Magnesium: A Key Player in Metabolic Health

Dawn (00:00):

Hello and welcome to the Gastric Health Show. My name is Dawn Boxell, Registered Dietitian, and this week’s topic is magnesium, a key player in metabolic health. And we are going to just really talk about the importance of this mineral that a lot of people do lack adequacy in. And you’ll quickly understand why that matters and why you should prioritize the magnesium rich foods. Although I’m not opposed to supplements when it comes to magnesium because sometimes it’s hard to be consistent with this mineral and it’s so important for so many different processes. So I’m not opposed to using a supplement, I just really encourage people to focus to food first if at all possible, and then add the supplement. And that will help give you the best well-rounded approach because remember, isolating any type of vitamin and mineral creates imbalances with other vitamins and minerals.

I use magnesium a lot for sleep

(01:22):

So now I will say with magnesium, this one is probably the least likely to create as many imbalances because there’s so many I processes that it is involved in. So out of all the minerals, I would say this one concerns me the least for you to take a supplement and there’s so much value in its benefits that sometimes it’s worth taking a supplement to ensure that number is hit or that you’re getting that benefit. For example, like with sleep, that one is, I use magnesium a lot for sleep. I also use magnesium if somebody’s constipated. I use different forms for each of those. So again, it depends on the person, depends on the need and depends on the product because sometimes I can use a blend that has the sleep property and the constipation property. So you’re only taking one supplement and benefiting yourself with less pills. Again, I think magnesium. I feel like with social media, a lot of people are aware of this, so you may not be surprised by the importance of it, but for those who’ve maybe never thought about magnesium being an issue for them,

What Is Magnesium?

(02:59):

I would definitely encourage you to listen up and just think through what do I normally do? And I can talk about some ways to evaluate with blood work and stuff as well. But magnesium is involved in hundreds of metabolic processes and it’s really just a co-factor for numerous enzymes and is really crucial for your brain and your body. It has a very important role for several areas of your health, and it truly can impact your mood, your blood sugar, your heart health. Can impact the way methylation occurs. It can impact bowel regularity. It touches so many body functions that it’s really one that you have to stay on top of. So what is magnesium? And magnesium is really the fourth most abundant mineral in the body after calcium, sodium, and potassium. So a lot of people think of sodium and potassium is just electrolytes, but really they are minerals.

Why do so many people make such a big deal about magnesium?

(04:15):

And all of these minerals are tightly regulated in the blood. And magnesium is also the second most intracellular mineral after potassium. So this is one that you want it to be inside the cell and not outside of the cell. So your bones is really about where most of the magnesium is stored. And the rest you will find in your blood tissues and cofactors. So you can kind of see how easy it would be because that’s a bunch of areas that magnesium would be necessary for. But why is it so important? Why do so many people make such a big deal about magnesium? Everybody’s magnesium deficient and although I don’t necessarily disagree, I don’t a hundred percent agree, I don’t think that all of us are. And I think that is something that you can’t just say that everybody is. I do check my magnesium at my doctor’s office and my latest one is great, it’s right where it should be.

Importance of Magnesium

(05:34):

It does help give you information when you do a blood test. The most accurate blood test is an RBC or red blood cell magnesium. That’s the most accurate one. And ideally it’s in the 6 range, like 6 to 6.1 is more ideal. So when you are asking for a magnesium to be drawn, I would just make sure you’re asking for an RBC magnesium so that you get the most accurate level evaluated. But let’s dig into, I have seven different I areas of why magnesium is so important. And number one is the human body needs magnesium for many physiological functions. Number two is there’s more than 300 enzymatic reactions that require magnesium as a co-factor or an activator. So if these enzymes that are necessary and you are lacking magnesium, then that enzyme is not going to be activated. You don’t have that. So hopefully that makes sense. But number three, it maintains your normal nerve and muscle functions. Number four, it supports a healthy immune system, so it’s even involved in your immunity. Number five, it’s necessary for strong bones. NO. six, and you can think of magnesium for strong bones is it’s part of the package. You don’t need just calcium.

