Paul Mason, editor
Magnesium Web Site, www.MgWater.com,
ray@mgwater.com
Within this document you can go to:
Magnesium deficiency appears to have caused Eight Million
sudden coronary deaths in America during the period 1940-1994,
based on census data and studies of similar deaths from magnesium
deficiency conducted in Canada, Great Britain, Finland, and
India. This global pattern of death from magnesium deficiency is
important in terms of setting priorities for further research and
setting standards of nutrition. The needless drag on the U. S.
economy from magnesium deficiency exceeds $86 Billion per
year.
The United States Dept. of Agriculture reported that only 25%
of 37,000 consumers surveyed had a dietary magnesium intake that
equalled or exceeded the Recommended Daily Allowance (RDA), and
39% of those surveyed ingested less than 70% of the magnesium RDA
(22). Many others have reported widespread magnesium deficiency
(1,2,3,4,7,8,10,12,17,18,19,20,23,32,34).
Fatal Chronic magnesium deficiency shows few recognized
symptoms until cardiac arrhythmia occurs (1,21,31). Magnesium
deficiency may cause migraine and premenstrual syndrome
(13,14,15,16,24,26,27,28,33).
To calculate the probable number of American deaths caused by
magnesium deficiency since 1940, I have calculated the numbers of
the American population that would correspond by age and sex to
those in each of the foreign studies. In each study, foreign
populations were divided into groups receiving magnesium-rich
water or a magnesium-rich diet, and a second group receiving less
magnesium. By obtaining the two annual death rates for each set
of two groups, it is possible to calculate the difference in
death rates and apply that rate to the corresponding American
population group, limited by age and sex. This may understate the
true U. S. deaths caused by magnesium deficiency, as deaths
occurring outside the age or sex limits of each study are not
represented.
A global pattern emerges of large numbers of sudden cardiac
deaths which can be correlated to magnesium deficiency, and it
seems reasonable to suppose that American rates of such deaths
would fall within or near the parameters experienced by the
benchmark countries of Great Britain, Finland, Canada, and
India.
In Great Britain (8) sudden coronary death was recorded for
the M/F population ages 25-64 in Glasgow (low Mg in water) and
London (high Mg in water), and the difference in death rates was
found to be .001813. The average number of Americans 25-64 in the
period 1940 to 1994 is 90,131,722, which, when multiplied by the
difference in annual death rates between high and low magnesium
intake gives 163,409, which, when multiplied by 54 years gives
8,824,076 American deaths in that age group during the period
1940-1994 which can be projected to have occurred from magnesium
deficiency. Note that sudden coronary deaths occurring before age
25 and after age 64 are not included, so the projection may be
understating total American deaths from magnesium deficiency.
In Finland (25) only male deaths were studied, ages 40-59,
which had a coronary heart disease annual death rate that was
.004578 different between the areas of high and low magnesium
intake from water. The corresponding American male population
aged 40-59 averaged 20,335,107 from 1940-1994. When that
population is multiplied by the difference in death rates between
areas of high and low magnesium intake, it gives 93,094, which,
when multiplied by 54 years gives 5,027,082 American deaths in
that sex and age group during the period 1940-1994 which can be
projected to have occurred from magnesium deficiency. Note that
coronary death among all women and deaths by men before age 40 or
after age 59 are not included, so the projection may be
understating total deaths from magnesium deficiency.
In Ontario, Canada (3), sudden ischemic heart disease deaths
were compared for two M/F populations aged 35-74 ingesting
different levels of magnesium in water. The annual difference in
sudden death rates was .000750. The equivalent age group in the
U. S. numbered an average of 73,351,322 from 1940-1994, which,
when multiplied by .000750 gives 55,013, which, when multiplied
by 54 years gives 2,970,729 American deaths in that age group
that can be projected to have occurred from magnesium deficiency.
Note that sudden coronary deaths by people under 35 or over 74
are not included, so the projection may be understating total
American deaths from magnesium deficiency.
