Review Article| Volume 19, ISSUE 1, P6-11.e3, January 2018

Minerals and Sarcopenia; The Role of Calcium, Iron, Magnesium, Phosphorus, Potassium, Selenium, Sodium, and Zinc on Muscle Mass, Muscle Strength, and Physical Performance in Older Adults: A Systematic Review



      Minerals may contribute to prevent and treat sarcopenia, the age-related loss of muscle mass, muscle strength, and physical performance. So far, there is no comprehensive review on the impact of minerals on sarcopenia outcomes. The aim of this systematic review is to evaluate the role of calcium, iron, magnesium, phosphorus, potassium, selenium, sodium, and zinc on muscle mass, muscle strength, and physical performance in older adults.


      A systematic search was conducted between March 2016 and July 2016, in the PubMed database using predefined search terms. Articles on the role of dietary mineral intake or mineral serum concentrations on muscle mass, muscle strength, physical performance, and/or the prevalence of sarcopenia in healthy or frail older adults (average age ≥ 65 years) were selected. Only original research publications were included. The search and data extraction were conducted in duplicate by 2 independent researchers. The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement was followed in constructing this systematic review. The Effective Public Health Practice Project (EPHPP) Quality Assessment Tool for Quantitative Studies was used to evaluate the quality of the selected articles.


      From the 3346 articles found, a total of 10 studies met the inclusion criteria. Observational studies showed that serum selenium (n = 1) and calcium intake (n = 1) were significantly associated with muscle mass, and magnesium (n = 1), selenium (n = 1), iron (n = 1), and zinc (n = 1) intake were significantly and positively associated with physical performance in older adults. Furthermore, magnesium (n = 2), selenium (n = 2), calcium (n = 2), and phosphorus (n = 1) intake were associated with the prevalence of sarcopenia. Magnesium supplementation improved physical performance based on one randomized controlled trial. No studies on the role of sodium or potassium on muscle mass, muscle strength, or physical performance were found.


      Minerals may be important nutrients to prevent and/or treat sarcopenia. Particularly, magnesium, selenium, and calcium seem to be most promising. Most of the included studies, however, were observational studies. Therefore, more randomized controlled trials are needed to elucidate the potential benefits of mineral intake to prevent and/or treat sarcopenia and support healthy aging.


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        • Cruz-Jentoft A.
        • Baeyens J.P.
        • Bauer J.
        • et al.
        Sarcopenia: European consensus on definition and diagnosis.
        Age Ageing. 2010; 39: 412-423
        • Morley J.E.
        • Anker S.D.
        • von Haehling S.
        Prevalence, incidence, and clinical impact of sarcopenia: Facts, numbers, and epidemiology—update 2014.
        J Cachexia Sarcopenia Muscle. 2014; 5: 253-259
        • Cruz-Jentoft A.
        • Landi F.
        • Schneider S.M.
        • et al.
        Prevalence of and interventions for sarcopenia in ageing adults: A systematic review. Report of the International Sarcopenia Initiative (EWGSOP and IWGS).
        Age Ageing. 2014; 43: 748
        • Edwards M.H.
        • Buehring B.
        Novel approaches to the diagnosis of sarcopenia.
        J Clin Densitom. 2015; 18: 472-477
        • Cruz-Jentoft A.
        • Landi F.
        Clin Med. 2014; 14: 183-186
        • Szent-Györgyi A.G.
        Calcium regulation of muscle contraction.
        Biophys J. 1975; 15: 707-723
        • De Baaij J.H.
        • Hoenderop J.G.
        • Bindels R.J.
        Magnesium in man: Implications for health and disease.
        Physiol Rev. 2015; 95: 1-46
        • Lukaski H.C.
        Magnesium, zinc, and chromium nutriture and physical activity.
        Am J Clin Nutr. 2000; 72: 593s
        • Clausen T.
        • Everts M.E.
        Regulation of the Na,K-pump in skeletal muscle.
        Kidney Int. 1989; 35: 1-13
        • Beard J.L.
        Iron biology in immune function, muscle metabolism and neuronal functioning.
        J Nutr. 2001; 131 (discussion 580S): 579S
        • Gravelyn T.R.
        • Brophy N.
        • Siegert C.
        • Peters-Golden M.
        Hypophosphatemia-associated respiratory muscle weakness in a general inpatient population.
        Am J Med. 1988; 84: 870-876
        • Amanzadeh J.
        • Reilly R.F.
        Hypophosphatemia: An evidence-based approach to its clinical consequences and management.
        Nat Clin Pract Nephrol. 2006; 2: 136-148
        • Chariot P.
        • Bignani O.
        Skeletal muscle disorders associated with selenium deficiency in humans.
        Muscle Nerve. 2003; 27: 662-668
        • Rayman M.P.
        Selenium and human health.
        Lancet. 2012; 379: 1256-1268
        • Rayman M.P.
        • Rayman M.P.
        The argument for increasing selenium intake.
        Proc Nutr Soc. 2002; 61: 203-215
        • Powell S.R.
        The antioxidant properties of zinc.
        J Nutr. 2000; 130: 54S
        • Prasad A.S.
        Zinc is an antioxidant and anti-inflammatory agent: Its role in human health.
        Front Nutr. 2014; 1: 14
        • Powers S.K.
        • Smuder A.J.
        • Judge A.R.
        Oxidative stress and disuse muscle atrophy: Cause or consequence?.
        Curr Opin Clin Nutr Metab Care. 2012; 15: 240-245
        • Liberati A.
        • Altman D.G.
        • Tetzlaff J.
        • et al.
        The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: Explanation and elaboration.
        J Clin Epidemiol. 2009; 62: 1
      1. Muscular Dystrophy Canada. Comprehensive list of neuromuscular disorders covered by Muscular Dystrophy Canada, 2009. Available at: Accessed June 26, 2017.

