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Nutrient Spotlight: Magnesium Magnesium oxide: Often used in laxative products but it has poor bioavailability and readily causes loose stools. Even though it’s the most commonly used form due its small size and cheap price it is considered the least optimal form to use as a therapeutic supplement.
Magnesium sulfate: Not used in oral formulations but can found in Epsom bath salts.
Magnesium citrate: A commonly used form that has a good bioavailability compared to oxide. It is also very rapidly absorbed in the digestive tract but it does have a stool loosening effect1. This form is found in many supplements and remains a solid option for delivering magnesium.
Magnesium Aspartate: Considered the “fatigue” magnesium because a few clinical trials found it had a positive effect on fatigue and they reduced muscle hyper-excitability2. This form has better bioavailability compared to oxide and citrate.
Magnesium helps to maintain normal muscle and nerve function, keeps heart rhythm regular, supports bones formation and improves athletic performance. Its wide range of health benefits and biological activity make it effective in addressing a number of common diseases and conditions including fibromyalgia, chronic pain, diabetes, osteoporosis, cardiovascular disease and headaches.
The problem with this essential mineral is that most people are deficient. A gradual depletion of nutrients from our soils has left many vegetables and grains with lower levels of magnesium. To make matters worse, absorption can be impaired due to common health conditions (i.e. IBS, crohns disease) and medications (i.e. proton pump inhibitors, diuretics). Athletes are also very predisposed to magnesium depletion
As a supplement, magnesium can be found in many forms. Minerals such as magnesium or calcium are combined with another molecule to stabilize the compound. Each combination, referred to as a chelate, has different absorption, bioavailability and therapeutic value. These additional molecules greatly impact the medicinal value of the magnesium and some even have beneficial effects in their own right. Let’s take a closer look:
Evidence Based Nutrition for Chiropractic and Physical Medicine (EBN) is an organization designed to educate physical medicine practitioners in clinical nutrition and supplementation. EBN is designed to provide simple and effective nutritional protocols for your practice! These protocols allow practitioners to improve clinical outcomes, maximize patient retention and increase revenue. Each seminar and module is delivered and presented by leading integrative clinicians.
EBN Quarterly allows practitioners to stay informed and up-to-date on the latest relevant nutrition research, while learning clinical pearls about specific nutrients. Overall, EBN provides clear, concise, easy to understand and immediately applicable information for clinical practice. Enjoy!
Welcome to EBN Quarterly!
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Magnesium Glycinate: This combination has excellent bioavailability and does not have a laxative effect (glycine is actively transported through the intestinal wall). Due to the calming and relaxing effect of both glycine & magnesium, this combination is effective for both pain and muscle hypertonicity.3
Magnesium Malate: The little known combination has been studied for use in fibromyalgia. Since malate is a substrate in the cellular energy cycle, it can help improve ATP production and there is some preliminary evidence that it may reduce muscle pain and tender points in fibromyalgia patients.
Magnesium Orotate: Considered the “heart” magnesium because the combination has been shown to improve heart failure, symptoms of angina and exercise performance in clinical trials.5,6
Magnesium Taurate: This synergistic combo both share the ability to improve cardiac function, increases insulin sensitivity and have a calming effects on neuromuscular excitability. Magnesium-L-threonate: This form has recently been studied to improve memory and brain function.
Volume 1 Edition 1 ~ Summer 2014
Dosage: The RDI of magnesium for adult males and females are 420 mg/day and 320 mg/day, respectively. High quality supplements contain at least 100mg of elemental magnesium. To achieve therapeutic results, patients may require higher doses initially before a maintenance dose of 200-400mg/d.
References available at www.evidencebasednutrition.ca
Practitioner Spotlight: Dr. Emmanuel Frantzis DC, DO(MP)
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Clinical Take Away: Magnesium is one of the most useful supplements in a physical medicine focused practice! If you are treating an athlete or a patient with chronic pain, you can assume they are magnesium deficient. Unfortunately, there is no reliable and clinically relevant way to measure magnesium levels so supplementation is recommended right away. To improve muscle function, reduce pain or promote sleep, magnesium glycinate, malate and aspartate forms are recommended as they are best at relaxing the nerves & muscles.
Practice focus: “My practice is diverse, but focused on healing individuals with complex problems by incorporating in-depth assessment of metabolic, neurologic, endocrine, immune and biomechanical systems.”
How you incorporate nutrition into your practice: “I integrate manual therapy with advanced concepts in nutrition and exercise to provide a comprehensive plan of rehabilitation. Nutrition is a vital portion of my practice because there is simply no separating a person's health from what they feed their body.”
Favourite Nutrient: “Curcumin. I like it, quite simply, because it works. It is a potent anti-inflammatory and anti-oxidant with a lot of evidence supporting it in the literature. A big percentage of my clientele presents with chronic
systemic inflammation so curcumin is a frequently utilized nutrient in my practice and has given me a lot of successful outcomes.”
