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12. CHOLESTEROL

In the first chapter showing the effect of magnesium in preventing heart attacks, the work of several physicians was mentioned. In one case, referring to an item from The Lancet, it was stated that recent work has suggested that magnesium may be related to atherosclerosis . . . a high magnesium diet has prevented the development of atherosclerosis in rats. Atherosclerosis is considered to be caused mainly by too high levels of cholesterol in the blood!

We quote from an article that appeared in the May 18, 1957, issue of The Lancet: "In a recent publication from this institute, Medical Proceedings (1956, 2, 455, I. Bersohn and P. J. Oelsfse), it was shown that in many cases of coronary heart disease a dramatic clinical improvement followed parenteral [by injection] administration of magnesium sulphate [Epsom salts]."

One of the things that occurred was that abnormal cholesterol patterns rapidly reverted to normal in many of the cases studied.

The authors state that coronary thrombosis (blood clots) is reported to be uncommon in Africans. In Johannesburg the disease is very rare among the Bantu. In one series of 352 postmortems of Bantus over 40, only one death was found to be caused by a coronary thrombosis.

In another study, of 523 postmortems of non Europeans, there was an incidence of 1.66 percent of coronary thrombosis in the 41-60 age group. This contrasts with a figure of 12.8 percent at the Massachusetts General Hospital.

The authors state: "Serum cholesterol levels are lower in the African native than in the European." But the cholesterol level in the newborn Bantu is the same as in European babies. Something happens after birth to give the Bantu the advantage, as far as cholesterol is concerned. It probably is the diet and the active physical life led by the natives.

In a study of 70 healthy South African Europeans, the cholesterol level was 215. In the Bantus, of similar age and sex, it was only 174.

"In view of our striking results with magnesium sulphate therapy in coronary thrombosis, and the low cholesterol levels and low incidence of coronary occlusion in the Bantu, we decided to investigate the serum magnesium level in European and Bantu groups, and to find out Whether it was correlated as was the serum-cholesterol level . . . Serum-magnesium levels were determined on 47 normal Europeans and 53 normal Bantu (all 25-75 years)." The results were 1.92 for the Europeans and 2.11 for the Bantus. According to the investigators, this .19 advantage of the Bantus' magnesium is highly significant.

More magnesium serum studies were made and the authors summarized. "These results show (1) that the magnesium level is significantly higher in the non-European than in the European, and (2) that a definite correlation exists between serum-magnesium and the serum-cholesterol levels. Where the serum-cholesterol content is low the magnesium content is significantly increased . . . These findings suggest that the part played by magnesium in diet and nutrition requires further study. The possible role of this element in cholesterol metabolism, and indirectly perhaps in atherosclerosis [hardening of the arteries], has not been fully appreciated, studied or recognized."

A few years later, the work just cited was questioned, and an item on it which appeared in The British Medical Journal (January 13, 1960) is herewith given in its entirety because of its importance.

"Magnesium Sulphate in Coronary Thrombosis--Drs. B. Malkiel-Shapiro and I. Bersohn (South African Institute for Medical Research, Johannesburg) write: In reply to a query by one of your readers (Any Questions? February 8, 1957, p. 353) as to whether our observations on the efficacy of parenteral magnesium sulphate in coronary thrombosis had been confirmed, you reply that 'no confirmatory study appears to have been published since,' and 'in the absence of confirmation of this work it is not possible to define the indications for magnesium sulphate therapy.' We have refrained from writing before, since we were awaiting possible confirmation of our original observations from other sources. Recently, Parsons, Butler, and Sellars, from the Royal Hobart Hospital, Tasmania, have published a paper on 'The Sulphate.' Their conclusions on the biochemical results of patients suffering from coronary artery disease after taking magnesium sulphate were, among others, as follows: (1) a significant reduction in the serum cholesterol levels; (2) a great improvement in the lecithin: cholesterol ratio; (3) a marked increase in serum magnesium levels; (4) a reduction in nearly all cases of the degree of inhibition of plasmin; (5) a marked reduction in the beta-lipoprotein content. On the clinical side, they report that 'over 100 patients suffering from coronary heart disease (of which at least one-third had acute myocardial infarctions) were treated with intramuscular magnesium sulphate with only one death, compared to their findings in the previous year when of 196 cases admitted and treated with routine anticoagulants, 60 died. They conclude as follows: 'It is evident that the work of Malkiel-Shapiro and Bersohn has been confirmed.' Confirmation on the clinical efficacy of magnesium therapy in coronary thrombosis has also been published by Agranat, Marais, and Teeger. We feel now, as we did when we published our preliminary communication, that although the clinical case is not yet definitely proved, there seems to be a growing mass of evidence, in experimental animals as well as in man, to indicate that magnesium sulphate may well have an important therapeutic action in this field.

"Our Expert replies: I agree that there now seems to be a growing quantity of evidence suggesting that magnesium sulphate may be of therapeutic value in arterial disease. Whether this is due to lipid changes, as suggested by your correspondent, or to a 'protective' action against steroids, as suggested by Selye, or again to a purely anticoagulant action, as suggested by Lehmann et al., is still under experimental investigation. Further clinical laboratory trials are in progress and. their results are awaited with interest. A letter from Dr. Parsons and his colleagues is printed on P. 276 of this Journal."

Another piece of evidence is an article called "Effect of a French Mineral Water on Serum, Cholesterol," by Korenyi, Harkavy, and Whittier, all M.D.'s, connected with the Creedmoor Institute for Psychobiologic Studies, Creedmoor State Hospital, Queens Village, New York. It appeared in Current Therapeutic Research (March, 1961).

The authors screened 143 patients at Creedmoor and selected 34 whose serum cholesterol levels were above 250 mg. percent (that is, mg. per 100 milliliters of blood). These 34 patients were not receiving any other type of treatment known to have any effect on serum cholesterol.

A volume of 30 1/2 fluid ounces of mineral water was given daily in three divided doses for 30 days. The mineral content of this water was as follows: calcium carbonate, 3.5 mg. per 100 cc; -calcium sulphate, 156.5 mg. per 100 cc; magnesium bicarbonate, 3.5 mg. per 100 cc; and magnesium sulphate, 19.0 mg. per 100 CC."

There was no other change in their treatment.

At the end of two weeks, there was an average decrease in serum cholesterol of 9.9 mg. %. After four weeks, at the conclusion of the study, the mean decrease had become 23.8 mg. %

In discussing their results, the authors state:

"The recent report by Schroeder ("Relation Between Mortality from Cardiovascular Disease and Treated Water Supplies", JAMA, 172, 1960) demonstrated a highly significant negative correlation of total death rates and mortality from coronary heart disease with total water hardness . . .

"Since there are many prior reports indicating a relation between magnesium metabolism and atherosclerosis and magnesium is required for the activation of most of the enzymes concerned with the transfer and removal of phosphate in biological systems, it is possible that the hypercholesterolemic and perhaps atheroprophylactic effect of mineral water is related to its content of this substance . . ."

For control of the serum cholesterol, therefore, one should exercise actively every day, eat a very low fat diet, make sure that the diet is rich in niacin, linoleic acid, pectin and vitamins C, A, D, and E, and take a magnesium supplement. Dr. Pierre Delbet, who has made contributions on the subject of magnesium to the French Academy of Medicine said, "Je répeète que le magnésium doit tre considéré comme un aliment et non comme un médicament ... I repeat that magnesium should be considered as a food and not as a drug."


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