Higher Dietary Magnesium Intake Linked to Reduced Frailty Risk in Patients With COPD

A linear relationship exists between dietary magnesium intake and frailty in patients with chronic obstructive pulmonary disease (COPD), with higher dietary magnesium intake associated with a reduced frailty risk.1

The authors of the International Journal of Chronic Obstructive Pulmonary Disease study noted that the incidence of frailty among patients with COPD ranges from 6.43% to 71.7% and is associated with poor clinical outcomes.2 Among patients with COPD, frailty reduces quality of life and increases the risk of hospital admission and the length of stay.1 Therefore, they emphasized the importance of strengthening the prevention and management of frailty in patients with COPD.

Assessing dietary and nutritional status also serves as an important predictor of clinical outcomes in patients with COPD. For example, higher levels of magnesium deficiency are associated with an increased risk of developing COPD.3 Magnesium plays a role in various biological processes, like energy production, muscle contraction, and nucleic acid and protein synthesis.1

Although past studies discovered positive associations between magnesium and COPD, the relationship between dietary magnesium intake and the risk of frailty in patients with COPD remains unclear. Consequently, the researchers investigated this relationship using data from the National Health and Nutrition Examination Survey (NHANES), spanning 1999 to 2018.

Higher dietary magnesium intake is associated with a reduced risk of frailty in patients with chronic obstructive pulmonary disease.

Image Credit: Yulia Furman - stock.adobe.com

Conducted by the CDC, NHANES is a study based on the entire US population; researchers used sampling weights to examine the health and nutritional status of all patients residing in the US. This study focused on NHANES patients with COPD aged older than 20.

Dietary magnesium intake was based on the US Department of Agriculture (USDA) Food and Nutrition Database for Dietary Studies (FNDDS). The researchers divided the data into 4 quartiles based on dietary magnesium intake (Q1: ≤ 182; Q2: 182-244.925; Q3: 244.93-340.25; Q4: > 340.25).

Frailty was defined using the Frailty Index, which is calculated by summing cumulative deficits along with other geriatric signs and symptoms. The Frailty Index is determined as the ratio of the number of observed deficits to the number of potential deficits; a higher Frailty Index indicates a greater degree of frailty.

Based on the characteristics of the NHANES database and previous research, the researchers selected 49 deficits, covering cognitive function, depression, and comorbidity. The Frailty Index is graded from 0 to 1, with 0 indicating a deficiency and 1 indicating a complete deficiency. A Frailty Index greater than or equal to 0.21 was defined as frailty, while a Frailty Index less than 0.21 was defined as non-frailty.

The researchers used logistic regression to determine the adjusted odds ratio (aOR) and 95% CI. Additionally, they performed curve fitting, subgroup analyses, and sensitivity analyses to further assess the relationship between dietary magnesium intake and frailty in patients with COPD.

Of the NHANES respondents, 1696 adult patients with COPD were included in the study, which represented 7,368,884 patients residing in the US. The mean (SD) age of participants was 60.4 (0.4) years, and most were male (56.7%) and frail (53.1%). Therefore, those with higher magnesium intakes tended to be male, drank alcohol, and were married; they also had a lower incidence of hypertension, higher levels of education, and a higher family income.

Weighted logistic regression and curve fitting showed a linear relationship between frailty and dietary magnesium intake in patients with COPD. More specifically, frailty risk decreased by 15% for each 100-unit increase in magnesium intake (OR, 0.85; 95% CI, 0.76-0.96). Participants in Q4 had a 52% lower risk of developing frailty than those in Q1 (OR, 0.48; 95% CI, 0.32-0.72). The researchers noted that subgroup and sensitivity analyses further supported the relationship’s stability.

Lastly, they acknowledged their limitations, including this being a cross-sectional study. Therefore, the researchers could not make causal inferences between frailty and dietary magnesium intake in patients with COPD. Despite their limitations, they expressed confidence in their findings, using them to suggest areas for future research.

“...further prospective studies are needed to confirm the relationship between dietary [magnesium] intake and frailty in patients with COPD,” the authors concluded.

References

1. Liang M, Ren X, Zhang Q, Ruan Z, Jin M, Xu Y, Chen X, Qiu Z. The association between dietary magnesium intake and frailty in patients with chronic obstructive pulmonary disease: National Health and Nutrition Examination Survey. Int J Chron Obstruct Pulmon Dis. 2024;19:2651-2660. doi:10.2147/COPD.S485017
2. Wang L, Zhang X, Liu X. Prevalence and clinical impact of frailty in COPD: a systematic review and meta-analysis. BMC Pulm Med. 2023;23(1):164. doi:10.1186/s12890-023-02454-z
3. Wang KJ, Chen H, Wang J, Wang Y. Association between magnesium depletion score and chronic obstructive pulmonary disease risk: a secondary data analysis from NHANES. BMJ Open. 2024;14(6):e083275. doi:10.1136/bmjopen-2023-083275