In India (32) two groups composed almost totally of males aged
25-63 were given two different diets, one averaging 1142 mg
magnesium per day, and the other averaging 418 mg magnesium per
day. The annual difference in death rates was .006241. The
equivalent male population in the U. S. averaged 44,185,470
during the period 1940-1994, which, when multiplied by the
difference in death rates gives 275,762 per annum; multiplied by
54 years gives 14,891,122 American deaths in that sex and age
group which can be projected to have occurred from magnesium
deficiency. Note that women, and all men under 25 or over 63,
were not included, so the projection may be understating total
deaths from magnesium deficiency.
It can be inferred from these foreign studies that nearly
eight million Americans have needlessly died from a deficiency of
magnesium, which apparently could have been easily and cheaply
avoided by drinking magnesium-rich water, or by a major change to
the traditional Asian diet, which is generally twice as
magnesium-rich as the Western diet (5).
If the benchmark average Mg-deficiency death rate of .003345
is applied to a current world population of near 6 billion, the
annual global deaths from Mg deficiency are about 20,000,000. The
American rate of death from Mg-deficiency is likely to be above
the benchmark average because the American diet is particularly
Mg-deficient; American beer contains only a fraction of the Mg
contained in European beers; American bottled water contains only
10% as much magnesium as bottled water in the rest of the world;
and American processed foods and snack foods are Mg-deficient
because processing often removes Mg. These points and references
can be found in our Citizen Petitions to the FDA, available at
http://www.mgwater.com/, our home
page.
In view of the average 590 American deaths caused each day by
magnesium deficiency, I recommend that the FDA require all
bottled water sold in the U. S. to contain at least 90 mg/L
magnesium, which can be accomplished by filtering non-spring
waters through Akdolit, Neutralite, or Magno (10), or by adding
magnesium chloride, magnesium citrate, or magnesium
carbonate.
The FDA or other governmental agencies should sponsor further
research, as magnesium is too cheap and common for any business
to justify spending the millions necessary to produce the 4,000
pounds of documents required by the FDA for new drug or nutrient
approval. The current literature on magnesium and Sudden Death
weighs perhaps less than 100 pounds, although the evidence is
overwhelming.
Water-borne magnesium is more completely and readily absorbed
by the gut than is food-borne magnesium (10).
Changing a population's diet to include magnesium-rich foods
appears to be less practical and less likely than improving the
magnesium content of drinking water, particularly bottled water,
and water-based beverages. European brands of water commonly
contain 27 mg/L or more magnesium, while domestic American brands
average 3 mg/L magnesium.
WATER NAME COUNTRY MAGNESIUM RDI%*
(mg/Liter) (8 oz)
-------------------------------------- --------- ---------- -----
Adobe Springs USA 110 6
Santa Ynez USA 87 19
S. Pellegrino ITALY 57 3
Penafiel MEXICO 41 2
Vittel FRANCE 38 2
Evian FRANCE 24 1
Naya CANADA 22 1
Volvic FRANCE 7 0
Saratoga Mineral Water USA 7 0
Perrier FRANCE 5 0
Alhambra USA 5 0
Arrowhead USA 5 0
Sparkletts Drinking Water USA 5 0
Calistoga Mineral Water USA 2 0
Cobb Mountain USA 2 0
Polar Spring Water USA 2 0
aSante Mineral Water USA 1 0
Black Mountain USA 1 0
Crystal Geyser Sparkling Mineral USA 1 0
*RDI=Recommended Daily Intake, which for Mg is 400 mg/day.
RDI%=% of Recommended Daily Intake per 8 oz. serving.
The source of information on mineral content of various brands
was "The Pocket Guide to Bottled Water" (35), except that it did
not mention Naya or the Adobe Springs
.
French medical literature has recommended that bottled water
contain at least 30-90 mg/L magnesium (22). Except in the
presence of renal failure, there is no need to limit magnesium
intake (6); at extremely high dosages, magnesium is commonly used
as a laxative, but does not have that effect at a low dosage of
90 mg/L.
The poor showing of American brands is probably due to
historic campaigns by the FDA and AMA against health claims for
minerals in water. In 1880 America had many brands of
mineral-rich water, but by 1950 Americans had been educated to
believe that "pure" water was best, meaning no minerals. The
European tradition is just the opposite, placing a high value on
minerals in water. The Europeans were right, at least in regard
to magnesium.
