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Magnesium and health outcomes: an umbrella review of systematic reviews and meta-analyses of observational and intervention studies

  • Nicola VeroneseEmail author
  • Jacopo Demurtas
  • Gabriella Pesolillo
  • Stefano Celotto
  • Tommaso Barnini
  • Giovanni Calusi
  • Maria Gabriella Caruso
  • Maria Notarnicola
  • Rosa Reddavide
  • Brendon Stubbs
  • Marco Solmi
  • Stefania Maggi
  • Alberto Vaona
  • Joseph Firth
  • Lee Smith
  • Ai Koyanagi
  • Ligia Dominguez
  • Mario Barbagallo
Original Contribution

Abstract

Purpose

To map and grade all health outcomes associated with magnesium (Mg) intake and supplementation using an umbrella review.

Methods

Umbrella review of systematic reviews with meta-analyses of observational studies and randomized controlled trials (RCTs) using placebo/no intervention as control group. We assessed meta-analyses of observational studies based on random-effect summary effect sizes and their p values, 95% prediction intervals, heterogeneity, small-study effects and excess significance. For meta-analyses of RCTs, outcomes with a random-effect p value < 0.005 and a high-GRADE assessment were classified as strong evidence.

Results

From 2048 abstracts, 16 meta-analyses and 55 independent outcomes were included (36 in RCTs and 19 in observational studies). In RCTs of Mg versus placebo/no active treatment, 12 over 36 outcomes reported significant results (p < 0.05). A strong evidence for decreased need for hospitalization in pregnancy and for decreased risk of frequency and intensity of migraine relapses in people with migraine was observed using the GRADE assessment. In observational studies, 9/19 outcomes were significant (p < 0.05). However, only one outcome presented highly suggestive evidence (lower incidence of type 2 diabetes in people with higher Mg intake at baseline) and one suggestive (lower incidence of stroke associated with higher Mg intake at baseline).

Conclusion

Strong evidence according to the GRADE suggests that Mg supplementation can decrease the risk of hospitalization in pregnant women and reduce the intensity/frequency of migraine. Higher Mg intake is associated with a decreased risk of type 2 diabetes and stroke with highly suggestive and suggestive evidence, respectively, in observational studies.

Keywords

Magnesium Meta-analysis Pregnancy Diabetes Stroke Umbrella review 

Notes

Acknowledgements

Dr Koyanagi’s work was supported by the Miguel Servet contract financed by the CP13/00150 and PI15/00862 projects, integrated into the National R + D + I and funded by the ISCIII—General Branch Evaluation and Promotion of Health Research—and the European Regional Development Fund (ERDF-FEDER). Dr. Demurtas received a honorary consultation from Bayer. Dr Stubbs is supported by Health Education England and the National Institute for Health Research HEE/ NIHR ICA Programme Clinical Lectureship (ICA-CL-2017-03-001). BS is partly supported by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care South London at King’s College Hospital NHS Foundation Trust. The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health and Social Care. Dr Firth is supported by a Blackmores Institute Fellowship.

Compliance with ethical standards

Conflict of interest

The other authors declare no conflict of interest with this work.

Supplementary material

394_2019_1905_MOESM1_ESM.docx (109 kb)
Supplementary material 1 (DOCX 109 KB)

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Nicola Veronese
    • 1
    • 2
    Email author
  • Jacopo Demurtas
    • 3
  • Gabriella Pesolillo
    • 4
  • Stefano Celotto
    • 5
  • Tommaso Barnini
    • 6
  • Giovanni Calusi
    • 7
  • Maria Gabriella Caruso
    • 2
  • Maria Notarnicola
    • 2
  • Rosa Reddavide
    • 2
  • Brendon Stubbs
    • 8
    • 9
    • 10
  • Marco Solmi
    • 11
  • Stefania Maggi
    • 1
  • Alberto Vaona
    • 12
  • Joseph Firth
    • 13
    • 14
  • Lee Smith
    • 15
  • Ai Koyanagi
    • 16
    • 17
  • Ligia Dominguez
    • 18
  • Mario Barbagallo
    • 18
  1. 1.National Research CouncilNeuroscience Institute, Aging BranchPadovaItaly
  2. 2.Research HospitalNational Institute of Gastroenterlogy, IRCCS De BellisCastellana GrotteItaly
  3. 3.Primary Care DepartmentAzienda USL Toscana Sud EstGrossetoItaly
  4. 4.Primary Care ServiceASL 02ChietiItaly
  5. 5.Primary Care DepartmentAzienda per l’Assistenza Sanitaria 3 Alto Friuli -Collinare -Medio FriuliUdineItaly
  6. 6.Primary Care ServiceAUSL Toscana CentroFirenzeItaly
  7. 7.Primary Care DepartmentAzienda USL Toscana CentroPratoItaly
  8. 8.Physiotherapy DepartmentSouth London and Maudsley NHS Foundation TrustLondonUK
  9. 9.Department of Psychological Medicine, Institute of Psychiatry, Psychology and NeuroscienceKing’s College LondonLondonUK
  10. 10.Faculty of Health, Social Care and EducationAnglia Ruskin UniversityChelmsfordUK
  11. 11.Neuroscience DepartmentUniversity of PadovaPadovaItaly
  12. 12.Primary Care DepartmentAzienda ULSS20 VeronaVeronaItaly
  13. 13.NICM Health Research InstituteUniversity of Western SydneyPenrithAustralia
  14. 14.Division of Psychology and Mental HealthUniversity of ManchesterManchesterUK
  15. 15.The Cambridge Centre for Sport and Exercise Sciences, Department of Life SciencesAnglia Ruskin UniversityCambridgeUK
  16. 16.Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAMMadridSpain
  17. 17.Research and Development UnitParc Sanitari Sant Joan de Déu, Universitat de BarcelonaBarcelonaSpain
  18. 18.Geriatric Unit, Department of Internal Medicine and GeriatricsUniversity of PalermoPalermoItaly

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