Magnesium, vital to health, is lost when sea water is converted to fresh water

Desalination sounds like the quintessential solution in a world undergoing climate change, but it isn’t. The process of removing salt from the Mediterranean Sea brings with it health dangers.

By JUDY SIEGEL-ITZKOVICH DECEMBER 29, 2024 00:53

THE SOREK Desalination Plant – health dangers? (photo credit: ISAAC HARARI/FLASH90)

The plentiful water in this blessed country is different than that in any other nation – not because it’s holy but because most of what is used for drinking and agriculture is now desalinated. 

It’s nearly January, but the amount of rainfall we have received since the beginning of autumn has been negligible. Just a few years ago, this dry spell would have seen pilots sent to dark clouds to seed them with ice (not very effective); rabbis leading special prayers for rain; and the authorities begging the public to conserve water by showing images of actresses with cracks on their faces as if they were parched land. But no longer.

The reason is that starting in 1997, the authorities decided to invest huge sums in building five desalination plants in Israel – Hadera, Sorek, Ashdod, Ashkelon, and Palmachim. Constructing just one such facility ranges in cost from $300 million and more than $1 billion. 

Desalination sounds like the quintessential solution in a world undergoing climate change, but it isn’t. The process of removing salt from the Mediterranean Sea brings with it health dangers. New research from Jerusalem’s Taub Center for Social Policy Studies has found that deficiency of this critical mineral greatly increases the risk of Type-2 diabetes, coronary heart disease, and ischemic stroke. 

Contrarily, magnesium helps maintain proper muscle and nerve function, supporting a steady heart rhythm, promoting the immune system, aiding bone building, and helping regulate blood-sugar levels and proper blood pressure.

MAYA SADEH led the study by the Taub Center’s Initiative for Research and Policy on Environment and Health. (credit: YOSSI ZAMIR/FLASH90)

Conducted by researchers of Taub’s Initiative for Research and Policy on Environment and Health, the study was led by Maya Sadeh and included Prof. Nadav Davidovich, Prof. Itamar Grotto, and Dr. Alex Weinreb. Before the age of desalination, natural water supplied 10-20% of magnesium consumption here but now, desalinated water – which today comprises over 80% of the water in Israeli households – has no magnesium at all. Household water filters used by almost half of Israelis also significantly reduce the amount. Deficiencies also have harmful impacts on animals that drinking and eating food with little of the mineral. It has also greatly depleted the amount of magnesium in locally grown fruits and vegetables because they are watered by wastewater treatment. 

To treat wastewater and reuse it for irrigation, there are nearly 90 large wastewater treatment plants in Israel. The Shafdan plant located on the outskirts of Tel Aviv is by far the largest such facility it treats wastewater from 35 municipalities, serving some 2.3 million people.

In an interview with The Jerusalem Post, Sadeh – currently completing her doctorate at Tel Aviv University (her thesis investigates the relationship between exposure to greenness in one’s environment and recovery from coronary bypass surgery) is deeply disappointed that a way has not been founded by the government to add magnesium to all drinking water, even though it has been discussed since 2004. 

A decade ago, then-health minister Yael German canceled the addition of fluoride to the water to promote dental health and made it illegal to add any substance to the water (See Page 12).

THE RESEARCHERS wrote in their extensive report that returning magnesium to desalinated water can lower morbidity (suffering from disease) and save the health system hundreds of millions of shekels. Annual savings in medical expenses directly from the prevention of Type-2 diabetes and ischemic stroke following an increase in magnesium consumption by 50 mg. per day ranges from NIS 83 million to NIS 188m and from NIS 110m to NIS 253m in 2040. According to the Health Ministry, returning the mineral will cost only about NIS 37 million annually. 

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Magnesium deficiency ranges from 10 mg. among Jewish women aged 18-44 to a 50-80% deficiency among Arabs and Jews aged 65 and older. The recommended daily intake of magnesium for women is 265-315 mg. and for men, 350-415 mg. Pregnant women need more, and so do the elderly. 