Favourite clinical pearl: “Something an old professor used to say over and over again when I was in Chiropractic College was "Every patient is entitled to more than one condition." I think about this every day because we often identify one problem and feel very content about it so we stop probing deeper and can miss very important issues.”
Dr. Frantzis practices in Toronto, ON and is a professor of Osteopathy at the Canadian College of Osteopathy. He has also served as the team therapist for Beach Volleyball Canada (1997-2008).
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New Research
Gluten-free diet reduces adiposity, inflammation and insulin resistance. A study in mice found that gluten-free animals showed a reduction in body weight gain and adiposity. There was an improvement in glucose homeostasis/insulin resistance and pro-inflammatory signaling molecules. This study shows the effects of gluten containing molecules on weight maintenance and inflammation regardless of calories. J Nutr Biochem. 2013 Jun;24(6):1105-11.
Low B12 levels predict incidence of fractures in elderly men. Large Population study from Sweden found that men
in the lowest quartile of plasma B12 levels have increased risk of all fractures. This study shows the importance of adequate vitamin B12 levels in addition to vitamin D as a preventative strategy in bone health and fracture reduction. Osteoporos Int. 2014 Jan;25(1):131-40
Curcumin reduces inflammation and destruction in cartilage cells. This study found curcumin reduced inflammation (via prostaglandin E2), reduced cartilage destruction (by decreasing matrix metalloproteinase-3) and promoted rebuilding (via increase in proteoglycan release) of cartilage cell. The study shows a promising mechanism that curcumin can not only reduce inflammation in joint pain but also promote cartilage regeneration. F1000 Research 2013 Jul 4 [revised 2013 Aug 20];2:147.
Long-term creatine supplementation does not impair kidney function. A 12-week randomized, double-blind, placebo-controlled trial using creatine supplementation showed that it did not affect kidney function in resistance-trained healthy individuals consuming a high-protein diet; thus reinforcing the safety of this dietary supplement. J Int Soc Sports Nutr. 2013 May 16;10(1):26.
Dietary nitrate supplementation improves team sport-specific intense intermittent exercise performance. A double-blind, randomized, crossover trial found that nitrate-rich beetroot juice increased results of an exercise performance test. The results the confirm evidence from a number of other recent studies that beet juice increases nitric oxide production and improves performance during intense intermittent exercise. Eur J Appl Physiol. 2013 Jul;113(7):1673-84.
Volume 1 Edition 1 ~ Summer 2014
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Functional Food Spotlight: Almonds
We all are familiar with almonds but they deserve a fresh look since they have such a high nutritional value. They contain protein, fibre, plant sterols, minerals and vitamins. They also are low in saturated fatty acids and rich in unsaturated fatty acids.
To complement the healthy fat content, almond meat is high in fat -soluble vitamin E and the skins are high in flavonoids (both of which are potent antioxidants). A number of research studies have found that almonds (and other nuts) can reduce LDL cholesterol levels as well as cholesterol oxidation.
Interested in a Seminar? Visit our website at www.evidencebasednutrition.ca to sign up!
Volume 1 Edition 1 ~ Summer 2014
References Blomhoff R, Carlsen MH, Andersen LF, Jacobs DR Jr. Health benefits of nuts: potential role of antioxidants. Br J Nutr. 2006 Nov;96 Suppl 2:S52-60. 2006.
Chen CY, Milbury PE, Lapsley K, Blumberg JB. Flavonoids from almond skins are bioavailable and act synergistically with vitamins C and E to enhance hamster and human LDL resistance to oxidation. J Nutr. 2005 Jun;135(6):1366-73. 2005.
Jambazian P, Haddad E, Rajaram S, Tanzman J, Sabate J. Almonds in the diet simultaneously improve plasma alpha- tocopherol concentrations and reduce plasma lipids. J Am Dietetic Assoc. 2005 March;105(3), 449-454. 2005.
Jenkins DJ, Kendall CW, Marchie A, Faulkner DA, Josse AR, et al. Direct comparison of dietary portfolio vs. statin on C-reactive protein. Eur J Clin Nutr. 2005 May 18; [Epub ahead of print]. 2005
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Another study found almonds are capable of reducing c-reactive protein, a marker of systemic inflammation.
In addition to healthy fats and vitamin E, a quarter-cup of almonds contains 62 mg of magnesium plus 162 mg of potassium, both of which are essential for muscle and cardiovascular function. Finally, almonds contain trace minerals and vitamins such as manganese, copper and riboflavin (vitamin
B2), all of which are essential cofactors for cellular energy production.
Recommended daily intake: One-quarter cup per day
Preparation tip: Avoid roasted almonds since the heat can damage the healthy fats. For a juicier taste try soaking a serving of almonds in spring water over night. The almonds soak up the water and are easier to consume raw.
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EBN Foundations: Module 1
Saturday October 4th, 2014 Can College of Nat Med (CCNM)
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