{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T14:56:47Z","timestamp":1787065007804,"version":"build-2736575974"},"reference-count":42,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2025,2,28]],"date-time":"2025-02-28T00:00:00Z","timestamp":1740700800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background: Magnesium (Mg) deficiency is associated with many common chronic conditions and potentially severe health care outcomes, including cardiovascular disease, cardiovascular risk factors, and diabetes. However, Mg deficiency is underdiagnosed and often underrecognized in the ambulatory health care setting, and nutrition education and training are often limited for health care providers (HCPs). Methods: A clinical guideline for detecting and treating Mg deficiency in the ambulatory care setting was developed. A pilot study was conducted in which HCPs received education on Mg and completed pre-test and post-test questionnaires to assess the intervention efficacy of the guideline. Results: Ten HCPs participated in the pilot study via telephone or face-to-face session. In general, there was a statistically significant increase in Mg knowledge among HCPs, due to the intervention of presentation of the guideline, with a nonsignificant increase in clinical practice application. However, the 1-month follow-up survey results showed that HCPs were likely to incorporate Mg assessment and treatment tools from the guideline in their future practice. Conclusions: These findings suggest that the use of the proposed clinical guideline may increase HCP knowledge and improve the diagnosis and treatment of Mg deficiency. Further use, development, and evaluation of this guideline is warranted.<\/jats:p>","DOI":"10.3390\/nu17050887","type":"journal-article","created":{"date-parts":[[2025,3,4]],"date-time":"2025-03-04T05:41:51Z","timestamp":1741066911000},"page":"887","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Clinical Guideline for Detection and Management of Magnesium Deficiency in Ambulatory Care"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-6811-2291","authenticated-orcid":false,"given":"Sherrie","family":"Colaneri-Day","sequence":"first","affiliation":[{"name":"CMER\u2014Center for Magnesium Education & Research, Pahoa, HI 96778, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7811-9517","authenticated-orcid":false,"given":"Andrea","family":"Rosanoff","sequence":"additional","affiliation":[{"name":"CMER\u2014Center for Magnesium Education & Research, Pahoa, HI 96778, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,2,28]]},"reference":[{"key":"ref_1","first-page":"9041694","article-title":"Magnesium and human health: Perspectives and research directions","volume":"2018","author":"Majoni","year":"2018","journal-title":"Int. J. Endocrinol."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Fiorentini, D., Cappadone, C., Farruggia, G., and Prata, C. (2021). Magnesium: Biochemistry, nutrition, detection, and social impact of diseases linked to its deficiency. Nutrients, 13.","DOI":"10.3390\/nu13041136"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"4179326","DOI":"10.1155\/2017\/4179326","article-title":"The importance of magnesium in clinical healthcare","volume":"2017","author":"Schwalfenberg","year":"2017","journal-title":"Scientifica"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1111\/j.1753-4887.2011.00465.x","article-title":"Suboptimal magnesium status in the United States: Are the health consequences underestimated?","volume":"70","author":"Rosanoff","year":"2012","journal-title":"Nutr. Rev."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1184s","DOI":"10.3945\/ajcn.113.073536","article-title":"Challenges and opportunities for nutrition education and training in the health care professions: Intraprofessional and interprofessional call to action","volume":"99","author":"Mirtallo","year":"2014","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Ahmed, F., and Mohammed, A. (2019). Magnesium: The forgotten electrolyte\u2014A review on hypomagnesemia. Med. Sci., 7.","DOI":"10.3390\/medsci7040056"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1007\/s11104-012-1471-5","article-title":"Changing crop magnesium concentrations: Impact on human health","volume":"368","author":"Rosanoff","year":"2013","journal-title":"Plant Soil"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Workinger, J.L., Doyle, R.P., and Bortz, J. (2018). Challenges in the diagnosis of magnesium status. Nutrients, 10.","DOI":"10.3390\/nu10091202"},{"key":"ref_9","first-page":"523","article-title":"Magnesium: A mineral essential for health yet generally underestimated or even ignored","volume":"6","author":"Ismail","year":"2016","journal-title":"J. Nutr. Food Sci."