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Dietary magnesium and inflammation

European Journal of Clinical Nutrition volume 68, page 970 (2014)Cite this article

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I read with interest the paper by Dibaba et al.,1 which reported that dietary magnesium intake is inversely associated with C-reactive protein (CRP). The authors acknowledged the possible limitations of their meta-analysis and I agree that the study’s finding is biologically plausible. However, it is known that dietary intake of magnesium is only a surrogate of magnesium status. As such, it would have been preferable to use serum magnesium concentrations or any other biological marker of magnesium status for the CRP association analysis. Since serum magnesium is not routinely assessed in epidemiological and clinical studies, assessment of dietary magnesium is the only feasible option. For example, the National Health and Nutrition Examination Survey (NHANES) of the United States has not assessed serum magnesium concentrations in its participants since 1974.2 The Dibaba et al.1 paper also did not clarify how CRP was measured in the different studies in the meta-analysis. It would have been useful to know whether all the studies used a high-sensitivity method for the CRP assays. Body size has also been shown to affect levels of inflammation and it would have been useful to understand whether and to what extent overweight and obesity contributed to the associations, although it would be expected to increase CRP levels. Ethnicity3 and the health status of the participants may also have effects on CRP concentrations. Nevertheless, the findings have important public health implications because CRP, a marker of low-grade systemic inflammation, is a useful index for disease risk assessment. For example, elevated CRP levels were associated with prospective lung cancer risk.4 The findings from the Dibaba et al.1 study will help to raise concerns about widespread suboptimal dietary magnesium intakes in the United States and its probable health consequences.2 Prospective studies have linked increased levels of magnesium intake with reduced risk for colon cancer.5, 6, 7 Magnesium is ubiquitous in foods, but the content varies substantially. Refined foods are poor sources of magnesium. Other food nutrients such as omega-3 fatty acids may also affect inflammation, and it is quite possible that the food supply with its endless processed and refined food products may contribute to the inverse nutrient–inflammation nexus. Some may argue that pharmacologic nutraceutical supplements should solve the problem posed by suboptimal nutrient intake, but we have learnt from several large-scale trials, for example, that some dietary supplements increase the risk for cancer.8 Future research should target magnesium status by ethnicity and obesity in terms of health outcomes. These should include prospective epidemiology studies and clinical trials of magnesium supplementation against inflammatory markers such as CRP.

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References

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  1. Division of Cancer Prevention and Population Sciences, Modifiable Risk Factors Branch, Epidemiology and Genomics Research Program, National Cancer Institute, Rockville, MD, USA

    S Mahabir

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Correspondence to S Mahabir.

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Mahabir, S. Dietary magnesium and inflammation. Eur J Clin Nutr 68, 970 (2014). https://doi.org/10.1038/ejcn.2014.110

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