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Essential Nutrients for Your Health: What is a Food Supplement?

This training provides information on essential nutrients, particularly focusing on magnesium and its importance to the body. It explores the benefits of magnesium for muscles, bones, nerves, and the heart, as well as its role in preventing magnesium deficiency. The training also covers the use of food supplements and their benefits in maintaining a healthy lifestyle.

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Essential Nutrients for Your Health: What is a Food Supplement?

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  1. Training Essential nutrients for your health &

  2. Whatis a Food Supplement?

  3. Contents Key message Introduction Product information Key benefits Target groups Posology & administration Comparison ofmagnesiumsalts Magnesium andbones Magnesium andnerves Magnesium andmuscles Magnesium andheart Magnesium anddiseases Magnesium deficiency Good to know Complementary treatment References

  4. 1. Key message • Everybody needs magnesium because it fulfills numerous important functions within the body. • The human body cannot produce magnesium itself and is therefore dependent on its oral supply. • The more active we are, the more magnesium we need. … support an active lifestyle! … supply heart, nerves and muscles with magnesium. &

  5. 2. Introduction • Even though the human body contains only 20 – 30 g magnesium, this mineral is the fourth most abundant in the body and plays many important roles in the body. 1 • Magnesium is a cofactor in more than 300 enzyme systems that regulate diverse biochemical reactions in the body, including protein synthesis, muscle and nerve function, blood glucose control and blood pressure regulation. 2, 3, 4 • Magnesium is required for 2, 3, 4 • energy production • oxidative phosphorylation • glycolysis • bone development • active transport of calcium and potassium ions across cell membranes • nerve impulse conduction and muscle contraction • and normal heart rhythm • 99 % of overall magnesium is located within body cells, only 1 % can be found in blood. 60 % of intracellular magnesium is located in bone tissue, the rest in muscles and other body cells. That is why magnesium is called „bone and muscle mineral“ as well. 1, 2, 3, 4

  6. 3. Product information

  7. 3. Product information

  8. 4. Key benefits • Beneficial to muscle function and a normally functioning nervous system • Fast supply of magnesium to muscles, bones, heart& nerves • Helps to reduce tiredness and fatigue • Perfect for sporty and physically active people – also suitable for pregnant women • Very good compliance - only 1 stick per day • Easy consumption without water • 2 different concentrations (300 mg and 400 mg) for individual requirement • magnes direct Denk: fruity lemon and orange flavour • magnes active Denk: fruity raspberry flavour

  9. 5. Target groups Magnesium recommendations2 300 mg magnesium

  10. 5. Target groups Magnesium recommendations2 400 mg magnesium

  11. 5. Target groups Further groupswithincreasedmagnesiumrequirements1 People with physical or mental stress Physically active people Older adults People on a diet

  12. 6. Posology & administration • INGREDIENTS • * Magnesium= Magnesium oxide • Fast absorption of magnesium and fast supply of muscle, heart and nerves • INTAKE • The recommended intake is 1 stick per day • Easy consumption - without water

  13. 7. Comparison of magnesium salts • There are several small studies that compared the bioavailability of various different magnesium salts. • Robust evidence of the superiority of one oral magnesium preparation over another does not yet exist in humans. Therefore, the type of magnesium salt appears to be less relevant than it is often thought. 5 • The ingested magnesium dose, on the contrary, is a major factor controlling the amount of absorbed magnesium. 5Low dietary magnesium intake shows an almost complete relative absorption rate 6 , whereas it is reduced with magnesium surfeits. 7

  14. 8. Magnesium and bones • EFFECTS OF MAGNESIUM ON BONES • About 60 % of total magnesium is stored in the bones. 2, 3, 4 • Besides calcium, magnesium plays a significant role in the maintenance of normal bones and teeth since it functions as counterpart to calcium and affects bone formation and maintenance. 8 • Also scientific evidence shows that there is a positive association between magnesium intake and bone mineral density:9 • Low dietary intake of magnesium is associated with lower bone mineral density. • Higher magnesium intake is associated with higher bone mineral density. •  Therefore, an adequate magnesium supply is very important for healthy bones.

