Associations Between Dietary Fiber and Inflammation, Hepatic Function, and Risk of Type 2 Diabetes in Older Men: Potential Mechanisms for the Benefits of Fiber on Diabetes Risk: Response to Ghanim, Chaudhuri, and Dandona

We thank Ghanim, Chaudhuri, and Dandona (1) for their interest in our article (2) and for providing some potential mechanisms linking a high-fiber diet with lower diabetes risk and anti-inflammatory status. Of course, further work is needed to determine to what extent inflammatory pathways, potentially contributed to by adverse dietary intake, are causally involved in the pathogenesis of type 2 diabetes. It is important to remember that our data also suggest a diet high in fiber may protect from type 2 diabetes via attenuating or preventing hepatic fat accumulation, an increasingly recognized feature in the pathogenesis of diabetes (3,4). The mechanism for this latter association, however, requires further study. Regardless, the totality of available literature suggests that high fiber intake (common in diets of lower average energy density [5]) should be promoted to help offset diabetes risk.