Association between dietary whole grain intake and risk of mortality: two large prospective studies in US men and women
Wu H, Flint AJ, Qi Q, van Dam RM, Sampson LA, Rimm EB, Holmes MD, Willett WC, Hu FB, Sun Q
JAMA internal medicine · 141 citations
Review labels
Neutral facts our review recorded about how this study was done. They describe method, never whether we like the result.
How it was studied
- Design
- Cohort study (indexed by PubMed)
- Studied in
- People
- Main outcome
- Clinical events such as disease or death
- Intake measured by
- Food frequency questionnaire
Who paid for it
- Funding
- Independent funding
- Government
- State of Connecticut Department of Public Health
- Government
- National Institutes of Health
- Government
- National Heart, Lung, and Blood Institute
- Government
- National Cancer Institute
- Government
- National Institute of Diabetes and Digestive and Kidney Diseases
- Government
- NIDDK NIH HHS
- Government
- NCI NIH HHS
- Government
- NHLBI NIH HHS
- Grants
- National Heart, Lung, and Blood Institute (HL60712); National Cancer Institute (U54CA155626); National Cancer Institute (P01 CA055075.); National Cancer Institute (P01 CA087969); National Heart, Lung, and Blood Institute (R01-HL034594); National Cancer Institute (UM1 CA186107); National Heart, Lung, and Blood Institute (R01 HL035464); National Cancer Institute (U19 CA055075); National Heart, Lung, and Blood Institute (R00 HL098459); National Cancer Institute (UM1-CA-167552); National Institute of Diabetes and Digestive and Kidney Diseases (R01-DK058845); National Cancer Institute (CA055075); National Heart, Lung, and Blood Institute (HL-034594); National Heart, Lung, and Blood Institute (R01 HL35464); National Institute of Diabetes and Digestive and Kidney Diseases (R01 DK58845); National Heart, Lung, and Blood Institute (HL35464); National Heart, Lung, and Blood Institute (CA167552); National Heart, Lung, and Blood Institute (R01 HL060712); National Cancer Institute ([P01 CA87969); National Institutes of Health (P01 CA 87969); National Institutes of Health (R01 HL034594); National Institutes of Health (UM1 CA167552); National Institutes of Health (HL034594); National Institutes of Health (R01HL35464); National Institutes of Health (U54CA155626); National Institutes of Health (HL 60712); National Institutes of Health (CA-167552); National Institutes of Health (DK58845); National Institutes of Health (CA 87969); National Institutes of Health (CA055075); National Institutes of Health (HL35464)
Based on 8 listed funder(s).
Publication
- Published
- 2015-01-05 · JAMA Intern Med · vol. 175 · issue 3 · p. 373
- Publisher
- American Medical Association
- Cited
- 194 citations · more than 100% of similar papers · 18.2× the field average
- Impact
- Top 10% most cited in its field
- References
- 52 works
- Access
- Open access (repository copy)
- Research areas
- Food composition and properties · Celiac Disease Research and Management · Nutritional Studies and Diet
- Keywords
- Medicine, Hazard ratio, Confounding, Body mass index, Prospective cohort study, Whole grains, Confidence interval, Cohort study, Internal medicine, Proportional hazards model, Relative risk, Refined grains, Cohort
- MeSH
- humans, cardiovascular diseases, diet, mortality, prospective studies, adult, middle aged, united states, female, male, edible grain
10 authors
From US, SG
- Hongyu Wu
- Alan John Flint
- Qibin QiAlbert Einstein College of Medicine
- Rob M. van DamNational University of Singapore; National University Health System
- Laura SampsonBrigham and Women's Hospital
- Eric B. RimmBrigham and Women's Hospital; Harvard University
Abstract
Importance
Higher intake of whole grains has been associated with a lower risk of major chronic diseases, such as type 2 diabetes mellitus and cardiovascular disease (CVD), although limited prospective evidence exists regarding whole grains' association with mortality.
Objective
To examine the association between dietary whole grain consumption and risk of mortality.
Design, setting, and participants
We investigated 74 341 women from the Nurses' Health Study (1984-2010) and 43 744 men from the Health Professionals Follow-Up Study (1986-2010), 2 large prospective cohort studies. All patients were free of CVD and cancer at baseline.
Main outcomes and measures
Hazard ratios (HRs) for total mortality and mortality due to CVD and cancer according to quintiles of whole grain consumption, which was updated every 2 or 4 years by using validated food frequency questionnaires.
Results
We documented 26 920 deaths during 2 727 006 person-years of follow-up. After multivariate adjustment for potential confounders, including age, smoking, body mass index, physical activity, and modified Alternate Healthy Eating Index score, higher whole grain intake was associated with lower total and CVD mortality but not cancer mortality: the pooled HRs for quintiles 1 through 5, respectively, of whole grain intake were 1 (reference), 0.99 (95% CI, 0.95-1.02), 0.98 (95% CI, 0.95-1.02), 0.97 (95% CI, 0.93-1.01), and 0.91 (95% CI, 0.88-0.95) for total mortality (P fortrend < .001); 1 (reference), 0.94 (95% CI, 0.88-1.01), 0.94 (95% CI, 0.87-1.01), 0.87 (95% CI, 0.80-0.94), and 0.85 (95% CI, 0.78-0.92) for CVD mortality (P fortrend < .001); and 1 (reference), 1.02 (95% CI, 0.96-1.08), 1.05 (95% CI, 0.99-1.12), 1.04 (95% CI, 0.98-1.11), and 0.97 (95% CI, 0.91-1.04) for cancer mortality (P fortrend = .43). We further estimated that every serving (28 g/d) of whole grain consumption was associated with a 5% (95% CI, 2%-7%) lower total morality or a 9% (95% CI, 4%-13%) lower CVD mortality, whereas the same intake level was nonsignificantly associated with lower cancer mortality (HR, 0.98; 95% CI, 0.94-1.02). Similar inverse associations were observed between bran intake and CVD mortality, with a pooled HR of 0.80 (95% CI, 0.73-0.87; P fortrend < .001), whereas germ intake was not associated with CVD mortality after adjustment for bran intake.
Conclusions and relevance
These data indicate that higher whole grain consumption is associated with lower total and CVD mortality in US men and women, independent of other dietary and lifestyle factors. These results are in line with recommendations that promote increased whole grain consumption to facilitate disease prevention.
Abstract via Europe PMC. Copyright remains with the authors or publisher.
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