Some magnesium literature stresses that the calcium/magnesium
ratio in water should be about 2 to 1 to benefit the heart
(10,11,18,37,38), and that corrosiveness should be avoided as
lead and cadmium can be leached out of pipes (11). The Langelier
and Ryznar Indexes of corrosivity work only with waters
containing calcium carbonate. Such indices are "more useful after
the fact, in helping to understand possible causes of the problem
(corrosion) rather than being useful in a predictive sense"
(36).
Empirical tests need to be invented of the leaching capability
for lead and cadmium of all municipal waters (11,29). Bottled
spring water contacts primarily cooking utensils, so leaching may
be of less concern.
What are the characteristics of the ideal bottled water? 1.
Most important, it should have as much magnesium as possible
without triggering the laxative effect, which seems to start at
about 150 mg/L. 2. It should have as little sodium as possible.
3. It should have a high magnesium-to-calcium ratio (18). Here is
how existing brands rate in those categories.
WATER NAME COUNTRY MAGNESIUM CALCIUM SODIUM
(mg/L) (mg/L) (mg/L)
----------------------------------------------------------------
--
Adobe Springs USA 110 3.3 5
Santa Ynez USA 87 19 -
S. Pellegrino ITALY 57 203 46
Penafiel MEXICO 41 131 159
Vittel FRANCE 38 181 3.7
Evian FRANCE 24 78 5
Naya CANADA 22 38 6
Volvic FRANCE 7 10 10.7
Saratoga Mineral Wtr USA 7 64 9
Perrier FRANCE 5 143 15.2
Alhambra USA 5 9.5 5.4
Arrowhead USA 5 20 3
Sparkletts Drinking USA 5 4.6 15.2
Calistoga Mineral Wtr USA 2 8 163
Cobb Mountain USA 2 5.6 4.6
Polar Spring Water USA 2 13.2 8.9
aSante Mineral Water USA 1 4.2 160
Black Mountain USA 1 25 8.3
Crystal Geyser Spark. USA 1 1.5 30
Many bottled waters are sold for their purity or healthfulness
which, in fact, cause death due to their magnesium deficiency.
Based on epidemiological evidence, these deaths would not occur
if the consumers instead drank water from springs richer in
magnesium, such as Vittel, Penafiel, S. Pellegrino, Santa Ynez,
or Adobe Springs .
To get some idea of the number of deaths caused by each
company selling deficient bottled water, I have invented the
"Mg-Deficiency Death Index", or MDDI-Bottled. The formula is:
GAL/YR * Benchmark Death Rate * (90-mg/L) = Deaths per yr
182 90
The way I arrived at this is: The RDA for water is eight 8-oz.
servings, (64 oz. per day) which works out to 182 gallons per
annum. Dividing a particular company's total annual gallonage by
182 gives the maximum number of possible customers who drink only
their brand. Multiplying by the benchmark average death rate of
.003465 caused by magnesium deficiency will give a ballpark
estimate of the maximum number of consumers killed by that
company per annum if the magnesium content were zero. Most
domestic bottled waters contain 1 to 7 mg/L, so to reflect that I
subtract the mg/L Mg in the subject water from 90, and divide
that figure by 90. A negative number of deaths would mean the
water was richer than 90 mg/L Mg, and a positive score would be
the probable number of deaths caused, if indeed 90 mg/L would
have been adequate Mg. This formula will work for any bottled
water except one with 90 mg/L, as that would mean dividing into
zero. Since nearly all domestic brands of water are very
magnesium deficient, it makes little difference if the consumer
drank just one brand or several different brands.
EXAMPLE: If company A sells 100,000,000 gallons per annum of
bottled water with 5 mg/L magnesium, the formula gives how many
deaths per annum that company has caused by selling magnesium
deficient water:
(100,000,000/182) * .003345*(90-5)/90 = 1735 Deaths per yr
(4.75 deaths per day)
In a similar fashion, municipal water supplies can be rated
for deaths caused by magnesium deficiency (MDDI-Municipal) by
ascertaining by survey how many customers drink tap water, and
multiplying that by the death rate, etc. 84.2% of U. S. liquid
consumption is water based, (see below), so it is possible to
simply multiply the total number of tap customers by 84.2%, and
multiply that figure by the death rate, etc. Most U.S. tap waters
are slightly richer in magnesium (mean 5.5 mg/L) than domestic
bottled water, but in some cases this benefit may be offset by
lead or cadmium contaminants in plumbing (36).
