Magnesium

Introduction
Fourth most abundant cation Total body magnesium content: ~25 g
0.05% body weight 50-60% found in bones
Along with calcium and potassium Reservoir to ensure normal blood concentrations

1% found in extracellular blood fluid Remainder in muscles, soft tissues

Claudio VS, Dirige OV, Ruiz AJ. Basic nutrition for Filipinos, 5th ed. Manila: Merriam & Webster Bookstore, Inc. 2004. Gropper SS, Smith JL, Groff JL. Advanced nutrition and human metabolism, 5th ed. California: Wadsworth Cengage Learning. 2009. Thompson JL, Manore MM, Vaughan LA. The science of nutrition. Illinois: Pearson Education, Inc. 2008. Whitney E, Rolfes SR. Understanding nutrition, 10th ed. California: Thomson Learning, Inc. 2005.

Nomenclature and forms

Exists in extracellular fluid as an ion (Mg2+) Forms many types of compounds/ complexes

History
Name comes from Magnesia, a district in Thessaly, Greece 1618: Farmer from Epsom, England discovers healing properties on skin = Epsom salts (hydrated magnesium sulfate) 1755: Magnesium recognized as an element by Joseph Black (distinguished magnesium oxide from lime)
Royal Society of Chemistry. Visual Elements Periodic Table. Accessed from http://www.rsc.org/periodic-table. 2013.

History
1789: Thomas Henry discovers magnesium silicate, used in making pipes for tobacco smoking 1808: Sir Humphry Davy isolates magnesium via electrolysis of magnesium oxide
Royal Society of Chemistry. Visual Elements Periodic Table. Accessed from http://www.rsc.org/periodic-table. 2013.

Unit of Measure
In serum: mEq/ L magnesium In foods: mg

Whitney E, Rolfes SR. Understanding nutrition, 10th ed. California: Thomson Learning, Inc. 2005.

Food Sources
Relatively widespread in foods Green leafy vegetables (e.g. spinach) Whole grains Legumes, seeds and nuts Chocolate and cocoa Coffee and tea Meats Drinking water (varies with hardness)
Claudio VS, Dirige OV, Ruiz AJ. Basic nutrition for Filipinos, 5th ed. Manila: Merriam & Webster Bookstore, Inc. 2004. Gropper SS, Smith JL, Groff JL. Advanced nutrition and human metabolism, 5th ed. California: Wadsworth Cengage Learning. 2009. Thompson JL, Manore MM, Vaughan LA. The science of nutrition. Illinois: Pearson Education, Inc. 2008..

Food Sources
Magnesium content can be estimated using a prediction formula mEq dietary Mg = 0.01117 + (0.0099 x Kcal)

Claudio VS, Dirige OV, Ruiz AJ. Basic nutrition for Filipinos, 5th ed. Manila: Merriam & Webster Bookstore, Inc. 2004.

Food Sources
Also available in supplement form (salts)
Magnesium sulfate Magnesium oxide Magnesium chloride Magnesium acetate Magnesium gluconate Magnesium citrate

Gropper SS, Smith JL, Groff JL. Advanced nutrition and human metabolism, 5th ed. California: Wadsworth Cengage Learning. 2009.

Digestion, Absorption, Transport and Excretion

Shares common transfer mechanism with Ca Approximately 50% of dietary magnesium is absorbed via passive and active transport
Maximum absorption: distal jejunum, ileum Colon absorbs small amounts Shares common transfer mechanism with calcium Decreases with higher dietary intakes

Gropper SS, Smith JL, Groff JL. Advanced nutrition and human metabolism, 5th ed. California: Wadsworth Cengage Learning. 2009. Thompson JL, Manore MM, Vaughan LA. The science of nutrition. Illinois: Pearson Education, Inc. 2008..

Digestion, Absorption, Transport, and Excretion

Factors influencing absorption
Enhancing Vitamin D Lactose Fructose Inhibiting Phytate Fiber Excessive unabsorbed fatty acids Nutrient interactions Calcium Phosphorus Potassium Protein

Gropper SS, Smith JL, Groff JL. Advanced nutrition and human metabolism, 5th ed. California: Wadsworth Cengage Learning. 2009.

Digestion, Absorption, Transport, and Excretion

Absorption occurs through 2 pathways
Saturable active transcellular pathway (for low intake) Nonsaturable passive paracellular pathway (for high intake)

Claudio VS, Dirige OV, Ruiz AJ. Basic nutrition for Filipinos, 5th ed. Manila: Merriam & Webster Bookstore, Inc. 2004. Gropper SS, Smith JL, Groff JL. Advanced nutrition and human metabolism, 5th ed. California: Wadsworth Cengage Learning. 2009. Thompson JL, Manore MM, Vaughan LA. The science of nutrition. Illinois: Pearson Education, Inc. 2008.

