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Effect of magnesium supplementation on muscular damage markers in

basketball players during a full season

Article  in  Magnesium research: official organ of the International Society for the Development of Research on Magnesium · August 2017
DOI: 10.1684/mrh.2017.0424

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 Magnesium Research 2017; xx (x): 1-10 ORIGINAL ARTICLE

Effect of magnesium supplementation

on muscular damage markers in
basketball players during a full
season
Córdova Martínez Alfredo1 , Fernández-Lázaro Diego1 , Mielgo-Ayuso Juan2 , Seco Calvo
Jesús3 , Caballero García Alberto4
1 University of Valladolid, Faculty of Physical Therapy, Department of Biochemistry and
Physiology, Campus de Soria, 42003 Soria, Spain; 2 ElikaEsport, Nutrition, Innovation and
Sport, Gipuzkoa, Spain; 3 University of León, I n s t i t u t e of Biomedicine (IBIOMED),
León, Spain; 4 University of Valladolid, Faculty of Physical Therapy, Department of Anatomy,
Cam- pus de Soria, 42003 Soria, Spain
Correspondence: Diego Fernández Lázaro. Facultad de Fisioterapia, Campus Universitario de Soria, 42003 Soria,
Spain.
<diego.fernandez.lazaro@uva.es>

Abstract. Although it has been widely accepted that Mg has a positive effect
on muscle function, studies on the efficacy of Mg supplementation in young
athletes have generated contrasting results. The aim of this work was to exa-
mine the effect of Mg supplementation on muscular damage markers and the
association between serum Mg levels with these muscular markers. Twelve
elite male basketball players (PB) from a team of Spanish Professional Bas-
ketball League and a control group (CG) comprising twelve university students
who practiced regularly recreational basketball and competed in minor univer-
sity leagues participated in this study. The athletes were supplemented with
400 mg/day of Mg, in the form of Mg lactate. Blood samples were taken four
times during the season, each separated by eight weeks: T1: October, T2: Decem-
ber, T3: March, and T4: April. Serum Mg concentrations showed a significant
decrease in T3 (1.56 ± 0.03 mg/dL), with respect to T1 (1.69 ± 0.04 mg/dL) and
T2 (1.69 ± 0.04 mg/L). At the end of the study, serum Mg concentration was sig-
nificantly higher (T4: 1.79 ± 0.06 mg/dL) than at T3. Levels of muscle damage
parameters remained the same during the entire season (P > 0.05), except for
creatinine, which significantly decreased after T2, and then increased signifi-
cantly in T3 and T4 compared to T2. In conclusion, these results suggest that
the supplementation with Mg during the season of competition may prevent
associated tissue damage.
Key words: Mg supplementation, serum Mg, basketball, muscular damage
doi:10.1684/mrh.2017.0424

Magnesium (Mg) is a cation closely involved
in different metabolic and physiological processes
related with muscular performance [1]. Mg is
essential for energy metabolism, transmembrane
transport, and muscle relaxation and contraction
[2]. On the basis of these physiological effects, Mg
has been studied as an ergogenic aid for athletes
[3].
Some authors have described that exercise may
increase the demand for Mg and/or Mg loss, poten-
tially leading to hypomagnesemia, and can result
in muscle weakness, neuromuscular dysfunction,

