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Coral Calcium Scientific Evidence
TrueBlue™ is
a rich source of supplemental Calcium, Magnesium and
Trace Minerals. There is a very large body of scientific
research on these elements available through the National
Library of Medicine's online resource, PubMed. Currently
PubMed lists 298,764 articles under the search term
Calcium, 64,051 articles on Magnesium, and 57,990
research papers on Minerals!
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Abstracts
on Calcium |
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Calcium, vitamin D,
dairy products, and risk of colorectal cancer
in the cancer prevention study II nutrition cohort
(United States).
McCullough ML, Robertson
AS, Rodriguez C, Jacobs EJ, Chao A, Carolyn J,
Calle EE, Willett WC, Thun MJ.
Epidemiology and Surveillance
Research Department, American Cancer Society,
1599 Clifton Rd NE, Atlanta GA, 30309 USA.
OBJECTIVE: Calcium, vitamin
D, and dairy product intake may reduce the risk
of colorectal cancer. We therefore examined the
association between these factors and risk of
colorectal cancer in a large prospective cohort
of United States men and women. METHODS: Participants
in the Cancer Prevention Study II Nutrition Cohort
completed a detailed questionnaire on diet, medical
history, and lifestyle in 1992-93. After excluding
participants with a history of cancer or incomplete
dietary information, 60,866 men and 66,883 women
remained for analysis. During follow-up through
31 August 1997 we documented 421 and 262 cases
of incident colorectal cancers among men and women,
respectively. Multivariate-adjusted rate ratios
(RR) were calculated using Cox proportional hazards
models. RESULTS: Total
calcium intake (from diet and supplements) was
associated with marginally lower colorectal cancer
risk in men and women (RR = 0.87, 95% CI
0.67-1.12, highest vs lowest quintiles, p trend
= 0.02). The association was strongest for calcium
from supplements (RR = 0.69, 95% CI 0.49-0.96
for > or = 500 mg/day vs none). Total vitamin
D intake (from diet and multivitamins) was also
inversely associated with risk of colorectal cancer,
particularly among men (RR = 0.71, 95% CI 0.51-0.98,
p trend = 0.02). Dairy product intake was not
related to overall risk. CONCLUSIONS: Our
results support the hypothesis that calcium modestly
reduces risk of colorectal cancer. Vitamin
D was associated with reduced risk of colorectal
cancer only in men.
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J Womens
Health (Larchmt). 2003 Mar;12(2):173-82.
Diet, body weight, and
colorectal cancer: a summary of the epidemiologic
evidence.
Giovannucci E.
Channing Laboratory, Department
of Medicine, Brigham and Women's Hospital, Boston,
Massachusetts 02115, USA. [email protected]
Colorectal cancer is the second
leading cause of cancer death in the United States,
and the number of new cases annually is approximately
equal for men and women. Several nutritional factors
are likely to have a major influence on risk of
this cancer. Physical inactivity and excessive
adiposity, especially if centrally distributed,
clearly increase the risk of colon cancer. Hyperinsulinemia
may be an important underlying risk factor. In
conjunction with obesity and physical inactivity,
which induce a state of insulin resistance, certain
dietary patterns that stimulate insulin secretion,
including high intakes of red and processed meats,
saturated and trans-fats, and highly processed
carbohydrates and sugars, may increase the risk
of colon cancer. There is evidence suggesting
that some component of red meat may independently
increase the risk of colorectal cancer, and
some micronutrients may be important as protective
agents. Currently, the evidence is strongest for
folate and calcium. Folate may be especially
important in alcohol drinkers because alcohol
appears to increase the risk, particularly when
folate intake is low. This interaction may be
related to the antifolate properties of alcohol.
In contrast to earlier studies, more recent epidemiologic
studies have generally not supported a strong
influence of dietary fiber or fruits and vegetables,
although these have other health benefits, and
their consumption should be encouraged. The majority
of colon cancers, as well as many other conditions,
may be prevented by lifestyle alterations in the
intake of these nutritional factors, in addition
to other factors, such as smoking.
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Dietary influences
on survival after ovarian cancer.
Nagle CM, Purdie
DM, Webb PM, Green A, Harvey PW, Bain CJ.
School of Population Health,
University of Queensland, Brisbane, Australia.
We evaluated the effects of
various food groups and micronutrients in the
diet on survival among women who originally participated
in a population-based case-control study of ovarian
cancer conducted across 3 Australian states between
1990 and 1993. This analysis included 609 women
with invasive epithelial ovarian cancer, primarily
because there was negligible mortality in women
with borderline tumors. The women's usual diet
was assessed using a validated food frequency
questionnaire. Deaths in the cohort were identified
using state-based cancer registries and the Australian
National Death Index (NDI). Crude 5-year survival
probabilities were estimated using the Kaplan-Meier
technique, and adjusted hazard ratios (HRs) and
95% confidence intervals (CIs) were obtained from
Cox regression models. After adjusting for important
confounding factors, a survival advantage was
observed for those who reported higher intake
of vegetables in general (HR = 0.75, 95% CI =
0.57-0.99, p-value trend 0.01 for the highest
third, compared to the lowest third), and cruciferous
vegetables in particular (HR = 0.75, 95% CI =
0.57-0.98, p-value trend 0.03), and among women
in the upper third of intake of vitamin E (HR
= 0.76, 95% CI = 0.58-1.01, p-value trend 0.04).
Inverse associations were also seen with protein
(p-value trend 0.09), red meat (p-value trend
0.06) and white meat (p-value trend 0.07), and
modest positive trends (maximum 30% excess) with
lactose (p-value trend 0.04), calcium and dairy
products. Although much remains to be learned
about the influence of nutritional factors after
a diagnosis of ovarian cancer, our study suggests
the possibility that a diet high in vegetable
intake may help improve survival.
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Am J Clin Nutr. 2003 Jun;77(6):1448-52.
Calcium intake,
body composition, and lipoprotein-lipid concentrations
in adults.
Jacqmain M,
Doucet E, Despres JP, Bouchard C, Tremblay A.
Division of Kinesiology
(MJ and AT) and the Department of Food Science
and Nutrition (J-PD), Laval University, Ste-Foy,
Quebec.
BACKGROUND: Recent data suggest
that variations in calcium intake may influence
lipid metabolism and body composition. OBJECTIVE:
The association between daily calcium intake and
body composition and plasma lipoprotein-lipid
concentrations was studied cross-sectionally in
adults from phase 2 of the Quebec Family Study.
DESIGN: Adults aged 20-65 y (235 men, 235 women)
were studied. Subjects who consumed vitamin or
mineral supplements were excluded. Subjects were
divided into 3 groups on the basis of their daily
calcium intake: groups A (< 600 mg), B (600-1000
mg), and C (> 1000 mg). RESULTS: Daily calcium
intake was negatively correlated with plasma LDL
cholesterol, total cholesterol, and total:HDL
cholesterol in women and men after adjustment
for variations in body fat mass and waist circumference
(P < 0.05). In women, a significantly greater
ratio of total to HDL cholesterol (P < 0.05)
was observed in group A than in group C after
correction for body fat mass and waist circumference.
