Breakfast Cereals and Risk of Heart Failure in the Physicians' Health Study I

Abstract

Background: Heart failure (HF) is the leading cause of hospitalization among the elderly population in the United States. Consumption of grain products and dietary fiber has been shown to reduce the risk of hypertension and myocardial infarction. However, it is not known whether a higher consumption of breakfast cereals is associated with risk of HF. Methods: This study evaluated prospectively the association between breakfast cereal intake and incident HF among 21 376 participants of the Physicians' Health Study I. Cereal consumption was estimated using a semiquantitative food frequency questionnaire. Incident HF was ascertained through annual follow-up questionnaires and validated using Framingham criteria. We used Cox regression models to estimate adjusted relative risk of HF across categories of cereal intake. Results: During an average follow-up of 19.6 years, 1018 incident cases of HF occurred. For average weekly cereal consumption of 0 servings, 1 or fewer, 2 to 6, and 7 or more, hazard ratios (95% confidence intervals) for HF were 1 (reference), 0.92 (0.78-1.09), 0.79 (0.67-0.93), and 0.71 (0.60-0.85), respectively (PϽ.001 for trend), adjusting for age, smoking, alcohol consumption, vegetable consumption, use of multivitamins, exercise, and history of atrial fibrillation, valvular heart disease, and left ventricular hypertrophy. However, the association was limited to the intake of whole grain cereals (P Ͻ.001 for trend) but not refined cereals (P=.70 for trend). Conclusions: Our data demonstrate that a higher intake of whole grain breakfast cereals is associated with a lower risk of HF. Additional studies are warranted to confirm these findings and determine specific nutrients that are responsible for such a protection.

Whole-Grain Intake and Mortality from All Causes, Cardiovascular Disease, and Cancer: A Systematic Review and Dose-Response Meta-Analysis of Prospective Cohort Studies

“…An increase of 3 servings total whole grains/d was associated with a 17% lower risk of mortality from all causes, a 25% lower risk of mortality from CVD, and a 10% reduced risk of total-cancer mortality. Similar to our findings, accumulating evidence from observational studies has shown significant inverse associations between whole-grain intake and risk of incident CVD (51)(52)(53). A meta-analysis of 7 cohort studies also revealed that greater whole-grain intake (2.5 servings/d compared with 0.2 servings/d) was associated with a 21% lower risk of CVD events (5).…”

Food groups and risk of coronary heart disease, stroke and heart failure: A systematic review and dose-response meta-analysis of prospective studies

“…Sixteen prospective studies were included in the meta-analysis for consumption of whole grains (16 reports) (Del Gobbo et al 2015;Djousse and Gaziano 2007;Hansen et al 2017;Helnaes et al 2016;Jensen et al 2004;Liu et al 2000b;Liu et al 1999;Mizrahi et al 2009;Muraki et al 2015;Neelakantan et al 2016;Nettleton et al 2008;Rautiainen et al 2012;Sonestedt et al 2015;Steffen et al 2003;Tektonidis et al 2015Tektonidis et al , 2016 (Supplemental Table 2), 9 studies for refined grains (8 reports) (Djousse and Gaziano 2007;Eshak et al 2014;Liu et al 2000b;Mizrahi et al 2009;Muraki et al 2015;Sonestedt et al 2015;Steffen et al 2003;Yu et al 2013) (Supplemental Table 3), 35 for vegetables (32 reports) (Belin et al 2011a;Bendinelli et al 2011;Bhupathiraju et al 2013;Buckland et al 2009;Dauchet et al 2004;Del Gobbo et al 2015;Dilis et al 2012;Gillman et al 1995;Hansen et al 2017;Hansen et al 2010;Hirvonen et al 2001;Johnsen et al 2003;Joshipura et al 1999;Keli et al 1996;…”

Consumption of cereal fiber, mixtures of whole grains and bran, and whole grains and risk reduction in type 2 diabetes, obesity, and cardiovascular disease

“…Reports from the Physicians' Health Study (76,79) limited the investigation to breakfast cereals containing whole grains and $25% bran. All 9 reports from 4 large and 1 small prospective cohort studies showed significant inverse associations between intakes of mixtures of whole grains and bran and risks of CVD mortality, CVD events, and heart failure in both males and females (Table 9; 13-15, 45, 76-79).…”