{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T04:49:24Z","timestamp":1791607764886,"version":"4.3.4"},"reference-count":36,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"King Saud University","award":["ORF-2026-21"],"award-info":[{"award-number":["ORF-2026-21"]}],"id":[{"id":"https:\/\/ror.org\/02f81g417","id-type":"ROR","asserted-by":"crossref"}]},{"award":["ORF-2026-21"],"award-info":[{"award-number":["ORF-2026-21"]}],"id":[{"id":"https:\/\/ror.org\/02f81g417","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background\/Objectives: Magnesium (Mg) is an essential micronutrient that participates in more than 300 enzymatic reactions, with well-established functions in glucose and lipid metabolism and cardiovascular health. Although serum Mg is routinely used in clinical practice, circulating concentrations may not accurately represent total body Mg status because of tight physiological regulation. The present study evaluated the associations of serum Mg concentration and dietary Mg intake with cardiometabolic outcomes in a cohort of Saudi adolescents. Methods: This cross-sectional study involved 234 Saudi adolescents (166 girls, 68 boys; mean age 14.8 \u00b1 1.7 years) who were assessed for anthropometrics, biochemical parameters and dietary intake. Hypomagnesemia was classified as serum Mg &lt;0.75 mmol\/L, while inadequate dietary Mg intake was based on age- and sex-specific cutoffs for children. Results: Hypomagnesemia was present in 87 participants (37.2%) and was more common among boys than girls (50% vs. 31.9%, p = 0.011). No significant differences in the assessed cardiometabolic measurements were observed across serum Mg tertiles. Absolute dietary Mg intake was strongly correlated with total energy and other dietary intakes and was inversely associated with body mass index. Associations based on absolute dietary Mg intake were attenuated after energy adjustment for overweight\/obesity. For elevated triglycerides, the highest vs. lowest tertile of residual-adjusted Mg showed a nominal inverse association in the age- and sex-adjusted model (OR: 0.40; 95% CI: 0.17\u20130.96). However, the corresponding trend did not remain statistically significant after false discovery rate correction. Conclusions: Serum Mg showed limited associations with cardiometabolic outcomes, while associations between dietary Mg and cardiometabolic outcomes were sensitive to energy adjustment and multiple-comparison correction. The inverse association between residual-adjusted Mg and elevated triglycerides should therefore be considered exploratory. These findings highlight potential differences between serum and dietary Mg as indicators of Mg status and underscore the importance of accounting for total energy intake when examining dietary Mg in relation to cardiometabolic health in adolescents.<\/jats:p>","DOI":"10.3390\/nu18193302","type":"journal-article","created":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T12:02:06Z","timestamp":1791547326000},"page":"3302","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Serum vs. Dietary Magnesium and Cardiometabolic Outcomes in Saudi Adolescents"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5200-2898","authenticated-orcid":false,"given":"Sobhy M.","family":"Yakout","sequence":"first","affiliation":[{"name":"Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"}]},{"given":"Malak Nawaz K.","family":"Khattak","sequence":"additional","affiliation":[{"name":"Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-5994-614X","authenticated-orcid":false,"given":"Abdullah M.","family":"Alnaami","sequence":"additional","affiliation":[{"name":"Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5248-2350","authenticated-orcid":false,"given":"Shaun","family":"Sabico","sequence":"additional","affiliation":[{"name":"Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9328-289X","authenticated-orcid":false,"given":"Nicola","family":"Veronese","sequence":"additional","affiliation":[{"name":"Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia"},{"name":"Geriatric Unit, Department of Internal Medicine and Geriatrics, Faculty of Medicine, Saint Camillus International University of Health Sciences, 00131 Rome, Italy"},{"name":"Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, 90100 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1349-6530","authenticated-orcid":false,"given":"Mario","family":"Barbagallo","sequence":"additional","affiliation":[{"name":"Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, 90100 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5472-1725","authenticated-orcid":false,"given":"Nasser M.","family":"Al-Daghri","sequence":"additional","affiliation":[{"name":"Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"funding-acquisition","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"}]}],"member":"1968","published-online":{"date-parts":[[2026,10,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2510","DOI":"10.1016\/S0140-6736(14)61746-3","article-title":"Child and adolescent obesity: Part of a bigger picture","volume":"385","author":"Lobstein","year":"2015","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1186\/1479-5868-8-140","article-title":"Physical activity, sedentary behaviors and dietary habits among Saudi adolescents relative to age, gender and region","volume":"8","author":"Abahussain","year":"2011","journal-title":"Int. J. Behav. Nutr. Phys. Act."