title: Perspective: The Case for an Evidence-Based Reference Interval for Serum Magnesium: The Time Has Come.
abstract: The 2015 Dietary Guidelines Advisory Committee indicated that magnesium was a shortfall nutrient that was underconsumed relative to the Estimated Average Requirement (EAR) for many Americans. Approximately 50% of Americans consume less than the EAR for magnesium, and some age groups consume substantially less. A growing body of literature from animal, epidemiologic, and clinical studies has demonstrated a varied pathologic role for magnesium deficiency that includes electrolyte, neurologic, musculoskeletal, and inflammatory disorders; osteoporosis; hypertension; cardiovascular diseases; metabolic syndrome; and diabetes. Studies have also demonstrated that magnesium deficiency is associated with several chronic diseases and that a reduced risk of these diseases is observed with higher magnesium intake or supplementation. Subclinical magnesium deficiency can exist despite the presentation of a normal status as defined within the current serum magnesium reference interval of 0.75-0.95 mmol/L. This reference interval was derived from data from NHANES I (1974), which was based on the distribution of serum magnesium in a normal population rather than clinical outcomes. What is needed is an evidenced-based serum magnesium reference interval that reflects optimal health and the current food environment and population. We present herein data from an array of scientific studies to support the perspective that subclinical deficiencies in magnesium exist, that they contribute to several chronic diseases, and that adopting a revised serum magnesium reference interval would improve clinical care and public health.
authors.affiliation: Center for Magnesium Education and Research, Pahoa, Hawaii; rbcostello@earthlink.net.
authors.forename: Rebecca B
authors.identifier: 0000-0003-0246-0273
authors.initials: RB
authors.lastname: Costello
authors.affiliation: Department of Pathology and Laboratory Medicine, University of Louisville, KY.
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Elin
authors.affiliation: Center for Magnesium Education and Research, Pahoa, Hawaii.
authors.forename: Andrea
authors.initials: A
authors.lastname: Rosanoff
authors.affiliation: Department of Nutrition and Food Studies, George Mason University, Fairfax, VA.
authors.forename: Taylor C
authors.identifier: 0000-0002-9403-2745
authors.initials: TC
authors.lastname: Wallace
authors.affiliation: Biomedical Research Unit, Mexican Social Security Institute, Durango, Mexico.
authors.forename: Fernando
authors.identifier: 0000-0001-9636-9870
authors.initials: F
authors.lastname: Guerrero-Romero
authors.affiliation: Nutritional Epidemiology Program, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA.
authors.forename: Adela
authors.identifier: 0000-0002-6549-4625
authors.initials: A
authors.lastname: Hruby
authors.affiliation: School of Public Health, Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN.
authors.forename: Pamela L
authors.initials: PL
authors.lastname: Lutsey
authors.affiliation: Grand Forks Human Nutrition Research Center, Grand Forks, ND.
authors.forename: Forrest H
authors.initials: FH
authors.lastname: Nielsen
authors.affiliation: Biomedical Research Unit, Mexican Social Security Institute, Durango, Mexico.
authors.forename: Martha
authors.initials: M
authors.lastname: Rodriguez-Moran
authors.affiliation: Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, IN; and.
authors.forename: Yiqing
authors.identifier: 0000-0003-3642-6778
authors.initials: Y
authors.lastname: Song
authors.affiliation: Division of Nutrition, Department of Preventive Medicine, Northwestern University, Chicago, IL.
authors.forename: Linda V
authors.identifier: 0000-0002-1362-5806
authors.initials: LV
authors.lastname: Van Horn
mesh_terms: D000818:Animals; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000209:etiology; D008274:Magnesium / Q000097:blood* / Q000652:urine; D008275:Magnesium Deficiency / Q000097:blood* / Q000150:complications; D008659:Metabolic Diseases / Q000097:blood / Q000209:etiology; D009140:Musculoskeletal Diseases / Q000097:blood / Q000209:etiology; D009422:Nervous System Diseases / Q000097:blood / Q000209:etiology; D015596:Nutrition Assessment; D018673:Nutrition Policy; D009751:Nutritional Requirements; D012016:Reference Values
chemical_list: D008274:Magnesium
keywords: chronic disease; magnesium deficiency; plasma magnesium; reference interval; serum magnesium