Vitamin C status and other nutritional indices in patients with stroke and other acute illnesses: a case-control study

Sixty-three patients with acute thrombotic stroke were compared with 47 age and sex-matched patients admitted concurrently with acute ischaemic cardiac pain and a further 44 with acute noncardiovascular illnesses. Overall the stroke patients scored highest on a questionnaire designed to estimate mean daily intake of vitamin C before hospital admission. There were problems with this retrospective dietary assessment, however, and the diet scores of the 27 stroke patients able to answer the questionnaire themselves fell between those of the other two groups. There were no significant differences between the three patient groups in plasma ascorbic acid or uric acid levels, but plasma magnesium and albumin levels were higher in the stroke patients. These findings were similar for patients aged over and under 70 but intergroup differences in magnesium and albumin levels were more marked in the elderly. These results do not support the postulated inverse relationship between vitamin C status and the risk of stroke.     

Alteration of tissue magnesium levels in rats by dietary vitamin B6 supplementation

Tissues from female Fisher rats fed varying levels of magnesium (100 ppm or 700 ppm) and pyridoxine hydrochloride (PN.HCl) (7, 35, or 1500 mg/kg diet for six weeks) were dry ashed and analyzed for magnesium using atomic absorption spectroscopy. In tissues from rats consuming magnesium diets, tissue magnesium levels increased as levels of dietary PN.HCl increased. Increases in plasma, liver, kidney, and brain magnesium levels were statistically significant (p less than 0.05). With the exception of liver, no statistically significant changes in tissue magnesium levels occurred with PN.HCl supplementation in rats fed diets with adequate magnesium. Dietary supplementation with PN.HCl produces alterations in tissue magnesium levels in the rat and these alterations are modulated by dietary magnesium and PN.HCl supplementation.     

The relation of magnesium and calcium intakes and a genetic polymorphism in the magnesium transporter to colorectal neoplasia risk

BACKGROUND: Mean magnesium intake in the US population does not differ from that in East Asian populations with traditionally low risks of colorectal cancer and other chronic diseases, but the ratio of calcium to magnesium (Ca:Mg) intake is much higher in the US population. Transient receptor potential melastatin 7 (TRPM7) is a newly found gene essential to magnesium absorption and homeostasis. OBJECTIVE: We aimed to test whether the association of colorectal polyps with intake of calcium, magnesium, or both and Thr1482Ile polymorphism in the TRPM7 gene is modified by the Ca:Mg intake. DESIGN: Included in the study were a total of 688 adenoma cases, 210 hyperplastic polyp cases, and 1306 polyp-free controls from the Tennessee Colorectal Polyp Study. RESULTS: We found that total magnesium consumption was linked to a significantly lower risk of colorectal adenoma, particularly in those subjects with a low Ca:Mg intake. An inverse association trend was found for hyperplastic polyps. We also found that the common Thr1482Ile polymorphism was associated with an elevated risk of both adenomatous and hyperplastic polyps. Moreover, this polymorphism significantly interacted with the Ca:Mg intake in relation to both adenomatous and hyperplastic polyps. The subjects who carried >or=1 1482Ile allele and who consumed diets with a high Ca:Mg intake were at a higher risk of adenoma (odds ratio: 1.60; 95% CI: 1.12, 2.29) and hyperplastic polyps (odds ratio: 1.85; 95% CI: 1.09, 3.14) than were the subjects who did not carry the polymorphism. CONCLUSION: These findings, if confirmed, may provide a new avenue for the personalized prevention of magnesium deficiency and, thus, colorectal cancer.     

Genotype-phenotype analysis for the polymorphic CA repeat in the insulin-like growth factor-I (IGF-I) gene

Polymorphic microsatellite dinucleotide (cytosine–adenine, CA) repeats of the insulin-like growth factor-I (IGF-I) gene may have implications in the development of certain types of cancer and osteoporosis. We studied correlations between IGF-I genotypes determined by direct sequencing and plasma IGF-I levels among 113 healthy individuals (60 men and 53 women), who were originally enrolled as controls for hospital-based case–control studies of breast and prostate cancer. On the contrary to an earlier observation, there were no differences in plasma IGF-I levels between those with and without the allele of 19 repeats. With adjustment for other confounders, there were no trends in plasma IGF-I levels with increasing or decreasing the number of CA repeats among all study subjects combined, all Whites or all Blacks, suggesting no overall functional significance of this polymorphism. Opposite trends observed in gender and racial subgroups, i.e., an inverse association between plasma IGF-I levels and the CA repeat length in white women and a positive association in black men, are likely to be chance findings.     