In women, body weight, percentage body fat, fat
mass, body mass index, waist circumference, and
total abdominal adipose tissue area measured by
computed tomography were significantly greater
(P < 0.05) in group A than in groups B and
C, even after adjustments for confounding variables.
Comparable trends were observed in men, but not
after adjustment for the same covariates. CONCLUSION:
A low daily
calcium intake is associated with greater adiposity,
particularly in women. In both sexes, a high calcium
intake is associated with a plasma lipoprotein-lipid
profile predictive of a lower risk of coronary heart
disease risk compared with a low calcium intake.
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Steroid
induced osteoporosis: prevention and treatment
[Article in French]
Roux C, Orcel P.
Institut de rhumatologie,
hopital Cochin, centre d'evaluation des maladies
osseuses, 27, rue du Faubourg-Saint-Jacques, 75014,
Paris, France
Purpose. - Corticosteroid induced
osteoporosis (CIO) is the most frequent complication
of long-term corticosteroid therapy, and the most
frequent cause of secondary osteoporosis. New
data from biological, epidemiological and therapeutic
studies provide basis for optimal management of
this bone disease.Main points. - Corticosteroids
are responsible for both quantitative and qualitative
deleterious effects on bone, through their effect
on bone cells, mainly on osteoblasts (with both
a decrease in osteoblast activity and an increase
in apoptosis). Epidemiological studies have shown
an increased risk of fractures related to CIO,
even for low doses, and during the first 6 months
of treatment. Relative risk is 1.3 and 2.6 for
peripheral and vertebral fractures respectively.
Bone mineral density, measured by dual-energy
X-ray absorptiometry, is decreased at spine and
hip; the risk of fracture is higher in CIO as
compared to post-menopausal osteoporosis, for
a similar bone density. Prevention
of CIO needs the use of the minimal efficacious
dose, and treatment of calcium, vitamin
D and gonadal hormones insufficiencies. Patients
at risk of fracture, as post-menopausal women
with prevalent fractures, should receive a bisphosphonate.Perspective.
- It may be possible to reduce the fracture risk
in patients on long-term corticosteroid therapy.
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Joint Bone Spine. 2003 Jun;70(3):203-208.
Effects on
bone mineral density of calcium and vitamin D
supplementation in elderly women with vitamin
D deficiency.
Grados F, Brazier
M, Kamel S, Duver S, Heurtebize N, Maamer M, Mathieu
M, Garabedian M, Sebert JL, Fardellone P.
Rheumatology Department,
North Hospital Group, 80054 cedex 1, Amiens, France
Objectives. - Calcium and vitamin
D deficiency is common in older individuals, particularly
those who live in nursing homes, and increases
the risk of osteoporosis and fractures.Methods.
- We conducted a randomized double-blind placebo-controlled
study of combined supplementation with 500 mg
of elemental calcium, as carbonate, and 400 IU
of vitamin D bid for 12 months in women older
than 65 years of age with vitamin D deficiency,
defined as serum 25(OH)D concentrations </=12
ng/ml.Results. - Mean patient age was 75 +/- 7
years, and median daily dietary intakes of calcium
and vitamin D were 697 mg and 66.8 IU in the supplemented
group (n = 95) and 671 mg and 61.8 IU in the placebo
group (n = 97). The median serum 25(OH)D level
was 7.0 ng/ml in both groups, and the medial intact
parathyroid hormone (PTHi) levels were 49 and
48 pg/ml in the supplemented and placebo groups,
respectively. The median increase in serum 25(OH)D
was 22.0 ng/ml in the supplemented group and 4
ng/ml in the placebo group (P < 0.0001), and
the median PTHi decrease was 17 and 5 pg/ml, respectively
(P < 0.0001). The median bone mineral density
increase was significantly greater in the supplemented
group than in the placebo group: +2.98% vs. -0.21%
at L2-L4 (P = 0.0009), +1.19% and -0.83% at the
femoral neck (P = 0.015), +0.86% and -0.56% at
the trochanter (P = 0.015), and +0.99% and +0.11%
for the whole body (P = 0.01). Similarly, the
median decrease in the main bone markers was significantly
greater in the treated group than in the placebo
group: -1.35 &mgr;g/l vs. +0.50 &mgr;g/l
for bone alkaline phosphatase (P = 0.008), -16.6
nmol/mmol creatinine vs. -2.3 nmol/mmol creatinine
for urinary type I amino-terminal telopeptide
(P = 0.001), and -896 pmol/l vs. -201 pmol/l for
serum type I carboxy-terminal telopeptide (P =
0.003). We found no significant differences between
the two groups for serum calcium, although urinary
calcium excretion changed more in the supplemented
group than in the placebo group. In conclusion, bone mass
in older women with vitamin D deficiency increases
significantly at the lumbar spine, femur, trochanter,
and whole body after calcium and vitamin D supplementation
for 1 year, and concomitantly bone markers
improved as vitamin D levels returned to normal.
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S Afr Med J. 2003 Mar;93(3):224-8.
Calcium
supplementation to prevent pre-eclampsia--a systematic
review.
Hofmeyr GJ, Roodt
A, Atallah AN, Duley L.
Effective Care Research
Unit, East London Hospital Complex, University
of the Witwatersrand, Johannesburg/Fort Hare University,
East London, E Cape.
BACKGROUND: Calcium supplementation
during pregnancy may prevent high blood pressure
and preterm labour. OBJECTIVE: To assess the effects
of calcium supplementation during pregnancy on
hypertensive disorders of pregnancy and related
maternal and child adverse outcomes. DESIGN: A
systematic review of randomised trials that compared
supplementation with at least 1 g calcium daily
during pregnancy with placebo. SEARCH STRATEGY:
The Cochrane Pregnancy and Childbirth Group trials
register (October 2001) and the Cochrane Controlled
Trials Register (Issue 3, 2001) were searched
and study authors were contacted. DATA COLLECTION
AND ANALYSIS: Eligibility and trial quality were
assessed. Data were extracted and analysed. MAIN
RESULTS: There was a modest reduction in the risk
of pre-eclampsia with calcium supplementation
(relative risk (RR) 0.68, 95% confidence interval
(CI): 0.57-0.81). The effect was greatest for
women at high risk of hypertension (RR 0.21, 95%
CI: 0.11-0.39) and those with low baseline calcium
intake (RR 0.32, 95% CI: 0.21-0.49). There was
no overall effect on the risk of preterm delivery,
although there was a reduction in risk among women
at high risk of hypertension (RR 0.42, 95% CI:
0.23-0.78). There was no evidence of any effect
of calcium supplementation on stillbirth or death
before discharge from hospital. There were fewer
babies with birthweight < 2,500 g (RR 0.83,
95% CI: 0.71-0.98). In one study, childhood systolic
blood pressure > 95th percentile was reduced
(RR 0.59, 95% CI: 0.39-0.91). CONCLUSIONS: Calcium
supplementation appears to be beneficial for women
at high risk of gestational hypertension and in
communities with low dietary calcium intake. These benefits were confined to several rather
small trials, and were not found in the largest
trial to date, conducted in a low-risk population.
