Cereals, legumes, and chronic disease risk reduction: evidence from epidemiologic studies

Abstract

There is growing evidence that cereals and legumes play important roles in the prevention of chronic diseases. Early epidemiologic studies of these associations focused on intake of dietary fiber rather than intake of grains or legumes. Generally, these studies indicated an inverse association between dietary fiber intake and risk of coronary artery disease; this observation has been replicated in recent cohort studies. Studies that focused on grain or cereal intake are fewer in number; these tend to support an inverse association between intake of whole grains and coronary artery disease. Studies on the association of dietary fiber with colon and other cancers have generally shown inverse relations, but whether these relations are attributable to cereals, other fiber sources, or other factors is less clear. Although legumes have been shown to lower blood cholesterol concentrations, epidemiologic studies are few and inconclusive regarding the association of legumes with risk of coronary artery disease. It has been hypothesized that legumes, in particular soybeans, reduce the risk of some cancers, but epidemiologic studies are equivocal in this regard. Overall, there is substantial epidemiologic evidence that dietary fiber and whole grains are associated with decreased risk of coronary artery disease and some cancers, whereas the role of legumes in these diseases appears promising but as yet inconclusive.

Role of fibre and fruit in the Mediterranean diet to protect against myocardial infarction: a case–control study in Spain

“…There is enough evidence supported by ample epidemiologic data indicating that the intake of dietary fibre is inversely associated to risk for coronary artery disease (Pietinen et al, 1996;Law & Morris, 1998;Kushi et al, 1999;Wolk et al, 1999;Todd et al, 1999). However, the epidemiological evidence about the protective role of fibre intake against CHD obtained in Mediterranean countries is sparse.…”

“…It is possible that the high between-subjects variability in the levels of fibre and fruit intake in our sample may have allowed us to show more ). However, no previous epidemiological study from Mediterranean areas was included in the meta-analysis by Law and Morris (1998) or in the review by Kushi et al (1999). Moreover, the best designed studies conducted in Mediterranean areas were negative (Tzounou et al, 1993) or did not specifically assess the protective role for dietary fibre (Fortes et al, 2000;Trichopoulou et al, 1995).…”

“…Dietary fibre has previously been shown to be inversely associated to the risk of coronary disease in many observational studies (Law & Morris, 1998;Kushi et al, 1999;Wolk et al, 1999). In some early studies the inverse relationship between fibre and CHD was entirely explained by cereal fibre or nuts (Fraser et al, 1992), rather than by fibre from fruits.…”

Diet quality and mortality: a population-based prospective study of men

“…The Recommended Food Score (RFS) is a simple approach based only on foods with beneficial effects on health (Kushi et al, 1999;Hu and Willett, 2002;Report WHO/FAO, 2003;Genkinger et al, 2004) and has been applied by Kant et al (2000). We previously extended this approach by adding even scores for Non-Recommended Foods (Non-RFS), (that is, foods which consumption should be limited (Willett, 1994;Hu et al, 2001;Report WHO/FAO, 2003)), and examined the association of RFS and Non-RFS with mortality in women (Michels and Wolk, 2002).…”

Fiber intake and risk of nonfatal acute myocardial infarction

“…Most have found significant inverse associations, although only a few have presented estimates adjusted for energy intake and separately for different types and sources of fiber (Kushi et al, 1999). These studies were conducted in the USA (Humble et al, 1993;Khaw & BarrettConnor, 1987;Kushi et al, 1985;Rimm et al, 1996;Wolk et al, 1999), the UK (Bolton-Smith et al, 1992;Burr & Sweetnam, 1982;Fehily et al, 1993;Kushi et al, 1985;Morris et al, 1977) or Northern Europe (Kromhout et al, 1982;Pietinen et al, 1996), and no data are available, to our knowledge, from Mediterranean countries, where the composition of the diet is qualitatively different, and smoking patterns and other relevant lifestyle habits and environmental exposures also differ.…”