Associations of Whole and Refined Grain Intakes with Adiposity-Related Cancer Risk in the Framingham Offspring Cohort (1991–2013)

Abstract

Case-control studies suggest that higher whole grain and lower refined grain intakes are associated with reduced cancer risk, but longitudinal evidence is limited. The objective of this prospective cohort study is to evaluate associations between whole and refined grains and their food sources in relation to adiposity-related cancer risk. Participants were adults from the Framingham Offspring cohort (N = 3,184; ≥18 yr). Diet, measured using a food frequency questionnaire, medical and lifestyle data were collected at exam 5 (1991-95). Between 1991 and 2013, 565 adiposity-related cancers were ascertained using pathology reports. Cox proportional hazards models were used to estimate adjusted hazard ratios and 95% confidence intervals for associations of whole and refined grains with risk of adiposity-related cancers combined and with risk of breast and prostate cancers in exploratory site-specific analyses. Null associations between whole and refined grains and combined incidence of adiposity-related cancers were observed in multivariable-adjusted models (HR: 0.94; 95% CI: 0.71-1.23 and HR: 0.98; 95% CI: 0.70-1.38, respectively). In exploratory analyses, higher intakes of whole grains (oz eq/day) and whole grain food sources (servings/day) were associated with 39% and 47% lower breast cancer risk (HR: 0.61; 95% CI: 0.38-0.98 and HR: 0.53; 95% CI: 0.33-0.86, respectively). In conclusion, whole and refined grains were not associated with adiposity-related cancer risk. Whole grains may protect against breast cancer, but findings require confirmation within a larger sample and in other ethnic groups.

Premenopausal breast cancer is a health challenge: nutritional habits show potential to prevent this disease

“…Participants were adults, belonging to the Framingham Offspring cohort (N = 3184; ⩾18 years old) between 1991 and 2013, identifying 565 cancers confirmed by pathology, concluding that a greater consumption of integral grains per day, and sources of integral foods per portion per day, was associated with 39% and 47% less risk of breast cancer, (OR 0.61; 95% CI: 0.38, 0.98 and hazard ratio 0.53; 95% CI: 0.33, 0.86, respectively). 26 …”

“…Participants were adults, belonging to the Framingham Offspring cohort (N = 3184; ⩾18 years old) between 1991 and 2013, identifying 565 cancers confirmed by pathology, concluding that a greater consumption of integral grains per day, and sources of integral foods per portion per day, was associated with 39% and 47% less risk of breast cancer, (OR 0.61; 95% CI: 0.38, 0.98 and hazard ratio 0.53; 95% CI: 0.33, 0.86, respectively). 26 There is growing evidence supporting the regular benefit of whole grains on the decrease in risk of different types of cancer. In a review of case and control studies in hospitals in Italy, Chatenoud et al 27 found a pattern of protection of whole grains for different types of cancer, including, among them, breast cancer.…”

Whole Grain Consumption for the Prevention and Treatment of Breast Cancer

“…Firstly, whole grains could influence the obesity situation by promoting satiation and satiety, reducing caloric intake, and controlling body adiposity due to its high fiber content, which can lower energy density [130,131]. Abundant fiber content in whole grains could significantly control insulin resistance and insulin-like growth factors expression [56,132]. Therefore, decreasing body adiposity and insulin resistance could contribute to reducing risks of cancer.…”

“…Consumption of whole grains has been proven to decrease the risk of obesity, diabetes, and cardiovascular diseases [43,44,45,46,47,48,49,50,51,52,53,54]. Over the last few decades, accumulating evidence has shown that high intake of whole grain products prevents cancer occurrence [53,55,56,57,58]. These health benefits of whole grains could be attributed to the abundant phytochemicals in different cereal species [59].…”

“…Another case-control study from Iran suggested that the consumption of resistant starch (RS)-containing food, such as whole grain bread, could reduce breast cancer risk (OR = 0.61; 95%CI = 0.37–0.99) for women aged from 25 to 65 years [83]. A 2017 cohort study showed that the consumption of whole grain food may protect against breast cancer risk with a 47% reduction rate (HR (hazard ratios) = 0.53; 95%C I = 0.33–0.86), while consumption of whole grain food had no clear association with other adiposity-related cancers [56]. Dietary intervention with whole grains and related products could be a pragmatic approach for breast cancer prevention and management.…”