title: Correlations suggest low magnesium may lead to higher rates of type 2 diabetes in Indigenous Australians.
abstract: BACKGROUND
  Diabetes accounts for a significant part of the morbidity and mortality experienced by Australian Aboriginal and Torres Strait Islander populations. Research over the past two decades has provided evidence of a clinical correlation between diabetes and low magnesium intake. Hypomagnesaemia is the most common electrolyte abnormality in diabetic outpatients and may be linked to the development of both macrovascular and microvascular diabetic complications. A diabetes risk reduction of 33%-34% has been found among those with diets highest in magnesium.
  
  
  OBJECTIVE
  This study examines the case for magnesium as a potential contributor to diabetes in Australia, especially among Aboriginal and Torres Strait Islander peoples. Specifically explored are associations between diabetes and the magnesium content of drinking water and diet, as well as climatic and socioeconomic factors that may impact on magnesium status including temperature, rainfall, education, employment and income.
  
  
  METHODS
  Queensland age-standardized death rates due to diabetes were correlated with the magnesium content of drinking water, maximum average temperature, rainfall, unemployment rate, proportion of population with post-school qualification, weekly income, and the percentage population identified as Indigenous. Multiple-pass 24-hour recalls from a convenience sample of 100 Indigenous patients at a regional centre were also analyzed to estimate dietary magnesium intake. The Indigenous nutrient intake was then compared with the Australian National Nutrition Survey estimates.
  
  
  RESULTS
  Diabetes related mortality was significantly correlated to the percentage of the population identified as Indigenous (r = 0.675), to water magnesium levels (r = -.414), and to average maximum daily temperature (r = 0.579). The average daily magnesium intake in an Indigenous cohort from a regional centre was 248 mg (men: 267 mg +/- 17; women: 245 mg +/- 6 mg), significantly less than intakes observed in the 1995 National Nutrition Survey (p<.001).
  
  
  CONCLUSIONS
  Although not representative of all Indigenous people, this study identified low dietary magnesium intake among an Indigenous cohort from a regional centre. We also found a significant correlation between the magnesium content of municipal water supplies and age-standardized deaths due to diabetes. We hypothesise that low magnesium dietary intake, compounded by inadequate magnesium replenishment in drinking water, may increase the risk of hypomagnesaemia in the Indigenous population of Queensland. The associations identified in this study support the hypothesis that magnesium may be a potential contributor to diabetes in Australia, especially among Indigenous people, and confirm the need for further research.
authors.affiliation: Townsville Aboriginal & Islander Health Service Ltd, Townsville, Queensland, Australia. dlongstreet@taihs.net.au
authors.forename: D A
authors.initials: DA
authors.lastname: Longstreet
authors.forename: D L
authors.initials: DL
authors.lastname: Heath
authors.forename: K S
authors.initials: KS
authors.lastname: Panaretto
authors.forename: R
authors.initials: R
authors.lastname: Vink
mesh_terms: D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D048909:Diabetes Complications / Q000209:etiology*; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology* / Q000209:etiology* / Q000401:mortality / Q000517:prevention & control; D004032:Diet / Q000706:statistics & numerical data; D004522:Educational Status; D005260:Female; D006801:Humans; D008274:Magnesium / Q000008:administration & dosage / Q000502:physiology; D008275:Magnesium Deficiency / Q000150:complications* / Q000208:ethnology*; D008297:Male; D015596:Nutrition Assessment; D011793:Queensland / Q000453:epidemiology; D012307:Risk Factors; D012959:Socioeconomic Factors; D014881:Water Supply / Q000032:analysis; D014887:Weather; D000095283:Australian Aboriginal and Torres Strait Islander Peoples
chemical_list: D008274:Magnesium