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"21","DOI":"10.3945\/ajcn.115.125401","article-title":"Irregular meal-pattern effects on energy expenditure, metabolism, and appetite regulation: A randomized controlled trial in healthy normal-weight women","volume":"104","author":"Alhussain","year":"2016","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1161\/01.CIR.93.1.54","article-title":"Persistent elevation of plasma insulin levels is associated with increased cardiovascular risk in children and young adults. The Bogalusa Heart Study","volume":"93","author":"Bao","year":"1996","journal-title":"Circulation"},{"key":"ref_5","first-page":"1","article-title":"Magnesium in man: Implications for health and disease","volume":"95","author":"Hoenderop","year":"2015","journal-title":"Physiol. Rev."},{"key":"ref_6","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_7","doi-asserted-by":"crossref","first-page":"1152","DOI":"10.4239\/wjd.v6.i10.1152","article-title":"Magnesium and type 2 diabetes","volume":"6","author":"Barbagallo","year":"2015","journal-title":"World J. Diabetes"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1111\/j.1365-2362.2010.02422.x","article-title":"Magnesium improves the beta-cell function to compensate variation of insulin sensitivity: Double-blind, randomized clinical trial","volume":"41","year":"2011","journal-title":"Eur. J. Clin. Investig."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1038\/jhh.2008.129","article-title":"The effect of lowering blood pressure by magnesium supplementation in diabetic hypertensive adults with low serum magnesium levels: A randomized, double-blind, placebo-controlled clinical trial","volume":"23","year":"2009","journal-title":"J. Hum. Hypertens."},{"key":"ref_10","first-page":"60","article-title":"Magnesium and cardiovascular system","volume":"23","author":"Shechter","year":"2010","journal-title":"Magnes. Res."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Marabelli, C., Santiago, D.J., and Priori, S.G. (2025). The Yin and Yang of Heartbeats: Magnesium-Calcium Antagonism Is Essential for Cardiac Excitation-Contraction Coupling. Cells, 14.","DOI":"10.3390\/cells14161280"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1053\/j.ackd.2018.02.010","article-title":"Magnesium and Cardiovascular Disease","volume":"25","author":"Tangvoraphonkchai","year":"2018","journal-title":"Adv. Chronic Kidney Dis."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1038\/ejcn.2014.7","article-title":"Dietary magnesium intake is inversely associated with serum C-reactive protein levels: Meta-analysis and systematic review","volume":"68","author":"Dibaba","year":"2014","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1007\/s00394-019-01905-w","article-title":"Magnesium and health outcomes: An umbrella review of systematic reviews and meta-analyses of observational and intervention studies","volume":"59","author":"Veronese","year":"2020","journal-title":"Eur. J. Nutr."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"596","DOI":"10.26574\/maedica.2022.17.3.596","article-title":"Association of Serum Magnesium with Insulin Indices in Patients with Type 2 Diabetes Mellitus","volume":"17","author":"Kuppusamy","year":"2022","journal-title":"Maedica"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"927","DOI":"10.1016\/0895-4356(94)00200-A","article-title":"Associations of serum and dietary magnesium with cardiovascular disease, hypertension, diabetes, insulin, and carotid arterial wall thickness: The ARIC study. Atherosclerosis Risk in Communities Study","volume":"48","author":"Ma","year":"1995","journal-title":"J. Clin. Epidemiol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2541","DOI":"10.2147\/DMSO.S257884","article-title":"Reduced Insulin Resistance Partly Mediated the Association of High Dietary Magnesium Intake with Less Metabolic Syndrome in a Large Chinese Population","volume":"13","author":"Yang","year":"2020","journal-title":"Diabetes Metab. Syndr. Obes."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1177\/0260106020982345","article-title":"Dietary magnesium intake in relation to body mass index and glycemic indices in middle school students from the HEALTHY Study","volume":"27","author":"Naseeb","year":"2021","journal-title":"Nutr. Health"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"ii333","DOI":"10.1093\/qjmed\/hcae175.771","article-title":"Insulin Sensitivity in Relation to Serum Magnesium in Obese Children","volume":"117","author":"Nassar","year":"2024","journal-title":"QJM Int. J. Med."