A helper molecule in biochemical reactions 

(07:15):

It can’t get through and to the bones without each other. So you need all of these. Even potassium is necessary for the process of building strong bones and even additional vitamins and micro minerals and things like boron and vitamin C, they play a role in your body’s ability to get calcium into the bone so that it is strong and you don’t have bone softening or that leads to osteoporosis. So it’s a blend of things. It’s not one mineral is doing the whole job. It’s a combination of minerals working together, and magnesium plays a big role in that bone health. And again, it gives you, again, more of a visual to think about when it’s being utilized in so many different areas of your body. Number six, it regulates your blood sugar levels. And number seven, it plays a role in protein fat and carbohydrate metabolism.

What are the health benefits?

(08:24):

So again, making sure that magnesium intake is there and making sure that you’re hitting a good amount and absorbing it well. So what are the health benefits? Yeah, so now we see it’s involved in so many different areas of the body and can impact a plethora of symptoms that could occur, could be caused by a magnesium deficiency. What are the health benefits of magnesium? One, it’s a helper molecule in many biochemical reactions. So in your body it participates in over 600 reactions. So think of I say this many times, our body is like a chemistry experiment going on 24/7-365. There are so many chemical reactions occurring every second of the day that it’s really hard to keep up. So again, if you follow a standard American diet where you really don’t eat many home cooked meals, you dine out for most of your meals or you’re buying a meal in a bag or a box or a container that may not have a whole lot of nutrient dense nutrition, so it might be lacking in a lot of good quality nutrients, that’s when problems arise for one. That’s again one example. If you’re following a standard American diet, then you are interfering with these 600 chemical reactions that are occurring naturally.

Methylation process

(10:15):

So it’s this helper molecule and it is even involved in the methylation process. So those methylation, if you remember, methylation is the process that turns genes on and off and you kind of think about when it comes to genetics. Your genes load the gun, methylation turns off the safety, and then your epigenetics or your diet and your lifestyle pull the trigger. So again, it’s part of that piece because magnesium is involved in that methylation process. It is a co-factor in the methylation process. So magnesium creates energy from food, it creates new proteins from amino acids. If you’ve had bariatric surgery, you are on top of your protein or you understand the importance, and this is this reaction that occurs. So when your body takes a chicken breast that you chew up and you eat and your body has to digest that into a liquid form.

A gastric sleeve compared to a runaway gastric bypass

(11:22):

So that is what’s happening when you eat food, you’re chewing it up, it gets to your stomach, the acids, the enzymes, the pepin, the hydrochloric acid, everything that your body needs to digest food has begun to arrive in your stomach and in your intestines, and that’s where the magic kind of occurs to break the food down. Now with a bariatric surgery, you have a pouch and sometimes the food is not liquified, especially in a ruined white gastric bypass. You are not going to have a hundred percent of the time liquified food like you would with a sleeve. So the potential for having liquified food like you’re supposed to before it goes into the intestines is more common if you have a sleeve, a gastric sleeve compared to a runaway gastric bypass because you don’t have that sphincter of the bottom of your stomach with a gastric bypass, you just have a hole.

Small intestinal bacterial overgrowth is so common with a gastric bypass

(12:29):

You just have an outlet that goes directly from your esophagus, the flap, the lower esophageal sphincter or the l e s is at the bottom of your esophagus and the top of your pouch. And then at the bottom of your pouch of a gastric bypass, there is no sphincter. You don’t have that flap that’s slowly releasing food into your intestines. It is just a hole that you get a constant drip or release of food into your small intestines when you’re eating it. So the opportunity for it to be in the right form, a liquid form where it’s already broken down and ready to be broken apart into little molecules even further, that is not as likely with a gastric bypass. So that’s why I would say small intestinal bacterial overgrowth is so common with a gastric bypass because you have whole foods that get into your small intestines and then have the opportunity to ferment and start creating the wrong environment for health in the right environment for disease and a lot of imbalances.

The digestive process

(13:56):

And it allows those gases, those methane and those hydrogen gases to develop and that bacteria level to rise because they’re fermenting off of whole foods instead of broken down foods. So that was a big long explanation, but I hope that helps you understand digesting and why all of this stuff matters when it comes to your overall health. If you want to get to the form of amino acids where you take a chicken breast and you break it down into amino acids, that should have begun in your stomach and then continues into your small intestines, and then the small intestines is where the magic occurs for the absorption. So you have these hair-like villi that line both sides of your intestines. You have that mucus layer and these amino acids that should be broken down as those protein molecules get broken apart from the digestive process, from the acids, the pepin, the proteases, lipases, all of those pancreatic enzymes and bile and everything that does its job to break that piece of meat down.

