Health & Fitness

I've previously discussed the synergy between magnesium and vitamin D, and the importance of vitamin D for optimal immune function and overall health — especially as it pertains to lowering your risk of COVID-19. Previous studies have also highlighted the role this duo plays in cognitive function among older adults, as well as overall mortality.

Vitamin D and Magnesium Protect Cognitive Health

One such study,¹ "Association of Vitamin D and Magnesium Status with Cognitive Function in Older Adults: Results from the National Health and Nutrition Examination Survey (NHANES) 2011 to 2014," points out that vitamin D not only protects neuronal structures and plays a role in neuronal calcium regulation, but also appears to impact your risk for neurodegeneration as you grow older.

Magnesium, meanwhile, aside from being required for converting vitamin D to its active form,^2,3,4 also plays a role in cognitive health, and magnesium deficiency has been implicated in several neurological disorders.

Using NHANES data from 2,984 participants over the age of 60, the researchers compared serum vitamin D status and dietary magnesium intake against cognitive function scores.

After adjusting for confounding factors, including total calorie consumption and magnesium intake, higher blood levels of vitamin D positively correlated with decreased odds of having a low cognitive function score on the Digit Symbol Substitution Test.

The same trend was found when they looked at vitamin D intake, rather than blood level. The correlation of higher vitamin D levels and better cognitive function was particularly strong among those whose magnesium intake was equal to or greater than 375 mg per day. According to the authors:⁵

"We found that higher serum 25(OH)D levels were associated with reduced risk of low cognitive function in older adults, and this association appeared to be modified by the intake level of magnesium."

Magnesium Improves Brain Plasticity

While magnesium intake by itself did not appear to have an impact on cognitive function in the study above, other research has highlighted its role in healthy cognition.

Memory impairment occurs when the connections (synapses) between brain cells diminish. While many factors can come into play, magnesium is an important one. As noted by Dr. David Perlmutter, a neurologist and fellow of the American College of Nutrition:⁶

"It has now been discovered that magnesium is a critical player in the activation of nerve channels that are involved in synaptic plasticity. That means that magnesium is critical for the physiological events that are fundamental to the processes of learning and memory."

A specific form of magnesium called magnesium threonate was in 2010 found to enhance "learning abilities, working memory, and short- and long-term memory in rats."⁷ According to the authors, "Our findings suggest that an increase in brain magnesium enhances both short-term synaptic facilitation and long-term potentiation and improves learning and memory functions."

COVID-19 Can Deprive Brain of Oxygen

While we're on the topic of the brain, a July 1, 2020, article⁸ in The Washington Post reviewed findings from autopsies of COVID-19 patients. Surprisingly, Chinese researchers have reported⁹ that COVID-19 patients can exhibit a range of neurological manifestations.

A June 12, 2020, letter to the editor¹⁰ published in The New England Journal of Medicine also discusses the neuropathological features of COVID-19. As reported by The Washington Post:¹¹

"Patients have reported a host of neurological impairments, including reduced ability to smell or taste, altered mental status, stroke, seizures — even delirium … In June, researchers in France reported that 84% of patients in intensive care had neurological problems, and a third were confused or disoriented at discharge.

… Also this month, those in the United Kingdom found that 57 of 125 coronavirus patients with a new neurological or psychiatric diagnosis had experienced a stroke due to a blood clot in the brain, and 39 had an altered mental state.

Based on such data and anecdotal reports, Isaac Solomon, a neuropathologist at Brigham and Women's Hospital in Boston, set out to systematically investigate where the virus might be embedding itself in the brain.

He conducted autopsies of 18 consecutive deaths, taking slices of key areas: the cerebral cortex (the gray matter responsible for information processing), thalamus (modulates sensory inputs), basal ganglia (responsible for motor control) and others …"

Interestingly, while doctors and researchers initially suspected that brain inflammation was causing the neurological problems seen in some patients, Solomon's autopsies found very little inflammation. Instead, these neurological manifestations appear to be the result of brain damage caused by oxygen deprivation.

Signs of oxygen deprivation were present both in patients who had spent a significant amount of time in intensive care, and those who died suddenly after a short but severe bout of illness. I believe this is likely due to increases in clotting in the brain microvasculature.

Solomon told The Washington Post he was "very surprised," by the finding. It makes sense, though, considering COVID-19 patients have been found to be starved for oxygen. As reported by The Washington Post:¹²

"When the brain does not get enough oxygen, individual neurons die … To a certain extent, people's brains can compensate, but at some point, the damage is so extensive that different functions start to degrade … The findings underscore the importance of getting people on supplementary oxygen quickly to prevent irreversible damage."