Digestion, Absorption, Transport, and Excretion

Gropper SS, Smith JL, Groff JL. Advanced nutrition and human metabolism, 5th ed. California: Wadsworth Cengage Learning. 2009.

Digestion, Absorption, Transport, and Excretion

Stipanuk MH. Biochemical, physiological, and molecular aspects of human nutrition, 2nd ed. Missouri: Saunders Elsevier. 2006.

Digestion, Absorption, Transport, and Excretion

Most magnesium (50-55%) in the bloodstream is found free
33% bound to protein 13% complexed with citrate, phosphate, sulfate Plasma concentration: 1.6-2.2 mg/dL

Homeostatic mechanism of control is unclear

Digestion, Absorption, Transfer, and Excretion

Magnesium not retained in body excreted through the kidneys
65% reabsorbed in loop of Henle 20-30% reabsorbed in proximal tubule Only 5% of filter Mg excreted in urine

Changes in intake can affect urinary excretion PTH inhibits Mg excretion May also be excreted via feces and in sweat
Gropper SS, Smith JL, Groff JL. Advanced nutrition and human metabolism, 5th ed. California: Wadsworth Cengage Learning. 2009.

Digestion, Absorption, Transfer, and Excretion

Stipanuk MH. Biochemical, physiological, and molecular aspects of human nutrition, 2nd ed. Missouri: Saunders Elsevier. 2006.

Functions and Mechanisms of Action

Make up structure of bone
Regulation of bone and mineral status Influence formation of hydroxyapatite crystals

Essential in cellular metabolism

Bound to phospholipids as part of cell membrane Membrane stabilization

Normal muscle contraction and conduction of nerve impulses

Claudio VS, Dirige OV, Ruiz AJ. Basic nutrition for Filipinos, 5th ed. Manila: Merriam & Webster Bookstore, Inc. 2004. Thompson JL, Manore MM, Vaughan LA. The science of nutrition. Illinois: Pearson Education, Inc. 2008. Whitney E, Rolfes SR. Understanding nutrition, 10th ed. California: Thomson Learning, Inc. 2005.

Functions and Mechanisms of Action

Associated with nucleic acids and protein
Important for over 300 enzyme systems
Structural cofactor Allosteric activator

May be associated with ATP or ADP

Mg-ATP: hexokinase, phosphofructokinase Mg-ADP: phosphoglycerate kinase, pyruvate kinase

Forms complexes with phosphate groups to assist in transfer

Whitney E, Rolfes SR. Understanding nutrition, 10th ed. California: Thomson Learning, Inc. 2005.

Functions and Mechanisms of Action

Functions and Mechanisms of Action

Glycolysis TCA cycle: oxidative decarboxylation Creatine phosphate formation: creatine kinase -oxidation: initiation by acylCoA synthetase Nucleic acid synthesis Amino acid activation Protein synthesis Cardiac and smooth muscle contractability Vascular reactivity and coagulation Cyclic adenosine monophosphate (cAMP) formation Ion channel regulation Insulin and insulin action Second messenger systems

Gropper SS, Smith JL, Groff JL. Advanced nutrition and human metabolism, 5th ed. California: Wadsworth Cengage Learning. 2009. Stipanuk MH. Biochemical, physiological, and molecular aspects of human nutrition, 2nd ed. Missouri: Saunders Elsevier. 2006. Whitney E, Rolfes SR. Understanding nutrition, 10th ed. California: Thomson Learning, Inc. 2005.

Interactions with Other Nutrients

Calcium
Needed for PTH secretion
For calcium homeostasis High magnesium concentration inhibit PTH release

Ratio affects muscle contraction

Mg competes with Ca for non-specific binding sites on troponin C and myosin Ca initiates acetylcholine release

Gropper SS, Smith JL, Groff JL. Advanced nutrition and human metabolism, 5th ed. California: Wadsworth Cengage Learning. 2009.

Interactions with Other Nutrients

Influence blood coagulation
Antagonistic relationship Ca promotes, Mg inhibits

Overlapping transport systems in kidney

Compete for reabsorption Changes flux of Ca across cell membrane

Helps regulate blood pressure and normal functioning of the lungs Prevent dental caries (holds Ca in tooth enamel)
Gropper SS, Smith JL, Groff JL. Advanced nutrition and human metabolism, 5th ed. California: Wadsworth Cengage Learning. 2009. Whitney E, Rolfes SR. Understanding nutrition, 10th ed. California: Thomson Learning, Inc. 2005.