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"3697","DOI":"10.1007\/s00394-022-02916-w","article-title":"Recommendation on an updated standardization of serum magnesium reference ranges","volume":"61","author":"Rosanoff","year":"2022","journal-title":"Eur. J. Nutr."},{"key":"ref_11","unstructured":"Frederickson, R. (2023). Nonspecific signs of magnesium deficiency. Magnesium Answers."},{"key":"ref_12","unstructured":"Seelig, M.S., and Rosanoff, A. (2003). Appendix E: Problems associated with low magnesium level. The Magnesium Factor, Avery."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1167s","DOI":"10.3945\/ajcn.113.073510","article-title":"Nutrition education in medical school: A time of opportunity","volume":"99","author":"Kushner","year":"2014","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e821","DOI":"10.1161\/CIR.0000000000000563","article-title":"Medical nutrition education, training, and competencies to advance guideline-based diet counseling by physicians: A science advisory from the American Heart Association","volume":"137","author":"Aspry","year":"2018","journal-title":"Circulation"},{"key":"ref_15","first-page":"A4","article-title":"The current state of nutrition education in medical schools in the United States: An analysis of curriculum, faculty perspectives, and resources (abstract 8)","volume":"7","author":"Eldin","year":"2024","journal-title":"BMJ Nutr. Prev. Health"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1153s","DOI":"10.3945\/ajcn.113.073502","article-title":"The need to advance nutrition education in the training of health care professionals and recommended research to evaluate implementation and effectiveness","volume":"99","author":"Akabas","year":"2014","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"378s","DOI":"10.3945\/an.112.003483","article-title":"Magnesium in disease prevention and overall health","volume":"4","author":"Volpe","year":"2013","journal-title":"Adv. Nutr."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1186\/s13012-016-0538-8","article-title":"Behavior change interventions and policies influencing primary healthcare professionals\u2019 practice-an overview of reviews","volume":"12","author":"Chauhan","year":"2017","journal-title":"Implement. Sci."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e010084","DOI":"10.1136\/bmjopen-2015-010084","article-title":"Realist synthesis of educational interventions to improve nutrition care competencies and delivery by doctors and other healthcare professionals","volume":"6","author":"Mogre","year":"2016","journal-title":"BMJ Open"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Fischer, F., Lange, K., Klose, K., Greiner, W., and Kraemer, A. (2016). Barriers and strategies in guideline implementation\u2014A scoping review. Healthcare, 4.","DOI":"10.3390\/healthcare4030036"},{"key":"ref_21","unstructured":"Colaneri-Day, S. (2020). Improving Health Care Providers Detection and Management of Magnesium Deficiency Through a Targeted Intervention and Clinical Guideline. [Dissertation for DNP, Keiser University]."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"106460","DOI":"10.1016\/j.nedt.2024.106460","article-title":"Nutrition education for nursing students: A scoping review","volume":"144","author":"Dogan","year":"2025","journal-title":"Nurse Educ. Today"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1111\/inr.12919","article-title":"Clinical nurse specialists in nutrition: A systematic review of roles and clinical experiences","volume":"71","author":"Mancin","year":"2024","journal-title":"Int. Nurs. Rev."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1331","DOI":"10.1080\/21645515.2015.1022691","article-title":"A brief educational intervention increases providers\u2019 human papillomavirus vaccine knowledge","volume":"11","author":"Berenson","year":"2015","journal-title":"Hum. Vaccines Immunother."},{"key":"ref_25","first-page":"84","article-title":"Serum magnesium: Time for a standardized and evidence-based reference range","volume":"34","author":"Micke","year":"2021","journal-title":"Magnes Res."