Tap consumers * .003345* (90-mgs per liter)/90 = Deaths per yr
These formulas represent the entire population, including the
high risk groups of infants and the aged. If the benchmark death
rate should prove to be inapplicable to all age and sex groups,
the formulas could overstate or understate the deaths. To apply
the formulas to only the average of benchmark subsets, multiply
the results by .248.
In addition to bottled water, attention should be paid to
fortifying beverages that use water as a major ingredient, such
as soft drinks, beer, coffee, tea, and powdered drinks.
U.S. Liquid Consumption Trends Estimated for 1992 by %*
Soft Drinks 26.3
Coffee 14.3
Beer 12.7
Milk 10.5
Tea 3.7
Bottled Water 5.4
Juices 3.6
Powdered Drinks 3.1
Wine 1.0
Distilled Spirits .7
Imputed Tap Water Consumption 18.7
*BEVERAGE INDUSTRY Annual Manual, 1993-1994.
84.2% of U. S. liquid consumption is water-based, including
beer but not including wine, spirits, milk, or juice.
The economic impact of magnesium deficiency is very
considerable. Conservatively, Mg-deficiency kills 215,585
Americans per annum, mostly men in their peak earning years (30);
the very old were not included in the projections, nor were the
very young.
If each death had an economic value (lost life-time earnings)
of only $200,000, that would be $43,117,000,000 per year of
economic loss caused by Mg deficiency. If there is just one other
incapacitated survivor for each fatality, the total economic loss
exceeds $86 Billion per annum, and that does not include billions
more spent on medical care and supporting the incapacitated.
These projections from international data represent an average
of subsets of only .248 of the population. If the same rate of
death proves to be applicable to the entire population, including
the high-risk groups of infants and the aged, there would be 4.03
times as many deaths; so the deaths from magnesium deficiency
since 1940 would be nearly 32 million, and the annual U. S.
deaths from magnesium deficiency would be 869,700. Annual lost
earnings would exceed $347 Billion. Sudden cardiac death is known
to peak between 0 and 6 months, and between 45-75 years,
according to Zipes, D. P., SUDDEN CARDIAC DEATH, American Journal
of Cardiology, Feb. '79.
By comparison, the deaths from the Hiroshima atom bomb were
only 80,000 to 200,000, so magnesium deficiency is equivalent to
the atomic bombings of several small American cities each year.
For another comparison, all American war deaths in the history of
the country total much less than 2,000,000, so magnesium
deficiency is a much greater catastrophe than all American wars
combined. Another comparison is Hitler's Holocaust, which claimed
6,000,000 lives.
COMPARISONS OF Mg-DEFICIENCY DEATHS TO OTHER CATASTROPHES
CAUSE OF DEATH LOW ESTIMATE HIGH ESTIMATE
Mg Deficit 1940-1994 8,000,000 32,000,000
Annual USA Mg Deficit 215,000 869,000
Hiroshima Atom Bomb 80,000 200,000
All American War Deaths - 2,000,000
Hitler's Holocaust - 6,000,000
Unless the problem is addressed, magnesium deficiency is
likely to get worse over the years because modern farming methods
of tilling the soil probably cause magnesium to leach from the
soil. The Illinois-American Water Co. has reported that at Alton,
Illinois, the Mississippi River contains 17 mg/L dissolved
magnesium, not including the undissolved dirt load. If the same
concentration exists at the Mississippi's mouth, the annual loss
of magnesium from Mid-western soils would be 343,590,400 cubic
feet, not including the undissolved dirt load. Unlike nitrogen
and other nutrients, it is not current practice in agriculture to
replace the soil magnesium that is harvested or leached. Soil
magnesium is so easily leached that apparently much of it has run
off to the oceans; commercial magnesium is generally obtained
from seawater rather than mining, as it is cheaper. Geologic
formations containing ancient ocean beds commonly contain the
highest concentrations of magnesium.
Magnesium is a cheap commodity, one of the most common
elements on the planet. The cost of implementing fortification of
bottled water-based products is a minuscule fraction of the
$90-341 Billion of annual losses caused by Mg deficiency, and
could be implemented in less than a year. The fortification of
milk with vitamin D provides a good benchmark for gauging costs.