1
To cite this article: Córdova Martínez A, Fernandez-Lazaro D, Mielgo-Ayuso J, S e c o C a l v o J, Caballero García A. Effect of
magnesium supplementation on muscular damage markers in basketball players during a full season. Magnes Res 2017; xx(x):
1-10 doi:10.1684/mrh.2017.0424
CORDOVA MARTINEZ A, ET AL.
and tetany, all affecting the physical performance
and/or health status [2, 4, 5]. Zorbas et al. [6] noted
that hypokinesia provokes a less utilization of Mg
accompanied with decrease in muscular Mg lev-
els, even after Mg supplementation. Brilla and
Haley [7] reported that supplementation with Mg
increases muscle strength and power. However,
Terblanche et al. [8] observed that marathon run-
ners with adequate Mg status did not improve
their running performance or skeletal muscle
function. Despite these discordant results, the
findings suggest that Mg supplementation can
be considered as an ergogenic aid with beneficial
effect on the physiological function and/or perfor-
mance when Mg status is normal [3, 9].
Stendig-Lindberg et al. [10] measured blood
Mg and creatine kinase (CK) activity in partici-
pants who completed a 120-mile hike and found
an increase in both at 24 h postexercise. Because
CK is released from damaged skeletal muscle
after exercise [11], the authors suggested that the
increased Mg levels 24 h postexercise may reflect a
release from damaged tissue. Significantly inverse
correlation exists between blood concentration of
this enzyme released from the muscle and athletic
performance [4, 12]. Other authors have recently
suggested that Mg status is related to tissue and
cell protection in athletes [13, 14].
Exercise stress leads to a proportional increase
in stress hormone levels, for example, cortisol (C),
and concomitant alterations of immunity [15]. In
addition, low plasma Mg concentrations and the
subsequent disruption in intracellular Mg home-
ostasis may play a role in activating inflammatory
response [16]. However, regular and moderate
exercise has been reported to improve the ability
of the immune system to protect from infection
[17].
There are an association between Mg and
immune function. This association is based on
findings that Mg deficiency induces inflamma-
tion Q1 [18]. The activation of immune cells,
such as monocytes, macrophages, and poly-
morphonuclear neutrophils, that synthesize a
variety of mediators, induces inflammatory events
[19, 20].
Although it has been widely accepted that Mg
has a positive effect on muscle function, studies
on the efficacy of Mg supplementation in young
athletes have generated contrasting results [7, 8].
Based on the existing data [3, 9, 21], and our
experience, it appears that most athletes do not
consume adequate amounts of Mg in their diets. In
2
addition, the analyses of diets may overestimate
true dietary intake; thus, diet supplementation
with this mineral may be justified.
In view of this information, the aim of this study
was to examine the effect of Mg supplementation
on muscular damage markers and the association
between serum Mg levels with these markers.
Material and methods
Participants
Twelve elite male basketball players from a team
of Spanish Professional Basketball (PB) League
have participated (25.3 ± 4.4 years; 198 ± 9.9 cm,
96.8 ± 13 kg; 56.5 ± 7.7 mL·kg-1 ·min-1 ) in the
study. The control group (CG) comprised twelve
university students who practiced regularly
recreational basketball and competed in minor
university leagues (22 ± 3.8 years; 178 ± 8.6 cm;
78.3 ± 8.6 kg; 47 ± 6.3 mL·kg-1 ·min-1 ). None of the
athletes smoked, drank alcohol regularly, or were
taking any medication known to alter hormonal
response. Additional repport Q2 and medical
examination. These sportsmen did not receive
supplements, except a multivitamin complex
during the season, and all performed the same
training program and matches. The PB group
was supplemented with
400 mg/day of Mg in the form of lactate Mg. The
CG was not supplemented with Mg.
The PB group followed a standardized diet
defined by the doctor and the dietician/nutritionist
of the team. Diet schedule was planned in Septem-
ber, during the days prior to the start of preseason
training. The dietician/nutritionist indicated the
type and quantity of total energy intake in func-
tion of requirements at each moment of the
competition. Intake was controlled by a dietary
record, maintained for 3-7 days, at each training
stage Q3. Calculated ingestion of Mg/1,000 kcal
was in an average range of 217 ± 4.6 mg, consi-
dering the full seasonQ4. The content of Mg was
determined using the food tables established by
the Spanish Society of Dietetics and Nutrition
[22].
The PB group trained daily in 2 sessions:
a morning session that consisted of a 2-hour
gym workout and an afternoon session of
3-hour basketball practice. This training program
was followed daily except on the days of official
 Serum Mg during a full season in basket players

