Magnesium intake, bone mineral density, and fractures: Results from the Women's Health Initiative Observational Study

Tonya S. Orchard, Joseph C. Larson, Nora Alghothani, Sharon Bout-Tabaku, Jane A. Cauley, Zhao Chen, Andrea Z. LaCroix, Jean Wactawski-Wende, Rebecca D. Jackson

Research output: Contribution to journalArticle

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Abstract

Background: Magnesium is a necessary component of bone, but its relation to osteoporotic fractures is unclear. Objective: We examined magnesium intake as a risk factor for osteoporotic fractures and altered bone mineral density (BMD). Design: This prospective cohort study included 73,684 postmenopausal women enrolled in the Women's Health Initiative Observational Study. Total daily magnesium intake was estimated from baseline food-frequency questionnaires plus supplements. Hip fractures were confirmed by a medical record review; other fractures were identified by self-report. A baseline BMD analysis was performed in 4778 participants. Results: Baseline hip BMD was 3% higher (P < 0.001), and whole-body BMD was 2% higher (P < 0.001), in women who consumed >422.5 compared with <206.5 mg Mg/d. However, the incidence and RR of hip and total fractures did not differ across quintiles of magnesium. In contrast, risk of lower-arm or wrist fractures increased with higher magnesium intake [multivariate-adjusted HRs of 1.15 (95% CI: 1.01, 1.32) and 1.23 (95% CI: 1.07, 1.42) for quintiles 4 and 5, respectively, compared with quintile 1; P-trend = 0.002]. In addition, women with the highest magnesium intakes were more physically active and at increased risk of falls [HR for quintile 4: 1.11 (95% CI: 1.06, 1.16); HR for quintile 5: 1.15 (95% CI: 1.10, 1.20); P-trend < 0.001]. Conclusions: Lower magnesium intake is associated with lower BMD of the hip and whole body, but this result does not translate into increased risk of fractures. A magnesium consumption slightly greater than the Recommended Dietary Allowance is associated with increased lower-arm and wrist fractures that are possibly related to more physical activity and falls. This trial was registered at clinicaltrials.gov as NCT00000611.

Original languageEnglish (US)
Pages (from-to)926-933
Number of pages8
JournalAmerican Journal of Clinical Nutrition
Volume99
Issue number4
DOIs
StatePublished - Apr 1 2014

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Bone Fractures
Women's Health
Bone Density
Magnesium
Observational Studies
Osteoporotic Fractures
Hip Fractures
Wrist
Arm
Pelvic Bones
Recommended Dietary Allowances
Self Report
Medical Records
Hip
Cohort Studies
Prospective Studies
Exercise
Bone and Bones
Food
Incidence

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

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Magnesium intake, bone mineral density, and fractures : Results from the Women's Health Initiative Observational Study. / Orchard, Tonya S.; Larson, Joseph C.; Alghothani, Nora; Bout-Tabaku, Sharon; Cauley, Jane A.; Chen, Zhao; LaCroix, Andrea Z.; Wactawski-Wende, Jean; Jackson, Rebecca D.

In: American Journal of Clinical Nutrition, Vol. 99, No. 4, 01.04.2014, p. 926-933.