Economists should be in the forefront of advocating the end of
Magnesium deficiency; it would boost the economy greatly, as well
as save precious lives.
I wish to particularly thank Dr. Mark J. Eisenberg, Dr.
Egelius Spierings, and Dr. Burton Altura for sharing journal
reprints or other information with me. I applaud my wife, Janet,
for her excellent suggestions, hard work, and computer
support.
Paul Mason
paulmason@mgwater.com
1/5/94
Expanded 9/3/94
1. Altura, B. M., Sudden-death ischemic heart disease and
dietary magnesium: Is the target site coronary vascular smooth
muscle?, Medical Hypotheses 5:843-848, 1979.
2. Anderson, T. W., Neri, L. C., Schreiber, G. B., Talbot, F.
D. F., Zdrojewski, A., Ischemic heart disease, water hardness and
myocardial magnesium, CMA Journal 113:199-203, 1975.
3. Anderson, T. W., Leriche, W. H., Hewitt, D., Neri, L. C.,
Magnesium, water hardness, and heart disease, Magnesium in Health
and Disease, pp. 565-571, 1980.
4. Anderson, T. W., Hewitt, D., Neri, L. C., Schreiber, G.,
Talbot, F., Water hardness and magnesium in heart muscle, Lancet,
pp. 1390-1391, December 15, 1973.
5. Chu, H. I., Liu, S. H., Hsu, H. C., Choa, H. C., and Cheu,
S. H., Calcium, phosphorus, nitrogen, and magnesium metabolism in
normal young Chinese adults, Chinese M. J., 59: 1, 1941.
6. Contribution of Drinking Water to Mineral Nutrition,
Drinking Water and Health, pp. 273-274.
7. Crawford, Margaret D., Gardner, M. J., Morris, J. N.,
Changes in water hardness and local death-rates, Lancet, pp.
327-329, August 14, 1971.
8. Crawford, T., Crawford, Margaret D., Prevalence and
pathological changes of ischaemic heart-disease in a hard-water
and in a soft-water area, Lancet, pp. 229-232, February 4,
1967.
9. Durlach, J., Durlach, V., Rayssiguier, Y., Ricquier, D.,
Goubern, M., Bertin, R., Bara, M., Guiet-Bara, A., Olive, G.,
Mettey, R., Magnesium and thermoregulation. I. Newborn and
infant. Is Sudden Infant Death Syndrome a magnesium-dependent
disease of the transition from chemical to physical
thermoregulation?, Magnesium Research, 4, 3/4, 137-152, 1991.
10. Durlach, J., Bara, M., Guiet-Bara, A., Magnesium level in
drinking water and cardiovascular risk factor: A hypothesis,
Magnesium 4: 5-15, 1985.
11. Durlach, J., Bara, M., Guiet-Bara, A., Magnesium level in
drinking water: its importance in cardiovascular risk, Magnesium
in Health and Disease, pp. 173-182, 1989.
12. Durlach, J., Recommended dietary amounts of magnesium: Mg
RDA, Magnesium Research 2, 3, 195-203, 1989.
13. Gallai, V., Sarchielli, P., Morucci, P., Abbritti, G., Red
blood cell magnesium levels in migraine patients, Cephalagia, pp.
94-98, 1993.
14. Gallai, V., Sarchielli, P., Coata, G., Firenze, C.,
Morucci, P., Abbritti, G., Serum and salivary magnesium levels in
migraine. Results in a group of juvenile patients, Headache, pp.
132-135, March, 1992.
15. Facchinetti, F., Sances, G., Borella, P., Genazzani, A. R.
Nappi, G., Magnesium prophylaxis of menstrual migraine: effects
on intracellular magnesium, Headache, pp. 298-301, May, 1991.
16. Facchinetti, F., Borella, P., Sances, G., Fioroni, L.,
Nappi, Rossella, E., Genazzani, A. R., Oral magnesium
successfully relieves premenstrual mood changes, Obstetrics &
Gynecology, pp. 177-181, Vol. 78, No. 2, August 1991.