matches played during the season and, therefore, (FAAS) [PerkinElmer, Inc. Waltham, MA (USA)]
during the study (2 matches per week, Wednes- in flame emission mode. White blood cell and
days and Sundays). platelet counts were determined on a Coul-
ter Counter (model MAX-M) [Beckman Coulter.
New Jersey, NJ (USA)]. Serum concentrations
Protocol and assessment plan of creatinine, urea, creatine kinase (CK), lactate
Protocol and assessment plan was done in 4 spe- dehydrogenase (LDH), aspartate transaminase
cific time points, each 8 weeks during the season: (AST), alanine transaminase (ALT), aldolase
(a) T1: October (in preseason, at the end of first (ALD), and total proteins (TP) were measured
mesocycle training); (b) T2: December (at the end at each time point (T0, T1, T2, T3, and T4).
of second mesocycle training: preseason + specific These biochemical parameters were measured
phase); (c) T3: March (at the end of competitive using coupled enzyme reactions on an automatic
phase I: coincident with King’s Cup competition); autoanalyzer [Hitachi 917, Tokyo, Japan]. Myo-
and (d) T4: April (at the end of competitive phase globin (Mb) was assessed by chemiluminescence
II: coincident with the final of the ACB and Euro reaction enzyme immunoassay “sandwich” of two
league regular seasons). The CG participants were points (Myoglobin ELISA Kit, MEXLAB. Zapopan,
required in the same day to attend the laboratory Jalisco, Mexico).
(8:00-8:30 a.m.), at the same time as those in the Serum total testosterone (TT) levels were mea-
PB group. sured by ELISA (DRG testosterone ELISA kit® ,
Antecubital venous blood samples were col- DRG Instruments GmbH, Marburg/Lahn, Ger-
lected from all the players in basal conditions many). Free testosterone (FT) was obtained by
after overnight fasting and 36 hours after the last the formula described and validated by Ver-
training or match day to avoid acute effects of meulen et al. [21]. Cortisol (C) concentrations
exercise on hormones. The players arrived at the were measured by an enzyme-linked fluorescent
laboratory at 8:30 in the morning, and after a 30- assay with®the aid of a multiparametric analyzer
minute rest in a comfortable seat, blood samples (Minividas , Biomerieux, Marcy l’Etoile, France),
were taken. Blood was collected by antecubital using as substrate 4 methylumbelliferone capable
venipuncture with Vacutainer system (10 mL to of a fluorescent emission at 450 nm, after stimula-
serum tubes with gel and clot activator; 5 mL and tion at 370-1 nm. TT, FT, and cortisol were expressed
3 mL to tubes with EDTA). Serum was separated in nMol·L . TT/C and FT/C ratios were calculated
from blood cells and stored at -20◦ C until further from TT, FT, and cortisol molar concentrations.
analyses. All biochemical analyses were carried out in an
The use of control group (CG) permits a com- official hospital laboratory with the corresponding
parison with PB group before the start of the strict control measures.
experiment. Later, when the PB group partici- Percent changes in plasma volume (%ΔPV)
pants are training and competing, this comparison were calculated using Van Beaumont’s equation
is not possible because the physical activity was [23]. The values of hematological and biochem-
not the same, that is, PB 5 h/day and CG ical markers were adjusted for plasma volume
5 h/week. In addition, we do not compare the changes using the following formula [24]:
results obtained by PB group in T1-T4 periods Corrected value = Uncorrected value
with T0 because the number of hours and intensity
of training were different. × 100+%ΔPV /100
The study was designed in accordance with the
Declaration of Helsinki of the World Medical Asso-
ciation recommendations for clinical research, and Statistical analyses
the protocol was reviewed and approved by the
Data were expressed as mean ± standard error
ethics local committee in the university.
of the mean. The Shapiro-Wilk test was used.
After checking the normal distribution, one-way
Blood analyses repeated measures ANOVA was carried out for
all biochemical parameters (minerals, white blood
Serum Ca and Mg were determined with a Perkin cells, muscle damage, and stress) by Greenhouse-
Elmer 272 flame atomic absorption spectrometer Geisser test to check if there were significant

3
Creatine kinase, lactate dehydrogenase, aldolase, myoglobin, troponin, aspartate aminotransferase, and
carbonic anhydrase CAIII
CORDOVA MARTINEZ A, ET AL.
.

