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Am J Public Health. 1999 March; 89(3): 322–329.
PMCID: PMC1508593

Is whole grain intake associated with reduced total and cause-specific death rates in older women? The Iowa Women's Health Study.

Abstract

OBJECTIVES: This study sought to determine whether nutrient-rich whole grains reduce mortality risk. METHODS: The study included 38,740 Iowa women, aged 55 to 69 years. A food frequency questionnaire was used to obtain data on grain intake. RESULTS: Median whole grain intake quintiles ranged from a median of 0.2 to more than 3 servings per day. Women with higher intakes had healthier lifestyles and less baseline disease. The total death rate decreased in increasing quintiles, and the pattern repeated for cancer, cardiovascular disease, and other causes combined. Adjusted for lifestyle and baseline disease, the relative hazard rate ratio for total death was about 0.85 in daily consumers of whole grain. Findings persisted in strata of baseline healthy and diseased and were not explained by dietary fiber. Rates of total mortality, but not cardiovascular disease mortality, were higher among frequent consumers of refined grain. CONCLUSIONS: Total mortality risk was inversely associated with whole grain intake and positively associated with refined grain intake. Refined grains contributed more than 20% of energy intake, and whole grains contributed 1%. Substitution of whole for refined grain may reduce chronic disease risk in the United States.