Further research is required.
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Adv Neurol. 2003;92:173-8.
Nutritional
and metabolic aspects of stroke prevention.
Spence JD.
Department of Clinical
Neurological Sciences, University of Western Ontario,
Stroke Prevention and Atherosclerosis Research
Centre, Robarts Research Institute, London, Ontario,
Canada.
Epidemiologic evidence, animal
studies, angiographic and ultrasound studies in
humans, and a limited number of clinical trials
suggest that vitamins C and E may be protective
and that folate, B6, and B12, by lowering homocysteine
levels, may reduce stroke. However, these hypotheses
require testing before widespread use of supplementary
vitamins can be generally recommended (62). Clinical
trials under way will test those hypotheses. In
the meantime, it should be understood that the
role of diet is much more important than is widely
recognized. A
diet low in saturated fat and cholesterol, low
in sodium, high in potassium and calcium, and
containing a lot of fruits and vegetables reduces
blood pressure as much as an antihypertensive
drug and in coronary patients is twice as effective
as statin drugs in reducing death and myocardial
infarction. Such a diet can therefore be
confidently recommended as a source not only of
natural proportions of vitamins and antioxidants
but also for benefits that we are only beginning
to define.
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Maturitas. 2003 Apr 25;44(4):299-305.
Calcium-vitamin
D3 supplementation is cost-effective in hip fractures
prevention.
Lilliu H, Pamphile
R, Chapuy MC, Schulten J, Arlot M, Meunier PJ.
CLP-Sante, 9-11 rue du
Mont Aigoual, F-75015 Paris, France. [email protected]
OBJECTIVE: To assess the cost
implications for a preventive treatment strategy
for institutionalised elderly women with a combined
1200 mg/day calcium and 800 IU/day vitamin D(3)
supplementation in seven European countries. DESIGN:
Retrospective cost effectiveness analysis based
on a prospective placebo-controlled randomised
clinical trial. DATA SOURCES: Recently published
cost studies in seven European countries. Clinical
results from Decalyos, a 3-year placebo-controlled
study in elderly institutionalised women. TRIALS:
Decalyos study, with 36 months follow-up of 3270
mobile elderly women living in 180 nursing homes,
allocated to two groups. One group received 1200
mg/day elemental calcium in the form of tricalcium
phosphate together with 800 IU/day (20 microg)
of cholecalciferol (vitamin D(3)), the other placebo.
RESULTS: In the 36 months analysis of the Decalyos
study, 138 hip fractures occurred in the group
of 1176 women, receiving supplementation and 184
hip fractures in the placebo group of 1127 women.
The mean duration of treatment was 625.4 days.
Adjusted to 1000 women, 46
hip fractures were avoided by the calcium and
vitamin D(3) supplementation. For all countries,
the total costs in the placebo group were higher
than in the group receiving supplementation, resulting in a net benefit of 79000-711000 per
1000 women. CONCLUSION: This analysis suggests
that the supplementation strategy is cost saving.
The results
may underestimate the net benefits, as this treatment
has also shown to be effective in decreasing the
incidence of other non-vertebral fractures in elderly
institutionalised women.
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J Hum Nutr Diet. 2003 Apr;16(2):97-109.
Nutritional management
of rheumatoid arthritis: a review of the evidence.
Rennie KL, Hughes
J, Lang R, Jebb SA.
MRC Human Nutrition Research,
Elsie Widdowson Laboratory, Fulbourn Road, Cambridge,
UK; Independent Nutrition Consultant, 7 Holmesdale
Park, Nutfield, Surrey, UK.
Rheumatoid arthritis (RA) is
a debilitating disease and is associated with
increased risk of cardiovascular disease and osteoporosis.
Poor nutrient status in RA patients has been reported
and some drug therapies, such as nonsteroidal
anti-inflammatory drugs (NSAIDs), prescribed to
alleviate RA symptoms, may increase the requirement
for some nutrients and reduce their absorption.
This paper reviews the scientific evidence for
the role of diet and nutrient supplementation
in the management of RA, by alleviating symptoms,
decreasing progression of the disease or by reducing
the reliance on, or combating the side-effects
of, NSAIDs. Supplementation with long-chain n-3
polyunsaturated fatty acids (PUFA) consistently
demonstrates an improvement in symptoms and a
reduction in NSAID usage. Evidence
relating to other fatty acids, antioxidants, zinc,
iron, folate, other B vitamins, calcium, vitamin
D and fluoride are also considered. The present
evidence suggests that RA patients should consume
a balanced diet rich in long-chain n-3 PUFA and
antioxidants. More randomized long-term
studies are needed to provide evidence for the
benefits of specific nutritional supplementation
and to determine optimum intake, particularly
for n-3 PUFA and antioxidants.
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Can Fam Physician. 2002 Nov;48:1789-97.
Premenstrual
syndrome. Evidence-based treatment in family practice.
Douglas S.
Department of Family Medicine,
Dalhousie University, Abbie Lane Bldg, QEII Hospital,
5909 Veterans Memorial Ln, Halifax, NS B3H 2E2.
[email protected]
OBJECTIVE: To evaluate the
strength of evidence for treatments for premenstrual
syndrome (PMS) and to derive a set of practical
guidelines for managing PMS in family practice.
QUALITY OF EVIDENCE: An advanced MEDLINE search
was conducted from January 1990 to December 2001.
The Cochrane Library and personal contacts were
also used. Quality of evidence in studies ranged
from level I to level III, depending on the intervention.
MAIN MESSAGE: Good
scientific evidence shows that calcium carbonate
(1200 mg/d) and selective serotonin reuptake inhibitors
are effective treatments for PMS. The most
commonly used therapies (including vitamin B6,
evening primrose oil, and oral contraceptives)
are based on inconclusive evidence. Other treatments
for which there is inconclusive evidence include
aerobic exercise, stress reduction, cognitive
therapy, spironolactone, magnesium, nonsteroidal
anti-inflammatory drugs, various hormonal regimens,
and a complex carbohydrate-rich diet. Although
evidence for them is inconclusive, it is reasonable
to recommend healthy lifestyle changes given their
overall health benefits. Progesterone and bromocriptine,
which are still widely used, are ineffective.