        • Argiles J.M.
        • Lopez-Soriano F.
        • Busquets S.
        Muscle wasting in cancer: The role of mitochondria.
        Curr Opin Clin Nutr Metab Care. 2015; 18: 221-225
        • von Haehling S.
        • Steinbeck L.
        • Doehner W.
        • et al.
        Muscle wasting in heart failure: An overview.
        Int J Biochem Cell Biol. 2013; 45: 2257-2265
        • Dasarathy S.
        Cause and management of muscle wasting in chronic liver disease.
        Curr Opin Gastroenterol. 2016; 32: 159-165
        • Dudgeon W.D.
        • Phillips K.D.
        • Carson J.A.
        • et al.
        Counteracting muscle wasting in HIV-infected individuals.
        HIV Med. 2006; 7: 299-310
        • Workeneh B.T.
        • Mitch W.E.
        Review of muscle wasting associated with chronic kidney disease.
        Am J Clin Nutr. 2010; 91: 1132S
        • Wust R.C.
        • Degens H.
        Factors contributing to muscle wasting and dysfunction in COPD patients.
        Int J Chron Obstruct Pulmon Dis. 2007; 2: 289-300
        • Carter W.J.
        • Van Der W.B.
        • Faas F.H.
        Effect of experimental hyperthyroidism on protein turnover in skeletal and cardiac muscle.
        Metabolism. 1980; 29: 910-915
      2. Effective Public Health, Practice Project. Quality Assessment Tool for Quantitative Studies, 2016. Available from: Accessed June 26, 2017.

