Dietary Magnesium and Calcium Intake in Relation to Metabolic Health Status in Iranian Adolescents with Overweight and Obesity

Background: There are insufficient data about the relationship between dietary consumption of magnesium and calcium with metabolic health phenotypes in adolescents. Objectives: The present study examined this association among Iranian adolescents with overweight and obesity. Methods: This cross-sectional study was performed on 203 adolescents chosen from students in grades 7 to 12 of 6 education areas in Isfahan city, Iran. Anthropometric and biochemical assessments were performed based on standard procedures. International Diabetes Federation (IDF) and a combination of IDF with HOMA-IR criteria were applied to group participants as metabolically healthy overweight/obese or metabolically unhealthy overweight/obese (MUO) (as the outcome of interest). Magnesium, calcium intake, and calcium-to-magnesium (Ca:Mg) intake ratio as the exposures of interest, and other dietary data were gathered by a validated 147-item food frequency questionnaire. Logistic regression analysis was applied to estimate the possible association by considering potential covariates. Results: Adolescents in the top tertile of magnesium consumption compared with those in the bottom tertile had 64% decreasing odds of MUO based on the IDF criteria in the fully adjusted model [odds ratio (OR) = 0.36; 95% confidence interval (CI): 0.14, 0.92]. No significant link was found between magnesium consumption and MUO defined by IDF/HOMA-IR definition. Individuals in the highest tertile of calcium consumption compared with those in the lowest tertile have respectively shown 82% (OR = 0.18; 95% CI: 0.07, 0.48) and 78% (OR = 0.22; 95% CI: 0.08, 0.62) lower odds of MUO based on IDF and IDF/HOMA-IR criteria, in a maximally-adjusted model. Subgroup analyses revealed that these associations were stronger among girls and overweight subjects. Higher Ca:Mg ratio was inversely associated with MUO based on IDF (OR = 0.30; 95% CI: 0.13, 0.73). Conclusions: This study suggests that higher dietary intakes of magnesium and calcium may prevent MU in adolescents with excess weight, particularly in girls. These findings highlight the potential role of these nutrients in maintaining metabolic health during adolescence.