CONCLUSION: Calcium carbonate should be recommended as first-line
therapy for women with mild-to-moderate PMS. Selective serotonin reuptake inhibitors can be
considered as first-line therapy for women with
severe affective symptoms and for women with milder
symptoms who have failed to respond to other therapies.
Other therapies may be tried if these measures
fail to provide adequate relief.
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Abstracts
on Magnesium |
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Panminerva Med. 2001 Sep;43(3):177-209.
Hypomagnesemia.
A review of pathophysiological, clinical and therapeutical
aspects.
Iannello S, Belfiore
F.
Institute of Internal Medicine
and Internal Specialties, Chair of Internal Medicine,
University of Catania Medical School, Garibaldi
Hospital, Catania, Italy. [email protected]
The aim of this paper is to
discuss, on the basis of an extensive literature
review, the role of magnesium (Mg) in health and
disease. Mg is an essential cation playing a crucial
role in many enzyme systems. Quantitative Mg body
stores are regulated by metabolic and hormonal
effects on gastrointestinal absorption and renal
excretion. Mg is a smooth muscle relaxant, dilates
coronary arteries and peripheral vessels, exerts
antiarrhythmic effects, may have a permissive
effect on catecholamine actions and can play a
role in various thrombogenic conditions. Today,
hypomagnesemia has become a recognized medical
occurrence which may be associated with many different
diseases, either genetic or acquired. Mg
deficiency is one of the most frequent electrolyte
abnormalities in clinical practice, but it is
probably the most underdiagnosed one. Clinical
manifestations of hypomagnesemia may begin insidiously
or dramatically sudden. A large part of the population
(especially aged subjects) may have an inadequate
Mg intake and a chronic latent Mg deficiency.
Routine inclusion of serum Mg analysis in the
electrolyte panel represents a continued need
to recognize hypomagnesemia and to treat Mg-depleted
patients. New clinical studies on Mg deficiency
are necessary to ascertain the usefulness and
cost-effectiveness of Mg replacement therapy.
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South Med J. 2001 Dec;94(12):1195-201.
Comment in:
• South Med J. 2003 Jan;96(1):104.
Magnesium:
its proven and potential clinical significance.
Fox C, Ramsoomair
D, Carter C.
Department of Family Medicine,
State University of New York at Buffalo, 14215,
USA.
Magnesium is the fourth most
abundant cation in the body and is present in
more than 300 enzymatic systems, where it is crucial
for adenosine triphosphate (ATP) metabolism. Deficiency
states result in increased insulin resistance,
as well as increased smooth muscle and platelet
reactivity. Magnesium
deficiency has been shown to correlate with a
number of chronic cardiovascular diseases, including
hypertension, diabetes mellitus, and hyperlipidemia.
Intravenous magnesium has been used therapeutically
in critical situations such as status asthmaticus,
torsades de pointes, and preeclampsia. Few controlled studies exist regarding the therapeutic
uses of oral magnesium supplementation in chronic
cardiovascular diseases. Randomized clinical trials
are urgently needed to determine whether magnesium
supplementation will alter the natural history
of these disease states.
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New Horiz. 1994 May;2(2):186-92.
Should
we supplement magnesium in critically ill patients?
Olerich MA, Rude
RK.
Department of Diabetes,
Los Angeles County/University of Southern California
Medical Center 90033.
Magnesium (Mg) deficiency is
a common yet underdiagnosed problem in the ICU.
Since only 1% of total body Mg is in the extracellular
fluid, serum Mg concentrations may not adequately
reflect Mg status. Utilizing techniques to measure intracellular
Mg concentrations, Mg depletion has been shown
to be present in about one half of all ICU patients.
These patients have significantly higher morbidity
and mortality rates than Mg-replete patients. Accurate identification of patients with Mg depletion
requires a knowledge of the risk factors associated
with Mg deficiency. These factors include poorly
controlled diabetes mellitus, alcohol ingestion,
severe diarrhea and steatorrhea, and the use of
a number of pharmacologic agents that induce renal
Mg wasting. Manifestations of Mg deficiency include
hypokalemia, hypocalcemia, neuromuscular hyperexcitability,
respiratory muscle weakness, and intractable arrhythmias.
Mg deficiency may also play a role in the genesis
of myocardial ischemia. In this article, we review
the assessment, causes, and manifestations of
Mg deficiency and suggest guidelines for adequate
treatment.
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Dis Mon. 1988 Apr;34(4):161-218.
Magnesium
metabolism in health and disease.
Elin RJ.
Clinical Pathology Department,
National Institutes of Health, Bethesda, Maryland.
Magnesium is an important element
for health and disease. Magnesium, the second
most abundant intracellular cation, has been identified
as a cofactor in over 300 enzymatic reactions
involving energy metabolism and protein and nucleic
acid synthesis. Approximately half of the total
magnesium in the body is present in soft tissue,
and the other half in bone. Less than 1% of the
total body magnesium is present in blood. Nonetheless,
the majority of our experimental information comes
from determination of magnesium in serum and red
blood cells. At present, we have little information
about equilibrium among and state of magnesium
within body pools. Magnesium is absorbed uniformly
from the small intestine and the serum concentration
controlled by excretion from the kidney. The clinical
laboratory evaluation of magnesium status is primarily
limited to the serum magnesium concentration,
24-hour urinary excretion, and percent retention
following parenteral magnesium. However, results
for these tests do not necessarily correlate with
intracellular magnesium. Thus, there is no readily
available test to determine intracellular/total
body magnesium status. Magnesium deficiency may
cause weakness, tremors, seizures, cardiac arrhythmias,
hypokalemia, and hypocalcemia. The causes of hypomagnesemia
are reduced intake (poor nutrition or IV fluids
without magnesium), reduced absorption (chronic
diarrhea, malabsorption, or bypass/resection of
bowel), redistribution (exchange transfusion or
acute pancreatitis), and increased excretion (medication,
alcoholism, diabetes mellitus, renal tubular disorders,
hypercalcemia, hyperthyroidism, aldosteronism,
stress, or excessive lactation). A
large segment of the U.S. population may have
an inadequate intake of magnesium and may have
a chronic latent magnesium deficiency that has
been linked to atherosclerosis, myocardial infarction,
hypertension, cancer, kidney stones, premenstrual
syndrome, and psychiatric disorders. Hypermagnesemia
is primarily seen in acute and chronic renal failure,
and is treated effectively by dialysis.
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Ann Pharmacother. 1993 Jun;27(6):775-80.
Magnesium
and diabetes: a review.
White JR Jr, Campbell
RK.
College of Pharmacy, Washington
State University, Spokane 99204.
OBJECTIVE: To discuss the potential
link between diabetes mellitus (DM) and hypomagnesemia,
the methods used to assess magnesium status, and
the potential benefits of magnesium repletion
in hypomagnesemic patients with DM. DATA SOURCES:
A MEDLINE search (key terms: magnesium and diabetes)
was conducted to identify pertinent literature.