Low 25-Hydroxyvitamin D and Myofascial Pain: Association of Cancer,Colon Polyps,and Tendon Rupture

Background: Myofascial pain that has been associated with cancer and increased risk of morbidity and mortality in cancer patients is intrinsically associated with low magnesium and low 25-hydroxyvitamin D (25(OH)D). Therefore, this physical finding was used as a clinical diagnostic proxy.

Objective: The objective of this study was to assess the association and prevalence of disease in individuals with myofascial pain and low 25(OH)D in a county with low magnesium in the drinking water.

Design: This is a retrospective cross-sectional study of a chart review of 269 subjects to assess subjects presenting with myofascial pain (assessed by tender trigger points) and 25(OH)D concentrations below 30 ng/mL or a history of 25(OH)D deficiency compared to those without these exposures.

Results: The association between the exposure of low 25(OH)D levels and myofascial pain was compared to all cancers, colon polyps, and tendon ruptures. The odds of having cancer with the combined exposures was 10.14 times the odds of not having either exposure (95% confidence interval [CI], 5.08, 20.25, p < 0.001). For adenomatous colon polyps, the odds ratio (OR) was 7.24 (95% CI, 3.83, 13.69, p < 0.001), and for tendon rupture, the OR was 8.65 (95% CI, 3.76, 19.94, p < 0.001). Of 80 subjects who had both myofascial pain and 25(OH)D less than 30 ng/mL, 74 were tested for red blood cell (RBC) magnesium. Half of those subjects had RBC magnesium concentrations < 4.6 mg/dL, and 23% had levels below the reference range (4.0–6.4 mg/dL).

Conclusion: Myofascial pain as assessed by tender trigger points and 25(OH)D deficiency showed a significant association with cancer, adenomatous colon polyps, and tendon rupture. Further studies to verify these results are needed, especially in areas where there is low magnesium in the drinking water.     

Effect of beer consumption on plasma magnesium: randomized comparison with mineral water

Moderate consumption of ethanol lowers mortality from coronary artery disease, and one of the possible mechanisms is an antiarrhythmic action. We therefore investigated the effect of a small daily dose of beer on plasma electrolytes. 52 men who seldom drank alcohol, clinically stable more than one year after coronary bypass surgery, were randomized to drink either 330 mL beer (containing about 20 g ethanol) or mineral water with similar potassium, magnesium, calcium and sodium content daily for 30 days. Plasma electrolytes and liver function indices, and also heart rate, blood pressure and weight, were measured before and after the trial period. The only significant before-and-after difference was in the group consuming beer, whose plasma magnesium rose from 0.89 (SD 0.01) to 0.98 (SD 0.02) mmol/L (P < 0.0025). This level of beer consumption did no obvious harm to liver function and its possibly beneficial effect on plasma magnesium deserves further investigation.     

Magnesium in drinking water in relation to morbidity and mortality from acute myocardial infarction

We investigated the importance of magnesium and calcium in drinking water in relation to morbidity and mortality from acute myocardial infarction. Cases were men and women 50-74 years of age living in 18 Swedish municipalities who had suffered an acute myocardial infarction some time between October 1, 1994, and June 30, 1996. Controls were randomly selected from the same study base. We interviewed the surviving cases (N = 823) and controls (N = 853), focusing on risk factors for acute myocardial infarction. We collected individual data on drinking water levels of magnesium and calcium. We classified subjects by quartile of water magnesium or calcium levels. The total number of cases was similar in the four quartiles. The risk of death was 7.6% (95% confidence interval = 2.1-13.1) lower in the quartile with high magnesium levels (> or = 8.3 mg/liter). The odds ratio for death from acute myocardial infarction in relation to water magnesium was 0.64 (95% confidence interval = 0.42-0.97) for the highest quartile relative to the three lower ones. Multivariate analyses showed that other risk factors were not important confounders. For calcium, this study was inconclusive. The data suggest that magnesium in drinking water is associated with lower mortality from acute myocardial infarction, but not with the total incidence.     

