Magnesium is all the rage. Or, rather, magnesium supplements are. Magnesium is the fourth most abundant cation in the body. A silent player in more than 300 enzymatic reactions. It participates in key processes such as energy production, protein and DNA synthesis. Muscle and nerve function, glucose control, and blood pressure regulation. Without it, cells wouldn’t function.
Such importance couldn’t go unnoticed by a consumer society constantly searching for healthy shortcuts. As happened previously with the vitamin D craze. A veritable epidemic that some health centers are now trying to address. Today, no self-respecting influencer fails to recommend magnesium for better sleep, reducing anxiety or fatigue. Preventing cramps or headaches, improving athletic recovery, or coping with pregnancy.
According to an IPSOS report for AFEPADI (Spanish Association of Food Supplements). Magnesium is one of the most consumed supplements in Europe. With 33 percent of users, second only to vitamin D (46 percent) and vitamin C (36 percent).
In Spain, however, its use is more limited. It is consumed by 15 percent of the population, below vitamin D, multivitamins, and vitamin C. But what does science say. What doesn’t it say—about all this? Do we really need magnesium capsules, tablets, or powder to live better?
Better from a plate than from a jar
An adult body contains about 25 grams of magnesium. Stored mostly in bones and muscles, which act as a dynamic reservoir in constant exchange. With the small circulating fraction. Only about one percent is found in the blood. A key fact for understanding why assessing your actual magnesium levels isn’t as simple as a standard blood test.
Magnesium is widely distributed in common foods. Especially in plant-based diets such as the Mediterranean or vegetarian diets. Therefore, the European Food Safety Authority (EFSA) states. That the necessary amounts “can easily be consumed as part of a balanced diet.”
It is also present in fortified cereals. Some medications (such as antacids or laxatives), and a wide range of nutritional supplements. With multiple salts and forms (citrate, bisglycinate, malate, etc.). In Spain, 888 products include magnesium in their name and 8,826 incorporate it into their composition. According to the Spanish Agency for Food Safety and Nutrition (AESAN).
Its main natural sources are green leafy vegetables—where it is part of chlorophyll—nuts. And seeds, legumes, whole grains (but not refined grains), cocoa and dark chocolate. As well as some fish and shellfish. Therefore, in a healthy person with a diet rich in vegetables, legumes, and nuts. Meeting daily requirements is simple.
“When people properly follow a Mediterranean diet, we don’t see magnesium deficiency.” Emphasizes Miguel Ángel Martínez-González, professor of preventive medicine and public health at the University of Navarra. He supports this with data from the SUN Project (University of Navarra Follow-up). A cohort study initiated in 1999 under the guidance of Harvard University. Which now has over 23,000 participants.
One of its most recent publications, in the European Journal of Nutrition. It shows that good adherence to these patterns is associated with a low risk of micronutrient deficiencies. Including vitamins and minerals, something also observed in children. “With a well-balanced diet, there’s no need to take any supplements,” he insists.
In the general population, clinically relevant deficiencies are infrequent. Partly because the body has mechanisms to maintain stable levels. The kidneys precisely regulate how much magnesium is eliminated in urine. And how much is reabsorbed, according to the body’s needs.
Thus, a temporary low intake doesn’t usually result in a real deficiency. While an excess from the diet is easily eliminated in people with normal kidney function.
Martínez-González recalls his surprise in the 1990s, during his time at Harvard. Also when he discovered that American pharmacies functioned like veritable “supermarkets of supplements.” In contrast to a generally poor-quality diet.
“People stuff themselves with magnesium. With multivitamins, but then they follow a junk diet that lacks the nutritional richness of the Mediterranean diet.” He remarked to his professors at the time. Even there, they observed that those who consistently followed the Mediterranean pattern didn’t need supplements.
More Promises Than Evidence
Although the role of magnesium has been studied in numerous chronic diseases and physiological conditions. In most cases the available evidence is limited or inconclusive.
In hypertension, for example, clinical trials show that supplementation only achieves modest reductions in blood pressure. Without any clear evidence of a significant role in cardiovascular prevention.
Similarly, the American Diabetes Association finds insufficient evidence to recommend magnesium for improving glycemic control. A similar situation exists in bone health. Although some studies describe lower levels in women with osteoporosis. So there is no conclusive evidence that magnesium supplementation prevents this disease.
The outlook is somewhat more favorable for migraines. Even with limited data, the American Academy of Neurology and the American Headache Society consider magnesium to be “probably effective” in preventing episodes.
A systematic review by the Cochrane Collaboration. Currently underway, will evaluate this potential benefit more rigorously. In other areas, the conclusions are clearer.
Previous Cochrane reviews have found no benefits during pregnancy. So nor evidence that magnesium reduces muscle cramps in older adults or in the context of exercise.
Regarding athletic performance, the results are contradictory.
While one Canadian review concludes that “magnesium supplements have no effect.” Another suggests that those who engage in intense exercise may have slightly higher requirements. Even so, it is not clear that these additional requirements. It cannot be met naturally through a proper diet and the body’s self-regulating mechanisms.
More is not always better.
It is also important to consider the possibility of overdoing it. Although excess magnesium from food rarely poses a problem. The kidneys eliminate excess amounts, the risk arises primarily with supplements or certain medications. Therefore, according to Martínez-González, “giving them indiscriminately is dangerous.”
Moreover the tolerable upper intake level for supplemental magnesium is 350 mg daily for adults. And between 65 and 350 mg for children and adolescents. Exceeding these doses can cause diarrhea, nausea, or abdominal pain. In severe cases or in people with kidney disease, hypotension, arrhythmias. Respiratory distress or even cardiac arrest.
There is also the risk of interactions with antibiotics, osteoporosis medications, diuretics, or gastric protectors.
Ultimately, Martínez-González reminds us. “It’s very difficult to capture the harmony and balance of foods found in nature in a pill.” His conclusion is clear: “The best magnesium supplement is a healthy diet.”
With information from Aser García Rada/El País.com
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