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  • Slavin J, Jacobs D, Marquart L. Whole-grain consumption and chronic disease: protective mechanisms. Nutr Cancer. 1997;27(1):14–21. [PubMed]
  • Thompson LU. Antioxidants and hormone-mediated health benefits of whole grains. Crit Rev Food Sci Nutr. 1994;34(5-6):473–497. [PubMed]
  • Jacobs DR, Jr, Slavin J, Marquart L. Whole grain intake and cancer: a review of the literature. Nutr Cancer. 1995;24(3):221–229. [PubMed]
  • Jacobs DR, Jr, Marquart L, Slavin J, Kushi LH. Whole-grain intake and cancer: an expanded review and meta-analysis. Nutr Cancer. 1998;30(2):85–96. [PubMed]
  • Jacobs DR, Jr, Meyer KA, Kushi LH, Folsom AR. Whole-grain intake may reduce the risk of ischemic heart disease death in postmenopausal women: the Iowa Women's Health Study. Am J Clin Nutr. 1998 Aug;68(2):248–257. [PubMed]
  • Willett WC, Sampson L, Browne ML, Stampfer MJ, Rosner B, Hennekens CH, Speizer FE. The use of a self-administered questionnaire to assess diet four years in the past. Am J Epidemiol. 1988 Jan;127(1):188–199. [PubMed]
  • Feskanich D, Rimm EB, Giovannucci EL, Colditz GA, Stampfer MJ, Litin LB, Willett WC. Reproducibility and validity of food intake measurements from a semiquantitative food frequency questionnaire. J Am Diet Assoc. 1993 Jul;93(7):790–796. [PubMed]
  • Munger RG, Folsom AR, Kushi LH, Kaye SA, Sellers TA. Dietary assessment of older Iowa women with a food frequency questionnaire: nutrient intake, reproducibility, and comparison with 24-hour dietary recall interviews. Am J Epidemiol. 1992 Jul 15;136(2):192–200. [PubMed]
  • Kushi LH, Kaye SA, Folsom AR, Soler JT, Prineas RJ. Accuracy and reliability of self-measurement of body girths. Am J Epidemiol. 1988 Oct;128(4):740–748. [PubMed]
  • Pietinen P, Rimm EB, Korhonen P, Hartman AM, Willett WC, Albanes D, Virtamo J. Intake of dietary fiber and risk of coronary heart disease in a cohort of Finnish men. The Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study. Circulation. 1996 Dec 1;94(11):2720–2727. [PubMed]
  • Fraser GE, Sabaté J, Beeson WL, Strahan TM. A possible protective effect of nut consumption on risk of coronary heart disease. The Adventist Health Study. Arch Intern Med. 1992 Jul;152(7):1416–1424. [PubMed]
  • Gramenzi A, Gentile A, Fasoli M, Negri E, Parazzini F, La Vecchia C. Association between certain foods and risk of acute myocardial infarction in women. BMJ. 1990 Mar 24;300(6727):771–773. [PMC free article] [PubMed]
  • Burr ML, Fehily AM, Gilbert JF, Rogers S, Holliday RM, Sweetnam PM, Elwood PC, Deadman NM. Effects of changes in fat, fish, and fibre intakes on death and myocardial reinfarction: diet and reinfarction trial (DART). Lancet. 1989 Sep 30;2(8666):757–761. [PubMed]
  • Ripsin CM, Keenan JM, Jacobs DR, Jr, Elmer PJ, Welch RR, Van Horn L, Liu K, Turnbull WH, Thye FW, Kestin M, et al. Oat products and lipid lowering. A meta-analysis. JAMA. 1992 Jun 24;267(24):3317–3325. [PubMed]
  • Fraser GE, Jacobs DR, Jr, Anderson JT, Foster N, Palta M, Blackburn H. The effect of various vegetable supplements on serum cholesterol. Am J Clin Nutr. 1981 Jul;34(7):1272–1277. [PubMed]
  • Sacks FM, Obarzanek E, Windhauser MM, Svetkey LP, Vollmer WM, McCullough M, Karanja N, Lin PH, Steele P, Proschan MA, et al. Rationale and design of the Dietary Approaches to Stop Hypertension trial (DASH). A multicenter controlled-feeding study of dietary patterns to lower blood pressure. Ann Epidemiol. 1995 Mar;5(2):108–118. [PubMed]
  • Appel LJ, Moore TJ, Obarzanek E, Vollmer WM, Svetkey LP, Sacks FM, Bray GA, Vogt TM, Cutler JA, Windhauser MM, et al. A clinical trial of the effects of dietary patterns on blood pressure. DASH Collaborative Research Group. N Engl J Med. 1997 Apr 17;336(16):1117–1124. [PubMed]
  • Steinmetz KA, Potter JD. Vegetables, fruit, and cancer. I. Epidemiology. Cancer Causes Control. 1991 Sep;2(5):325–357. [PubMed]
  • Steinmetz KA, Potter JD. Vegetables, fruit, and cancer. II. Mechanisms. Cancer Causes Control. 1991 Nov;2(6):427–442. [PubMed]
  • Prineas RJ, Kushi LH, Folsom AR, Bostick RM, Wu Y. Walnuts and serum lipids. N Engl J Med. 1993 Jul 29;329(5):359–360. [PubMed]
  • Kushi LH, Folsom AR, Prineas RJ, Mink PJ, Wu Y, Bostick RM. Dietary antioxidant vitamins and death from coronary heart disease in postmenopausal women. N Engl J Med. 1996 May 2;334(18):1156–1162. [PubMed]
  • Meyskens FL., Jr Strategies for prevention of cancer in humans. Oncology (Williston Park) 1992 Feb;6(2 Suppl):15–24. [PubMed]
  • Strain JJ. Putative role of dietary trace elements in coronary heart disease and cancer. Br J Biomed Sci. 1994 Sep;51(3):241–251. [PubMed]
  • Boushey CJ, Beresford SA, Omenn GS, Motulsky AG. A quantitative assessment of plasma homocysteine as a risk factor for vascular disease. Probable benefits of increasing folic acid intakes. JAMA. 1995 Oct 4;274(13):1049–1057. [PubMed]
  • Selhub J, Jacques PF, Wilson PW, Rush D, Rosenberg IH. Vitamin status and intake as primary determinants of homocysteinemia in an elderly population. JAMA. 1993 Dec 8;270(22):2693–2698. [PubMed]
  • Chasan-Taber L, Selhub J, Rosenberg IH, Malinow MR, Terry P, Tishler PV, Willett W, Hennekens CH, Stampfer MJ. A prospective study of folate and vitamin B6 and risk of myocardial infarction in US physicians. J Am Coll Nutr. 1996 Apr;15(2):136–143. [PubMed]
  • Jenkins DJ, Wesson V, Wolever TM, Jenkins AL, Kalmusky J, Guidici S, Csima A, Josse RG, Wong GS. Wholemeal versus wholegrain breads: proportion of whole or cracked grain and the glycaemic response. BMJ. 1988 Oct 15;297(6654):958–960. [PMC free article] [PubMed]
  • Potter JD. Food and phytochemicals, magic bullets and measurement error: a commentary. Am J Epidemiol. 1996 Dec 1;144(11):1026–1027. [PubMed]

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