Background

Drinking water (DW) is an important dietary source of magnesium. Recently, Israel has increased its use of desalinated seawater (DSW) as DW country-wide. Its negligible magnesium content, however, raises concern that consumption of DSW may be associated with hypomagnesemia and increase the risk of ischemic heart disease (IHD), diabetes mellitus (DM), and colorectal cancer (CRC).

Objectives

We tested whether there was a change in incidence of negative health outcomes (IHD, DM, and CRC) following the introduction of DSW supply in a population-based ecologic study in Israel.

Methods

A historical prospective analysis was applied to members aged 25–76 during 2004–2013 of Clalit Health Services (Clalit), the largest healthcare provider in Israel, using its electronic medical record database. Multivariable analyses were adjusted for age, sex, socioeconomic status, smoking status, and body mass index.

Results

An increased odds ratio was found for IHD (0.96, 95% CI 0.93–0.99 at baseline and 1.06, 95% CI 1.02–1.11 at the end of the follow-up period), but no time trend was observed.

Conclusions

We found that the risk for IHD increased during the study period. The risks for DM and CRC were unchanged. Long term studies are needed for assessing the risk for CRC due to the long latency. The higher risk for IHD has practical public health implications and raise the need to add magnesium to DSW.

中文翻译：

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接触淡化海水与缺血性心脏病，糖尿病和结直肠癌之间的联系；以色列的一项基于人口的研究

背景

饮用水（DW）是镁的重要饮食来源。最近，以色列在全国范围内增加了对淡化海水（DSW）的使用。然而，其镁含量微不足道，引起人们的担忧，即食用DSW可能与低镁血症有关，并增加了缺血性心脏病（IHD），糖尿病（DM）和结直肠癌（CRC）的风险。

目标

我们测试了在以色列基于人群的生态研究中引入DSW供应后，负面健康结果（IHD，DM和CRC）发生率是否发生了变化。

方法

使用其电子病历数据库，对以色列最大的医疗保健提供者Clalit Health Services（Clalit）在2004-2013年期间年龄在25-76岁的成员进行了历史前瞻性分析。对年龄，性别，社会经济状况，吸烟状况和体重指数进行多变量分析调整。

结果

发现IHD的优势比增加（基线时为0.96，95％CI为0.93–0.99，随访期结束时为1.06，95％CI 1.02–1.11），但未观察到时间趋势。

结论

我们发现研究期间IHD的风险增加。糖尿病和结直肠癌的风险没有改变。需要长期的研究来评估由于较长的等待时间而导致的CRC风险。IHD的较高风险对公共健康有实际影响，并增加了在DSW中添加镁的需求。