        • Armijo-Olivo S.
        • Stiles C.R.
        • Hagen N.A.
        • et al.
        Assessment of study quality for systematic reviews: A comparison of the Cochrane Collaboration Risk of Bias Tool and the Effective Public Health Practice Project Quality Assessment Tool: Methodological research.
        J Eval Clin Pract. 2012; 18: 12-18
        • Veronese N.
        • Berton L.
        • Carraro S.
        • et al.
        Effect of oral magnesium supplementation on physical performance in healthy elderly women involved in a weekly exercise program: A randomized controlled trial.
        Am J Clin Nutr. 2014; 100: 974-981
        • Bartali B.
        • Frongillo E.A.
        • Guralnik J.M.
        • et al.
        Serum micronutrient concentrations and decline in physical function among older persons.
        JAMA. 2008; 299: 308-315
        • Martin H.
        • Aihie Sayer A.
        • Jameson K.
        • et al.
        Does diet influence physical performance in community-dwelling older people? Findings from the Hertfordshire Cohort Study.
        Age Ageing. 2011; 40: 181-186
        • Waters D.L.
        • Wayne S.J.
        • Andrieu S.
        • et al.
        Sexually dimorphic patterns of nutritional intake and eating behaviors in community-dwelling older adults with normal and slow gait speed.
        J Nutr Health Aging. 2014; 18: 228-233
        • Chaput J.P.
        • Lord C.
        • Cloutier M.
        • et al.
        Relationship between antioxidant intakes and class I sarcopenia in elderly men and women.
        J Nutr Health Aging. 2007; 11: 363-369
        • Chen Y.L.
        • Yang K.C.
        • Chang H.H.
        • et al.
        Low serum selenium level is associated with low muscle mass in the community-dwelling elderly.
        J Am Med Dir Assoc. 2014; 15: 807-811
        • Seo M.H.
        • Kim M.K.
        • Park S.E.
        • et al.
        The association between daily calcium intake and sarcopenia in older, non-obese Korean adults: The fourth Korea National Health and Nutrition Examination Survey (KNHANES IV) 2009.
        Endocr J. 2013; 60: 679-686
        • Oh C.
        • Jho S.
        • No J.K.
        • Kim H.S.
        Body composition changes were related to nutrient intakes in elderly men but elderly women had a higher prevalence of sarcopenic obesity in a population of Korean adults.
        Nutr Res. 2015; 35: 1-6
        • Ter Borg S.
        • de Groot L.C.
        • Mijnarends D.M.
        • et al.
        Differences in nutrient intake and biochemical nutrient status between sarcopenic and nonsarcopenic older adults-results from the Maastricht Sarcopenia Study.
        J Am Med Dir Assoc. 2016; 17: 393-401
        • Verlaan S.
        • Aspray T.J.
        • Bauer J.M.
        • et al.
        Nutritional status, body composition, and quality of life in community-dwelling sarcopenic and non-sarcopenic older adults: A case-control study.
        Clin Nutr. 2017; 36: 267-274
        • Scott D.
        • Blizzard L.
        • Fell J.
        • et al.
        Associations between dietary nutrient intake and muscle mass and strength in community-dwelling older adults: The Tasmanian Older Adult Cohort Study.
        J Am Geriatr Soc. 2010; 58: 2129-2134
        • Dominguez L.J.
        • Barbagallo M.
        • Lauretani F.
        • et al.
        Magnesium and muscle performance in older persons: The InCHIANTI study.
        Am J Clin Nutr. 2006; 84: 419-426
        • Barbagallo M.
        • Dominguez L.J.
        Magnesium and aging.
        Curr Pharm Des. 2010; 16: 832-839
      3. Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes (DRIs): Elements, 2011. Available from: Accessed June 26, 2017.

        • Nielsen F.H.
        • Lukaski H.C.
        Update on the relationship between magnesium and exercise.
        Magnes Res. 2006; 19: 180-189
        • Beck J.
        • Ferrucci L.
        • Sun K.
        • et al.
        Low serum selenium concentrations are associated with poor grip strength among older women living in the community.
        Biofactors. 2007; 29: 37-44
        • Lauretani F.
        • Semba R.D.
        • Bandinelli S.
        • et al.
        Association of low plasma selenium concentrations with poor muscle strength in older community-dwelling adults: The InCHIANTI Study.
        Am J Clin Nutr. 2007; 86: 347-352
        • Rederstorff M.
        • Krol A.
        • Lescure A.
        Understanding the importance of selenium and selenoproteins in muscle function.
        Cell Mol Life Sci. 2006; 63: 52-59
        • Lescure A.
        • Rederstorff M.
        • Krol A.
        • et al.
        Selenoprotein function and muscle disease.
        Biochim Biophys Acta. 2009; 1790: 1569-1574
        • Brotto M.
        Aging, sarcopenia and store-operated calcium entry: A common link?.
        Cell Cycle. 2011; 10: 4201-4202
        • Fleet J.C.
        • Schoch R.D.
        Molecular mechanisms for regulation of intestinal calcium absorption by vitamin D and other factors.
        Crit Rev Clin Lab Sci. 2010; 47: 181-195
        • Masuyama R.
        Bone and nutrition. Vitamin D independent calcium absorption.
        Clin Calcium. 2015; 25: 1023-1028
        • Galaris D.
        • Pantopoulos K.
        Oxidative stress and iron homeostasis: Mechanistic and health aspects.
        Crit Rev Clin Lab Sci. 2008; 45: 1-23
        • Rando T.A.
        Oxidative stress and the pathogenesis of muscular dystrophies.
        Am J Phys Med Rehabil. 2002; 81: 175
        • Baumann C.W.
        • Kwak D.
        • Liu H.M.
        • Thompson L.V.
        Age-induced oxidative stress: How does it influence skeletal muscle quantity and quality?.
        J Appl Physiol (1985). 2016; 121: 1047-1052