STUDY SELECTION: All major clinical trials and
most published case reports were reviewed. SYNTHESIS:
Several studies have demonstrated a higher than
expected frequency of magnesium deficiency in
patients with DM. Hypomagnesemia may play a role
in the development of retinopathy, altered glucose
disposition, hypertension, abnormal platelet function,
and other problems frequently observed in patients
with DM. The lack of a widely available, accurate
screening methodology is one of the main problems
in assessing total body magnesium status. One
study has suggested that hypomagnesemia in patients
with DM may be related to enhanced urinary loss
of magnesium. Several studies evaluating hypomagnesemia
and glucose disposal have suggested a direct correlation
between magnesium concentration and glucose disposal,
with an improvement in glucose disposal with magnesium
supplementation. It has been suggested that there
is a relationship between hypomagnesemia and diabetic
retinopathy; however, the effect of magnesium
supplementation on the development of diabetic
retinopathy has not been evaluated.
Researchers
evaluating the effect of magnesium on platelet aggregation
have suggested that magnesium supplementation may
reduce the incidence of vascular disease in hypomagnesemic
patients with DM. Several studies have demonstrated
a correlation between hypomagnesemia and hypertension.
CONCLUSIONS: Studies have suggested a link between
hypomagnesemia and hyperglycemia, as well as an
association between hypomagnesemia and the complications
of DM. The American Diabetes Association has published
a consensus statement suggesting that patients who
have documented hypomagnesemia and DM receive magnesium
supplementation.
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South Med J. 1999 Nov;92(11):1040-7.
Magnesium
for the next millennium.
Swain R, Kaplan-Machlis
B.
New Millennium Wellness
and Sports Medicine, and the Department of Family
Medicine, West Virginia University, Charleston,
USA.
BACKGROUND: Magnesium is a
trace mineral in several hundred chemical reactions
in the body. It has therapeutic potential in many
medical conditions. In this review, we attempted
to clarify the current information on the role
of magnesium as a therapeutic agent. METHODS:
A MEDLINE search from 1966 through March 1999
was conducted, using PubMed and "Magnesium"
and "Therapeutic Usage" as the two initial
key headings. Important articles were also identified
from the bibliographies of the initial articles.
RESULTS: A total of 51 articles were included
in this review. Articles were excluded if they
were based on animal study or were in a language
other than English. CONCLUSION: Magnesium has
long been used as an ingredient in laxatives and
antacids. It seems clear that intravenous magnesium also
is effective for the suppression of ventricular
ectopy in the hospital setting and is a first-line
agent for torsades de pointes. It is less
clear whether it is useful in patients with congestive
heart failure or acute myocardial infarction (MI). Although effective
for treatment of preeclampsia/eclampsia, its use in the termination of preterm labor has
recently been questioned.
In
asthma and chronic lung disease, intravenous magnesium
may be useful when conventional treatment has failed.
Finally, magnesium may have a role in the prevention
and treatment of vascular headaches.
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Mol Aspects Med. 2003 Feb 6;24(1-3):137-46.
Low magnesium
and atherosclerosis: an evidence-based link.
Maier JA.
Dipartimento di Scienze
Precliniche-LITA Vialba, Universita di Milano,
Via GB Grassi 74, 20157, Milano, Italy
Data
indicates that magnesium deficiency caused by
poor diet and/or errors in its metabolism may
be a missing link between diverse cardiovascular
risk factors and atherosclerosis. Experimentally
induced low plasma levels of magnesium accelerate
atherogenesis by increasing LDL concentrations
and their oxidative modifications, and by promoting
inflammation. In vitro studies have shown that
low magnesium determines endothelial dysfunction,
the initiating event leading to the formation
of the plaque. Moreover,
oral
magnesium therapy has been shown to improve endothelial
function in patients with coronary artery disease.Magnesium,
which is an inexpensive, natural and rather safe
element, could be useful in preventing atherosclerosis
and as an adjuvant therapy in patients with clinical
manifestations of the disease.
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Mol Aspects Med. 2003 Feb 6;24(1-3):107-36.
Role of magnesium
in the pathogenesis of hypertension.
Touyz RM.
Multidisciplinary Research
Group on Hypertension, Clinical Research Institute
of Montreal, University of Montreal, 110 Pine
Avenue West, Que., H2W IR7, Montreal, Canada
Human essential hypertension
is a complex, multifactorial, quantitative trait
under polygenic control. Although the exact etiology
is unknown, the fundamental hemodynamic abnormality
in hypertension is increased peripheral resistance,
due primarily to changes in vascular structure
and function. These changes include arterial wall
thickening, abnormal vascular tone and endothelial
dysfunction and are due to alterations in the
biology of the cellular and non-cellular components
of the arterial wall. Many of these processes
are influenced by magnesium. Small changes in
magnesium levels may have significant effects
on cardiac excitability and on vascular tone,
contractility and reactivity. Accordingly magnesium
may be important in the physiological regulation
of blood pressure whereas perturbations in cellular
magnesium homeostasis could play a role in pathophysiological
processes underlying blood pressure elevation. For the most
part, epidemiological and experimental studies
demonstrate an inverse association between magnesium
and blood pressure and support a role for magnesium
in the pathogenesis of hypertension. However
data from clinical studies have been less convincing
and the therapeutic value of magnesium in the
prevention and management of essential hypertension
remains unclear. In
view of the still ill-defined role of magnesium
in clinical hypertension, magnesium supplementation
is advised in those hypertensive patients who
are receiving diuretics, who have resistant or
secondary hypertension or who have frank magnesium
deficiency. A magnesium-rich diet should be encouraged
in the prevention of hypertension, particularly
in predisposed communities because of the other
advantages of such a diet in prevention. The clinical aspect that has demonstrated the
greatest therapeutic potential for magnesium in
hypertension, is in the treatment of pre-eclampsia
and eclampsia. The present review discusses the
role of magnesium in the regulation of vascular
function and blood pressure and the implications
in mechanisms underlying hypertension. Alterations
in magnesium regulation in experimental and clinical
hypertension and the potential antihypertensive
therapeutic actions of magnesium will also be
addressed.
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Med Hypotheses. 2002 Jan;58(1):47-60.
The central
role of magnesium deficiency in Tourette's syndrome:
causal relationships between magnesium deficiency,
altered biochemical pathways and symptoms relating
to Tourette's syndrome and several reported comorbid
conditions.
Grimaldi BL.
[email protected]
Prior studies have suggested
a common etiology involved in Tourette's syndrome
and several comorbid conditions and symptomatology.