Magnesium Deficiency

(15:23):

Then it gets broken further into amino acids. And those amino acids then can filter through those villi and get absorbed and the right types get into the bloodstream and get circulated throughout your body. So then you have energy to do the things you want to do. Okay, so going back to the magnesium. And so it also is a cellular creation and repair. So it plays a role in repairing damaged cells, in making new cells. It facilitates the contraction and relaxation of muscles. So if I have somebody that’s having a lot of Charlie horses or leg cramps, you can think potassium, you can think magnesium, but really magnesium is a great way to support those cramps, and that is a sign that your body isn’t getting enough, and maybe it’s just what’s in the blood. Maybe you’ve been working out or maybe you were outside in this awful heat.

The blood for electrolytes

(16:33):

With the heat index being so high and humid, it’s making it easy to sweat when you just walk outside and do nothing. So if you’re losing a lot of electrolytes, magnesium is one of those minerals that is tightly regulated in the blood for electrolytes. So again, that can play a role in those muscle cramps. It supports neurotransmitters which transmit messages throughout the brain and the nervous system. So this is when your nervous system is dysregulated, and it could be because of the lack of magnesium in your diet. Studies report 50% of the population don’t get enough magnesium in their diet. So now let’s talk about supporting healthy blood sugar levels. So two studies showed that magnesium supplements enhance insulin sensitivity, and then another study reported 48% of those with type two diabetes are deficient in magnesium. We know that when it comes to blood sugar balance and insulin sensitivity, having adequate magnesium is important.

How is it beneficial to heart health?

(17:55):

Now, how is it beneficial to heart health? A 2021 study found that magnesium can lower your blood pressure, which is correlated with having a healthy heart when you have a normal blood pressure. Now remember, your kidneys kind of regulate your blood pressure, so it’s a package deal. So you’ve got to make sure you have good functioning kidneys to help support a healthy heart anti-inflammatory properties. Meta-analysis of 11 studies found that magnesium supplementation lowered the CRP or your C-reactive protein, which is a inflammatory response lab that you can have drawn at any local doctor as well as the interleukin six(IL-6) and other markers of inflammation. But this kind of helps you understand. So say for example, say you had your CRP drawn and you had your magnesium, the RBC magnesium drawn, and that would give you a good information. So if your CRP is greater than one, so you want it less than one, and if it’s greater than one and your RBC magnesium is less than six, then adding more magnesium rich food and or probably a magnesium supplement would be ideal in a great way to help lower that inflammation.

Magnesium Deficiency

(19:24):

So how much magnesium is typically recommended? So the United States RDA for females it’s 320 milligrams, and for males it’s 420 milligrams. The European Food Safety Authority or the EFSA, the females are 300 milligrams and the males are 350 milligrams. But insufficient magnesium intake is estimated in nearly 56 to 68 of Americans in their diet to meet the RDA. So most people do not even hit these 320 and 420 US RDA guidelines. Again, something so simple, so a mineral, a simple mineral that could impact several areas of your health to me seems like an easy way to really support you without really having to do a whole heck of a lot. So let’s talk about the factors associated with magnesium loss. You also have to think about that. So it’s not about just getting enough magnesium in your diet, it’s also about not losing too, and there are a variety of causes that lead to a magnesium deficiency or what would cause someone to have a magnesium deficiency.

Alcohol abuse: 

(21:01):

One is chronic alcohol abuse, and alcohol is a diuretic which increases the amount of magnesium excreted in the urine. Anytime you are consistently drinking alcohol, then you just realize that you are also losing magnesium as well, older adults. So as we age, magnesium absorption decreases, and this is true with a lot of nutrition, a lot of vitamins and minerals and proteins, and they change our ability to absorb shifts if you don’t support it. And this is where I really like to use digestive enzymes because it really can help enhance the absorption, which is why I would say out of the products that we offer our gastric health line of supplements, probably my product, I’m most proud of that I truly invested a ton of research into the formula and what I really wanted in it for bariatric patients, because I feel like there’s so many areas that could be lacking when it comes to digestion after a gastric bypass or even a sleeve gastrectomy.

