Intake of whole grains and incidence of oesophageal cancer in the HELGA Cohort

Abstract

Few prospective studies have investigated the association between whole-grain consumption and incidence of oesophageal cancer. In the Scandinavian countries, consumption of whole grains is high and the incidence of oesophageal cancer comparably low. The aim of this paper was to study the associations between consumption of whole grains, whole-grain products and oesophageal cancer, including its two major histological subtypes. The HELGA cohort is a prospective cohort study consisting of three sub-cohorts in Norway, Sweden and Denmark. Information regarding whole-grain consumption was collected through country-specific food frequency questionnaires. Cancer cases were identified through national cancer registries. Cox proportional hazards ratios were calculated in order to assess the associations between whole grains and oesophageal cancer risk. The analytical cohort had 113,993 members, including 112 cases, and median follow-up time was 11 years. When comparing the highest tertile of intake with the lowest, the oesophageal cancer risk was approximately 45 % lower (adjusted HR 0.55, 95 % CI 0.31-0.97 for whole grains, HR 0.51, 95 % CI 0.30-0.88 for whole-grain products). Inverse associations were also found in continuous analyses. Whole-grain wheat was the only grain associated with lower risk (HR 0.32, 95 % CI 0.16-0.63 highest vs. lowest tertile). Among whole-grain products, the results were less clear, but protective associations were seen for the sum of whole-grain products, and whole-grain bread. Lower risk was seen in both histological subtypes, but particularly for squamous cell carcinomas. In this study, whole-grain consumption, particularly whole-grain wheat, was inversely associated with risk of oesophageal cancer.

Phytochemicals in whole grain wheat and their health‐promoting effects

“…Mounting evidence from epidemiological studies suggests that consumption of whole cereal grains, particularly WG wheat, may reduce risk of various cancers . WB has been found to be the only cereal bran that shows consistent protection against colon cancer in humans and in experimental animal models .…”

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

“…For colorectal cancer, 3 (42-44) out of 7 studies (19,42-47) reported a 6-33% reduction in risk with higher whole grain consumption. More recently, a study within the Scandinavian HELGA cohort reported 45% lower risk of oesophageal cancer when comparing the highest vs. the lowest tertile of whole grain intakes (48). Collectively, these findings indicate that whole grains may be particularly protective against gastrointestinal cancers.…”

The Impact of Whole Grain Intake on Gastrointestinal Tumors: A Focus on Colorectal, Gastric, and Esophageal Cancers

“…In a small case-control study, for example, Levi and co-workers reported significant decrease in cancer risk in individuals consuming high amounts of WG foods (whole wheat bread and cereals), while cancer onset was directly related to consumption of RG items (white bread and biscuits, pizza, pasta, and rice) [91]. Decreased risk for high WG intake has been reported by retrospective and prospective studies, although with different ratios: for example, the above mentioned Italian casecontrol study from La Vecchia's group [108] reported 60% decreased risk for the highest WG intake, while the recent HELGA cohort study from Skeie and co-workers showed 35-45% reduction [181]. Noticeably, authors observed that such association varied with cereals and food products, with WG wheat and bread being associated with lower risk.…”