Magnesium and Vitamin D Impact Mortality

Getting back to magnesium and vitamin D, previous research¹³ using NHANES data from 2001 through 2006 found the duo has a positive impact on overall mortality rates. This study also pointed out that magnesium "substantially reversed the resistance to vitamin D treatment in patients with magnesium-dependent vitamin-D-resistant rickets."

The researchers hypothesized that magnesium supplementation increases your vitamin D level by activating more of it, and that your mortality risk might therefore be lowered by increasing magnesium intake. That is indeed what they found. According to the authors:

"High intake of total, dietary or supplemental magnesium was independently associated with significantly reduced risks of vitamin D deficiency and insufficiency respectively. Intake of magnesium significantly interacted with intake of vitamin D in relation to risk of both vitamin D deficiency and insufficiency.

Additionally, the inverse association between total magnesium intake and vitamin D insufficiency primarily appeared among populations at high risk of vitamin insufficiency.

Furthermore, the associations of serum 25(OH)D with mortality, particularly due to cardiovascular disease (CVD) and colorectal cancer, were modified by magnesium intake, and the inverse associations were primarily present among those with magnesium intake above the median.

Our preliminary findings indicate it is possible that magnesium intake alone or its interaction with vitamin D intake may contribute to vitamin D status. The associations between serum 25(OH)D and risk of mortality may be modified by the intake level of magnesium."

Magnesium Lowers Vitamin D Requirement by 146%

According to a scientific review^14,15 published in 2018, as many as 50% of Americans taking vitamin D supplements may not get significant benefit as the vitamin D simply gets stored in its inactive form, and the reason for this is because they have insufficient magnesium levels.

Research published in 2013 also highlighted this issue, concluding that higher magnesium intake helps reduce your risk of vitamin D deficiency by activating more of it. As noted by the authors:¹⁶

"High intake of total, dietary or supplemental magnesium was independently associated with significantly reduced risks of vitamin D deficiency and insufficiency respectively.

Intake of magnesium significantly interacted with intake of vitamin D in relation to risk of both vitamin D deficiency and insufficiency … Our preliminary findings indicate it is possible that magnesium intake alone or its interaction with vitamin D intake may contribute to vitamin D status."

More recently, GrassrootsHealth concluded¹⁷ you need 146% more vitamin D to achieve a blood level of 40 ng/ml (100 nmol/L) if you do not take supplemental magnesium, compared to taking your vitamin D with at least 400 mg of magnesium per day.

The interplay between magnesium and vitamin D isn't a one-way street, though. It goes both ways. Interestingly, while vitamin D improves magnesium absorption,¹⁸ taking large doses of vitamin D can also deplete magnesium.¹⁹ Again, the reason for that is because magnesium is required in the conversion of vitamin D into its active form.

Magnesium + Vitamin K Lowers Vitamin D Requirement Even More

Magnesium isn't the only nutrient that can have a significant impact on your vitamin D status. GrassrootsHealth data further reveal you can lower your oral vitamin D requirement by a whopping 244% simply by adding magnesium and vitamin K2. As reported by GrassrootsHealth:²⁰

"… 244% more supplemental vitamin D was needed for 50% of the population to achieve 40 ng/ml (100 nmol/L) for those not taking supplemental magnesium or vitamin K2 compared to those who usually took both supplemental magnesium and vitamin K2."

How to Boost Your Magnesium Level

The recommended daily allowance for magnesium is around 310 mg to 420 mg per day depending on your age and sex,²¹ but many experts believe you may need anywhere from 600 mg to 900 mg per day.²²

Personally, I believe many may benefit from amounts as high as 1 to 2 grams (1,000 to 2,000 mg) of elemental magnesium per day, as most of us have EMF exposures that simply cannot be mitigated, and the extra magnesium may help lower the damage from that exposure.

My personal recommendation is that unless you have kidney disease and are on dialysis, continually increase your magnesium dose until you have loose stools and then cut it back. You want the highest dose you can tolerate and still have normal bowel movements.

When it comes to oral supplementation, my personal preference is magnesium threonate, as it appears to be the most efficient at penetrating cell membranes, including your mitochondria and blood-brain barrier. But I am also fond of magnesium malate, magnesium citrate, and ionic magnesium from molecular hydrogen as each tablet has 80 mg of elemental magnesium.