Gut health conditions

(22:27):

I would say I’m most proud of the WLS formulated digestive enzymes. That one is my favorite product, but our Ultimate Gut Restore probiotic is probably our most purchased product, not probably it is. So if you have low magnesium levels and you have digestive issues, you have some bloating, you have some gas, you have maybe a combination of constipation or diarrhea or you find that it’s hard to eat some of those solid dense proteins, I would strongly encourage you to try a bottle of our WLS formulated digestive enzymes because I’m telling you, you can tell within the first few days of just taking it because you will notice when you take the right dose because you only have to take one per meal and you take it at the beginning of the meal a few minutes before a meal, you can take it during the meal and you can take it after the meal.

Symptoms and signs of magnesium deficiency

(23:35):

So there’s no wrong answer there. Think of it as you’re supporting all of the organs that are involved in digestion. So there’s no wrong answer to this, but it’s finding the right dose that your body needs based on the symptoms that you are experiencing. If you have questions, if you’re like, I’m curious to try this, but you have questions, just hit contact us and I’d be happy to answer any questions so that you have the full information that you need on these digestive enzymes and if it’s really a good match for you. So again, it’s about how well you absorb and as we age, our ability to absorb nutrients changes and it lowers. Taking digestive enzymes as you get older is actually a great thing and a great way to support healthy body gut health conditions. So this is where you have to think about where your absorption area is.

Absorb nutrition is in your gut

(24:43):

This is where you absorb nutrition is in your gut. So your small intestines is the hard worker, and the only thing that you really absorb in your stomach is alcohol and aspirin. So other than that, the rest is done in your small intestines. You have a small area right before you get to the colon called the ileum, and this is an area where it can really make up for maybe some insufficient absorption earlier in the small intestines. So as you travel through the digestive tract, once you get to the ilium, it’s kind of like this area where it can uptake nutrients. It’s just not going to uptake everything. So if you miss some absorption sites earlier up the intestines, then the ileum area is where you can make that up. It’s just we don’t control that. There’s no way to really control. Again, it’s about having the right environment for absorption, and that’s why I feel like digestive enzymes are super helpful, but then also having a healthy gut, having the right type of gut bacteria and not having gut dysbiosis really does help.

You have low magnesium

(26:06):

So those with celiac disease, so if you have celiac disease and have had a gastric sleeve or gastric bypass, you do have lower magnesium secondary to the loss of the brush border proteins, which really regulate the transport of nutrients into the bloodstream from the digest digestive tract. So that doesn’t mean that just having it means you have low magnesium. You want to test get that RBC magnesium blood test done to know for sure and evaluate the need for it because if you have been gluten free, wheat free for a long time and those and villi and those brush border proteins are super healthy, all of that is functioning correctly, then you may not need it because you can heal all of that after a celiac diagnosis. All of that stuff can get healthier and improve.

Malabsorptive procedure

(27:18):

So other gut conditions are those with malabsorptive issues like inflammatory bowel disease, gastric bypass. You already have malabsorption. So gastric bypass is a malabsorptive procedure. We are bypassing the absorption site of nutrients, certain nutrients you skip right by them. So your saving grace is your ileum, is your catchall, is where you catch up in absorbing some of those nutrients. It’s just, again, like I said, you can’t control it and you don’t get to pick if you’re lacking an iron that doesn’t guarantee that just because you’re lacking an iron means that your body’s going to absorb the iron that got missed earlier up because we bypass that area. It just, you don’t have the control. You want to create that environment, get a healthy gut, have healthy digestion so that you can maximize and optimize that ability to absorb.

Influence motility and gut barrier integrity

(28:24):

It can also influence motility and gut barrier integrity. So all of those are super important to your overall gut health. Type two diabetes, high blood sugar can increase urination, which that’s usually one of the first signs that people will experience when their blood sugar is elevated. They’re going to the bathroom a lot more frequently again, which leads to more magnesium losses because you’re frequently urinating and also metformin, which is used for insulin resistance and type two diabetes. But metformin has been associated with increased magnesium losses. So if you do take metformin, it also depletes B 12 absorption. So again, I’m not against metformin, I’m not against using berberine in its place because it pretty much acts the same. I think you got to do what works best for you, but you need to be aware of this. So if it decreases B 12 absorption and decreases magnesium absorption, that’s going to matter.

