Perspective: The Case for an Evidence-Based Reference Interval for Serum Magnesium: The Time Has Come

Area of Science:

• Nutritional Science
• Clinical Biochemistry
• Public Health

Background:

• Magnesium is identified as a shortfall nutrient, with approximately 50% of Americans consuming less than the Estimated Average Requirement (EAR).
• Magnesium deficiency is linked to numerous chronic conditions, including cardiovascular diseases, metabolic syndrome, diabetes, and osteoporosis.
• Current serum magnesium reference intervals may not accurately reflect optimal health or subclinical deficiency.

Purpose of the Study:

• To review scientific evidence on the role of magnesium deficiency in chronic diseases.
• To advocate for a revised, evidence-based serum magnesium reference interval.
• To highlight the public health implications of subclinical magnesium deficiency.

Main Methods:

• Systematic review of animal, epidemiologic, and clinical studies.
• Analysis of existing data on serum magnesium levels and health outcomes.
• Evaluation of the current serum magnesium reference interval's limitations.

Main Results:

• Subclinical magnesium deficiency is prevalent and associated with various pathologies.
• Higher magnesium intake or supplementation shows a reduced risk of associated chronic diseases.
• The current serum magnesium reference interval (0.75-0.95 mmol/L) is based on population distribution, not clinical outcomes.

Conclusions:

• Subclinical magnesium deficiency contributes significantly to chronic disease development.
• A revised serum magnesium reference interval is crucial for improving clinical care.
• Updating the reference interval can enhance public health by addressing widespread underconsumption.