Eat More Magnesium-Rich Foods

Last but not least, while you may still need magnesium supplementation (due to denatured soils), it would certainly be wise to try to get as much magnesium from your diet as possible. Dark-green leafy vegetables lead the pack when it comes to magnesium content, and juicing your greens is an excellent way to boost your intake. Foods with high magnesium levels include:²³

Avocados	Swiss chard
Turnip greens	Beet greens
Herbs and spices such as coriander, chives, cumin seed, parsley, mustard seeds, fennel, basil and cloves	Broccoli
Brussel sprouts	Organic, raw grass fed yogurt and natto
Bok Choy	Romaine lettuce

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Sleeping with a partner gets a bad rap lately because of how many people, mostly women, say they are fleeing their partners' disruptive snoring and sleep apnea for a separate bed. Several years ago, researchers writing in the journal Sleep also found negatives from sleeping with a partner, sometimes called co-sleeping.¹

They found it was correlated with more night awakenings, more body movements and generally poorer sleep, even if the sleepers did not realize their sleep was compromised.²

Disrupted sleep also has negative effects on your immune system, according to the Mayo Clinic.³ Recently, scientists wrote in the journal Science that disrupted or fragmented sleep is linked to atherosclerosis,⁴ a buildup of fatty plaque in the arteries correlated to heart disease.⁵

In June 2020, however, researchers writing in the journal Frontiers of Psychiatry reported a positive benefit to sleeping with a partner when it comes to the all-important rapid eye movement (REM) sleep. Co-sleeping, stated the researchers, yielded "10% more REM sleep, less fragmented REM sleep [and] longer undisturbed REM fragments."⁶

New Sleep Technology Yields Better Information

The reason the REM sleep improvements with co-sleeping have not been fully explored until now, say the authors, is that the traditional instrument used in sleep studies is actigraphy, a wrist device that records movements, and it does not monitor sleep stages such as REM.⁷

There are four distinct phases of sleep. In stage one and two there is no REM sleep. Stages three and four, on the other hand, are the deepest stages of sleep that feature the highly restorative REM sleep.⁸ This study used instrumentation called dual simultaneous polysomnography that is different from actigraphy.⁹

According to lead author Dr. Henning Johannes Drews of the Center for Integrative Psychiatry, Christian-Albrechts-Universität in Kiel, Germany, the technology is a "very exact, detailed and comprehensive method to capture sleep on many levels — from brain waves to movements, respiration, muscle tension [to] movements, heart activity."¹⁰

Twelve young and healthy heterosexual couples were studied for four nights in a sleep lab, wired to dual simultaneous polysomnography in the research study.

The Many Benefits of REM Sleep

REM sleep occurs during the first 90 minutes of sleep and often again later in the night.¹¹ It is the sleep stage most correlated with dreaming and has a positive role in consolidation of memories, learning and mood. According to the Frontiers in Psychiatry researchers:¹²

"REM sleep is known to benefit memory formation particularly of emotionally salient and episodic memories.

The latter or both have been linked to sociality. Moreover, imaging studies show that REM sleep is associated with an activation of — among others — the amygdala and the medial prefrontal cortex, the latter of which is part of the theory-of-mind network and therefore highly important for social cognition.

Therefore, REM sleep might increase our preparedness and fitness to navigate the social world. Connecting this hypothesis to the findings of our study leads us to propose the existence of a positive feedback loop of REM-sleep-sociality interactions: social sleep enhances and stabilizes REM sleep which in turn enhances our ability to interact socially."

In addition to the possible positive feedback loop, REM sleep may also play an important role in mental health, the authors stated. The REM sleep of people with "suboptimal social support" showed the biggest improvement from co-sleeping.¹³

"REM sleep is related to dissolving emotional stress and balancing fear- related amygdala reactiveness. Moreover, REM sleep fragmentation is related to insomnia, which in turn is a risk factor for developing a mental illness [e.g., insomnia doubles the risk for depression].

Therefore, REM-sleep stabilization due to co-sleep might mediate (or moderate) the established effect of partnerships on mental health."

The Relationship With a Partner Affects Sleep

The quality of a relationship would seem to have an impact on the type of co-sleeping that occurs. What if the couple just had a fight? What if they are both worried about financial stress or one of their children? What if they just met and are madly in love?

The researchers studied the effect of such factors as "conflict, relationship depth, passionate love [and] relationship duration" on sleeping and found they did affect "individual and dyadic parameters." However, the quality of a relationship had a bigger impact on sleeping arrangements than on REM sleep, they wrote.¹⁴

"Depending on the sleeping arrangement, couple's sleep architecture and synchronization show alterations that are modified by relationship characteristics. We discuss that these alterations could be part of a self- enhancing feedback loop of REM sleep and sociality and a mechanism through which sociality prevents mental illness.

