# Efficacy of a Naturally Calcium and Magnesium-Rich Mineral Water on Musculoskeletal Fragility: A Randomized, Double-Blind Controlled Trial

## TL;DR

Drinking mineral water rich in calcium and magnesium reduced fall risk and improved muscle mass in older adults over a year.

## Contribution

Demonstrates that calcium- and magnesium-rich mineral water can be a complementary strategy for improving musculoskeletal health in older adults.

## Key findings

- SG9 mineral water reduced fall risk by 82% at 6 months compared to low-mineral water.
- SG9 improved appendicular skeletal muscle mass in participants with and without osteosarcopenia.
- No significant differences in physical performance or quality of life were observed between groups.

## Abstract

Background/Objectives: Calcium and magnesium play a key role in musculoskeletal health and neuromuscular function. Mineral waters naturally rich in these elements provide a highly bioavailable dietary source. This study evaluated whether daily intake of naturally calcium and magnesium-rich mineral water compared with low-mineral water affects fall risk, muscle mass, and muscle function in adults aged ≥50 years, with or without osteosarcopenia. Methods: In this 12-month, randomized, double-blind, controlled trial, 98 participants (86.7% women, 13.3% men) were assigned to consume 1 L/day of either SG9 (mineral water with high calcium and magnesium content) or J66 (low-mineral water). Outcomes included incidence of falls (primary endpoint), appendicular skeletal muscle mass (ASMM), muscle strength, physical performance, biochemical markers, and patient-reported measures. Assessments were performed at baseline, 6 months, and 12 months following CONSORT guidelines. Results: Ninety-eight participants (mean age ~63 years) were randomized and completed the 12-month follow-up. At 6 months, the incidence of falls was significantly lower in the SG9 group compared with the J66 group (relative risk reduction 82%; RR = 0.18, 95% CI 0.04–0.88; p < 0.05), whereas no significant between-group difference was observed at 12 months. Appendicular skeletal muscle mass indexed to height (ASMM/h2) was significantly higher in the SG9 group at 12 months (p = 0.0002). In participants with osteosarcopenia, SG9 intake was associated with a consistent improvement in ASMM/h2 at 6 and 12 months (p = 0.004 and p = 0.006, respectively). No significant between-group differences were detected in physical performance scores, biochemical markers, or quality-of-life measures. Conclusions: Daily consumption of calcium- and magnesium rich mineral water reduced fall risk and improved muscle mass in adults over 50 years, with or without osteosarcopenia. These findings support the role of calcium and magnesium-rich mineral water use as a complementary nutritional strategy for musculoskeletal health and fragility prevention.