Research output: Contribution to journalArticle

Orchard, TS, Larson, JC, Alghothani, N, Bout-Tabaku, S, Cauley, JA, Chen, Z, LaCroix, AZ, Wactawski-Wende, J & Jackson, RD 2014, 'Magnesium intake, bone mineral density, and fractures: Results from the Women's Health Initiative Observational Study', American Journal of Clinical Nutrition, vol. 99, no. 4, pp. 926-933. https://doi.org/10.3945/ajcn.113.067488
Orchard, Tonya S. ; Larson, Joseph C. ; Alghothani, Nora ; Bout-Tabaku, Sharon ; Cauley, Jane A. ; Chen, Zhao ; LaCroix, Andrea Z. ; Wactawski-Wende, Jean ; Jackson, Rebecca D. / Magnesium intake, bone mineral density, and fractures : Results from the Women's Health Initiative Observational Study. In: American Journal of Clinical Nutrition. 2014 ; Vol. 99, No. 4. pp. 926-933.
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abstract = "Background: Magnesium is a necessary component of bone, but its relation to osteoporotic fractures is unclear. Objective: We examined magnesium intake as a risk factor for osteoporotic fractures and altered bone mineral density (BMD). Design: This prospective cohort study included 73,684 postmenopausal women enrolled in the Women's Health Initiative Observational Study. Total daily magnesium intake was estimated from baseline food-frequency questionnaires plus supplements. Hip fractures were confirmed by a medical record review; other fractures were identified by self-report. A baseline BMD analysis was performed in 4778 participants. Results: Baseline hip BMD was 3{\%} higher (P < 0.001), and whole-body BMD was 2{\%} higher (P < 0.001), in women who consumed >422.5 compared with <206.5 mg Mg/d. However, the incidence and RR of hip and total fractures did not differ across quintiles of magnesium. In contrast, risk of lower-arm or wrist fractures increased with higher magnesium intake [multivariate-adjusted HRs of 1.15 (95{\%} CI: 1.01, 1.32) and 1.23 (95{\%} CI: 1.07, 1.42) for quintiles 4 and 5, respectively, compared with quintile 1; P-trend = 0.002]. In addition, women with the highest magnesium intakes were more physically active and at increased risk of falls [HR for quintile 4: 1.11 (95{\%} CI: 1.06, 1.16); HR for quintile 5: 1.15 (95{\%} CI: 1.10, 1.20); P-trend < 0.001]. Conclusions: Lower magnesium intake is associated with lower BMD of the hip and whole body, but this result does not translate into increased risk of fractures. A magnesium consumption slightly greater than the Recommended Dietary Allowance is associated with increased lower-arm and wrist fractures that are possibly related to more physical activity and falls. This trial was registered at clinicaltrials.gov as NCT00000611.",
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AU - Orchard, Tonya S.

AU - Larson, Joseph C.

AU - Alghothani, Nora

AU - Bout-Tabaku, Sharon

AU - Cauley, Jane A.

AU - Chen, Zhao

AU - LaCroix, Andrea Z.

AU - Wactawski-Wende, Jean

AU - Jackson, Rebecca D.

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N2 - Background: Magnesium is a necessary component of bone, but its relation to osteoporotic fractures is unclear. Objective: We examined magnesium intake as a risk factor for osteoporotic fractures and altered bone mineral density (BMD). Design: This prospective cohort study included 73,684 postmenopausal women enrolled in the Women's Health Initiative Observational Study. Total daily magnesium intake was estimated from baseline food-frequency questionnaires plus supplements. Hip fractures were confirmed by a medical record review; other fractures were identified by self-report. A baseline BMD analysis was performed in 4778 participants. Results: Baseline hip BMD was 3% higher (P < 0.001), and whole-body BMD was 2% higher (P < 0.001), in women who consumed >422.5 compared with <206.5 mg Mg/d. However, the incidence and RR of hip and total fractures did not differ across quintiles of magnesium. In contrast, risk of lower-arm or wrist fractures increased with higher magnesium intake [multivariate-adjusted HRs of 1.15 (95% CI: 1.01, 1.32) and 1.23 (95% CI: 1.07, 1.42) for quintiles 4 and 5, respectively, compared with quintile 1; P-trend = 0.002]. In addition, women with the highest magnesium intakes were more physically active and at increased risk of falls [HR for quintile 4: 1.11 (95% CI: 1.06, 1.16); HR for quintile 5: 1.15 (95% CI: 1.10, 1.20); P-trend < 0.001]. Conclusions: Lower magnesium intake is associated with lower BMD of the hip and whole body, but this result does not translate into increased risk of fractures. A magnesium consumption slightly greater than the Recommended Dietary Allowance is associated with increased lower-arm and wrist fractures that are possibly related to more physical activity and falls. This trial was registered at clinicaltrials.gov as NCT00000611.

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