Consumption of whole grains and cereal fiber and total and cause-specific mortality: prospective analysis of 367,442 individuals

Abstract

BackgroundIntakes of whole grains and cereal fiber have been inversely associated with the risk of chronic diseases; however, their relation with total and disease-specific mortality remain unclear. We aimed to prospectively assess the association of whole grains and cereal fiber intake with all causes and cause-specific mortality.MethodsThe study included 367,442 participants from the prospective NIH-AARP Diet and Health Study (enrolled in 1995 and followed through 2009). Participants with cancer, heart disease, stroke, diabetes, and self-reported end-stage renal disease at baseline were excluded.ResultsOver an average of 14 years of follow-up, a total of 46,067 deaths were documented. Consumption of whole grains were inversely associated with risk of all-cause mortality and death from cancer, cardiovascular disease (CVD), diabetes, respiratory disease, infections, and other causes. In multivariable models, as compared with individuals with the lowest intakes, those in the highest intake of whole grains had a 17% (95% CI, 14–19%) lower risk of all-cause mortality and 11–48% lower risk of disease-specific mortality (all P for trend <0.023); those in the highest intake of cereal fiber had a 19% (95% CI, 16–21%) lower risk of all-cause mortality and 15–34% lower risk of disease-specific mortality (all P for trend <0.005). When cereal fiber was further adjusted, the associations of whole grains with death from CVD, respiratory disease and infections became not significant; the associations with all-cause mortality and death from cancer and diabetes were attenuated but remained significant (P for trend <0.029).ConclusionsConsumption of whole grains and cereal fiber was inversely associated with reduced total and cause-specific mortality. Our data suggest cereal fiber is one potentially protective component.

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

“…Two other studies (38,39) were also excluded because they considered consumption of specific whole-grain foods instead of total whole-grain intake. After these exclusions, 5 studies (11,14,15,22,45) remained in this dose-response analysis. For CVD mortality as an outcome, we did not include 5 studies in the dose-response meta-analysis because of the use of whole-grain intake as a dichotomous variable (24,42) or lack of information about the number of deaths in each category (11,17,43).…”

“…For CVD mortality as an outcome, we did not include 5 studies in the dose-response meta-analysis because of the use of whole-grain intake as a dichotomous variable (24,42) or lack of information about the number of deaths in each category (11,17,43). Therefore, 6 studies [3 for total whole grains (15,22,45) and 3 for specific whole-grain foods (38,39,41)] remained for this dose-response analysis. Regarding cancer mortality, 5 studies were not included in the doseresponse meta-analysis because they considered specific whole-grain foods rather than total whole-grain intake (38,44), considered specific cancer rather than total cancer (44), treated whole-grain intake as a dichotomous variable (24), did not report the number of deaths in each category of whole-grain intake (11,16), or considered whole-grain intake in a days-perweek unit without reporting the quantity of intake in each category (12).…”

“…Required information (RRs for highest compared with lowest intake of whole grain or RRs for fatal MI) for these studies could not be obtained even by contacting the authors. Finally, 20 cohort studies (11, 12, 14-18, 22, 24, 35-45) were included in the systematic review and 17 prospective cohort studies (11, 12, 14-18, 22, 24, 38-45) were included in this meta-analysis: 11 for all-cause mortality (11, 14, 15, 18, 22, 24, 38-40, 43, 45), 11 for CVD mortality (11,15,17,22,24,38,39,(41)(42)(43)45), 6 for total cancer mortality (11,15,22,24,38,45), and 4 for specific cancers mortality (12,16,24,44) (Figure 1). Of the 20 studies included in the systematic review, 9 reported intake of total whole grain (11,12,14,15,22,35,37,43,45), and 11 others reported the intake of specific whole-grain foods (16-18, 24, 36, 38-42, 44).…”

“…Regarding cancer mortality, 5 studies were not included in the doseresponse meta-analysis because they considered specific whole-grain foods rather than total whole-grain intake (38,44), considered specific cancer rather than total cancer (44), treated whole-grain intake as a dichotomous variable (24), did not report the number of deaths in each category of whole-grain intake (11,16), or considered whole-grain intake in a days-perweek unit without reporting the quantity of intake in each category (12). Finally, 3 studies (15,22,45) were included to examine dose-response association between total whole-grain intake and mortality from total cancers. For mortality from specific cancers, dose-response analysis was not performed because of lack of adequate publications.…”

<p align="center">Kavuzlu Siyez (<em>Triticum monococcum</em> ssp. <em>monococcum</em>) ve Ekmeklik (<em>Triticum aestivum</em> L.) Buğdaylarda Kurak ve Tuz Stresinin Erken Fide Gelişimi ve Antioksidan Aktivite Üzerine Etkisi </p>

“…2014), lif, fitokimyasal ve antioksidan maddeleri bünyesinde bulunduran bir tahıldır (Andersson et al 2013). Protein ve nişastasıyla günlük besin gereksinimlerini karşılarken, lifleriyle sindirimi kolaylaştırır ve böylece kolon kanserine yakalanma riskini azaltır (Huang et al 2015). Fitokimyasallarıyla ise serbest radikalleri yok ederek, DNA ve diğer hücre komponentlerini oksidasyon hasarından korur.…”