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Amer, O.E., Sabico, S., Khattak, M.N.K., Alnaami, A.M., Aljohani, N.J., Alfawaz, H., AlHameidi, A., and Al-Daghri, N.M. (2021). Increasing Prevalence of Pediatric Metabolic Syndrome and Its Components among Arab Youth: A Time-Series Study from 2010\u20132019. Children, 8.","DOI":"10.3390\/children8121129"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Sabico, S., Al-Daghri, N.M., Alenad, A., Al-Saleh, Y., Khattak, M.N.K., Wani, K., Alnaami, A.M., Reginster, J.Y., Alokail, M.S., and Cavalier, E. (2025). Sexual dimorphism in LC-MS\/MS-based vitamin D metabolite profiling and nutrition-acquired biochemical osteomalacia among adolescents. Front. Nutr., 12.","DOI":"10.3389\/fnut.2025.1696230"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1590\/S0036-36342012000200009","article-title":"Anemia and iron, zinc, copper and magnesium deficiency in Mexican adolescents: National Health and Nutrition Survey 2006","volume":"54","author":"Gaona","year":"2012","journal-title":"Salud Publica Mex."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"636","DOI":"10.15537\/smj.2017.6.20055","article-title":"Development of a Saudi Food Frequency Questionnaire and testing its reliability and validity","volume":"38","author":"Gosadi","year":"2017","journal-title":"Saudi Med. J."},{"key":"ref_24","unstructured":"Otten, J.J., Hellwig, J.P., and Meyers, L.D. (2006). DRI, Dietary Reference Intakes: The Essential Guide to Nutrient Requirements, National Academies Press."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1001\/archpedi.157.8.821","article-title":"Prevalence of a metabolic syndrome phenotype in adolescents: Findings from the third National Health and Nutrition Examination Survey, 1988\u20131994","volume":"157","author":"Cook","year":"2003","journal-title":"Arch. Pediatr. Adolesc. Med."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Wani, K., Khattak, M.N.K., Saadawy, G.M., Al-Attas, O.S., Alokail, M.S., and Al-Daghri, N.M. (2023). Sex-Specific Cut-Offs of Single Point Insulin Sensitivity Estimator (SPISE) in Predicting Metabolic Syndrome in the Arab Adolescents. Diagnostics, 13.","DOI":"10.3390\/diagnostics13020324"},{"key":"ref_27","first-page":"1","article-title":"CDC growth charts: United States","volume":"314","author":"Kuczmarski","year":"2000","journal-title":"Adv. Data"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1111\/j.1399-5448.2007.00271.x","article-title":"The metabolic syndrome in children and adolescents\u2014An IDF consensus report","volume":"8","author":"Zimmet","year":"2007","journal-title":"Pediatr. Diabetes"},{"key":"ref_29","first-page":"42","article-title":"The association between serum and dietary magnesium with cardiovascular disease risk factors in Iranian adults with metabolic syndrome","volume":"3","author":"Darroudi","year":"2020","journal-title":"Transl. Metab. Syndr. Res."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Li, W., Jiao, Y., Wang, L., Wang, S., Hao, L., Wang, Z., Wang, H., Zhang, B., Ding, G., and Jiang, H. (2022). Association of Serum Magnesium with Insulin Resistance and Type 2 Diabetes among Adults in China. Nutrients, 14.","DOI":"10.3390\/nu14091799"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"111425","DOI":"10.1016\/j.nut.2021.111425","article-title":"Whole-blood magnesium and blood lipids are individually and jointly associated with an elevated likelihood of youngsters being overweight or obese: A matched case-control study using the propensity score","volume":"93","author":"Wang","year":"2022","journal-title":"Nutrition"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1186\/s12986-021-00593-w","article-title":"Association of whole blood copper, magnesium and zinc levels with metabolic syndrome components in 6-12-year-old rural Chinese children: 2010\u20132012 China National Nutrition and Health Survey","volume":"18","author":"Zhang","year":"2021","journal-title":"Nutr. Metab."},{"key":"ref_33","first-page":"1074","article-title":"Serum magnesium in relation with obesity","volume":"8","author":"Shamnani","year":"2018","journal-title":"Natl. J. Physiol. Pharm. Pharmacol."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Song, Q., Song, L., Liu, H., Tan, H., Yang, B., Fan, C., and Liu, L. (2024). Association of magnesium intake with predicted atherosclerotic lesions and cardiovascular risk in young adults based on PDAY score: A cross-sectional study. BMC Public Health, 24.","DOI":"10.1186\/s12889-024-20785-2"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"e41253","DOI":"10.1097\/MD.0000000000041253","article-title":"Hypomagnesemia in adults with type 2 diabetes mellitus in Riyadh, Saudi Arabia: A cross-sectional study","volume":"104","author":"Yakout","year":"2025","journal-title":"Medicine"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Alkazemi, D.U.Z., Zafar, T.A., Alsouri, N.Y., Aljahdali, A.A., and Kubow, S. (2024). Low dietary magnesium and fiber intakes among women with metabolic syndrome in Kuwait. Front. Nutr., 11.","DOI":"10.3389\/fnut.2024.1451220"}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/18\/19\/3302\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T04:15:05Z","timestamp":1791605705000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/18\/19\/3302"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,8]]},"references-count":36,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2026,10]]}},"alternative-id":["nu18193302"],"URL":"https:\/\/doi.org\/10.3390\/nu18193302","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,8]]}}}