Study shows magnesium deficiency in desalinated water could lead to diseases
Researchers urge government to add mineral to water to reduce risk of type 2 diabetes and ischemic stroke, and drastically cut national healthcare costs
Reporter at The Times of Israel
The lack of magnesium in Israel’s desalinated water — which flows into 70 percent of the country’s households — may lead to an increased risk of ischemic stroke and type 2 diabetes, according to a recent study published by the Taub Center for Social Policy Studies in Israel.
“Israel needs to put back magnesium into its drinking water,” said Maya Sadeh, head of the Environment and Health Research and Policy Initiative at Taub Center, who conducted the study with professors Itamar Grotto, Nadav Davidovitch, and Alex Weinreb.
The researchers said that adding magnesium to desalinated water could help reduce the country’s annual healthcare expenses by approximately NIS 83 million to NIS 188 million ($22 million to $49 million) in 2025 and NIS 110 million to 253 million ($29 million to $67 million) by 2040.
They said that the Health Ministry reported that the annual cost of adding magnesium to drinking water at a concentration of 20-30 mg per liter would be NIS 37 million ($10 million).
Before desalination, people who drank plain tap water received about 15% of their recommended daily magnesium intake from it. Today, the lack of magnesium in the water means a drop in consumption of the mineral. In addition, about 46% of the population have home water filters, which removes all the magnesium.
“These are concerning figures,” the researchers said.
Why is magnesium so crucial?
According to the Health Ministry’s website, magnesium is a necessary mineral for the proper functioning of body cells, and important for the cardiovascular, immune systems, nerve, bone, and muscle systems.
The recommended daily magnesium intake is 320 to 360 mg/day for women and 410 to 420 mg/day for men.
The main food sources for magnesium are green leafy vegetables, legumes, nuts, seeds, and whole-grain products, such as whole-grain bread.
A multivitamin, taken daily, could supplement a magnesium deficiency in the diet. Yet, for most people in lower socioeconomic classes, water has historically provided an important source of magnesium.
Magnesium deficiencies in all age groups
A deficiency in magnesium intake, primarily due to magnesium-poor water and a magnesium-low diet, affects all ages and population groups in Israel.
There is a decrease in the magnesium content in fruits and vegetables because they’re now mostly irrigated with desalinated water, Grotto said. This leads to a “reduced intake of this essential mineral through people’s diet.”
The researchers found significant deficiencies among Jewish men and women aged 18–34. Among Arab men and women, the deficiency is more pronounced in older age groups, 45–65.
This deficiency could contribute to ischemic stroke, which occurs when a vessel supplying blood to the brain is obstructed.
According to the researchers, older people are also more likely to have medical conditions such as diabetes, which prevent efficient magnesium absorption. In turn, lack of magnesium may lead to type 2 diabetes.
Since the risk of diabetes is higher among socioeconomically disadvantaged populations, the lack of magnesium in drinking water exacerbates health inequality.
A 2018 study from Bar Ilan University, Clalit Medical Services, and Tel Hashomer hospital showed that magnesium deficiency could also be a contributing factor to heart issues and death by cardiac arrest.
The researchers found that if people get a daily dose of 50 mg more magnesium through drinking water, this could prevent over 1,000 new cases of type 2 diabetes and more than 100 new cases of stroke each year.
The lifetime cost of treating these extra cases of type 2 diabetes that arise from a deficiency of 50 mg of magnesium ranges from NIS 800 million ($212 million) to NIS 2.1 billion ($557 million), depending on baseline magnesium intake.
The real cost to society and the economy of treating a type 2 diabetes patient is at least two times more than treating a non-diabetic person if indirect costs are considered. There is the loss of work capacity, sick days, additional treatments, caregiver and family costs, and disability pensions from the National Insurance Institute.
Water fights
There are currently five desalination plants in Israel: Hadera, Sorek, Ashdod, Ashkelon, and Palmachim. A sixth plant is under construction north of Acre.
At these plants, Israel desalinates approximately 585 million cubic meters of water each year.
Discussions about adding magnesium to desalinated drinking water in Israel began as early as 2004.
In 2014, the Health Ministry called for the establishment of a pilot facility to add magnesium to water after studies showed that reducing morbidity and mortality from type 2 diabetes, coronary heart disease, and ischemic stroke carried significant economic benefits.
But the pilot has yet to be established, the researchers said, “and it remains unclear if and when this will happen.” They urged the Health Ministry and the Water Authority to “immediately” launch the pilot.
A Health Ministry spokesperson told The Times of Israel that the ministry is working with the Water Authority and the national water supplier, Mekorot, to “plan a practical pilot for adding magnesium to desalinated water.”
At the same time, the ministry is also working to amend drinking water regulations so that water suppliers can add magnesium to drinking water.
However, the Water Authority said as early as 2018 that adding magnesium could cost as much as NIS 600 million (approximately $160 million) annually, adding that the government needs to find a way to fund the plan without raising the cost of water for consumers.
Sadeh disagreed. She told The Times of Israel that the researchers estimate the annual cost to be as low as NIS 37 million ($10 million). She also said the long-range financial benefits to the country “far outweigh the cost.”
The researchers also said that the addition of magnesium to water should be a condition in tenders for new desalination plants, and they called for further research into how magnesium can be added to water in existing facilities.
“Increasing magnesium intake will improve health in Israel in general, help prevent serious diseases, and reduce the economic burden on the healthcare system,” Sadeh said.
