You will be presented with a collection of medical randomized controlled trial (RCT) reports addressing a shared clinical question -- for instance, the efficacy of a medical intervention on a disease or condition. Given the titles and abstracts of these reports, your task is to generate the conclusion of the systematic review article synthesizing the key findings. Your conclusion should be a few sentences long. In your response, include only the conclusion and no other text. The RCT reports are below.



Title 1:
Low dietary intake of magnesium is associated with increased externalising behaviours in adolescents.
Abstract 1:
OBJECTIVE Adequate Zn and Mg intakes may be beneficial for the prevention and treatment of mental health problems , such as depression , anxiety and attention-deficit hyperactivity disorder . We aim ed to investigate the prospect i ve association between dietary intakes of Zn and Mg and internalising and externalising behaviour problems in a population -based cohort of adolescents . DESIGN Prospect i ve analysis ( general linear mixed models ) of dietary intakes of Zn and Mg assessed using a vali date d FFQ and mental health symptoms assessed using the Youth Self-Report ( YSR ) , adjusting for sex , physical activity , family income , supplement status , dietary misreporting , BMI , family functioning and energy intake . SETTING Western Australian Pregnancy Cohort ( Raine ) Study . SUBJECTS Adolescents ( n 684 ) at the 14- and 17-year follow-ups . RESULTS Higher dietary intake of Mg ( per SD increase ) was significantly associated with reduced externalising behaviours ( β = -1.45 ; 95 % CI -2.40 , -0.50 ; P = 0.003 ) . There was a trend towards reduced externalising behaviours with higher Zn intake ( per SD increase ; β = -0.73 ; 95 % CI -1.57 , 0.10 ; P = 0.085 ) . CONCLUSIONS The study shows an association between higher dietary Mg intake and reduced externalising behaviour problems in adolescents . We observed a similar trend , although not statistically significant , for Zn intake . R and omised controlled trials are necessary to determine any benefit of micronutrient supplementation in the prevention and treatment of mental health problems in adolescents


Title 2:
Supplementation of polyunsaturated fatty acids, magnesium and zinc in children seeking medical advice for attention-deficit/hyperactivity problems - an observational cohort study
Abstract 2:
Background Polyunsaturated fatty acids are essential nutrients for humans . They are structural and functional components of cell membranes and pre-stages of the hormonally and immunologically active eicosanoids . Recent discoveries have shown that the long-chained omega-3 fatty acids eicosapentaenoic acid ( EPA ) and docosahexaenoic acid ( DHA ) also play an important role in the central nervous system . They are essential for normal brain functioning including attention and other neuropsychological skills . Material s and methods In our large observational study we monitored 810 children from 5 to 12 years of age referred for medical help and recommended for consuming polyunsaturated fatty acids ( PUFA ) in combination with zinc and magnesium by a physician over a period of at least 3 months . The food supplement ESPRICO ® ( further on referred to as the food supplement ) is developed on the basis of current nutritional science and containing a combination of omega-3 and omega-6 fatty acids as well as magnesium and zinc . Study objective was to evaluate the nutritional effects of the PUFA-zinc-magnesium combination on symptoms of attention deficit , impulsivity , and hyperactivity as well as on emotional problems and sleep related parameters . Assessment was performed by internationally st and ardised evaluation scales , i.e. SNAP-IV and SDQ . Tolerance ( adverse events ) and acceptance ( compliance ) of the dietary therapy were documented . Results After 12 weeks of consumption of a combination of omega-3 and omega-6 fatty acids as well as magnesium and zinc most subjects showed a considerable reduction in symptoms of attention deficit and hyperactivity/impulsivity assessed by SNAP-IV . Further , the assessment by SDQ revealed fewer emotional problems at the end of the study period compared to baseline and also sleeping disorders . Mainly problems to fall asleep , decreased during the 12 week nutritional therapy . Regarding safety , no serious adverse events occurred . A total of 16 adverse events with a possible causal relationship to the study medication were reported by 14 children ( 1.7 % ) and only 5.2 % of the children discontinued the study due to acceptance problems . Continuation of consumption of the food supplement was recommended by the paediatricians for 61.1 % of the children . Conclusion Our results suggest a beneficial effect of a combination of omega-3 and omega-6 fatty acids as well as magnesium and zinc consumption on attentional , behavioural , and emotional problems of children and adolescents . Thus , considering the behavioural benefit in combination with the low risk due to a good safety profile , the dietary supplementation with PUFA in combination with zinc and magnesium can be recommended