variations among parameters in the different
phases of the study. To determine differences
among different periods of study, post hoc Bon-
ferroni multiple comparisons test was applied.
Bivariate correlations for changes in Mg with
blood cells, muscle damage, and stress parameters
during season Δ(T1-T4) were performed using
Pearson rank order correlation test after the next
calculationQ5:
Δ (T1-T4) = ((T4-T1) /T1) ×100
Statistical analyses were performed by IBM
Statistical (SPSS Version 22) and Graphpad
Prism 5 software (Version 5.2) packages. A value
of P < 0.05 was considered as significant.
Results
As shown in table 1, serum Mg concentrations
between CG and PB group were not significantly
different. Figure 1 shows the serum Mg and Ca
concentrations in the 4 periods of season. Serum
Mg concentration significantly decreased in T3 in
comparison to T1 and T2. However, at the end
of the study (T4), Mg concentration was signifi-
cantly higher than T3. Serum Ca concentration
in T1 presented significantly lower value than the
other 3 points. Moreover, T2 showed lower level of
serum Ca concentration than T3 and T4.
The levels of muscle damage parameters in the
PB group remained the same during the entire
season (P > 0.05) (table 2), except for creatinine,
concentrations of which significantly decreased
after the second mesocycle in December, and then
increased significantly in T3 and T4 in comparison
with T2 level. In table 2, we also show the %ΔPV
changes between T1 and other periods.
Table 3 shows blood hormone parameters in the
four test points during the basketball season. Cor-
tisol levels were significantly lower at the end of
the second mesocycle in December and at the end
of the third mesocycle in April; this was coincident
with the end of the ACB and Euro league reg-
ular season. However, cortisol remained at high

Table 1. Biochemical, mineral, hormonal, and hematological data in the control group (CG) and the
professional basketball players (PB) group 15 days before the start of the studyQ9.

Parameter Group Mean ± SEM Parameter Group Mean ± SEM

CG 0.95 ± 0.14 CG 14.58 ± 4.53
Creatinine (mg/dL) Cortisol (C) (nmol/L)
PB 1.20 ± 0.09 PB 22.19 ± 3.44
CG 30.64 ± 7.27 Total Testosterone CG 4.95 ± 1.66
Urea (mg/dL) (TT) (nmol/L)
PB 37.58 ± 6.97 PB 6.48 ± 0.69
Creatine kinase CG 200.08 ± 69.62 CG 0.339 ± 0.004
(CK) (U/L) TT/C
PB 292.00 ± 87.07 PB 0.292 ± 0.006
Myoglobin CG 30.98 ± 11.11 CG 238.71 ± 24.61
(Mb) (ng/mL) Platelets ( ×103 /fLL 3)
PB 35.84 ± 2.95 PB 227.58 ± 33.69
Lactate dehydrogenase CG 159.79 ± 17.80 CG 5.66 ± 1.09
(LDH) (U/L) WBC (×103/fLL)
PB 380.08 ± 50.92 PB 6.92 ± 1.86
Aspartate transaminase CG 23.50 ± 6.12 CG 2.62 ± 0.78
Neutrophils (%)
(AST) (U/L) PB 25.83 ± 4.30 PB 41.24 ± 8.29
Alanine transaminase CG 16.36 ± 6.77 CG 2.31 ± 0.42
(ALT) (U/L) Lymphocytes (%)
PB 22.00 ± 3.07 PB 37.30 ± 8.51
Total proteins CG 7.53 ± 0.51 CG 0.50 ± 0.12
Monocytes (%)
(g/dL) PB 7.61 ± 0.19 PB 7.31 ± 0.21
Aldolase (ALD) CG 4.93 ± 0.33 CG 0.19 ± 0.14
(U/L) Eosinophils (%)
PB 5.37 ± 0.41 PB 2.44 ± 1.16
Magnesium (Mg) CG 2.07 ± 0.18 CG 0.04 ± 0.02
Basophils (%)
(mg/L) PB 1.83 ± 0.29 PB 0.71 ± 0.41
Calcium (Ca) CG 9.99 ± 0.55 CG 48.05 ± 2.14
(mg/dL) Hematocrit (Hct) %
PB 9.1 ± 0.57 PB 46.76 ± 2.46

4
 Serum Mg during a full season in basket players

Mg Ca
2.0 11.0

a, b
1.8
a, b
mg/dL

mg/dL
1.7 a
a, b 9.5
1.6
9.0
1.5

1.4 8.5

Data are expressed as mean ± standard error of the mean (SEM). N=12
Significant differences among period of study by Bonferroni’s test a,bp<0.01: avs. T1. bvs. T2, cvs. T3.

Figure 1. Serum magnesium (Mg) and calcium (Ca) concentrations in professional basketball (PB)
players during a full season. (T1: October; T2: December; T3: March; T4: April). Data are expressed as
mean ± standard error of the mean (SEM) (n = 12). Significant differences among the periods of study
by Bonferroniı̌s test a,b P < 0.01: a versus T1; b versus T2; c versus T3.

Table 2. Biochemical data and changes of plasmatic volume (%ΔPV) in function of hematocrit (Hct) in
professional basketball players (PB) during a full season (T1: October; T2: December; T3: March; T4:
April)Q10.

