title: Essential Nutrient Interactions: Does Low or Suboptimal Magnesium Status Interact with Vitamin D and/or Calcium Status?
abstract: Although much is known about magnesium, its interactions with calcium and vitamin D are less well studied. Magnesium intake is low in populations who consume modern processed-food diets. Low magnesium intake is associated with chronic diseases of global concern [e.g., cardiovascular disease (CVD), type 2 diabetes, metabolic syndrome, and skeletal disorders], as is low vitamin D status. No simple, reliable biomarker for whole-body magnesium status is currently available, which makes clinical assessment and interpretation of human magnesium research difficult. Between 1977 and 2012, US calcium intakes increased at a rate 2-2.5 times that of magnesium intakes, resulting in a dietary calcium to magnesium intake ratio of >3.0. Calcium to magnesium ratios <1.7 and >2.8 can be detrimental, and optimal ratios may be ∼2.0. Background calcium to magnesium ratios can affect studies of either mineral alone. For example, US studies (background Ca:Mg >3.0) showed benefits of high dietary or supplemental magnesium for CVD, whereas similar Chinese studies (background Ca:Mg <1.7) showed increased risks of CVD. Oral vitamin D is widely recommended in US age-sex groups with low dietary magnesium. Magnesium is a cofactor for vitamin D biosynthesis, transport, and activation; and vitamin D and magnesium studies both showed associations with several of the same chronic diseases. Research on possible magnesium and vitamin D interactions in these human diseases is currently rare. Increasing calcium to magnesium intake ratios, coupled with calcium and vitamin D supplementation coincident with suboptimal magnesium intakes, may have unknown health implications. Interactions of low magnesium status with calcium and vitamin D, especially during supplementation, require further study.
authors.affiliation: Center for Magnesium Education and Research, Pahoa, HI; arosanoff@gmail.com.
authors.forename: Andrea
authors.initials: A
authors.lastname: Rosanoff
authors.affiliation: Vanderbilt Epidemiology Center, Department of Medicine, School of Medicine, Vanderbilt University, Nashville, TN; and.
authors.forename: Qi
authors.initials: Q
authors.lastname: Dai
authors.affiliation: Rutgers University, New Brunswick, NJ.
authors.forename: Sue A
authors.initials: SA
authors.lastname: Shapses
mesh_terms: D002118:Calcium / Q000097:blood*; D002908:Chronic Disease / Q000517:prevention & control; D002149:Energy Intake; D005260:Female; D006801:Humans; D008274:Magnesium / Q000097:blood*; D008275:Magnesium Deficiency / Q000097:blood / Q000150:complications*; D008297:Male; D009752:Nutritional Status; D014807:Vitamin D / Q000097:blood*; D014808:Vitamin D Deficiency / Q000097:blood / Q000150:complications*
chemical_list: D014807:Vitamin D; D008274:Magnesium; D002118:Calcium
keywords: calcium; calcium/magnesium ratio; essential mineral interactions; magnesium; nutrient interactions; vitamin D