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Am J Clin Nutr. 2016 Jul;104(1):164-72. doi: 10.3945/ajcn.115.122432. Epub 2016 May 25.

Whole-grain intake and total, cardiovascular, and cancer mortality: a systematic review and meta-analysis of prospective studies.

Author information

1
Department of Nutrition and Food Hygiene, School of Public Health.
2
Key Laboratory of Radiation Biology, School of Radiation Medicine and Protection, and.
3
Division of Medical Genetics, Maternal and Child Health Hospital of Hunan Province, Changsha, China.
4
Department of Nutrition and Food Hygiene, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Disease, Soochow University, Suzhou, China; and qinliqiang@suda.edu.cn.

Abstract

BACKGROUND:

The potential role of whole grain in preventing various mortality outcomes has been inconsistently reported in a wealth of prospective observational studies.

OBJECTIVE:

We evaluated the relations between whole-grain intake and risks of dying from any cause, cardiovascular disease (CVD), and cancer through a meta-analytic approach.

DESIGN:

Relevant studies were identified by searching PubMed and EMBASE databases and bibliographies of retrieved full publications. Summary RRs with 95% CIs were calculated with a random-effects model.

RESULTS:

Thirteen studies on total mortality (104,061 deaths), 12 on CVD mortality (26,352 deaths), and 8 on cancer mortality (34,797 deaths) were included. Three studies reported whole-grain intake, and the remaining studies reported whole-grain product intake. In the dose-response analysis in which the intake of whole-grain products was converted to the amount of whole grain, the summary RRs for an increment in whole-grain intake of 50 g/d were 0.78 (95% CI: 0.67, 0.91) for total mortality, 0.70 (95% CI: 0.61, 0.79) for CVD mortality, and 0.82 (95% CI: 0.69, 0.96) for cancer mortality. A similar reduction was observed for the mortality from ischemic heart disease (RR: 0.68; 95% CI: 0.55, 0.84) but not from stroke (RR: 0.93; 95% CI: 0.54, 1.62). There was evidence of nonlinear associations of whole-grain intake with total (P-nonlinearity < 0.001) and CVD mortality (P-nonlinearity <0.001), but not with cancer mortality (P-nonlinearity = 0.12), with the curves for the associations appearing slightly steeper at lower ranges (<35 g/d) of the intake than at higher ranges.

CONCLUSIONS:

Our findings suggest significant inverse relations between whole-grain intake and mortality due to any cause, CVD, or cancer. The findings support the recommendation of increasing whole-grain intake to improve public health.

KEYWORDS:

cancer; cardiovascular disease; meta-analysis; mortality; whole grain

PMID:
27225432
DOI:
10.3945/ajcn.115.122432
[Indexed for MEDLINE]

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