Interactions with Other Nutrients

Potassium
Influences fluid balance

Phosphorus
Mg inhibits absorption (precipitates as Mg3(PO4)2)

Vitamin D
Needs Mg for hydroxylation in liver 2 forms of Vitamin D enhance absorption of Mg
25-hydroxyvitamin D 1,25-dihydroxyvitamin D
Gropper SS, Smith JL, Groff JL. Advanced nutrition and human metabolism, 5th ed. California: Wadsworth Cengage Learning. 2009. Thompson JL, Manore MM, Vaughan LA. The science of nutrition. Illinois: Pearson Education, Inc. 2008..

Recommended Nutrient Intakes

Population Group Infants, mo Birth - <6 6 - < 12 6 9 36 54 Reference weight (kg) RNI (mg/day)

Children, y 13 46 79 13 19 24 65 76 100

Males, y 10 12 13 15 16 18 19+ 34 50 58 59 155 255 260 235

Females, y 10 12 13 15 16 18 19 + 35 49 50 51 160 220 240 205 205 220

Pregnant women Lactating women

Food and Nutrition Research Institute. Recommended energy and nutrient intakes: Philippines, 2002 edition. Bicutan: Department of Science and Technolgy. 2002.

Assessment of Nutriture
Serum magnesium concentration
17-22 mg/L (0.7-1.0 mmol/L) Less than 17 mg/L indicates some degree of magnesium depletion

Ion-specific electrodes can also be used to measure ionized Mg in plasma Further assessment: amount of Mg excreted in urine following intravenous injection
Gropper SS, Smith JL, Groff JL. Advanced nutrition and human metabolism, 5th ed. California: Wadsworth Cengage Learning. 2009. Stipanuk MH. Biochemical, physiological, and molecular aspects of human nutrition, 2nd ed. Missouri: Saunders Elsevier. 2006.

Deficiency
Hypomagnesemia or hypomagnesemic tetany Symptoms rarely appear except with disease:
Kidney disease Prolonged diarrhea Prolonged vomiting Intestinal malabsorption Chronic alcohol abuse Hyperparathyrodoism Diabetes milletus Toxemia of pregnancy Postsurgical complications

Claudio VS, Dirige OV, Ruiz AJ. Basic nutrition for Filipinos, 5th ed. Manila: Merriam & Webster Bookstore, Inc. 2004. Gropper SS, Smith JL, Groff JL. Advanced nutrition and human metabolism, 5th ed. California: Wadsworth Cengage Learning. 2009. Thompson JL, Manore MM, Vaughan LA. The science of nutrition. Illinois: Pearson Education, Inc. 2008. Whitney E, Rolfes SR. Understanding nutrition, 10th ed. California: Thomson Learning, Inc. 2005.

Deficiency
Symptoms
Muscle cramps, spasms, seizures Nausea Weakness Irritability and confusion Difficulty swallowing Hallucinations Personality changes

Can also lead to

Heart disease High blood pressure Osteoporosis Type 2 diabetes Hypertension Impaired central nervous system activity

Claudio VS, Dirige OV, Ruiz AJ. Basic nutrition for Filipinos, 5th ed. Manila: Merriam & Webster Bookstore, Inc. 2004. Gropper SS, Smith JL, Groff JL. Advanced nutrition and human metabolism, 5th ed. California: Wadsworth Cengage Learning. 2009. Thompson JL, Manore MM, Vaughan LA. The science of nutrition. Illinois: Pearson Education, Inc. 2008. Whitney E, Rolfes SR. Understanding nutrition, 10th ed. California: Thomson Learning, Inc. 2005.

Toxicity
Hypermagnesemia
Occurs in individuals with impaired kidney function Caused by consumption of non-dietary magnesium (e.g antacids) Side effects: impairment of nerves, muscle, heart

Thompson JL, Manore MM, Vaughan LA. The science of nutrition. Illinois: Pearson Education, Inc. 2008.

Toxicity
Mild cases
Hypotension Diarrhea Nausea Flushing Abdominal cramps Double vision Slurred speech Weakness

Severe cases
Depression Acid-base imbalances Massive dehydration Arrythmia ECG changes Decreased tendon reflexes Paralysis Cardiac arrest

Gropper SS, Smith JL, Groff JL. Advanced nutrition and human metabolism, 5th ed. California: Wadsworth Cengage Learning. 2009. Thompson JL, Manore MM, Vaughan LA. The science of nutrition. Illinois: Pearson Education, Inc. 2008.