Soy isoflavones ameliorate the adverse effects of chemotherapy in children

Genistein sensitizes cancer cells to chemotherapy and radiation by modulating cell survival pathways. At the same time, genistein's antioxidant and anti-inflammatory effects may protect normal tissues from adverse effects of chemotherapy and radiation, which are largely due to oxygen-free radicals and inflammation. We conducted a small pilot study with a soy isoflavone mixture containing 8 mg of genistein in children receiving chemotherapy and/or radiation to investigate genistein's potential toxicity preventive effect. We monitored clinical and laboratory parameters in children with cancer who received their first cycle of chemotherapy without genistein and the subsequent cycles with genistein. Patients served as their own controls, and the clinical-laboratory data from the first cycle were compared to the data from subsequent cycles. Nine cycles of chemotherapy were administered without genistein and 57 cycles with genistein. Patients experienced less myelosuppression, mucositis, and infection when they received genistein with chemotherapy. During supplementation, serum genistein levels were 2 to 6 times higher compared to presupplementation levels. Patients who received abdominal radiation reported less pain and diarrhea when they took the genistein supplement. Further clinical investigation of soy isoflavones in pediatric cancer patients receiving chemotherapy and/or radiation should be conducted.     

Magnesium in joint health and osteoarthritis

Osteoarthritis (OA) is a prevalent debilitating age-related skeletal disease. The hallmark of OA is the degradation of articular cartilage that cushions the joint during movement. It is characterized by chronic pain and disability. Magnesium, a critical trace element in the human body, plays a pivotal role in metabolism homeostasis and the energy balance. Humans obtain magnesium mainly from the diet. However, inadequate magnesium intake is not uncommon. Moreover, the magnesium status deteriorates with ageing. There has been a growing body of clinical studies pointing to an intimate relationship between dietary magnesium and OA although the conclusion remains controversial. As reported, the magnesium ion concentration is essential to determine cell fate. Firstly, the low-concentration magnesium ions induced human fibroblasts senescence. Magnesium supplementation was also able to mitigate chondrocyte apoptosis, and to facilitate chondrocyte proliferation and differentiation. In this literature review, we will outline the existing evidence in animals and humans. We will also discuss the controversies on plasma or intracellular level of magnesium as the indicator of magnesium status. In addition, we put forward the interplay between dietary magnesium intake and intestinal microbiome to modulate the inflammatory milieu in the conjecture of OA pathogenesis. This leads to an emerging hypothesis that the synergistic effect of magnesium and probiotics may open a new avenue for the prevention and treatment of OA.     

Concurrent peripheral pathologies and complex regional pain syndrome type 1 as contributors to acute post-stroke shoulder pain: a case report

Post-stroke shoulder pain is associated with either a peripheral or central pathology. However, most of the time, it is challenging to establish a cause-and-effect relationship between the suggested pathology and shoulder pain reported. We report a 66 year-old man who developed a right hemiplegic shoulder pain two months post stroke with initial investigations suggestive of peripheral pathologies. Pharmacological and non-pharmacological treatment did not improve his shoulder pain. Later he developed complex regional pain syndrome (CRPS) of the right hand and the initial shoulder pain subsequently relieved following resolution of the CRPS.     

Chronic contained rupture of abdominal aortic aneurysm presenting with longstanding back pain

Abdominal aortic aneurysm (AAA) is one of the important differential diagnoses of back pain which is often missed. Chronic contained rupture is a rare event that can cause diagnostic difficulties, presenting in different ways such as back pain, neuropathy or groin mass. We are presenting a case of 46-year-old man who presented with history of recurrent low back pain radiating to his left leg, associated with sensory deficit in the left thigh. His complaint proved to be resulting from chronic contained AAA leak.     

Soy Isoflavones Ameliorate the Adverse Effects of Chemotherapy in Children

Genistein sensitizes cancer cells to chemotherapy and radiation by modulating cell survival pathways. At the same time, genistein's antioxidant and anti-inflammatory effects may protect normal tissues from adverse effects of chemotherapy and radiation, which are largely due to oxygen-free radicals and inflammation. We conducted a small pilot study with a soy isoflavone mixture containing 8 mg of genistein in children receiving chemotherapy and/or radiation to investigate genistein's potential toxicity preventive effect. We monitored clinical and laboratory parameters in children with cancer who received their first cycle of chemotherapy without genistein and the subsequent cycles with genistein. Patients served as their own controls, and the clinical-laboratory data from the first cycle were compared to the data from subsequent cycles. Nine cycles of chemotherapy were administered without genistein and 57 cycles with genistein. Patients experienced less myelosuppression, mucositis, and infection when they received genistein with chemotherapy. During supplementation, serum genistein levels were 2 to 6 times higher compared to presupplementation levels. Patients who received abdominal radiation reported less pain and diarrhea when they took the genistein supplement. Further clinical investigation of soy isoflavones in pediatric cancer patients receiving chemotherapy and/or radiation should be conducted.     