  15. 9. Magnesium and nerves • EFFECTS OF MAGNESIUM ON NERVE FUNCTION • Magnesium is of special significance for the normal functioning of the nervous system: 10, 11 • Magnesium affects optimal nerve transmission and neuromuscular coordination (e.g. processes relating the interplay of nerves and muscles) by interacting with other essential electrolytes and nutrients. 10, 11 Magnesium contributes to the proper transmission of signals and messages throughout the nervous system. • Severe magnesium deficiency leads to an increased stimulation of nerve cells and thereby to an increase in neural signals. People affected may experience nervous disorders. 10, 11 Magnesium it is important for the protection of nerves against excessive excitation.

  16. 10. Magnesium and muscles • EFFECTS OF MAGNESIUM ON MUSCLE FUNCTION • The role of magnesium in muscle function has been studied extensively. Magnesium is important for muscle performance because… • …it is essential for ATPase activity and activates adenosine triphosphate (ATP), the so-called fuel of the cells. Muscle action requires a lot of energy and therefore a lot of ATP. 12 Magnesium is essential for normal energy metabolism. 12 • …it is the counterpart to calcium. Calcium and magnesium work together to control muscle contraction. Calcium is primary responsible for muscle contraction, magnesium for muscle relaxation. 13 Magnesium is important for the maintenance of normal muscle contraction and relaxation. 13

  17. 11. Magnesium and heart • EFFECTS OF MAGNESIUM ON THE HEART • Magnesium is also essential for ATPase activity in cardiac tissue and hence for energy metabolism in the heart. 14 Magnesium is important for cardiac energy metabolism. • Moreover, magnesium deficiency causes an increase in intracellular calcium. Higher intracellular calcium levels enhance calcium-mediated vasoconstriction and inhibit cardiac (and smooth muscle) relaxation.15 Magnesium is important for the maintenance of normal cardiac muscle contraction and relaxation.

  18. 12. Magnesium and diseases • MAGNESIUM AND CRAMPS • Leg cramps are reported in up to 60 % of adults and can cause severe pain and sleep disturbances. 16,17 • Since magnesium plays a role in neuromuscular transmission and muscle contraction, it has been hypothesized that magnesium deficiency may predispose to muscle cramps. 16 • Pregnant women • Leg cramps are a common problem during pregnancy. 18 • Oral magnesium supplementation was shown to significantly reduce leg cramps in pregnant women. 18 • Older adults • Ageing constitutes a risk factor for magnesium deficit that originates from two mechanisms: insufficient dietary intake and reduced intestinal absorption. 19 • Athletes • Most athletes do not consume adequate amounts of magnesium in their diet. 20

  19. 12. Magnesium and diseases • MAGNESIUM AND MIGRAINE • Migraine is the most common neurological disorder in the United Sates with a prevalence rate of nearly 20%. 21 • Significant lower levels of magnesium have been reported in people with migraines during and between migraine attacks. 22 • Magnesium has been shown to prevent migraine, improve life quality and reduce migraine days between 22–43%across five clinical trials reviewed from 1990–2016. 23 • It is suggested that 600 mg of magnesium daily may be efficient in migraine prophylaxis. 23

  20. 12. Magnesium and diseases • MAGNESIUM AND DIABETES • Magnesium is involved in glycolysis and blood glucose control. 2, 3, 4 • Several studies have shown an inverse relationship between low serum magnesium levels and incidence of type 2 diabetes mellitus. 15, 24, 25 • Higher dietary magnesium intake is associated with a lower risk of developing type 2 diabetes mellitus and metabolic syndrome. 15, 24, 25 • Oral magnesium supplementation could reduce plasma glucose levels and improve the glycemic status in randomized controlled trials (RCTs) involving adults with prediabetes and diabetes. 26, 27

  21. 13. Magnesium deficiency • GROUPS AT RISK OF MAGNESIUM INADEQUACY • People with gastrointestinal diseases 1 • Chronic diarrhea and fat malabsorption resulting e.g. from Crohn’s disease, celiac disease or reginal enteritis can lead to magnesium depletion, malabsorption or loss. • People with type 2 diabetes 1 • Magnesium deficits and increased urinary excretion can occur in people with insulin resistance and/or type 2 diabetes. • The magnesium loss appears to be secondary to higher concentrations of glucose in the kidney that increase urine output.