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Razzaque, M.S. (2018). Magnesium: Are we consuming enough?. Nutrients, 10.","DOI":"10.3390\/nu10121863"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1136\/bmjnph-2023-000807","article-title":"Establishing consensus on nutrition competencies for medicine: A Delphi study","volume":"7","author":"Lepre","year":"2024","journal-title":"BMJ Nutr. Prev. Health"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1159\/000450863","article-title":"Magnesium and kidney health\u2014More on the \u2018forgotten electrolyte\u2019","volume":"44","author":"Vormann","year":"2016","journal-title":"Am. J. Nephrol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"329","DOI":"10.3934\/publichealth.2016.2.329","article-title":"Magnesium: Nutrition and homoeostasis","volume":"3","author":"Vormann","year":"2016","journal-title":"AIMS Publ. Health"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"730s","DOI":"10.1080\/07315724.2004.10719416","article-title":"About the misdiagnosis of magnesium deficiency","volume":"23","author":"Liebscher","year":"2004","journal-title":"J. Am. Coll. Nutr."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1186\/s12963-017-0119-3","article-title":"The share of ultra-processed foods and the overall nutritional quality of diets in the US: Evidence from a nationally representative cross-sectional study","volume":"15","author":"Popkin","year":"2017","journal-title":"Popul. Health Metr."},{"key":"ref_32","unstructured":"CMER Center for Magnesium Education and Research (2025, January 10). Magnesium in Refined vs. Whole Foods. Available online: https:\/\/magnesiumeducation.com\/magnesium-in-refined-vs-whole-foods\/."},{"key":"ref_33","unstructured":"Foster, R.A. (2020). Magnesium Missing in Drinking Water: A Persistent; Ink to Cardiovascular Disease?. [Ph.D. Thesis, Hawthorn University]."},{"key":"ref_34","first-page":"120","article-title":"The effects of magnesium supplementation on subjective anxiety","volume":"29","author":"Boyle","year":"2016","journal-title":"Magnes. Res."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1053\/j.ajkd.2015.05.012","article-title":"Proton pump inhibitors and hypomagnesemia in the general population: A population-based cohort study","volume":"66","author":"Kieboom","year":"2015","journal-title":"Am. J. Kidney Dis."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1080\/07315724.1986.10720143","article-title":"Serum magnesium levels in the United States, 1971\u20131974","volume":"5","author":"Lowenstein","year":"1986","journal-title":"J. Am. Coll. Nutr."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1684\/mrh.2011.0298","article-title":"Re-evaluation of the concept of chronic, latent, magnesium deficiency","volume":"24","author":"Elin","year":"2011","journal-title":"Magnes. Res."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"973","DOI":"10.1016\/j.advnut.2023.06.008","article-title":"Perspective: Call for re-evaluation of the tolerable ipper intake level for magnesium supplementation in adults","volume":"14","author":"Costello","year":"2023","journal-title":"Adv. Nutr."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"111294","DOI":"10.1016\/j.nut.2021.111294","article-title":"Bioavailability of magnesium food supplements: A systematic review","volume":"89","author":"Pardo","year":"2021","journal-title":"Nutrition"},{"key":"ref_40","unstructured":"US Institute of Medicine (1997). Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride, National Academies Press."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Vermeulen, E.A., and Vervloet, M.G. (2023). Magnesium administration in chronic kidney disease. Nutrients, 15.","DOI":"10.3390\/nu15030547"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"e016795","DOI":"10.1136\/bmjopen-2017-016795","article-title":"The effect of magnesium supplementation on vascular calcification in chronic kidney disease-a randomised clinical trial (MAGiCAL-CKD): Essential study design and rationale","volume":"7","author":"Bressendorff","year":"2017","journal-title":"BMJ Open"}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/17\/5\/887\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:45:13Z","timestamp":1760028313000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/17\/5\/887"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,28]]},"references-count":42,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2025,3]]}},"alternative-id":["nu17050887"],"URL":"https:\/\/doi.org\/10.3390\/nu17050887","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,28]]}}}