Foetal plasma magnesium levels during maternal hypo- or hypermagnesaemia in ewes

1. The influence of maternal hypo- or hypermagnesaemia of foetal plasma magnesium levels was studied in pregnant ewes between the 120th and the 145th day of gestation using a permanent catheter inserted in utero into the left aorta of the foetus on the 115th day of gestation. 2. In seven ewes, carrying eleven foetuses, the injection of 1 alpha-hydroxycholecalciferol induced a hypomagnesaemia which lasted 72 h. This had no significant effect on foetal plasma Mg levels. 3. In five ewes, carrying six foetuses, hypermagnesaemia induced by a 2 h magnesium chloride infusion had no significant effect on foetal plasma Mg levels. 4. These results provide evidence that in sheep during the last 20 d of gestation the foetal regulation of plasma Mg is independent of the maternal plasma Mg levels.     

Intracellular (polymorphonuclear) magnesium content in patients with bronchial asthma between attacks.

Previous studies have demonstrated the role of polymorphonuclears in asthma, the importance of increases in intracellular concentrations of ionized calcium in the release of chemical mediators, the role of magnesium as natural calcium channel blocker, and the importance of magnesium deficiency in plasma histamine concentration and in tissue prostanoid concentration. The objective of our study was to measure the polymorphonuclear magnesium content in patients with asthma in the interval between attacks. We measured the polymorphonuclear magnesium content, and serum and erythrocyte sodium, calcium, and magnesium concentrations in 21 healthy volunteers and 50 patients with different types of asthma. In our patients, the polymorphonuclear magnesium content was lower than in the control group (P < 0.001), while magnesium levels in erythrocytes and serum and the levels of other ions in erythrocytes and serum were normal. This is the first report to document low polymorphonuclear magnesium content in patients with bronchial asthma. The reduction of polymorphonuclear magnesium content may have an important role in the pathogenesis of asthma.     

Magnesium status and association with diabetes in the Taiwanese elderly

The average dietary intake of magnesium is below recommended dietary allowances in many affluent Western countries. Prolonged low magnesium intake tends to result in hypomagnesaemia which might increase the risk of chronic diseases in elderly people. A national population-based cross-sectional nutrition survey, the Elderly Nutrition and Health Survey in Taiwan (1999-2000), was used to investigate the magnesium status and association with diabetes in the Taiwanese elderly. Dietary magnesium intake was based on 24-hour dietary recalls. Blood biochemical parameters including plasma magnesium and blood glucose were also measured. Average magnesium intake was 250 mg in men and 216 mg in women, which is equivalent to 68-70% of relevant Taiwanese Dietary Reference Intakes. The mean plasma magnesium concentration was 0.903 mmol/L in men and 0.906 mmol/L in women. The prevalence of a plasma magnesium level of <0.7 mmol/L was 0.7-0.9% in the elderly, and that of <0.8 mmol/L was 8.0-9.1%. Elderly vegans had a significantly lower magnesium intake than ovo-lacto vegetarians and non-vegetarians. Diabetic men and women had significantly higher blood glucose levels than non-diabetics. The risk of diabetes was elevated 3.25 times at plasma magnesium levels<0.863 mmol/L. There was an inverse association between plasma magnesium concentration and the prevalence of diabetes. However, no association was found between diabetes and low dietary magnesium. Taiwanese elderly persons had suboptimal levels of dietary magnesium intake, which although may be sufficient to avoid overt magnesium deficiency, may not be sufficient to reduce the risk of diabetes in the elderly. Further prospective study is required to help explain the differential results between dietary and plasma magnesium levels.     

Effects of dietary magnesium on the development of hypertension in the spontaneously hypertensive rat.

The effect of varying the amount of dietary magnesium on the development of hypertension in spontaneously hypertensive (SH) rats was investigated with three diets containing 1.05% (H1Mg diet), 0.52% (H2Mg diet), and 0.008% (LMg diet). The control group was given a diet containing a normal amount of magnesium (0.2%). When the diet was sufficiently supplemented with magnesium (H1Mg diet), the development of hypertension was significantly slowed and the heart rate slightly lowered. With dietary magnesium depletion (LMg diet), the heart rate was accelerated and hypertension developed more rapidly. Excretion of urinary electrolytes (calcium, magnesium, and sodium) was increased by rats fed the H1Mg diet and decreased by rats on the LMg diet. Urinary cAMP was decreased both on the HMg diets and on the LMg diet. With the H1Mg diet, total and ionized calcium and sodium levels in plasma fell, and magnesium plasma levels rose. Rats fed the LMg diet had increased total and ionized calcium and decreased magnesium plasma levels. These results show that dietary magnesium modifies the metabolism of calcium, sodium, magnesium, which can modulate the development of genetic hypertension.     

