Rolul magneziului în sănătatea copiilor: de la necesitate la conștientizare. Consens elaborat de experți de top din Europa Centrală și de Est

Introduction

Magnesium is essential for regulating nerve conduction, neurotransmission, muscle function, energy metabolism and psychological resilience. In children, these processes support growth, cognitive development, emotional regulation and social adaptation. According to the World Health Organization (WHO), health includes physical, mental and social well-being – highlighting the role of nutrition in mental health.

In recent years, children’s nutritional and psychological stability has been undermined by chronic stress (e.g., pandemics, conflict), digital overstimulation and poor diet – especially increased consumption of ultra-processed foods and reduced intake of magnesium-rich options like vegetables and fish. These trends compromise neurodevelopmental resilience and contribute to rising rates of anxiety and behavioral issues.

Biological importance of magnesium in pediatric health

Physiological functions

Magnesium serves as a critical cofactor in over 300 enzymatic reactions, playing essential roles in pediatric development. Its fundamental functions include bone development, where 60% of body magnesium supports hydroxyapatite formation and bone density acquisition during growth^(1,2).Notably, magnesium is essential for the activation and optimal function of vitamin D, supporting osteoblast activity and the formation of a strong bone matrix in children⁽³⁾. It was found that a magnesium intake of 133 mg/day in children aged 4-8 years old achieved the minimum net retention (10 mg/day) required for growth, suggesting that dietary magnesium may be an underrecognized factor in pediatric bone health⁽⁴⁾. In neuromuscular function, magnesium regulates calcium channels and neurotransmitter release, while also facilitating ATP production during periods of accelerated growth and physical activity. Additionally, it influences hormonal regulation and supports DNA/RNA synthesis during crucial developmental phases^(1,2). As children are typically more physically active than adults, they require increased magnesium intake due to higher energy needs and rapid growth. Ensuring adequate magnesium levels is extremely important for maintaining optimal health and activity levels in children.

Neurodevelopment and mental health

Magnesium supports neurodevelopment and mental health by regulating stress-response systems and acting as an NMDA receptor antagonist, facilitating neurotransmission, neuroplasticity and synaptogenesis, essential for learning and emotional regulation. Low magnesium status correlates with pediatric anxiety, ADHD and depression in observational studies^(1,2).

Modern stressors – COVID-19 and social media exposure – amplify this importance by increasing magnesium utilization via stress pathways while compromising dietary quality, making adequate magnesium intake crucial for maintaining children’s mental health resilience^(5-7).

Dietary sources and intake gaps

Magnesium inadequacy remains common in children due to limited intake of magnesium-rich foods such as nuts, seeds, legumes, whole grains, leafy vegetables and fish. The European Food Safety Authority recommends 230-300 mg/day for children and adolescents, yet surveys in Eastern Europe consistently show lower intakes⁽⁸⁾.

High consumption of ultra-processed foods, depletion of magnesium during food processing and reduced intake of whole grains and vegetables contribute to this deficit⁽⁹⁾.Additional barriers include food selectivity in children and socioeconomic constraints limiting access to nutrient-dense diets, particularly in regions affected by economic instability.

Clinical evidence and diagnostic challenges

The assessment of magnesium status in children is challenging, because serum testing reflects less than 1% of total body magnesium and may miss intracellular or bone depletion, creating a “hidden deficiency” where normal serum levels mask functional inadequacy⁽¹⁰⁾.

Subclinical magnesium insufficiency may manifest as irritability, fatigue, sleep disturbances, or muscle cramps. High-risk pediatric groups include children with gastrointestinal disorders (celiac disease, inflammatory bowel disease), restrictive eating patterns (autism spectrum disorders, ARFID), chronic conditions requiring magnesium-depleting medications, highly active athletes with increased metabolic demands and sweat losses, and those experiencing chronic stress.

Given these diagnostic limitations, a symptom-oriented clinical approach focusing on neuromuscular, neurological and gastrointestinal indicators can identify children who may benefit from dietary optimization or supplementation when laboratory assessment is inconclusive.

Psychosocial context and contemporary stressors

The modern psychosocial landscape presents unprecedented challenges affecting magnesium requirements in Eastern European pediatric populations. The COVID-19 pandemic’s disruption of routines, education and social connections coincided with deteriorating dietary quality, while armed conflicts – particularly in Ukraine – compound stress through displacement and economic instability^(5-7). These factors simultaneously increase magnesium utilization through activated stress pathways while reducing access to magnesium-rich foods. With UNICEF data indicating one in seven children experiences a diagnosable mental health disorder, and digital media increasingly displacing physical activity and family meals, the cumulative impact on children’s well-being is substantial. As part of a broader nutritional strategy, magnesium supplementation may help mitigate stress-related physiological impacts, providing an accessible intervention to support pediatric mental health resilience.

Communication and public awareness strategies

Poland’s successful magnesium awareness campaign demonstrates an effective three-phase approach: beginning with caregiver education on magnesium’s role in bone, nervous system and mental health; progressing to empowerment through practical screening tools and diet-first messaging; and establishing sustained engagement via digital campaigns, school programs and medical professional partnerships. To combat social media misinformation, this model leverages key opinion leaders and healthcare providers to deliver trustworthy, evidence-based nutritional guidance that builds family confidence.

Recommendations

Growing evidence linking magnesium to neurocognitive and emotional health necessitates coordinated action across multiple sectors. Healthcare providers should assess dietary patterns, recognize nonspecific deficiency symptoms and consider supplementation for high-risk children with dietary restrictions, chronic illness or elevated stress levels.

Public health initiatives should incorporate magnesium education into nutritional guidelines and school programs, while supporting research to refine supplementation protocols and diagnostic methods. Regulatory frameworks have to ensure access to high-quality products meeting safety standards for long-term use, like magnesium citrate, which exemplifies evidence-based supplementation, being the most extensively studied and well-characterized magnesium salt with established safety and efficacy for pediatric practice^(11,12).

For caregivers, priorities include promoting magnesium-rich diets, reducing ultra-processed foods and monitoring behavioral or physical signs of deficiency. This integrated multisectoral strategy – combining prevention, early identification and safe supplementation – supports optimal cognitive function, emotional stability and healthy development in children.

Conclusions

Magnesium is a vital yet underappreciated nutrient in pediatric health, with critical relevance for physical growth, mental well-being and resilience in the face of modern stressors. While definitive clinical guidelines remain scarce, symptom-based supplementation strategies, integrated into broader nutritional and lifestyle interventions, can address both overt and subclinical deficiencies.

Sources: Opella funded the expert meeting. The authors received no payment from Opella related to the development of this publication. Opella had the opportunity to review the publication; however, the authors remain responsible for all content, editorial decisions and the decision to submit the manuscript.

Autor corespondent: Daniel Śliż E-mail: sliz.daniel@gmail.com

CONFLICT OF INTEREST: none declared.

FINANCIAL SUPPORT: none declared.

This work is permanently accessible online free of charge and published under the CC-BY.