Wholegrain Intake and Risk of Type 2 Diabetes: Evidence from Epidemiological and Intervention Studies

Abstract

Type 2 diabetes mellitus (T2DM) is one of the most common metabolic diseases and represents a leading cause of morbidity and mortality because of its related complications. The alarming rise in T2DM prevalence worldwide poses enormous challenges in relation to its social, economic, and a clinical burden requiring appropriate preventive strategies. Currently, lifestyle modifications—including approaches to promote a moderate body weight reduction and to increase regular physical exercise—are the first crucial intervention for T2DM prevention. In the light of the difficulty in reducing body weight and in long-term maintenance of weight loss, quality changes in dietary patterns—in terms of macro and micronutrient composition—can also strongly affect the development of T2DM. This may provide a more practical and suitable preventative approach than simply implementing caloric restriction. Along this line, there is increasing evidence that wholegrain consumption in substitution of refined grains is associated with a reduction of the incidence of several non-communicable chronic diseases. The aim of the present review is to summarize the current evidence from observational and randomized controlled clinical trials on the benefits of wholegrain on T2DM prevention and treatment. Plausible mechanisms by which wholegrain could act on glucose homeostasis and T2DM prevention are also evaluated. Altogether, the totality of the available evidence supports present dietary recommendations promoting wholegrain foods for the prevention and treatment of T2DM.

Replacement of Red and Processed Meat With Other Food Sources of Protein and the Risk of Type 2 Diabetes in European Populations: The EPIC-InterAct Study

“…Fermented dairy products like cheese and yogurt contain odd-chain fatty acids, ruminant trans fatty acids, and probiotic bacteria, all of which have been hypothesized to have beneficial effects on glucose metabolism ( 32 , 33 ). Cereals, in our study consisting of both refined and whole grains, may lower diabetes risk primarily through the intake of whole grains high in dietary fiber and phytochemicals with benefits on the production of short-chain fatty acids, improved insulin sensitivity, and glucose control and anti-inflammatory effects ( 34 ).…”

Whole Grains and Phenolic Acids: A Review on Bioactivity, Functionality, Health Benefits and Bioavailability

“…A review carried out by The German Nutrition Society concluded that prospective observational studies consistently report that a high consumption of whole grain products or dietary fiber from cereal products contributes to a reduced risk of diabetes [ 89 ]. The recent systematic reviews and meta-analysis of prospective studies reported that whole-grain foods have a significant relationship with the risk of T2D, showing a consistent decrease of risk with increasing consumption [ 90 , 91 ]. A meta-analysis of six observational studies indicated a 26% lower risk of T2D in the population with an intake of 48–80 g whole grain/day (3–5 servings) compared to those with the lowest intakes [ 9 ].…”

Advances on the Valorisation and Functionalization of By-Products and Wastes from Cereal-Based Processing Industry

“…According to the European Food Safety Authority (EFSA), whole grain cereals represent a major dietary source of dietary fibres [59]. Recent studies confirmed that cereal fibre intake was inversely associated with cardiovascular disease (CVD) risk factors [60], body mass index (BMI) and waist circumference and tended to be inversely associated with total and low-density lipoprotein (LDL) cholesterol [61] and type-2 diabetes [62]. In cereals and pseudocereals, dietary fibres contain different compounds, mostly found in the outer layers of the grains and cell walls.…”