T1 T2 T3 T4
Creatinine (mg/dL) 1.25 ± 0.03 1.14 ± 0.02a 1.30 ± 0.03b 1.25 ± 0.02b
Urea (mg/dL) 42.33 ± 1.81 39.50 ± 2.62 41.83 ± 1.77 43.75 ± 2.74
Creatine kinase (CK) (U/L) 621.7 ± 177.2 438.3 ± 52.8 391.8 ± 59.5 545.9 ± 99.5
Myoglobin (Mb) (fLg/mL) 36.29 ± 9.64 34.21 ± 2.22 35.38 ± 2.46 37.78 ± 2.48
Lactate dehydrogenase (LDH) (U/L) 373.9 ± 15.5 374.9 ± 15.5 375.0 ± 15.4 383.5 ± 18.7
Aspartate transaminase (AST) (U/L) 40.67 ± 5.69 33.17 ± 2.15 31.42 ± 2.04 34.58 ± 3.37
Alanine transaminase (ALT) (U/L) 30.17 ± 4.37 29.00 ± 1.82 27.00 ± 1.53 24.83 ± 1.55
Total proteins (TP) (g/dL) 7.39 ± 0.12 7.29 ± 0.12 7.32 ± 0.08 7.30 ± 0.08
Aldolase (ALD) (U/L) 10.62 ± 1.90 7.17 ± 0.43 7.67 ± 0.69 7.03 ± 0.52
T0-T1 T1-T2 T1-T3 T1-T4
%ΔPV <1 7.10 8.05 7.06

Data are expressed as mean ± standard error of the mean (SEM). Significant differences among the periods of study
by Bonferroniı̌s test a,b P < 0.01: a versus T1; b versus; T2. c versus T3 (%ΔPV): percent changes of plasma volume.

levels at the end of the first mesocycle training in
October and at the end of King’s cup in March (T3).
Total testosterone (TT) concentration increased
significantly in T2, T3, and T4 with respect to T1
(table 3). This increase was higher at the end of the
King’s Cup in T3. Free testosterone (FT) concen-
tration was significantly lower in T3 compared to
other studied periods. TT/C ratio increased signi-
ficantly in T2, T3, and T4 in comparison to T1.
However, at the end of King’s Cup in T3, this
decreased TT/C ratio remained in T4. The FT/C
ratio significantly decreased during the season; a
detailed description of each of the periods showed
that the FT/C ratio was higher in T2 than in the
other control points, with the lowest value in T3,
at the end of King’s CupQ6.
Table 4 shows white blood cell count and hema-
tocrit (Hct) during season. Platelets’ number was
not significantly affected during the study period.
WBC count showed statistically higher value at

5
CORDOVA MARTINEZ A, ET AL.
.

Table 3. Plasma hormones in professional basketball players (PB) during a full season (T1: October;
T2: December; T3: March; T4: April)Q11 Q12

P
Cortisol (C) (nmol/L)
T1 623.2 ± 48.2
T2 451.9 ± 27.2a P < 0.05
T3 624.7 ± 33.7b
T4 487.5 ± 32.0a
Total testosterone (TT) (nmol/L)
T1 19.44 ± 2.13
T2 23.90 ± 2.08a P < 0.001
T3 26.76 ± 2.25a,b
T4 22.30 ± 1.67a
Free testosterone (FT) (nmol/L)
T1 0.093 ± 0.006
T2 0.116 ± 0.014 P < 0.05
T3 0.074 ± 0.008a,b
T4 0.082 ± 0.015
TT/C
T1 0.034 ± 0.005
T2 0.054 ± 0.005a P < 0.001
T3 0.043 ± 0.003b
T4 0.047 ± 0.003a
FT/C × 103
T1 0.157 ± 0.016
T2 0.268 ± 0.039 P < 0.05
T3 0.123 ± 0.014b
T4 0.174 ± 0.032

Data are expressed as mean ± standard error of the mean (SEM). Significant differences among the periods of study
by Bonferroniı̌s test a,b P < 0.01: a versus T1; b versus T2.

