Effect of Magnesium Oxide Supplementation on Nocturnal Leg Cramps: A Randomized Clinical Trial.

Importance: Magnesium supplements are widely marketed for prophylaxis of nocturnal leg cramps (NLC) despite no evidence of significant benefit. Objective: To determine whether magnesium oxide is better than placebo for NLC prophylaxis. Design, Setting, and Participants: A randomized, double-blind, placebo-controlled clinical trial of 2 weeks eligibility screening followed by 4 weeks of treatment was conducted in northern Israel, from February to October 2013. An intention-to-treat data analysis was performed from March 22, 2014, to April 17, 2016. We used a volunteer sample of community-dwelling individuals experiencing NLC, 21 years or older, with 4 or more documented episodes of NLC during 2 weeks of screening. Interventions: Capsules containing either magnesium oxide or a similar-looking placebo to be taken orally, once daily at bedtime for a period of 4 weeks. Main Outcomes and Measures: The primary outcome was the difference in the mean number of NLC per week between the screening and treatment phases. Secondary outcomes included severity and duration of NLC, quality of life, and quality of sleep. Results: Of the 166 volunteers, 72 (43%) were excluded, of whom 15 declined to participate and 57 did not meet the inclusion criteria. Of the 94 individuals (39% male; mean [SD] age, 64.9 [11.1] years) randomly assigned to magnesium oxide (48) or placebo (46), 6 did not complete the study protocol (3 in each group). Mean (SD) change of NLC was -3.41 (4.05) (from 7.84 [5.68] to 4.44 [5.66]) and -3.03 (4.53) (from 8.51 [5.20] to 5.48 [4.93]) per week in the magnesium oxide and placebo groups, respectively, a difference between groups of 0.38 (0.48) NLC per week (P = .67 in an intention-to-treat analysis). There were no between-group differences in the severity and duration of NLC, quality of life, or quality of sleep. Conclusions and Relevance: Oral magnesium oxide was not superior to placebo for older adults experiencing NLC. The decrease in the mean number of NLC per week, from the screening to the treatment phase in both groups, is probably a placebo effect that may explain the wide use of magnesium for NLC. Trial Registration: clinicaltrials.gov Identifier: NCT01709968.

[Attitudes of immigrants from the former Soviet Union towards complementary medicine].

BACKGROUND: The use of complementary and alternative medicine (CAM) in primary care in Israel is growing. Limited data is available on the influence of immigration and cross-cultural health-beliefs concerning CAM use. OBJECTIVES: This study explores the perspectives toward CAM of immigrants who came to Israel since 1990 from the former Soviet Union. RESEARCH DESIGN AND METHODS: Questionnaires were administered to a random sample of patients attending an urban academic primary care clinic located in Northern Israel. RESULTS: Out of 1146 participants in this study, 106 were immigrants from the former Soviet-Union. No statistical significance was found in the extent of CAM use in the last year among immigrants (63%) and non-immigrants (54%). Immigrants using CAM reported significantly less in reference to CAM practitioners and more use of herbal products. They also more significantly supported the idea of including an herbal therapist in the clinical staff at the medical center. Both groups expected their family physician to refer them to CAM, but immigrants had significantly higher expectations of their physician to provide CAM. Both groups anticipated an active role for their family physician in a future scenario of integrative care at the clinic. CONCLUSIONS: The use of CAM in primary care can be interpreted in a cross-cultural perspective. Patients who emigrated from the former USSR have unique perspectives toward CAM. The authors propose practical suggestions for primary care clinicians concerning anamnesis of immigrants regarding CAM. They also suggest health administrators take into account cross-cultural diversity when planning integration of CAM in primary care.