If your clinical focus is on pharmaceuticals as the primary intervention and not nutrition, it can be easy to not recognise the significant impact on patient health a nutrient insufficiency can have. In this update, magnesium, known by all nutritional orientated practitioners to be needed for over 300 enzymes in humans; with 90% of total body magnesium being contained in the muscles and bones (~27% and ~63%, respectively), of which 90% is bound with only 10% being free. In the serum, 32% of magnesium is bound to albumin, whereas 55% is free.
Subclinical deficiency of nutrients including magnesium have been recognised for decades to have a role in clinical management and risk, but it has to a large part been ignored or considered non-relevant for the great majority of primary care physicians.
However, it seems that this is likely to evolve and change in large part due to the renewed recognition of the effect that food and food substrates can have on health and function outside of the more proclaimed diseases of scurvy, rickets, pellagra and beri beri!
Subclinical deficiencies (are reflective of a clinically silent reduction in physiological, cellular and/or biochemical functions). It is hard to diagnose and predisposes to numerous chronic diseases.
We (by which I mean all people invested in nutrition and its related problems/benefits) should or do recognise that there are real challenges ensuring adequate nutrient intake, especially minerals – as previously discussed in an earlier opinion piece, the change in CO2 and soil destruction through aggressive fertilisation and agricultural practices means that plants have less minerals than they did and so create a nutrient gap, into which accommodation, adaption and redundancy of pathways fall, leaving us as humans and all animals co-dependent on these nutrients with a lowered capacity to manage health challenges. “Hidden hunger” is a new term for an age-old problem we know how to solve. It refers to the lack of access to micronutrients critical to proper physical and cognitive development. The nutritional value of agriculturally important food crops, such as wheat and rice, will continue to decrease as rising levels of atmospheric carbon dioxide continue to reduce the concentrations of protein and essential minerals in most plant species
- Thomas D. The mineral depletion of foods available to us as a nation (1940-2002) --a review of the 6th Edition of McCance and Widdowson. Nutr Health. 2007;19(1-2):21-55.
- Loladze I. Hidden shift of the ionome of plants exposed to elevated CO₂ depletes minerals at the base of human nutrition. Elife. 2014 May 7
This type of micronutrient deficiency constitutes one of the world’s leading health risk factors and adversely affects metabolism, the immune system, cognitive development and maturation—particularly in children. In addition, micronutrient deficiency can exacerbate the effects of diseases and can be a factor in the prevalence of obesity. The ongoing increase in atmospheric CO2 is also very likely to deplete other elements essential to human health (such as calcium, copper, iron, magnesium, and zinc) by 5% to 10% in most plants.
So, you can imagine our interest when in the journal Open Heart a BMJ publication published a review paper titled: Subclinical magnesium deficiency: a principal driver of cardiovascular disease and a public health crisis, in January 2018, that we felt a sense of intrigue and interest. Straight away they state their position:
subclinical magnesium deficiency is rampant and one of the leading causes of chronic diseases including cardiovascular disease and early mortality around the globe and should be considered a public health crisis.
We recommend you take the time to visit the paper and remind yourself of the ubiquity of mineral depletion, the deleterious impact it has on health, the generally depleted state of our soils and the subsequent validity for appropriate oral supplementation and the shift in food production mechanisms needed to restore soil health.
Yours in health
Mike and Antony