Reportedly, current medications used in Tourette's
syndrome have intolerable side-effects or are
ineffective for many patients. After
thoroughly researching the literature, I hypothesize
that magnesium deficiency may be the central precipitating
event and common pathway for the subsequent biochemical
effects on substance P, kynurenine, NMDA receptors,
and vitamin B6 that may result in the symptomatology
of Tourette's syndrome and several reported comorbid
conditions. These comorbid conditions and
symptomatology include allergy, asthma, autism,
attention deficit hyperactivity disorder, obsessive
compulsive disorder, coprolalia, copropraxia,
anxiety, depression, restless leg syndrome, migraine,
self-injurious behavior, autoimmunity, rage, bruxism,
seizure, heart arrhythmia, heightened sensitivity
to sensory stimuli, and an exaggerated startle
response. Common possible environmental and genetic
factors are discussed, as well as biochemical
mechanisms. Clinical studies to determine the
medical efficacy for a comprehensive magnesium
treatment option for Tourette's syndrome need
to be conducted to make this relatively safe,
low side-effect treatment option available to
doctors and their patients.
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Headache. 2002 Apr;42(4):242-8.
Serum ionized
magnesium levels and serum ionized calcium/ionized
magnesium ratios in women with menstrual migraine.
Mauskop A, Altura
BT, Altura BM.
New York Headache Center,
SUNY Downstate Medical Center, Brooklyn 11203,
USA.
OBJECTIVE: It has been suggested
that magnesium deficiency may play an important
role in menstrual migraine and that the serum
ionized calcium (ICa2+)/ionized magnesium (IMg2+)
ratio is important in migraine headache. Studies
were designed to test these hypotheses. DESIGN:
We prospectively evaluated 270 women seen at a
headache clinic and in 61 women with menstrual
migraine measured IMg2+, total magnesium, and
ICa2+ levels so as to calculate the ICa2+/IMg2+
ratio. RESULTS: The incidences of IMg2+ deficiency
were 45% during menstrual attacks, 15% during
nonmenstrual attacks, 14% during menstruation
without a migraine, and 15% between menstruations
and between migraine attacks. The serum ICa2+
levels were within our reference range, but the
ICa2+/IMg2+ ratio was elevated (P<.01) in menstrual
migraine. CONCLUSIONS:
The
high incidence of IMg2+ deficiency and the elevated
ICa2+/IMg2+ ratio during menstrual migraine confirm
previous suggestions of a possible role for magnesium
deficiency in the development of menstrual migraine.
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Headache. 2002 Feb;42(2):114-9.
Oral magnesium
load test in patients with migraine.
Trauninger A, Pfund
Z, Koszegi T, Czopf J.
Department of Neurology,
Medical Faculty, University of Pecs, Hungary.
OBJECTIVE: To determine whether
migraineurs may have a systemic deficiency of
magnesium. BACKGROUND: Magnesium deficiency has
been shown to play a potential role in the pathogenesis
of migraine, but there are no data on total body
magnesium status in migraineurs. METHODS: An oral
magnesium load test was performed by giving 3000
mg of magnesium lactate during a 24-hour interictal
period to 20 patients with migraine (15 women
and 5 men; mean age, 37.9 years) and 20 healthy
volunteers (16 women and 4 men; mean age, 39.6
years). Baseline and postload magnesium concentrations
were determined from serum and 24-hour urine specimens.
RESULTS: There was no significant difference between
the groups in the baseline serum and urine magnesium
concentrations, although the latter tended to
be lower (P = .064) in the migraine group. The
postload magnesium concentrations were significantly
higher within both the migraine (P < .0001
and P < .0001) and the control (P = .0009 and
P < .0001) groups compared to the baseline
values. After loading, the 24-hour urinary magnesium
excretions were significantly lower (P = .0007)
in the patients with migraine than in the controls,
but serum values did not differ. CONCLUSIONS:
Magnesium retention
occurs in patients with migraine after oral loading,
suggesting a systemic magnesium deficiency.
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J Med Assoc Thai. 2001 Dec;84
Suppl 3:S645-9.
Serum
magnesium in Thai coronary artery disease patients.
Wannasilp N, Poungvarin
N, Pokum S, Leowattana W, Mahanonda N.
Department of Clinical
Pathology, Faculty of Medicine, Siriraj Hospital,
Mahidol University, Bangkok, Thailand.
Hypomagnesemia or magnesium
(Mg) deficiency has been hypothesized to play
a role in coronary artery disease (CAD). The authors
aimed to evaluate serum Mg concentration in 100
CAD patients compared with 100 healthy controls.
Mean values of serum Mg level in CAD and the control
group were 2.14 +/- 0.39, 2.24 +/- 0.3 mg/dL respectively
(P=0.052). The prevalence of Mg deficiency was
12 per cent in the CAD patients, and 5 per cent
in the control group (odds ratio=2.59, 95% confident
interval = 0.88-7.65, P=0.063). There was no significant
difference in the serum Mg level between the 2
groups, although it tended to be lower in CAD
patients. The prevalence of Mg deficiency did
not differ significantly between the study group,
however, it tended to be higher in CAD patients.
These findings
demonstrated that CAD patients may be associated
with Mg deficiency, and contribute to the pathogenesis
of CAD or acute thrombosis. Following this evidence,
Mg treatment may be necessary in CAD patients with
Mg deficiency or acute myocardial infarction (AMI).
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Eur J Clin Nutr. 2002 May;56(5):409-14.
Dietary magnesium
intake in type 2 diabetes.
Walti MK, Zimmermann
MB, Spinas GA, Jacob S, Hurrell RF.
Laboratory for Human Nutrition,
Institute of Food Science, Swiss Federal Institute
of Technology (ETH) Zurich, Switzerland. [email protected]
BACKGROUND: Magnesium
deficiency is common in type 2 diabetes and may
have a negative impact on glucose homeostasis
and insulin resistance, as well as on the evolution
of complications such as retinopathy, thrombosis
and hypertension. OBJECTIVE: To assess
the dietary magnesium intake of patients with
type 2 diabetes in Zurich, Switzerland and to
compare the magnesium intake of diabetic and non-diabetic
subjects. DESIGN: The magnesium intake of 97 randomly
selected patients with type 2 diabetes and 100
healthy, non-diabetic controls matched for age
and sex was estimated using a diet history method.
During winter and summer periods, mean daily magnesium
intakes were calculated from detailed information
given by the test subjects about their eating
habits over the previous 2 months. The calculations
were performed using EBIS, a computer program
based on a German nutrient data base (BLS 2.3),
with food items specific to Switzerland added
or directly analysed when necessary. RESULTS:
The mean+/-s.d. daily magnesium intake of the
male diabetic and male control subjects was 423.2+/-103.1
and 421.1+/-111.0 mg, respectively. The mean daily
magnesium intake of the female diabetic and female
control subjects was 419.1+/-109.7 and 383.5+/-109.7
mg, respectively. There were no significant differences
in daily magnesium intake between the diabetic
and the non-diabetic subjects and mean intakes
in both groups exceeded Swiss recommended dietary
intakes. CONCLUSIONS: Dietary intake of magnesium
appears sufficient in Swiss adults with type 2
diabetes and is unlikely to contribute to the
aetiology of magnesium deficiency. SPONSORSHIP:
The Swiss Federal Institute of Technology, Zurich,
Switzerland.
