Association Analysis Between Dietary Magnesium Intake and All-Cause and Cause-Specific Mortality in Individuals With Chronic Neck Pain

Abstract

This study investigated the association between dietary magnesium intake and all‑cause and cause‑specific mortality among individuals with chronic neck pain (CNP). We enrolled 2955 CNP patients aged ≥20 years from the 1999-2020 NHANES database and used Cox regression, subgroup analysis, and Mendelian randomization‑based mediation analysis to explore relevant associations and mechanisms. During follow‑up, 719 all‑cause deaths, 180 cardiovascular disease (CVD) deaths, and 179 cancer deaths occurred. Multivariable‑adjusted analyses showed that higher dietary magnesium intake was significantly associated with reduced CVD mortality, with each 1 g/day increment linked to a 78% lower risk. A non‑linear association with a threshold of 0.5181 g/day was found for cancer mortality, above which mortality risk dropped significantly. Subgroup analyses confirmed result robustness. Mediation analysis revealed that magnesium lowered all‑cause and CVD mortality directly and indirectly by reducing C‑reactive protein (CRP) levels. These findings indicate that higher dietary magnesium intake predicts lower mortality risk in CNP patients, partly via CRP‑mediated anti‑inflammatory pathways, supporting dietary magnesium optimization from whole‑food sources to improve long‑term prognosis.

Keywords: C‐reactive protein; all‐cause mortality; cancer mortality; cardiovascular disease mortality; chronic neck pain; dietary magnesium; inflammation.