Title 3:
The effects of magnesium physiological supplementation on hyperactivity in children with attention deficit hyperactivity disorder (ADHD). Positive response to magnesium oral loading test.
Abstract 3:
Children with ADHD are ' a group at risk ' as far as their further emotional and social development and educational possibilities are concerned , and the consequences of the lack of an appropriate therapy appears to be serious . Some of these children do not respond to prevailing therapy methods . It is reported that dietetic factors can play a significant role in the etiology of ADHD syndrome , and magnesium deficiency can help in revealing hyperactivity in children . The aim of our work was to assess the influence of magnesium supplementation on hyperactivity in patients with ADHD . The examination comprised 50 hyperactive children , aged 7 - 12 years , who fulfilled DSM IV criteria for ADHD syndrome , with recognized deficiency of magnesium in the blood ( blood serum and red blood cells ) and in hair using atomic absorption spectroscopy . In the period of 6 months those examined regularly took magnesium preparations in a dose of about 200 mg/day . 30 of those examined with ADHD showed coexisting disorders specific to developmental age , and 20 of them showed disruptive behaviour . The control group consisted of 25 children with ADHD and magnesium deficiency , who were treated in a st and ard way , without magnesium preparations . 15 members of this group showed coexisting disorders specific for developmental age , and 10 members showed disruptive behaviour . Hyperactivity was assessed with the aid of psychometric scales : the Conners Rating Scale for Parents and Teachers , Wender 's Scale of Behavior and the Quotient of Development to Freedom from Distractibility . In the group of children given 6 months of magnesium supplementation , independently of other mental disorders coexisting with hyperactivity , an increase in magnesium contents in hair and a significant decrease of hyperactivity of those examined has been achieved , compared to their clinical state before supplementation and compared to the control group which had not been treated with magnesium


Title 4:
Effect of dextroamphetamine and methylphenidate on calcium and magnesium concentration in hyperactive boys
Abstract 4:
Levels of calcium in plasma , red blood cells , and mononuclear blood cells , levels of calcium in plasma , and the plasma calcium-to-magnesium ratio were measured at baseline and after 3 weeks of each drug phase of a double-blind , placebo-controlled study of  methylpheni date and dextroamphetamine in hyperactive boys .  Levels of magnesium in plasma were significantly higher after 3 weeks of dextroamphetamine treatment , and the calcium-to-magnesium ratio was significantly lower after 3 weeks of either drug compared with the baseline or placebo condition . There was no change in magnesium levels in red blood cells or mononuclear blood cells . These measures were obtained 30 minutes before the morning dose and at 9 a.m. , 9:30 a.m. , 10:30 a.m. , 11:00 a.m. , and noon on the last day of each 3-week phase . Analysis of variance revealed a drug effect on plasma magnesium and on the calcium-to-magnesium ratio but no drug x time interaction . Although these changes were not correlated with the time course of acute symptomatic response to stimulant therapy , the decrease in the ratio may be relevant to side effects and treatment resistance associated with stimulant use


Title 5:
Assessment of magnesium levels in children with attention deficit hyperactivity disorder (ADHD).
Abstract 5:
A positive influence of magnesium in the prevention and treatment of  hyperactivity in children is more and more frequently raised in the literature . The aim of our work was to estimate  magnesium contents in children with attention deficit hyperactivity disorder , ( ADHD ) . The investigations comprised 116 children ( 94 boys and 20 girls ) , aged 9 - 12 years , with recognized ADHD . In 68 out of 116 patients examined ADHD occurred with other coexisting disorders specific to the developmental age and in the remaining 48 patients it occurred together with disruptive behaviour . Magnesium levels have been determined in blood serum , red blood cells and in hair with the aid of atomic absorption spectroscopy . Magnesium deficiency was found in 95 per cent of those examined , most frequently in hair ( 77.6 per cent ) , in red blood cells ( 58.6 per cent ) and in blood serum ( 33.6 per cent ) of children with ADHD . The conclusion from the investigations is that magnesium deficiency in children with ADHD occurs more frequently than in healthy children . Analysis of the material indicated the correlation between levels of magnesium and the quotient of development to freedom from distractibility
HighlightsWe found significantly lower blood magnesium levels , either in plasma or serum , in ADHD children than those in controls .
The serum magnesium levels in ADHD children was significantly lower than those in controls .
Also , in situation of definite diagnosis based upon DSM system , the subgroup meta‐ analysis revealed similar result .Finally , we also found significantly lower hair magnesium levels in children diagnosed with ADHD than those in controls