  22. 13. Magnesium deficiency • GROUPS AT RISK OF MAGNESIUM INADEQUACY • Older adults 1 • Older adults have lower dietary intakes of magnesium than younger adults. • In addition, magnesium absorption from the gut decreases and renal magnesium excretion increases with age. • People with alcohol dependence 1 • Magnesium deficiency is common in people with chronic alcoholism. • In these individuals, poor dietary intake and nutritional status and gastrointestinal problems can all contribute to decreased magnesium status.

  23. 13. Magnesium deficiency • SYMPTOMS OF HYPOMAGNESEMIA • Symptoms of magnesium deficiency can be nonspecific and usually overlap with symptoms of other electrolyte imbalances. 28 • The severity of symptoms and signs depends on the degree of magnesium depletion. 28 • The symptoms usually occur when serum magnesium levels fall < 0.5 mmol/l (1.2 mg/dl).28

  24. 14. Good to know • DRUG INTERACTIONS • Magnesium interferes with the absorption of digoxin (a heart medication), nitrofurantoin (an antibiotic) and certain anti-malarial drugs, which could potentially reduce drug efficacy. 29 • Tetracycline antibiotics and bisphosphonates(e.g., alendronate, etidronate), which are drugs used to treat osteoporosis and magnesium should be taken two hours apart so that the absorption of the antibiotics and bisphosphonates is not inhibited.30, 31 • Magnesium has also been found to reduce the efficacy of chlorpromazine (a tranquilizer), penicillamine, oral anticoagulants and certain antibiotics. 30, 31

  25. 14. Good to know • In the past, quinine was frequently prescribed in the US and UK as an off-label treatment for nocturnal leg cramps. 32 • Quininedoesreduce the frequency of idiopathic leg cramps at night compared with placebo but its knownforitsadverseeffects: 33,34, 35 • Teratogenicity • Cardiac arrhythmias • Thrombocytopenia • Severe hypersensitivity reactions • → better use

  26. 15. Complementary treatment INDICATION: Diabetes • Magnesium supports blood glucose control • Magnesium supplementation could reduce plasma glucose levels + + or GlimepirideDenk MetforminDenk

  27. 15. Complementary treatment INDICATION: Cardiovascular diseases • Supports blood pressure regulation. • Hypertension is a major risk factor for heart disease. + Captopril+HCTDenk AtenololDenk Nifedi-Denk Vera-Denk Ena-Denk Carvedi-Denk Ena+HCTDenk Amlo-Denk Valsar-Denk CoValsar-Denk Losar-Denk CoLosar-Denk CaptoprilDenk

  28. 16. References 1National Institutes of Health (2018): Magnesium. Fact Sheet for Health Professionals. 2Institute of Medicine (IOM) (1997): Food and Nutrition Board. Dietary Reference Intakes: Calcium, Phosphorus, Magnesium, Vitamin D and Fluoride. Washington, DC: National Academy Press. 3Rude RK (2010): Magnesium. In: Coates PM, Betz JM, Blackman MR, Cragg GM, Levine M, Moss J, White JD, eds. Encyclopedia of Dietary Supplements. 2nd ed. New York, NY: Informa Healthcare. 527-537. 4 Rude RK (2012): Magnesium. In: Ross AC, Caballero B, Cousins RJ, Tucker KL, Ziegler TR, eds. Modern Nutrition in Health and Disease. 11th ed. Baltimore, Mass: Lippincott Williams & Wilkins. 159-175. 5 Schuchardt JP, Hahn A (2017): Intestinal Absorption and Factors Influencing Bioavailability of Magnesium – An Update. CurrNutr Food Sci. 13: 260-278. 6 Graham LA, Caesar JJ, Burgen AS (1960): Gastrointestinal absorption and excretion of Mg 28 in man. Metabolism. 9: 646-659. 7 Quamme GA (2008): Recent developments in intestinal magnesium absorption. CurrOpinGastroenterol. 24: 230-235. 8Rude RK, Singer FR, Gruber HE (2009): Skeletal and hormonal effects of magnesium deficiency. J Am CollNutr. 28: 131–141. 9 Orchard et al. (2014): Magnesium intake, bone mineral density and fractures. Am J ClinNutr. 99 (4): 926-933. 10 Gröber U, Schmidt J, Kisters K (2015): Magnesium in preventionandtherapy. Nutrients. 7: 8199–8226. 11 Kirkland AE, Sarlo GL, Holton KF (2018): The Role of Magnesium in Neurological Disorders. Nutrients. 10 (6): 730. 12Rosanoff A (2009): The Essential Nutrient Magnesium. Key To Mitochondrial ATP Production And Much More. ProHealth. 13Potter JD, Robertson SP, Johnson JD (1981): Magnesium and the regulation of muscle contraction. Fed Proc. 40 (12): 2653-2656. 14 Grycova L et al. (2009): ATP and magnesium drive conformational changes of the Na(+)/K(+)-ATPase cytoplasmic headpiece. BiochimBiophysActa. 15 Barbagallo M et al. (2003): Role of magnesium in insulin action, diabetes and cardio-metabolic syndrome X. Mol Aspects Med. 24: 39-52.