… Depth of relationship represented an additional significant main effect regarding synchronization, reflecting a positive association between the two. Neither REM sleep nor synchronization was influenced by gender, chronotype, or other relationship characteristic."

The researchers also noted that romantic relationships affect mental health and co-sleeping "expands" such relationships.¹⁵

Co-Sleeping Can Provide Comfort

The debate over co-sleeping has also extended to pets. Sleeping with your pet has been discouraged by some experts in the past because it could lead to poor pet behavior, sleep disturbances and even transfer of a disease.¹⁶ But the website Bark says it is a source of comfort that improves sleep.¹⁷

"[S]leeping with your pup has many mental benefits such as an increased feeling of safety and comfort. People suffering from PTSD [post-traumatic stress disorder] found that sleeping with their pet helped diminish nightmares.

There are physical benefits as well, like the fact that sleeping with your dog releases oxytocin in the brain. This is the chemical that’s released when a person falls in love, or when they are around their baby. The chemical promotes theta brainwaves which are associated with REM sleep.

This means it’s likely that you’re sleeping deeper when sleeping with your pet. The chemical also mitigates anxiety and stress, which can help you sleep better. Petting and touching your dog can even help lower your blood pressure. This not only happens during the waking hours, but when you sleep with your dog too."

The Frontiers in Psychiatry researchers agree that having a bed partner can relieve stress.

"Another potential mechanism to be considered in future studies is how a partner alters stress levels before and during sleep. Presence of a partner might facilitate perceiving a sleeping environment as 'safe', whereas sleep in isolation might represent a stressor.

Psychosocial stress has been reported to fragment REM sleep and might promote insomnia. Moreover, it has been shown in rats that sociality improves stress resilience by stabilizing REM sleep."

Humans are not the only animals that co-sleep, wrote the authors, citing the example of the hyrax, a small, furry herbivore. One theory of the origins of co-sleeping is that it produces the biophysical phenomenon of "partner-driven stabilization of ambient temperature."¹⁸

Light Also Affects Sleep Quality

In addition to the improved REM sleep that co-sleeping seems to cause, the light that people receive and don't receive has a big impact on sleep quality.

Most people in Western societies spend the larger portion of each day indoors, which essentially puts you in a state of "light deficiency," as the light indoors is about two orders of magnitude lower, in terms of light intensity, than outdoor light. Just 30 to 60 minutes of outdoor light exposure that you can receive during the morning or midday or your lunch break, creates about 80% of the light you need.

On the opposite end, you need to avoid bright artificial lighting after sunset, as that light will impair your melatonin production. Melatonin is a hormone secreted by the pineal gland, a small endocrine gland in the brain that helps regulate sleep and wake cycles. When light is between 50 lux and 1,000 lux it will begin to suppress melatonin production.

A 2011 study in the Journal of Clinical Endocrinology & Metabolism compared daily melatonin profiles in individuals living in room light (<200 lux) versus dim light (<3 lux).¹⁹ Results showed that, compared with dim light, exposure to room light before bedtime suppressed melatonin in 99% of individuals and shortened the time period when the body has an elevated melatonin level by about 90 minutes.²⁰

Other Health Benefits of Optimal Sleep

Optimal sleep helps you avoid many negative health conditions. Sleep is arguably the biggest key to good health and it is free and available to everyone. Lack of quality sleep is associated with:

Impaired memory and reduced ability to learn new things.21

Reduced ability to perform tasks, resulting in reduced productivity at work and poor grades in school.

Reduced athletic performance.

Reduced creativity at work or in other activities.

Slowed reaction time and risk of accidents on the road and at work.

Increased risk of neurological problems, ranging from depression to dementia and Alzheimer's disease.22

Increased risk of Type 2 diabetes and obesity.23

Increased risk of cancer, high blood pressure, heart attacks and cardiovascular disease.24

Increased risk of osteoporosis.

Increased risk of pain and pain-related conditions such as fibromyalgia.25

Increased susceptibility to stomach ulcers.

Impaired sexual function.26

Impaired regulation of emotions and emotional perception.

Increased risk of depression and anxiety (including PTSD), schizophrenia and suicide.27

Premature aging.