17. Jones, John E., Manalo, Romualda, Flink, Edmund B.,
Magnesium requirements in adults, American Journal of Clinical
Nutrition, Vol. 20, No. 6, pp. 632-635, June, 1967.
18. Karppanen, H., Epidemiological studies on the relationship
between magnesium intake and cardiovascular diseases, Artery
9:190-9, 1981.
19. Karppanen, H., Neuvonen, P. J., Ischaemic heart-disease
and soil magnesium in Finland, Lancet, p. 1390, December 15,
1973.
20. Karppanen, H., Tanskanen, A., Tuomilehto, J., Puska, P.,
Vuori, J., Jantti, V., Seppanen, M., Safety and effects of
potassium- and magnesium-containing low sodium salt mixtures,
Journal of Cardiovascular Pharmacology 6:s236-s243, 1984.
21. Kubena, K. S., Durlach, J., Historical review of the
effects of marginal intake of magnesium in chronic experimental
magnesium deficiency, Magnesium and Cardiovascular Disease,
pp.219-226.
22. Marier, J. R., Magnesium content of the food supply in the
modern-day world, Magnesium 5:1-8, 1986.
23. Marier, J. R., Nutritional and myocardial aspects of
magnesium in drinking-water, Magnesium Bull 1a:48-54, 1981.
24. Mauskop, A., Altura, B. T., Cracco, R. Q., Altura, B. M.,
Deficiency in serum ionized magnesium but not total magnesium in
patients with migraines. Possible role of ICa 2+ /IMg 2+ ratio,
Headache,pp. 136-138, March 1993.
25. Punsar, S., Karvonen, M. J., Drinking Water Quality and
Sudden Death: Observations from West and East Finland,
Cardiology, 64:24-34, 1979.
26. Ramadan, N. M., Halvorson, H., Vande-Linde, A., Levine,
Steven R., Helpern, J. A., Welch, K. M. A., Low brain magnesium
in migraine, Headache, pp. 416-419, 1989.
27. Sarchielli, P., Coata, G., Firenze, C., Morucci, P.,
Abbritti, G., Gallai, V., Serum and salivary magnesium levels in
migraine and tension-type headache. Results in a group of adult
patients, Cephalagia, pp. 21-21, 1992.
28. Schoenen, J., Sianard-Gainko, J., Lenaerts, M., Blood
magnesium levels in migraine, Cephalagia, pp. 97-99, 1991.
29. Schroeder, Henry, Kraemer, Luke A., Cardiovascular
mortality, municipal water, and corrosion, Arch Environ Health,
Vol 28, pp. 303-311, June 1974.
30. Lown, Bernard, Sudden cardiac death: the major challenge
confronting contemporary cardiology,The American Journal of
Cardiology, Vol 43, p. 313, Feb 1979.
31. Seelig, Mildred S., The requirement of magnesium by the
normal adult, American Journal of Clinical Nutrition, Vol. 14,
pp. 342-389, June 1964.
32. Singh, R. B., Effect of dietary magnesium supplementation
in the prevention of coronary heart disease and sudden cardiac
death, Magnesium Trace Elem 9: 143-151, 1990.
33. Swanson, Don R., Migraine and magnesium: Eleven neglected
connections, Perspectives in Biology and Medicine, 31, 4 pp.
526-557, 1988.
34. Tzivoni, Dan, Keren, Andre, Suppression of ventricular
arrhythmias by magnesium, American Journal of Cardiology, pp.
1397-1399, June 1, 1990.
35. Von Wiesenberger, Arthur, The Pocket Guide to Bottled
Water. Chicago, IL: Contemporary Books, 1991.
36. Water Quality and Treatment, A Handbook of Community Water
Supplies, American Water Works Association, Frederick W.
Pontius, Technical Editor, 4th ed., p. 1073.
37. Durlach, J., Recommended Dietary Amounts Of Magnesium: Mg
RDA, Magnesium Research, (1989) 2 ,3, pp. 195-203
38. Seelig, M., American Journal of Clinical Nutrition, 14, p
342, 1964
JUSTIFICATION of the Intermediate
Calculations in Support of this Article, a detailed explanation
of the calculations given here
This page was first uploaded to The Magnesium Web Site on
September 30, 1995
http://www.mgwater.com/
Healthy Water
Association--USA