Stress increases cortisol

(29:40):

So that means need to pay attention to those types of foods or be on some type of supplement to replace it. Intense exercise. So sweating increases magnesium losses and increases the metabolic demand or that demand for more magnesium is there because you’re working out and you’re using your muscles stress. Unfortunately, stress is always involved in something in a negative way a lot of times. But stress increases cortisol, which can lead to an increase in the excretion of magnesium. So even somebody doing some caffeinated beverages can increase your cortisol level, which again leads to more urinary excretion. Sleep deprivation, a lack of sleep can disrupt magnesium homeostasis. Then we got to talk about medications. So not only the metformin, but there are also PPIs and antacids. They also block the absorption diuretics, prednisone, and certain antibiotics all interfere with magnesium absorption. Oh, and then lastly, insulin.

So what are the signs and symptoms of magnesium deficiency?

(30:52):

That also if you’re taking actual insulin for diabetes, that can lower the absorption of magnesium. So what are the signs and symptoms of magnesium deficiency? Now, I’m going to preface this with saying probably all of us could say we’ve experienced these symptoms and you could easily say, maybe I’m low in magnesium, but pair this information with some lab data, pair this with a conversation with your health professional to really vet it out. But I’m going to tell you there’s really not a lot of harm in really pushing those magnesium rich foods, which I’ll get to in a minute. But even adding a magnesium supplement, for me personally, I use different formulas or different types of magnesium for different things. So I’m not really going to get into the details of which form for what. But in general, work with a practitioner that can get you the right type of magnesium so that you can make sure you’re taking the right type of supplement.

The early signs

(32:05):

The early signs are fatigue, nausea, weakness, vomiting, and loss of appetite. Moderate is tingling, seizures, numbness, abnormal heart rhythms, personality changes, cramping and contractions of the muscles. And severe is you’re going to also have low blood potassium and low sodium. So both of those are in addition going to be. So your electrolytes are going to be off balance for sure with severe, and I have had patients, so somebody that has excessive chronic diarrhea, they are having 30 plus bowel movements a day. Magnesium definitely could cause magnesium deficiency would not be out of the picture. So adding some type of magnesium to help support that stabilization of all of your electrolytes is helpful. So making sure that you are taking some type of magnesium. If you are having lots of diarrhea in the course of a day or chronically, this is a problem. You’re having several bowel movements that depletes that magnesium level.

So what about magnesium and health conditions?

(33:26):

So what about magnesium and health conditions? Magnesium has connections in Alzheimer’s, insulin resistance, asthma, A D H D, hypertension, migraines, and osteoporosis. So I’ve already mentioned some of the others, but I wanted to make sure I covered the whole gamut of all of the health conditions. So we don’t miss that magnesium and electrolyte balance. When magnesium levels dip, that delicate, tightly regulated blood level of electrolytes can be disrupted. So this can lead to irregular heartbeats, muscle cramps, and other complications. If you’re noticing that maybe I have heart palpitations or my heart is racing at times it seemed odd, or you’re starting to get Charlie horses or cramps, you really got to think about your magnesium and the balance of that electrolytes. So your sodium, potassium, magnesium, calcium, all of those work together in your blood. And even like, so calcium, I’m just going to throw this in there because we’ve had this before with bariatric patients, they have where their hands kind of just start curving in and tightening up, and that is a sign of even a depleted calcium level.

Calcium and magnesium work together

(34:52):

But calcium and magnesium work together. So it’s the whole package, probably the sodium, the potassium, the calcium, the magnesium, they’re probably all off to some degree that’s creating that muscle to cramp and curve in and their hands or feet, either one of those, which is really you’re exceeding into the extreme, which is really getting into some disease states that is created. So osteoporosis and magnesium. Meta-analysis showed that high magnesium intake increased bone mineral density in the hip and femur, both of which are susceptible fractures. Those are places that are, I don’t want to say common for fractures, but if people get fractures as we age, when osteoporosis is kind of a problem, then having adequate magnesium intake is a great way to protect yourself. So just making sure that you stay on top of that is good. Let’s talk about magnesium rich foods.