  29. 16. References 16NPS Medicinewise (2014): Magnesium, a treatment for leg cramps? https://www.nps.org.au/news/magnesium-a-treatment-for-leg-cramps 17Bordoni B, Varacallo M (2019): Muscle Cramps. StatPerls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK499895/ 18Sebo P, Cerutti B, Haller DM (2014): Effect of magnesium therapy on nocturnal leg cramps: a systematic review of randomized controlled trials with meta-analysis using simulations. Fam Pract. 31 (1): 7-19. 19Durchlach J et al. (1998): Magnesium status and ageing: an update. magnes Res. 11 (1): 25 – 42. 20Volpe SL (2015): Magnesium and the Athlete. Curr Sports Med Rep. 279 – 283. 21Silberstein S (2007): Probable migraine in the United States: Results of the American migraine prevalence and prevention (AMPP) study. Cephalalgia. 27: 220–229. 22 Nattagh-Eshtivani E et al. (2018): The role of nutrients in the pathogenesis and treatment of migraine headaches. Biomed. Pharmacother. 102: 317–325. 23Von Luckner A, Riederer F (2018): Magnesium in migraine prophylaxis - Is there an evidence-based rationale? A systematic review. Headache J. Head Face Pain. 58: 199–209. 24Kao WH (1999): Serum and dietary magnesium and the risk for type 2 diabetes mellitus: the Atherosclerosis Risk in Communities Study. Arch Intern Med. 159 (18): 2151-2159. 25Resnick L et al. (1993): Intracellular and extracellular magnesium depletion in type 2 (non-insulin-dependent) diabetes mellitus. Diabetologia. 36 (8): 767–770. 26 Guerrero-Romero F et al. (2015): Oral magnesium supplementation improves glycaemic status in subjects with prediabetes and hypomagnesaemia: A double-blind placebo-controlled randomized trial. Diabetes Metab. 41(3): 202-207. 27 Rodríguez-Morán M, Guerrero-Romero F (2003): Oral magnesium supplementation improves insulin sensitivity and metabolic control in type 2 diabetic subjects: a randomized double-blind controlled trial. Diabetes Care. 26 (4): 1147-1152.

  30. 16. References 28Al Alawi AM, Majoni, SW, Falhammar H (2018): Magnesium and Human Health: Perspectives and Research Directions. Int J Endocrinol. 29Linus Pauling Institute, Oregon State University (2019): Magnesium. 30Hendler SS, Rorvik DM (2008): PDR for Nutritional Supplements. Montvale: Thomson Reuters. 31 Natural Medicines Database (2019): Magnesium. 32Young G (2009): Leg cramps. Clinical Evidence. 03: 1113-1122. 33 Zhou K et al. (2015): Interventions for leg cramps in pregnancy. Cochrane Database Syst Rev. (8). 34Cochrane (2019): Quinine for muscle cramps. 35GOV UK (2019): Quinine: not to be used routinely for nocturnal leg cramps.

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