Table 4. Hematological data of professional basketball (PB) players during a full season. (T1: October;
T2: December; T3: March; T4: April)Q13

T1 T2 T3 T4
Platelets (×103 /fLL3 ) 222.75 ± 12.78 216.25 ± 8.60 216.50 ± 10.42 214.83 ± 10.52
WBC (×103 /fLL) 5.25 ± 0.26 5.25 ± 0.23 5.30 ± 0.32 6.13 ± 0.34a,b
Neutrophils (%) 46.53 ± 3.76 43.51 ± 3.92 44.93 ± 2.93 43.98 ± 3.28
Lymphocytes (%) 39.88 ± 3.36 44.58 ± 4.04 42.03 ± 2.43 42.97 ± 3.11
Monocytes (%) 6.98 ± 0.32 7.08 ± 0.57 6.98 ± 0.41 7.11 ± 0.54
Eosinophils (%) 2.83 ± 0.51 2.62 ± 0.49 2.28 ± 0.35 2.49 ± 0.30
Basophils (%) 1.16 ± 0.13 0.89 ± 0.13 0.94 ± 0.08 0.95 ± 0.11
Hematocrit (Hct) (%) 46.50 ± 1.99 44.80 ± 2.06 44.57 ± 1.70 44.82 ± 2.55

Data are expressed as mean ± standard error of the mean (SEM). Significant differences among the periods of study
by Bonferroniı̌s test a,b P < 0.01: a versus T1; b versus T2.

the end of the season (T4) than in T1 and T2. The the %ΔPV, which revealed a change with respect
percent distribution of different types of leuko- to T1 (start of study). Three time points were ana-
cytes or hematocrit was not significantly different lyzed: T1-T2 (7.10%), T1-T3 (8.05%), and T1-T4
among various periods. In table 1, we also show (7.06%).

6
 Serum Mg during a full season in basket players

Δ (T1 - T4)
50

40

30

Leucocytes
20

10

0
r=0.590
-10
p=0.044
-20
-20 -10 0 10 20 30
Mg

Δ (T1 - T4)
4

2
Total proteins

-2

-4
r=0.617
-6 p=0.033

-8
-20 -10 0 10 20 30
Mg

Figure 2. Bivariate correlations among magnesium (Mg) and leukocytes and total protein changes
during a full season (ΔT1-T4).

Bivariate correlations among changes during
season in Mg concentration and white blood cells
count, muscle damage, and stress parameters
were analyzed. Significantly positive correlations
(P < 0.05) between Mg concentration and leuko-
cytes, and between serum Mg and total protein
concentrations, were observed (figure 2).
Discussion
In the current study, we aimed at investigating
the changes in muscular damage markers along
the season and their relation with serum Mg
changes in basketball players. These sportsmen
received regularly a supplementation of 400 mg of
Mg/day. Our main findings under these conditions
were that none of the athletes showed significant
changes in Mg levels or change in the muscular
damage markers along the season.
According to the Spanish Society of Diete-
tics and Nutrition [22], 400 mg/day of Mg is
the suggested intake recommendation for adult
men. Similarly, in the United States (US) [25],
the recommended daily intake of Mg for adult
men between 19 and 30 years is 400 mg/day,
and for adults between 31 and 50 years, it is
420 mg/day.
A large number of nutrition and performance
researches report that most athletes do not con-
sume adequate amounts of magnesium in their
diets [3, 9, 21, 26-28]. In this context, sport nutri-
tionists and dieticians must be aware of potential
differences between calculated and real content of
vitamins and minerals in the analyzed daily food
rations of athletes [29].
Our athletes followed a standardized and
controlled diet supervised by the dietician/
nutritionist of the team according to rules of sport
nutrition, which is based on carbohydrate, lipid,
and protein content. The mean Mg consumption in