Magnesium rich foods

(36:06):

So almonds, a handful of almonds gives you about 80 milligrams of magnesium. So remember, if you think through where we talked about the U S RDA is 320 milligrams for females and 420 for males is what you’re trying to accomplish because we don’t even hit that consistently. Most humans, they are saying in the US do not hit that more than half of us. So almonds, a handful of almonds is about 80 milligrams of potassium. Bananas. A banana has about 32 milligrams of magnesium. Brazil nuts, I think it’s like eight Brazil nuts have 64 milligrams along with some selenium, which is great for your thyroid. Next brown rice, brown rice offers 86 milligrams of magnesium. So instead of using just your standard white rice, choose the brown rice so that you get some benefit of the magnesium. Cashew nuts. Cashews provide, I think it’s one ounce, provides 74 milligrams of magnesium mackerel.

Sources of Magnesium

(37:23):

So this one I know a lot of people probably aren’t going to be a fan of, but macro are the canned fish, kind of like sardines, but you can get ’em skinless where you don’t have to have it with the skin, although that’s very beneficial for your health. But the fatty fish offers not only omega fatty acids, but also about 97 milligrams of magnesium. And if you get them where it has the skin and it hasn’t been altered in a big way, then you’re also going to get a good amount of calcium as well. Garbanzo beans is the next one, and chickpeas are rich in magnesium offering about 78 milligrams per cup. And then lima beans is another one, and they have about 81 milligrams per cup. And then oat brand cereal gives you about 96 per cup. Then spinach. Spinach has about 157 milligrams of magnesium per cup.

Magnesium plays a key role in several metabolic processes

(38:28):

So you could think through, okay, how can I get more of these foods in my diet? You could easily even using almond butter or a cashew butter on a banana or having brown rice with some sauteed veggies, with some mackerel on the side or making a chickpea hummus. And then even just doing a spinach salad or adding spinach to a smoothie or adding it in with your eggs. Finding ways to sneak all of this stuff in is how you’re going to optimize your magnesium intake. So let’s wrap this up. Magnesium’s role in metabolic health extends far beyond its reputation as really just supporting bone health. It’s involved in energy production, insulin sensitivity, protein synthesis, stress modulation, and magnesium plays a key role in several metabolic processes. So making sure you have a diet that is rich in magnesium foods as well as adding a supplement if you need to, can really help support a healthy metabolism and keeping your body functioning well.

Conclusion

(39:50):

So hopefully you’ll have a new favorite mineral that you can prioritize and really start incorporating some of these foods that can support you in many ways. Again, I say this, I know frequently, but by doing food first, you’re getting that blend of nutrients. So it’s not that you’re just getting magnesium when you’re having a food, you’re getting vitamin A, vitamin C, magnesium, calcium, potassium. You’re getting a whole mix of all of that. So the best way to approach it is optimize the food piece. And then maybe if you don’t have good enough absorption of magnesium or your gut health really isn’t that healthy and you’ve got to do some work on it, maybe add a supplement, a magnesium supplement too so that you keep that at optimal levels. But again, I would highly encourage you to get your RBC magnesium tested before you add a crazy ton amount of supplements to really understand that first is honestly ideal. If you have enough of the symptoms, I don’t think there’s really any harm with taking magnesium supplements. But again, you don’t. Not all magnesium supplements over the counter are equal and the type of magnesium matters for optimal absorption. So that’s where I’d reach out to your

(41:33):

Practitioner. I’d love to work with you if you need support in that area and be happy to help you with that. So I hope this has helped you kind of get a new perspective of magnesium and maybe prioritize it a little more than maybe you have in the past. So it will give you the ability to hit your health goals faster. You guys have a great week and we will see you next time. Bye-bye.

Listen, Learn, Enjoy…

1. Razzaque, M. S. (2018). Magnesium: Are We Consuming Enough? Nutrients, 10(12). https://doi.org/10.3390/nu10121863

2. Veronese, N., Dominguez, L. J., Pizzol, D., Demurtas, J., Smith, L., & Barbagallo, M. (2021). Oral magnesium supplementation for treating glucose metabolism parameters in people with or at risk of diabetes: a systematic review and meta-analysis of double-blind randomized controlled trials. Nutrients, 13(11), 4074.

3. Hruby, A., Guasch-Ferré, M., Bhupathiraju, S. N., Manson, J. E., Willett, W. C., McKeown, N. M., & Hu, F. B. (2017). Magnesium Intake, Quality of Carbohydrates, and Risk of Type 2 Diabetes: Results From Three U.S. Cohorts. Diabetes Care, 40(12), 1695-1702. https://doi.org/10.2337/dc17-1143

4. Zhao, B., Deng, H., Li, B., Chen, L., Zou, F., Hu, L., … & Zhang, W. (2020). Association of magnesium consumption with type 2 diabetes and glucose metabolism: A systematic review and pooled study with trial sequential analysis. Diabetes/metabolism research and reviews, 36(3), e3243.

