Fiber and Magnesium Intake and Incidence of Type 2 Diabetes

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Abstract
The predicted increase in diabetes mellitus prevalence from 171 million individuals diagnosed as having diabetes worldwide in 2000 to 370 million by the year 20301 and the alarming projections in terms of associated morbidities and mortality,2 as well as health care costs,3 emphasize the need for preventive action. Current guidelines for the prevention of type 2 diabetes by the American Diabetes Association4 and the European Association for the Study of Diabetes5 include goals for total dietary fiber intake. It has been suggested that the benefits of increased fiber intake result principally from the greater consumption of soluble forms6 due to effects on gastric emptying, macronutrient absorption, and reduced postprandial glucose responses.7-9 Insoluble fiber may reduce diabetes risk by the production of short-chain fatty acids in the colon and their effect on hepatic insulin sensitivity.10,11 However, although prospective studies have observed reduced diabetes risk with high cereal fiber and whole grain consumption,12-20 these findings have not been confirmed by all studies,16,21 and beneficial effects of fruit and vegetable fiber remain unclear so far. In addition, while magnesium deficiency is plausibly linked to diabetes,22 the absence of clinical trials and the inconsistency among prospective studies regarding the role of magnesium in diabetes prevention14,21,23-25 preclude definitive recommendations at present.5