Increased risk of dying from any cause.28

Ways to Improve Your Sleep Besides Co-Sleeping

As I noted above, sleep is crucial for health and we now know that it benefits each and every organ in the human body because every cell in the body has its own biological clock. These cellular clocks, all of which work in tandem to control and maintain biological homeostasis, regulate everything from metabolism to psychological functioning. Here are 33 ways to improve your sleep:

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Before the start of the COVID-19 pandemic, food insecurity (lack of reliable access to nutritious food) was a considerable problem, affecting 11% of the country, with higher rates among low-income and racial and ethnic minorities. The shutdown of businesses to slow the spread of COVID-19 has led to historically high levels of unemployment, most recently reported at 11% in June. That translates to more than 40 million people losing their jobs. Like food insecurity, jobless claims also disproportionately harm Black and Hispanic populations. However, it is possible to envision different paths, and even a path that leads to food security for many more adults and children across the US.

How are people faring now?

Food insecurity is a major public health concern linked to common, costly, and preventable chronic conditions like obesity, diabetes, heart disease, and poor mental health. It results in an estimated $78 billion in additional health care costs annually.

To get a handle on how American households are faring during the COVID-19 pandemic, the Census Bureau and other government agencies launched a weekly Household Pulse Survey in late April 2020. The survey includes questions about food insufficiency, a narrower definition of food insecurity. It captures data about food consumption and affordability, but not lack of resources, the inability to acquire enough nutritious food, anxiety about being able to get food, or attempts to stretch available food. Census questions likely underestimate food insecurity, and are difficult to directly compare to pre-pandemic levels. Still, the results are instructive.

Using recent census data from week eight (June 18–23), we see very large disparities in food insufficiency by race and ethnicity. While about 7% of white households report sometimes or often not having enough to eat, this rate is almost triple (about 19%) among Black households, and double (about 14%) among Hispanic households. Affordability was the most common reason for not having enough food. This is not surprising, given that food prices have increased during this pandemic. Other estimates suggest that in the next year, one in four children will experience food insecurity.

What can we do to move toward food security?

We have proven policy approaches that meaningfully address the problem of food insecurity. Key among them is leveraging the Supplemental Nutrition Assistance Program (SNAP). Formerly known as food stamps, SNAP is by far the largest federal nutrition assistance program. Prior to COVID-19, SNAP helped 38 million people — nearly half of whom are children — afford food each month. Enrollment in SNAP has increased substantially during COVID-19 due to massive unemployment. During a crisis, SNAP is one of the easiest and fastest ways to get money into the hands of low-income Americans. These benefits can be adjusted easily because recipients receive them on a debit card.

Through the recent stimulus bills responding to COVID-19, Congress has appropriated $15.8 billion for expanded SNAP enrollment and made some key changes to SNAP, which are surely helping with food insecurity. Temporarily, the expanded benefits for people receiving SNAP provide

• two months of emergency benefits up to a maximum (this varies — it’s $646 for a family of four)
• a pandemic EBT of about $114 per child per month
• a temporary suspension of work requirements for able-bodied adults without dependents
• state waivers, to allow for re-enrollment flexibilities.

Is the SNAP benefit adequate?

Notably, none of these changes increase the overall size of the monthly SNAP benefit. The benefit is widely recognized as inadequate, because it unrealistically assumes that households have certain types of ingredients, time, equipment, and knowledge to prepare food from scratch. The average SNAP household receives a monthly benefit of about $1.40 per person per meal, which does not cover the cost of a meal in 99% of US counties.

The fourth stimulus bill, the HEROES Act, passed the House in May. It has a provision to increase monthly SNAP benefits by 15% ($100 per month for a family of four) for two months. If this bill passes the Senate, it could provide a critical and much-needed boost for low-income households, perhaps helping to attenuate the longstanding inequities in food insecurity. It would also help to stabilize the economy, because increased SNAP spending creates a multiplier effect by generating income for food production, distribution, marketing, and sales.

How else could Congress act with food security in mind?

The House HEROES bill includes promising additional policy options to address food insecurity. For example:

• extending pandemic EBT benefits
• keeping the SNAP work requirement suspension for able-bodied adults without dependents; these requirements decrease participation among groups at higher risk for food insecurity
• increasing school meal reimbursements for schools scrambling to feed children while also grappling with the costs of measures to help prevent the spread of COVID-19.

The bill is awaiting a vote in the Senate and the president’s final approval. Senators return from the two-week July 4th recess on July 20th, and will have three weeks to act before the traditional August recess. Interested readers can contact their senators and urge action.

Food insecurity is entirely preventable. We have proven policy tools to address this problem. We just need the political will to deploy them, and the recognition that food insecurity is not an individual problem, but a reflection of systemic inequality.

The post Envisioning food security: Steps we take now can help appeared first on Harvard Health Blog.

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