5. Kostov, K. (2019). Effects of Magnesium Deficiency on Mechanisms of Insulin Resistance in Type 2 Diabetes: Focusing on the Processes of Insulin Secretion and Signaling. International Journal of Molecular Sciences, 20(6). https://doi.org/10.3390/ijms20061351

6. Rosanoff, A., Costello, R. B., & Johnson, G. H. (2020). Effectively Prescribing Oral Magnesium Therapy for Hypertension: A Categorized Systematic Review of 49 Clinical Trials. Nutrients, 13(1). https://doi.org/10.3390/nu13010195

7. Nielsen, F. H. (2018). Magnesium deficiency and increased inflammation: Current perspectives. Journal of Inflammation Research, 11, 25-34. https://doi.org/10.2147/JIR.S136742

8. Furman, D., Campisi, J., Verdin, E., Carrera-Bastos, P., Targ, S., Franceschi, C., Ferrucci, L., Gilroy, D. W., Fasano, A., Miller, G. W., Miller, A. H., Mantovani, A., Weyand, C. M., Barzilai, N., Goronzy, J. J., Rando, T. A., Effros, R. B., Lucia, A., Kleinstreuer, N., . . . Slavich, G. M. (2019). Chronic inflammation in the etiology of disease across the life span. Nature Medicine, 25(12), 1822. https://doi.org/10.1038/s41591-019-0675-0

9. Pelczyńska, M., Moszak, M., & Bogdański, P. (2021). The Role of Magnesium in the Pathogenesis of Metabolic Disorders. Nutrients, 14(9), 1714. https://doi.org/10.3390/nu14091714

10. Caruso, R., Pallone, F., Stasi, E., Romeo, S., & Monteleone, G. (2013). Appropriate nutrient supplementation in celiac disease. Annals of medicine, 45(8), 522-531.

11. Barbagallo, M., Veronese, N., & Dominguez, L. J. (2021). Magnesium in aging, health and diseases. Nutrients, 13(2), 463.

12. Rondanelli, M., Faliva, M. A., Tartara, A., Gasparri, C., Perna, S., Infantino, V., Riva, A., Petrangolini, G., & Peroni, G. (2021). An update on magnesium and bone health. Biometals, 34(4), 715-736. https://doi.org/10.1007/s10534-021-00305-0

13. Groenendijk, I., Van Delft, M., Versloot, P., Van Loon, L. J., & De Groot, L. C. (2021). Impact of magnesium on bone health in older adults: A systematic review and meta-analysis. Bone, 154, 116233. https://doi.org/10.1016/j.bone.2021.116233

14. Weyh, C., Krüger, K., Peeling, P., & Castell, L. (2022). The role of minerals in the optimal functioning of the immune system. Nutrients, 14(3), 644.

15. Farag, M. A., Abib, B., Qin, Z., Ze, X., & Ali, S. E. (2023). Dietary macrominerals: Updated review of their role and orchestration in human nutrition throughout the life cycle with sex differences. Current Research in Food Science, 100450.

16. Chen, Y., Michalak, M., & Agellon, L. B. (2018). Focus: Nutrition and food science: Importance of nutrients and nutrient metabolism on human health. The Yale journal of biology and medicine, 91(2), 95.

17. Pickering, G., Mazur, A., Trousselard, M., Bienkowski, P., Yaltsewa, N., Amessou, M., … & Pouteau, E. (2020). Magnesium status and stress: The vicious circle concept revisited. Nutrients, 12(12), 3672.

18. Piuri, G., Zocchi, M., Della Porta, M., Ficara, V., Manoni, M., Zuccotti, G. V., … & Cazzola, R. (2021). Magnesium in obesity, metabolic syndrome, and type 2 diabetes. Nutrients, 13(2), 320.

19. Fiorentini, D., Cappadone, C., Farruggia, G., & Prata, C. (2021). Magnesium: biochemistry, nutrition, detection, and social impact of diseases linked to its deficiency. Nutrients, 13(4), 1136.