Is your water killing you?
TRACK YOUR PLAQUE
Much of your daily magnesium should come from drinking water, but tap and bottled water often contain little or none! Don't let this deplorable deficiency jeopardize your plaque-control program.
Humans evolved in a world where drinking water flowed from natural streams, rivers, and lakes rich in mineral content. Our bodies adapted to obtaining minerals, especially magnesium, from natural water sources.
In the modern industrial world, municipal and home water treatment converts "hard" into "soft" water and most magnesium is removed. It is not uncommon to have nearly zero quantities of magnesium in city water supplies. American municipal water is a mosaic of quality ranging from excellent to virtually undrinkable. Just sample the water on a state-to-state drive and you'll immediately be struck with the variation in taste.
It's no wonder that many people have turned to bottled water in frustration, not to mention convenience. But bottled water has only served to worsen the situation. The great majority of brands sold in the U.S. contain little or no magnesium. If you rely exclusively on bottled water, you are likely obtaining no magnesium from your water.
Several studies have also demonstrated that magnesium intake is dropping precipitously because Americans indulge in magnesium-depleted processed foods. Soft drinks are manufactured using de-ionized water and are essentially devoid of magnesium. Carbonated beverages, like soda, contain phosphates that bind magnesium in the intestinal tract, making it unavailable for absorption.
As a result, the average American ingests substantially less than the Recommended Daily Allowance (RDA) of 420 mg per day for men, 320 mg/day for women. Daily deficiencies of 30% or more each and every day are frighteningly common. In the cities with the greatest magnesium water content, only 30% of the RDA can be obtained by drinking two liters of tap water per day. More commonly, only 10–20% can be obtained.
Low magnesium—a worldwide health issue
Measurable increases in the numbers of sudden death victims have been reported in municipalities with the lowest water magnesium levels. These observations have caught the attention of national and international public health officials. A recent World Health Organization (WHO) report on the quality of drinking water cited 80 studies that have examined the relationship between cardiovascular death and water hardness (measured principally by magnesium and calcium content). The WHO concluded that magnesium content of water is indeed a cardiovascular risk and should become a priority for water supplementation.
"…results from the early epidemiologic studies suggest that sudden death rates in soft water areas are at least 10% greater than sudden death rates in hard water areas. If Mg supplementation causes even a modest decrease in sudden death rates a substantial number of lives might be saved."
Mark J. Eisenberg, MD, MPH
McGill University
Magnesium—crucial nutrient for health
Magnesium is a crucial nutrient required for the proper functioning of approximately 300 enzymes in the human body. Functions as diverse as blood pressure regulation, muscle contraction, heart rhythm stabilization, and nervous system communication are all magnesium-dependent processes. Humans cannot survive without magnesium in the food or water supply.
Magnesium blood levels are routinely monitored in hospitalized patients, particularly if diuretics (e.g., furosemide, hydrochlorothiazide) are administered. It is an everyday fact of life in hospitals that when blood levels of magnesium are low, abnormal heart rhythms can suddenly develop. Dangerous ventricular rhythms (ventricular tachycardia and Torsade de Pointes) can result. People suffering from congestive heart failure are especially susceptible to these rhythms when magnesium levels are low. People prone to a common rhythm, atrial fibrillation, can suffer recurrences due to low magnesium levels. In the hospital, magnesium is easily replaced through intravenous supplementation.
Blood magnesium levels are, however, poor reflections of true body (intracellular) magnesium. If blood magnesium is low, you do indeed have low—very low— cellular magnesium levels. But if your blood magnesium is normal, you may still have low cellular or tissue levels of magnesium. The most striking reduction in tissue magnesium is found in heart muscle (myocardium). Unfortunately, determination of tissue magnesium levels is not easy to obtain in living, breathing humans. In one study, only 7.7% of coronary patients were low in blood measures of magnesium, while tissue levels were reduced in an astounding 53%. (Some cardiologists will therefore administer intravenous magnesium to patients with rhythm disorders, even when blood magnesium is in the normal range.) In effect, a blood magnesium test only helps if it's low. Normal levels don't necessarily mean anything.
Then how do you know whether your tissue magnesium level is low? Several signs can tip you off:
* Cardiac arrhythmias—Having any sort of heart rhythm disorder should cause your doctor to question whether magnesium levels in your body are adequate, since low magnesium levels can trigger abnormal heart rhythms. (While you can't rely on magnesium alone to treat abnormal rhythms, magnesium can be a useful preventive strategy to help avoid developing them in the first place.)
* Low potassium—Potassium is another electrolyte commonly depleted by diuretic use and is commonly deficient in many diseases (e.g., excessive alcohol use, some forms of hypertension, losses from malabsorption or diarrhea). Like magnesium, potassium may not be fully replenished by diet. Low magnesium commonly accompanies low potassium.
* Muscle cramps—Especially leg cramps that occur at night. (Leg cramps that occur with physical activity, such as walking, are usually due to atherosclerotic blockages in the leg or abdominal arteries, not low magnesium.)
