Hadera desalination plant - Eyal Toueg - 04092011
A sea water desalination plant in Hadera. Photo by Eyal Toueg
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The government's decision last month not to add magnesium to desalinated tap water, at a cost of up to NIS 500 million, could gradually cause the deaths of 250 Israelis a year, a recent Health Ministry report warns.

The report says that without the cardiovascular disease-preventing properties of magnesium in the water, an additional 250 people will die of heart attacks.

"Magnesium is instrumental in preventing blood vessel dysfunction and cardiovascular disease, and slows down blood clotting," said Itamar Grotto, who heads the Health Ministry's public health department. Magnesium also helps regulate biochemical processes in human cells and maintain muscular and skeletal structures.

Magnesium is present in sea water, but the mineral gets lost in the desalination process that is producing an increasing proportion of the drinking water supply in Israel. By 2020, 66 percent of Israelis are expected to consume desalinized water.

In addition to drinking water, magnesium can be found in crops such as lettuce, cereals, beans, nuts, cocoa, figs and bananas. But the report says the growing use of desalinized water in agriculture would reduce indirect magnesium consumption as well, and recommends using fertilizer to compensate.

Health Ministry figures show that the average magnesium consumption has dropped from 500 milligrams a day to 175-220 milligrams a day.

"The recommended level is 400-420 milligrams a day," the report says. "The gap is enormous."

It is particularly striking among teenagers, the report says, adding that an additional 30 milligrams of magnesium will be required to maintain the current mortality rates for heart attacks.

According to Water Authority and Finance Ministry estimates, adding magnesium to drinking water would cost between NIS 150 million and NIS 500 million, which would entail a price hike of up to NIS 0.81 per cubic meter of water. They say such investment is unwarranted because just 0.5 percent of tap water is used for drinking and the average magnesium level among Israelis is similar to international levels.

The Prime Minister's Office said the cabinet is scheduled to discuss the issue next month in an attempt to make a decision that would satisfy all parties.

A Health Ministry study published in 2009 found that in Kibbutz Ma'agan Michael, where the water supply is provided by a desalination facility, residents consume 1.25 liters of water, as opposed to the national average of 0.5 liters. Based on these findings, ministry officials predict that 15 percent to 20 percent of magnesium consumption will come from drinking water, as opposed to the Water Authority estimates of 2 percent to 8 percent.

The Health Ministry sought to introduce special magnesium provisions into the water supply directives, which are pending the approval of the Knesset Labor, Welfare and Health Committee. But these were met with the refusal of other government bodies.

"Several surveys have found that the magnesium consumption of Israeli citizens does not fall short of international standards," the Finance Ministry said in a statement. "Also, there was no established link between magnesium deficiency and cardiac morbidity. There is no scientifically proven evidence that adding magnesium to desalinized water would have any effect. It would only burden the people who would be obliged to pay higher prices without getting anything in return."

Grotto says the Finance Ministry's cost estimates are too high, and may be lower, depending on the technology the government uses.

The Water Authority said most U.S. citizens consume water without added magnesium, including in big cities like New York, San Francisco, and parts of Chicago and Los Angeles, and that the rate of cardiac mortality is not exceptionally high. However, Health Ministry officials say London has recently decided to add magnesium to desalinized drinking water, which is also a policy in Cyprus.

The report also says the ministry would rather add magnesium to drinking water than recommend that Israelis consume magnesium via food additives.

"Such a recommendation is unsustainable in the long run," the report said, "and it would further widen socioeconomic gaps because lower classes will be unable to afford the purchase of food additives, as opposed to drinking water."

The Water Authority also said the recommended policy is controversial even among Health Ministry officials. But a Health Ministry spokesperson said that "despite the disagreement between experts, which is customary, the ministry's advice is unambiguous."