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Crit Rev Oncol Hematol. 2002
Apr;42(1):79-91.
Magnesium-DNA
interactions and the possible relation of magnesium
to carcinogenesis. Irradiation and free radicals.
Anastassopoulou J,
Theophanides T.
National Technical University
of Athens, Chemical Engineering Department, Radiation
Chemistry and Biospectroscopy, Zografou Campus,
Zografou 15780, Athens, Greece. [email protected]
Magnesium
deficiency causes renal complications. The appearance
of several diseases is related to its depletion
in the human body. In radiotherapy, as well as
in chemotherapy, especially in treatment of cancers
with cis-platinum, hypomagnesaemia is observed.
The site effects of chemotherapy that are due
to hypomagnesaemia are decreased using Mg supplements.
The role of magnesium in DNA stabilization is
concentration dependent. At high concentrations
there is an accumulation of Mg binding, which
induces conformational changes leading to Z-DNA,
while at low concentration there is deficiency
and destabilization of DNA. The biological and
clinical consequences of abnormal concentrations
are DNA cleavage leading to diseases and cancer.
Carcinogenesis and cell growth are also magnesium-ion
concentration dependent. Several reports point
out that the interaction of magnesium in the presence
of other metal ions showed that there is synergism
with Li and Mn, but there is magnesium antagonism
in DNA binding with the essential metal ions in
the order: Zn>Mg>Ca. In the case of toxic
metals such as Cd, Ga and Ni there is also antagonism
for DNA binding. It was found from radiolysis
of deaerated aqueous solutions of the nucleoside
5'-guanosine monophosphate (5'-GMP) in the presence
as well as in the absence of magnesium ions that,
although the addition of hydroxyl radicals (*OH)
has been increased by 2-fold, the opening of the
imidazole ring of the guanine base was prevented.
This effect was due to the binding of Mg2+ ions
to N7 site of the molecule by stabilizing the
five-member ring imitating cis-platinum. It was
also observed using Fourier Transform Infrared
spectroscopy, Raman spectroscopy and Fast Atom
Bombardment mass spectrometry that *OH radicals
subtract H atoms from the C1', C4' and C5' sites
of the nucleotide. Irradiation of 5'-GMP in the
presence of oxygen (2.5 x 10(-4) M) shows that
magnesium is released from the complex. There
is spectroscopic evidence that superoxide anions
(O2-*) react with magnesium ions leading to magnesium
release from the complex. From radiolysis data
it was suggested that magnesium ions can act as
radiosensitizers in the absence of oxygen, while
in the presence of oxygen they act as protectors
and stabilizers of DNA.
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Med Hypotheses. 2001 Dec;57(6):705-13.
Tension headaches
and muscle tension: is there a role for magnesium?
Altura BM, Altura
BT.
Department of Physiology
and Pharmacology, and The Center for Cardiovascular
and Muscle Research, SUNY Health Science Center
at Brooklyn, New York 11203, USA.
Although many theories and
hypotheses have been offered for the etiology
of tension-type headache (TH), no one previous
hypothesis seems to adequately explain TH. This
may, in large measure, account for why it is often
difficult to effectively treat TH. Herein, we
review current and old hypotheses of TH and offer
a new hypothesis which is consistent with what
is known about TH. We
show that magnesium (Mg) metabolism may be pivotal
in both the etiology and treatment of TH. Measurement
of serum ionized Mg2+ (IMg2+) levels and brain
intracellular free Mg2+ ([Mg2+]i) appear to offer
excellent methods for establishing the validity
of our hypothesis. Since approximately 70% of
patients who have a TH exhibit muscular tightness
and tenderness, it is distinctly possible that
problems in Mg metabolism and dietary intake are
the links to concomitant muscle tension and TH.
The significance of release of pain mediators,
muscle cramps, muscle strains (and damage) and
muscle tension to TH, and its relationship to
Mg metabolism, are reviewed. These are all associated
with a Mg-deficient state. It
seems clear from the available data that TH's
are more associated with muscle tension or scalp
tension than any other headache type. From the
data available, Mg supplementation appears to
be of great benefit in many of these situations. We believe there is a great need for clinicians
to examine Mg2+ metabolism, bioavailable Mg2+
in muscle tissues and blood, and the effectiveness
of Mg salts (in a double-blinded, placebo-controlled
manner) in subjects with TH and muscle tension.
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Abstracts
on Minerals |
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J Nutr. 1979 Aug;109(8):1432-7.
Serum
levels of selenium, calcium, copper magnesium,
manganese and zinc in various human diseases.
Sullivan JF, Blotcky
AJ, Jetton MM, Hahn HK, Burch RE.
Serum selenium as well as serum
zinc, copper, magnesium, calcium and manganese
were investigated in a control group of adult
males and in 11 groups of patients in various
disease states. Not only the change of each trace
element but also the possible association between
elements was studied in the various groups. All
patients were fasting when sampled and studied
only after the acute phase of the disease was
corrected. Trace metal determinations were performed
by atomic absorption spectrophometry (Mg, Ca,
Cu, Zn) and by neutron activation analysis (Se,
Mn).
All patients
showed low serum zinc when compared to controls.
Cirrhotic patients had a low serum selenium level
as well as low calcium, magnesium and zinc. Emphysemia
and cancer patients had an elevated serum copper
concentration while copper and manganese levels
were elevated in congestive heart failure, infection
and pschoses. To our knowledge this is the first
time low serum selenium values have been demonstrated
to be associated with the low serum zinc, calcium
and magnesium levels found in cirrhotic patients.
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Fed Proc. 1982 Sep;41(11):2807-12.
Trace
minerals and atherosclerosis.
Mertz W.
Although there is no evidence
for a direct cause-effect relationship between
mineral and trace element status and atherosclerosis
in humans, many elements exert a strong influence
on individual risk factors for cardiovascular
disease, such as disorders of blood lipids, blood
pressure, coagulation, glucose tolerance, and
circulating insulin. Studies
in humans and animals have shown that optimal
intakes of elements such as sodium, magnesium,
calcium, chromium, copper, zinc, and iodine can
reduce individual risk factors; some of these
studies are consistent with the results of epidemiologic
correlations. Influences of local geochemical
environment and of dietary practices can result
in mineral and trace element imbalances; deficiencies
of chromium, iron, copper, zinc, selenium, and
iodine are well defined. Detection and correction
of such imbalances in populations, through diminishing
individual risk factors, might ultimately reduce
the incidence of atherosclerotic heart disease.