The impact of total parenteral nutrition on antithrombin III

A prospective study was undertaken to elucidate the effect, if any, of total parenteral nutrition on plasma Antithrombin III levels. A total of 309 patients were included in the study. The patients suffered from cancer, or chronic illness, or major trauma which necessitated total parenteral nutrition. Each patient acted as his own control. Pre and postinfusion Antithrombin III levels were measured at regular intervals. Statistically, the results of the study have shown that total parenteral nutrition does not significantly alter Antithrombin III levels.     

Low Plasma Cholesterol Predicts an Increased Risk of Lung-Cancer in Elderly Women

Background. There have been significant efforts in the United States to lower high cholesterol levels. Studies of men, however, have found a higher total cancer mortality rate at lower levels of plasma cholesterol. Many of these studies have found that lung cancer is more closely associated than other cancers with low cholesterol. Of the studies that include women, none has demonstrated a statistically significant inverse association between low cholesterol and lung cancer. Methods. We examined the relation between very low plasma cholesterol levels (<160 mg/dl) and lung cancer death in an 18-year prospective study of 2,011 men and 2,327 women. Results. After adjusting for age, body mass index, smoking, and education, the relative hazard of lung cancer mortality for those with low cholesterol (<160 mg/dl) compared with all other cholesterol levels (≥ 160 mg/dl) was 1.75 among men (P = 0.28) and 3.29 among women (P = 0.02). Excluding those who died within 5 years of baseline did not change the results. Conclusions. Both men and women with baseline plasma cholesterol levels <160 mg/dl were more likely to die of lung cancer. This difference was statistically significant in women. The association could not be explained by occult malignancy, smoking, or socioeconomic status.     

Plasma selenium levels and risk of hepatocellular carcinoma among men with chronic hepatitis virus infection.

Both experimental and epidemiologic studies have linked a low dietary intake of selenium with an increased risk of cancer. The authors examined the association between plasma selenium levels and risk of hepatocellular carcinoma (HCC) among chronic carriers of hepatitis B and/or C virus in a cohort of 7,342 men in Taiwan who were recruited by personal interview and blood draw during 1988-1992. After these men were followed up for an average of 5.3 years, selenium levels in the stored plasma were measured by using hydride atomic absorption spectrometry for 69 incident HCC cases who were positive for hepatitis B surface antigen (HBsAg) and/or antibodies against hepatitis C virus (mostly HBsAg positive) and 139 matched, healthy controls who were HBsAg positive. Mean selenium levels were significantly lower in the HCC cases than in the HBsAg-positive controls (p = 0.01). Adjusted odds ratios of HCC for subjects in increasing quintiles of plasma selenium were 1.00, 0.52, 0.32, 0.19, and 0.62, respectively. The inverse association between plasma selenium levels and HCC was most striking among cigarette smokers and among subjects with low plasma levels of retinol or various carotenoids. There was no clear evidence for an interaction between selenium and alpha-tocopherol in relation to HCC risk.     

Effects of dietary magnesium on the development of hypertension in the spontaneously hypertensive rat

The effect of varying the amount of dietary magnesium on the development of hypertension in spontaneously hypertensive (SH) rats was investigated with three diets containing 1.05% (H1Mg diet), 0.52% (H2Mg diet), and 0.008% (LMg diet). The control group was given a diet containing a normal amount of magnesium (0.2%). When the diet was sufficiently supplemented with magnesium (H1Mg diet), the development of hypertension was significantly slowed and the heart rate slightly lowered. With dietary magnesium depletion (LMg diet), the heart rate was accelerated and hypertension developed more rapidly. Excretion of urinary electrolytes (calcium, magnesium, and sodium) was increased by rats fed the H1Mg diet and decreased by rats on the LMg diet. Urinary cAMP was decreased both on the HMg diets and on the LMg diet. With the H1Mg diet, total and ionized calcium and sodium levels in plasma fell, and magnesium plasma levels rose. Rats fed the LMg diet had increased total and ionized calcium and decreased magnesium plasma levels. These results show that dietary magnesium modifies the metabolism of calcium, sodium, magnesium, which can modulate the development of genetic hypertension.