changes and sources. Heliyon. 2020 Nov 3;6(11):e05390.

[4] Loladze I. Hidden shift of the ionome of plants exposed to elevated CO₂ depletes minerals at the base of human nutrition. Elife. 2014;3:e02245. Published 2014 May 7.

[5] Awika J.M. ACS Symp. Ser. 2011. Major cereal grains production and use around the world; pp. 1–13.

[6] Green R., Sutherland J., Dangour A.D., Shankar B., Webb P. Global dietary quality, undernutrition and non-communicable disease: a longitudinal modelling study. BMJ Open. 2016 Jan 12;6(1):e009331.

[7] Dinicolantonio J.J., O’keefe J.H., Wilson W. Subclinical Mgdeficiency: a principal driver of cardiovascular disease and a public health crisis Coronary artery disease. Open Heart. 2018;5:668.

[8] Wacker WE, Parisi AF. Mgmetabolism. N Engl J Med 1968;278:658–63

[9] Martyka Z, Kotela I, Blady-Kotela A. [Clinical use of magnesium]. Przegl Lek 1996;53:155–8

[10] Galland L. Magnesium, stress and neuropsychiatric disorders. Magnes Trace Elem 1991;10:287–301

[11] Rylander R, Mégevand Y, Lasserre B, et al.. Moderate alcohol consumption and urinary excretion of Mgand calcium. Scand J Clin Lab Invest 2001;61:401–5.

[12] MgDeficiency in the Pathogenesis of Disease: Early Roots of Cardiovascular, Skeletal, and Renal Abnormalities

[13] Johnson S. The multifaceted and widespread pathology of Mgdeficiency. Med Hypotheses. 2001 Feb;56(2):163-70.

[14] Mountokalakis TD. Effects of aging, chronic disease, and multiple supplements on Mgrequirements. Mg1987;6:5–11.

[15] Hanna S. Influence of large doses of vitamin D on Mgmetabolism in rats. Metabolism 1961;10:735–43

[16] Whang R. Routine serum Mgdetermination-a continuing unrecognized need. Mg1987;6:1–4.