The main food sources for magnesium are vegetables, especially green-leafy vegetables, legumes, nuts, seeds, whole grains and their products, such as whole wheat bread). But one can’t consume enough to make up for the deficiency.

Sadeh maintains that the Water Authority has opposed the move, and argued that people who need the magnesium can swallow pills. Yet if so, they have to be actively reminded to take them and get the proper dosage; adding it to the water would provide the proper dose, she insisted. There is no need to consume magnesium supplements, except for certain high-risk groups and in accordance with a doctor or dietitian’s recommendation.

Looking at Saudi Arabia and their desalination facilities

MEANWHILE, SAUDI Arabia has some of the largest desalination facilities in the world. The Shoaiba and the Al Jubail complexes can each produce over 800 million liters daily. Experimentation with desalination technologies there dates back to the 1890s due to the water needs of millions of pilgrims to Mecca, but it wasn’t until the 1950s that the first modern desalination plants were established in Saudi Arabia, as well as in Bahrain, Kuwait, and Qatar. A detailed 2023 study published in Science Direct reports that in 2022, it implemented the addition of magnesium at a Saline Water Conversion Corporation desalination plant on the Red Sea and has been delivering enriched water since 2022 to 1.3 Saudis at an estimated additional operational cost of $0.007 per square meter.

Our Health Ministry has apparently not asked Saudi Arabia whether it adds magnesium to its drinking water or how.

Asked to comment, Dr. Sharon Alroy-Preis who heads the ministry’s public health division endorsed the need to add the mineral. Why is it taking so long? 

Ignoring the Saudi experience, Alroy-Preis declared that “no Western country has done it. There is no data on how it’s carried out. First, we had to initiate a study to show that Israelis suffer from a deficiency and that there isn’t enough in the water they drink; some may drink a mix of natural and desalinized water. The law prohibiting the addition of anything to the water has to be changed, and the public has to be educated about the mineral. We are now working with the Water Authority. There is a clear need to do it, but now we have to decide how and how much,” she said.

“We have to restore magnesium to the drinking water to the pre-desalination level, following feasibility, applicability, and cost-benefit tests,” she stated, but she couldn’t announce a date for its implementation.

The researchers present economic estimates according to which adding 50 mg. of magnesium to a person’s daily intake may prevent over 1,000 new cases a year of diabetes and over 100 new cases of stroke. In total, this is an annual savings of hundreds of millions of shekels for the health system.

Also asked to comment, Dr. Nahum Itzkovitz – former director-general of the Agriculture and Food Security Ministry (with a doctorate from the Faculty of Management at the Sorbonne in France) said that “the consequences of magnesium deficiency must not be ignored, but the solution to magnesium deficiency is not one-dimensional. A joint team should be established by the ministries of health, finance, and agriculture – and the Volcani Institute (Agricultural Research Organization) – along with local government representatives. 

“They must allocate a budget and time for practical and useful research and to present all the alternatives.” 

The Taub report declared that healthcare costs per capita for diabetes patients are 1.7 to 2.7 times higher than the expenses for those who do not have diabetes. The lifetime cost of treating diabetes in a one-year cohort due to a deficiency of 50 mg. of magnesium is NIS 2.1 billion in relation to the treatment costs per capita between diabetic patients and those who are not sick, and in the percentage of patients who manage their condition well. The real cost to society and the economy of treating a diabetic patient is at least twice the cost for a non-diabetic if the indirect costs involved are taken into account. These include, among other things, impairment of work capacity, sick days, additional treatments, ancillary costs of caring for family members, and a disability allowance from the National Insurance Institute.

Davidovich concluded that “one of the main failures in the context of magnesium deficiency in water is that the external costs of desalination are not fully taken into account in the decision-making process. This failure ultimately harms public health, and especially the weaker populations, who are less aware of the problem and in many cases do not.”