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Magnesium Intake, Quality of Carbohydrates, and Risk of Type 2 Diabetes: Results From Three U.S. Cohorts.
Diabetes Care 2017; 40(12):1695-1702DC

Abstract

OBJECTIVE

Magnesium intake is inversely associated with risk of type 2 diabetes in many observational studies, but few have assessed this association in the context of the carbohydrate quality of the diet. We hypothesized that higher magnesium intake is associated with lower risk of type 2 diabetes, especially in the context of a poor carbohydrate-quality diet characterized by low cereal fiber or high glycemic index (GI) or glycemic load (GL).

RESEARCH DESIGN AND METHODS

In the Nurses' Health Study (NHS; 1984-2012, n = 69,176), NHS2 (1991-2013, n = 91,471), and the Health Professionals' Follow-Up Study (1986-2012, n = 42,096), dietary intake was assessed from food frequency questionnaires every 4 years. Type 2 diabetes was ascertained by biennial and supplementary questionnaires. We calculated multivariate hazard ratios (HRs) of magnesium intake and incident diabetes, adjusted for age, BMI, family history of diabetes, physical activity, smoking, hypertension, hypercholesterolemia, GL, energy intake, alcohol, cereal fiber, polyunsaturated fats, trans fatty acids, and processed meat, and we considered the joint associations of magnesium and carbohydrate quality on diabetes risk.

RESULTS

We documented 17,130 incident cases of type 2 diabetes over 28 years of follow-up. In pooled analyses across the three cohorts, those with the highest magnesium intake had 15% lower risk of type 2 diabetes compared with those with the lowest intake (pooled multivariate HR in quintile 5 vs. 1: 0.85 [95% CI 0.80-0.91], P < 0.0001). Higher magnesium intake was more strongly associated with lower risk of type 2 diabetes among participants with high GI or low cereal fiber than among those with low GI or high cereal fiber (both P interaction <0.001).

CONCLUSIONS

Higher magnesium intake is associated with lower risk of type 2 diabetes, especially in the context of lower carbohydrate-quality diets.

Authors+Show Affiliations

Nutritional Epidemiology Program, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA mguasch@hsph.harvard.edu adela.hruby@tufts.edu. Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA.Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA mguasch@hsph.harvard.edu adela.hruby@tufts.edu.Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA. Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA. Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.Nutritional Epidemiology Program, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA.Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA. Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28978672

Citation

Hruby, Adela, et al. "Magnesium Intake, Quality of Carbohydrates, and Risk of Type 2 Diabetes: Results From Three U.S. Cohorts." Diabetes Care, vol. 40, no. 12, 2017, pp. 1695-1702.
Hruby A, Guasch-Ferré M, Bhupathiraju SN, et al. Magnesium Intake, Quality of Carbohydrates, and Risk of Type 2 Diabetes: Results From Three U.S. Cohorts. Diabetes Care. 2017;40(12):1695-1702.
Hruby, A., Guasch-Ferré, M., Bhupathiraju, S. N., Manson, J. E., Willett, W. C., McKeown, N. M., & Hu, F. B. (2017). Magnesium Intake, Quality of Carbohydrates, and Risk of Type 2 Diabetes: Results From Three U.S. Cohorts. Diabetes Care, 40(12), pp. 1695-1702. doi:10.2337/dc17-1143.
Hruby A, et al. Magnesium Intake, Quality of Carbohydrates, and Risk of Type 2 Diabetes: Results From Three U.S. Cohorts. Diabetes Care. 2017;40(12):1695-1702. PubMed PMID: 28978672.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Magnesium Intake, Quality of Carbohydrates, and Risk of Type 2 Diabetes: Results From Three U.S. Cohorts. AU - Hruby,Adela, AU - Guasch-Ferré,Marta, AU - Bhupathiraju,Shilpa N, AU - Manson,JoAnn E, AU - Willett,Walter C, AU - McKeown,Nicola M, AU - Hu,Frank B, Y1 - 2017/10/04/ PY - 2017/06/08/received PY - 2017/09/05/accepted PY - 2017/10/6/pubmed PY - 2018/2/10/medline PY - 2017/10/6/entrez SP - 1695 EP - 1702 JF - Diabetes care JO - Diabetes Care VL - 40 IS - 12 N2 - OBJECTIVE: Magnesium intake is inversely associated with risk of type 2 diabetes in many observational studies, but few have assessed this association in the context of the carbohydrate quality of the diet. We hypothesized that higher magnesium intake is associated with lower risk of type 2 diabetes, especially in the context of a poor carbohydrate-quality diet characterized by low cereal fiber or high glycemic index (GI) or glycemic load (GL). RESEARCH DESIGN AND METHODS: In the Nurses' Health Study (NHS; 1984-2012, n = 69,176), NHS2 (1991-2013, n = 91,471), and the Health Professionals' Follow-Up Study (1986-2012, n = 42,096), dietary intake was assessed from food frequency questionnaires every 4 years. Type 2 diabetes was ascertained by biennial and supplementary questionnaires. We calculated multivariate hazard ratios (HRs) of magnesium intake and incident diabetes, adjusted for age, BMI, family history of diabetes, physical activity, smoking, hypertension, hypercholesterolemia, GL, energy intake, alcohol, cereal fiber, polyunsaturated fats, trans fatty acids, and processed meat, and we considered the joint associations of magnesium and carbohydrate quality on diabetes risk. RESULTS: We documented 17,130 incident cases of type 2 diabetes over 28 years of follow-up. In pooled analyses across the three cohorts, those with the highest magnesium intake had 15% lower risk of type 2 diabetes compared with those with the lowest intake (pooled multivariate HR in quintile 5 vs. 1: 0.85 [95% CI 0.80-0.91], P < 0.0001). Higher magnesium intake was more strongly associated with lower risk of type 2 diabetes among participants with high GI or low cereal fiber than among those with low GI or high cereal fiber (both P interaction <0.001). CONCLUSIONS: Higher magnesium intake is associated with lower risk of type 2 diabetes, especially in the context of lower carbohydrate-quality diets. SN - 1935-5548 UR - https://www.unboundmedicine.com/medline/citation/28978672/Magnesium_Intake_Quality_of_Carbohydrates_and_Risk_of_Type_2_Diabetes:_Results_From_Three_U_S__Cohorts_ L2 - http://care.diabetesjournals.org/cgi/pmidlookup?view=long&amp;pmid=28978672 DB - PRIME DP - Unbound Medicine ER -