* Anxiety, weakness—Notoriously non-specific symptoms like anxiety and weakness occasionally respond to magnesium supplementation.
* Metabolic syndrome—Yes, the ubiquitous metabolic syndrome (low HDL, high triglycerides, small LDL, high blood pressure, excessive abdominal fat, etc.) is clearly associated with low magnesium levels. Lack of intracellular magnesium impairs insulin responsiveness.
Being free of any of these tell-tale signs also does not mean that your tissue level of magnesium is okay. Then how do you really know? You don't. In all practicality, we recommend that you supplement magnesium intake to ensure healthy levels. To our knowledge, there is no other way to be certain that magnesium is not a factor in your cardiac health.
Magnesium-like getting an oil change for your car
We view magnesium as a lot like changing the oil in your car: If you maintain your car with periodic oil changes, you're more likely to have a smoothly running car for many thousands of miles, even though this simple practice by itself does not ensure that your car will perform its best. In other words, changing the oil in your car—or maintaining healthy magnesium levels in your body—is simply a basic requirement to permit proper operation.
Beyond basic functions, what else can you expect by supplementing magnesium to healthy levels? Research over the past 20 years suggests that magnesium supplementation will accomplish several goals:
* Magnesium improves insulin sensitivity—and thereby helping correct the fundamental defect in pre-diabetes and metabolic syndrome. An intracellular enzyme called tyrosine kinase requires magnesium to allow insulin to exerts its effects. This enzyme's function is impaired when magnesium levels are low. Magnesium will not be sufficient to correct metabolic syndrome all by itself, but it can be a useful adjunct when combined with weight loss, exercise, niacin and other strategies. In several studies, daily oral magnesium supplementation substantially improved insulin sensitivity by 10% and reduced blood sugar by 37%.
* Magnesium helps correct abnormal lipoprotein patterns—Improved sensitivity to insulin reduces triglycerides. A reduction in triglyceride availability thereby reduces VLDL and small LDL (triglyceride-rich particles).
* Magnesium lowers blood pressure—a modest effect of only 2–4 mm but nonetheless helpful along with all of magnesium's other benefits.
Does magnesium have any direct effects on plaque growth? The jury is out on this question. Some very provocative observations have been made in experimental models, such as rabbits, demonstrating impressive reductions in plaque area when magnesium is administered. However, there are not yet any human observations that substantiate these preliminary findings.
Can you correct metabolic syndrome, insulin resistance, and high blood pressure without replacing magnesium? Of course you can, just like you can operate your car without changing the oil. But it will catch up with you. You're simply better off correcting this basic supplement to allow you to achieve your goals more easily.
Supplementing magnesium is easy!
Because low magnesium tissue levels are virtually endemic in the U.S., magnesium supplementation should be taken by nearly everyone in the Track Your Plaque program. (People with kidney disease should not take magnesium supplements without consulting their physician.) Magnesium supplements are inexpensive and safe, the only side-effect being diarrhea, which generally occurs with single doses exceed 250 mg. (For this reason, many over-the-counter laxatives contain magnesium. But don't take these regularly!)
Several different forms of magnesium are available that vary in magnesium content. Magnesium oxide is a common form that is inexpensive and widely available. Because magnesium comprises approximately 60% of magnesium oxide tablets, they are somewhat more prone to cause loose stools. Other less concentrated forms include magnesium gluconate, magnesium chloride, magnesium lactate, and magnesium citrate.
A confident dose for supplementation is 500 mg per day of "elemental" magnesium. This is the quantity of magnesium regardless of the form you take (e.g., magnesium citrate, magnesium lactate, magnesium oxide, etc.) The quantity of elemental magnesium should be listed on the bottle. Doses are best taken distributed throughout the day in order to avoid diarrhea. (As with any supplement, it is wise to not overdo magnesium supplementation.)
Foods rich in magnesium
You can also supplement magnesium intake by choosing foods rich in magnesium. These are listed in the table.
Magnesium content (mg)
Almonds (1 oz; 24 nuts) 78
Artichokes (1 cup) 101
Barley (1 cup, raw) 158
Beans, black (1 cup, cooked) 120
Beans, lima (1 cup, cooked) 101
Brazil nuts (1 oz; 6-8 nuts) 107
Halibut (1/2 filet) 170
Filberts, Hazelnuts (1 oz) 46
Oat bran (1 cup, raw) 221
Oatmeal (1 cup, cooked) 56
Pumpkin seeds (1 oz; 142 seeds) 151
Rice, brown (1 cup, cooked) 84
Soybeans (1 cup, cooked) 148
Spinach (1 cup cooked) 163
Trail mix (1 cup) 235
Walnuts (1 oz; 14 halves) 45
Wheat flour, whole grain (1 cup) 166
Source: USDA National Nutrient database for Standard Reference, Release 17
Nuts, pumpkin seeds, spinach, and oat bran are particularly plentiful and healthy sources of magnesium. |