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Biol Trace Elem Res. 1992 Jan-Mar;32:173-85.
Clinical
implications of trace elements in endocrinology.
Neve J.
Department of Pharmaceutical
Organic Chemistry, Free University of Brussels,
Belgium.
The implications of essential
trace elements in endocrinological processes,
mainly thyroid function, growth, gonadal function,
adrenal hormones, prolactin, glucose homeostasis,
calcium-phosphorus metabolism, and thymulin activity,
are reviewed. Most concerned elements in this
field include iodine, zinc, selenium, copper,
chromium, manganese and vanadium. The
minerals are powerful modulators of several physiological
functions that can be considerably perturbed in
deficiency states. The resulting biochemical and
clinical modifications can be prevented and/or
corrected by adequate supplementation. Sometimes, however, they act like pharmacological
agents when their beneficial effects are not the
result of a correction of a nutritional deficiency
state. Their potentialities as therapeutic agents
are perfectly described in many cases, but some
indications deserve further investigations.
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J Am Coll Nutr. 1993 Aug;12(4):384-9.
The
role of trace minerals in osteoporosis.
Saltman PD, Strause
LG.
Dept. of Biology, University
of California San Diego, La Jolla 92093.
Osteoporosis is a multifactorial
disease with dimensions of genetics, endocrine
function, exercise and nutritional considerations.
Of particular considerations are calcium (Ca)
status, Vitamin D, fluoride, magnesium and other
trace elements. Several
trace elements, particularly copper (Cu), manganese
(Mn) and zinc (Zn), are essential in bone metabolism
as cofactors for specific enzymes. Our
investigations regarding the role of Cu, Mn and
Zn in bone metabolism include data from studies
with animals on Cu- and Mn-deficient diets. We
have also demonstrated cellular deficiencies using
bone powder implants, as well as fundamental changes
in organic matrix constituents.
In
clinical studies we have demonstrated the efficacy
of Ca, Cu, Mn and Zn supplementation on spinal bone
mineral density in postmenopausal women. Each of
these studies demonstrated the necessity of trace
elements for optimal bone matrix development and
bone density sustenance.
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J Nutr. 1996 Sep;126(9 Suppl):2304S-2308S.
Intakes
of minerals from diets and foods: is there a need
for concern?
Pennington JA.
Division of Nutrition Research
Coordination, National Institute of Diabetes and
Digestive and Kidney Diseases, National Institutes
of Health, Bethesda MD 20892-6600, USA.
Continuous monitoring of the
food supply through the Total Diet Studies allows
for the identification of changes and trends in
the mineral content of foods resulting from agricultural
or manufacturing practices. The studies also allow
for the estimation of average daily intakes of
minerals and a comparison of these intakes with
Recommended Dietary Allowances. The Total Diet
Studies use a small number of foods (core foods)
to represent the U.S. food supply. The core foods
are purchased four times per year, prepared for
consumption, and analyzed for 11 nutritional minerals.
The food composition data are then merged with
food consumption data from national surveys to
provide estimates of daily intakes of minerals
for selected age-sex groups. Results of the 1982-1991
Total Diet Studies indicated that average intakes
of potassium, phosphorus, selenium, iodine and
manganese were adequate. Sodium could not be adequately
assessed because the studies did not include discretionary
salt. Intakes
of calcium, magnesium, iron, zinc and copper were
below recommended intakes for some age-sex groups. Studies based on clinical and biochemical
measurements confirm that calcium, iron and zinc
are of concern for segments of the U.S. population.
There are conflicting opinions about the need
for concern for copper and magnesium.
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J Am Coll Nutr. 1998 Apr;17(2):124-7.
The effect
of a marathon run on plasma and urine mineral
and metal concentrations.
Buchman AL, Keen
C, Commisso J, Killip D, Ou CN, Rognerud CL, Dennis
K, Dunn JK.
Division of Gastroenterology,
Hepatology and Nutrition, University of Texas
Houston Health Science Center, 77030, USA.
BACKGROUND: Little data exist
on the requirements of trace metals and minerals
for endurance athletes. Changes in body status
of these elements must be examined before specific
nutritional recommendations can be made. This
study was designed to determine whether a marathon
run was associated with changes in serum and urine
metal and mineral concentrations. METHODS: Forty
subjects who planned to complete the 1996 Houston-Tennaco
marathon were recruited. Subjects had blood and
urine samples collected 2 weeks prior to the race
and immediately following the race. Blood and
urine specimens were analyzed for copper, iron,
magnesium and zinc concentrations. Blood was also
analyzed for calcium concentration and ceruloplasmin
activity. RESULTS: Twenty-six subjects (24 male,
2 female) completed the marathon. Finish times
varied between 2 hours 43 minutes and 5 hours
28 minutes. There was no significant change in
serum calcium, copper or zinc concentrations or
ceruloplasmin activity. Serum and urine magnesium
concentration decreased significantly (19.55+/-1.73
to 16.55+/-1.53 ppm, p=0.00001; 34.02+/-8.64 to
21.80+/-12.24 ppm, p=0.003, respectively). Serum
iron concentration increased significantly (1.06+/-0.48
to 1.35+/-0.42 ppm, p=0.006), while urine copper
and iron concentrations were below the limits
of detection, zinc concentration did not change.
CONCLUSIONS: Serum
and urinary magnesium concentrations decrease
during endurance running, consistent with the
possibility of magnesium deficiency. This
may be related to increased demand in skeletal
muscle. Serum iron concentration increases, possibly
related to tissue injury. The exact etiology for
these observations, as well as their clinical
significance, requires further investigation.
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Biol Trace Elem Res. 2002 Mar;85(3):193-209.
Effects of
elements in human blood pressure control.
Loyke HF.
St. Vincent Charity Hospital,
Department of Medicine, Cleveland, OH 44115, USA.
This review enumerates
and discusses the elements involved in the control
of human blood pressure via a historical evolutionary
form. The older and most recent element literature
presentations were researched using MEDLINE and
a manual review of documents cited. Independent
data extraction and cross-referencing was performed.
Of the 28 known elements that can influence blood
pressure, 15 were found to be involved in human
blood pressure regulation. The elements were divided
into four groups: electrolyte, composed of sodium,
potassium, calcium, and magnesium; metal, which
included zinc, copper, and iron; toxic, made up
of lead, mercury, cadmium, barium, thallium, arsenic;
miscellaneous (lithium and selenium). Evolutionary
historical data, possible mechanisms of actions,
and interactions between elements that have been
shown to influence blood pressure are discussed. Controversy exists over the therapeutic use of
elements to alter blood pressure but is absent
in the case of the toxic group where preventive
control is a proven public health matter. The
significance of these 15 elements in the regulation
of human blood pressure has been established and
ongoing studies will continue to reinforce their
influence and importance.
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