Magnesium and Vitamin D - pre-colon cancer – RCT Dec 2018


Magnesium status and supplementation influence vitamin D status and metabolism: results from a randomized trial

The American Journal of Clinical Nutrition, Vol 108, Issue 6, 1 Dec 2018, Pages 1249–1258, https://doi.org/10.1093/ajcn/nqy274
Qi Dai Xiangzhu Zhu JoAnn E Manson Yiqing Song Xingnan Li Adrian A Franke Rebecca B Costello Andrea Rosanoff Hui Nian Lei Fan

Mg involved with Vitamin D in 5 places (another study says 8)

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Summary of study

PDF shows
Virtually all participants had colon adenomas (and perhaps gut problems)
    wonder if results also apply to people without adenomas
All participants had between 700 and 1200 mg of Calcium
    Wonder if results apply to people not taking so much Calcium
    Note: Calcium is known to decrease colon adenomas
    Note: This is a strong interaction between Calcium and Magnesium
Vitamin D levels were changed by about only 3 ng
     Note: From trial listing: Magnesium glycinate daily for 12 weeks

 Download the PDF from Sci-Hub via VitaminDWiki
Background
Previous in vitro and in vivo studies indicate that enzymes that synthesize and metabolize vitamin D are magnesium dependent. Recent observational studies found that magnesium intake significantly interacted with vitamin D in relation to vitamin D status and risk of mortality. According to NHANES, 79% of US adults do not meet their Recommended Dietary Allowance of magnesium.

Objectives
The aim of this study was to test the hypothesis that magnesium supplementation differentially affects vitamin D metabolism dependent on baseline 25-hydroxyvitamin D [25(OH)D] concentration.

Methods
The study included 180 participants aged 40–85 y and is a National Cancer Institute independently funded ancillary study, nested within the Personalized Prevention of Colorectal Cancer Trial (PPCCT), which enrolled 250 participants. The PPCCT is a double-blind 2 × 2 factorial randomized controlled trial conducted in the Vanderbilt University Medical Center. Doses for both magnesium and placebo were customized based on baseline dietary intakes. Subjects were randomly assigned to treatments using a permuted-block randomization algorithm. Changes in plasma 25-hydroxyvitamin D3 [25(OH)D3], 25-hydroxyvitamin D2 [25(OH)D2], 1,25-dihydroxyvitamin D3, 1,25-dihydroxyvitamin D2, and 24,25-dihydroxyvitamin D3 [24,25(OH)2D3] were measured by liquid chromatography–mass spectrometry.

Results
The relations between magnesium treatment and plasma concentrations of 25(OH)D3, 25(OH)D2, and 24,25(OH)2D3 were significantly different dependent on the baseline concentrations of 25(OH)D, and significant interactions persisted after Bonferroni corrections. Magnesium supplementation increased the 25(OH)D3 concentration when baseline 25(OH)D concentrations were close to 30 ng/mL, but decreased it when baseline 25(OH)D was higher (from ∼30 to 50 ng/mL). Magnesium treatment significantly affected 24,25(OH)2D3 concentration when baseline 25(OH)D concentration was 50 ng/mL but not 30 ng/mL. On the other hand, magnesium treatment increased 25(OH)D2 as baseline 25(OH)D increased.

Conclusion: Our findings suggest that optimal magnesium status may be important for optimizing 25(OH)D status.
This trial was registered at clinicaltrials.gov as NCT03265483


Some of the limitations of this study - from editorial in the same issue

  • "As acknowledged by the authors, there were only 2 participants with baseline 25(OH)D <12 ng/mL, making it powerless to determine any magnesium–vitamin D interaction among those with such low concentrations at baseline."
  • "Similarly, findings of 25(OH)D2 had wide 95% CIs among those whose baseline 25(OH)D was >50 ng/mL"
    • Too much variance in the results to be believable
  • "...only 180 (68% of enrolled participants) were included in the current analysis"
  • "Finally, trial participants had previously been diagnosed with colorectal adenomas or hyperplastic polyps (and 14 participants were polyp-free individuals with a high risk of colorectal cancer), thus they were clearly not representative of the general population"

 Download the PDF from Sci-Hub via VitaminDWiki


Strange: Add Mg then Vitamin D 50 ng ==> 30 ng, placebo made all Vitamin D levels ~30 ng

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114 citations of this study as of June 2022

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