7
CORDOVA MARTINEZ A, ET AL.
.
the diet in our study was 217 ± 4.6 mg/1,000 kcal,
which exceeded the widely recognized dietary rec-
ommendations. However, Czaja et al. [21] have
indicated that the specific RDA for athletes is not
established. The sportsmen, who limit the vari-
ety of the consumed food or energy requirement
in their diet, are exposed to the risk of insufficient
intake of microelements and vitamins [21, 30].
Hassapidou et al. [31] studied elite Greek bas-
ketball players during competitive season and
reported that most athletes do not follow an ade-
quate dietary intake. Considering the condition of
professional sportsmen and taking into account
the possible deleterious consequences of Mg defi-
ciency, we consider that supplementation of Mg
may be of interest for this population.
In our study, we choose to supplement athletes
with 400 mg of Mg/day. Previously, Mg supple-
mentation was used by elite German and Polish
athletes [21, 32]. The polish elite athletes [21]
were supplemented daily with 284 ± 58 mg of Mg.
In other studies, with volleyball players, Setaro
et al. [33] used 350 mg of Mg/day supplements.
In addition, in the review by Newhouse et al. [29],
all studies showed positive effects on sports perfor-
mance with magnesium supplementation ranging
from 240 to 413 mg/day. Veronese et al. [27]
showed that oral supplementation with 400 mg
Mg as Mg oxide for 12 weeks had a significant po-
sitive effect on physical performance. In our study,
supplementation with organic salt of Mg, that is
lactate, my offer better conditions for the absorp-
tion of Mg [34].
It is important to consider that all systems, mus-
culoskeletal, nervous, immune, and metabolic, are
stressed by exercise and competition, and there-
fore the recovery strategies postexercise are very
important for sportive success. Mg has a funda-
mental role in muscle function and is essential for
energy metabolism, transmembrane transport,
and muscle relaxation and contraction [2, 25].
However, previous studies on the efficacy of Mg
supplementation in young athletes have gene-
rated contrasting results [7, 8, 35, 36]. Differences
in Mg status may be the reason for these dif-
ferent findings. It has been suggested that Mg
supplementation might be only efficient in Mg-
deficient people [4]. In our study, all athletes
(n = 12) had serum Mg below the normal values
during measurement at point T3. This point was
in a competitive period of high effort demand as is
the King’s cup, with 3 games in 5 days. The main
8
feature of our study is that serum Mg levels were
maintained high along the season, and even in the
last control, we observed an increaseQ7. When we
corrected (in function of %ΔPV), the serum Mg
levels are in the normal range. It should be borne
in mind that some authors have indicated that a
transient shift of Mg from the extracellular fluid
to skeletal muscle is the proposed mechanism for
the decrease in Mg during exercise [37-39]. Mus-
cle exercise leads to a slow increase in muscle Mg
content, which is paralleled by a decline in plasma
Mg concentration. This suggests that the reduc-
tion in serum Mg observed during exercise may
be, in part, a function of redistribution of serum
Mg into the working muscle. These Mg shifts into
contracting muscle may a function of increased
metabolic need [37-39]. In this study, only limited
changes in serum Mg were observed, which were
probably related to adequate Mg supply in the diet
and as supplement.
Some muscular enzymes and proteins are
considered as markers of muscle metabolism
intensity and damages [11, 40]. Previously, we
observed that muscle damage is associated with
increase in plasma CK, alanine aminotransferase
(ALT), and aldolase (ALD) levels, which is a rou-
tine biochemical evaluation in the diagnosis of
muscle disease [39-41]. This study supports that
magnesium supplementation may prevent a drop
in serum magnesium level and an increase in the
level of biochemical markers of muscular damage
in basketball players along the season.
In T3 (3 matches in 5-day tournament), we
observed a decrease in FT and an increase in cor-
tisol as a consequence of failing to meet recovery
periods to return to baseline values [42]. However,
our athletes with adequate training, nutrition,
and supplementation maintained a good anabolic-
catabolic balance, as was reported in other studies
[43].
The main limitation of this study is the absence
of a similar control group without Mg supplemen-
tation. To have professional players as controls
was not easy, because they are few and placed
in different cities with particular training (differ-
ent coaches) and nutritional habits. However, at
the beginning of the study, groups CG and PB
had similar values of biochemical and hematolog-
ical parameters. We also used as reference groups
athletes from other studies reporting changes in
markers of muscle damage indices in soccer, bas-
ketball, volleyball, and handball games at an elite

competitive level [40, 44, 45]. However, the effect 10. Stendig-Lindberg G, Shapiro Y, Epstein Y, et al.
of supplementation was not reported in these
studies.
In conclusion, these results show that supple- 11. Clarkson PM, Nosaka K, Braun B. Muscle func-
mental Mg in elite athletes, during a competition
season, could exert a protective effect on the mus-
cle. This occurred without significant changes in 12. Hyldahl RD, Chen TC, Nosaka K. Mechanisms
cortisol and anabolic hormone levels.
Disclosure
Financial support: none. Conflict of interest: none.
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 Author Queries

Q1 Please check if the edits made in the sentence are appropriate and convey the intended meaning.
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