Whole grain consumption and risk of cardiovascular disease, cancer, and all cause and cause specific mortality: systematic review and dose-response meta-analysis of prospective studies

Abstract

Objective To quantify the dose-response relation between consumption of whole grain and specific types of grains and the risk of cardiovascular disease, total cancer, and all cause and cause specific mortality.Data sources PubMed and Embase searched up to 3 April 2016.Study selection Prospective studies reporting adjusted relative risk estimates for the association between intake of whole grains or specific types of grains and cardiovascular disease, total cancer, all cause or cause specific mortality.Data synthesis Summary relative risks and 95% confidence intervals calculated with a random effects model.Results 45 studies (64 publications) were included. The summary relative risks per 90 g/day increase in whole grain intake (90 g is equivalent to three servings—for example, two slices of bread and one bowl of cereal or one and a half pieces of pita bread made from whole grains) was 0.81 (95% confidence interval 0.75 to 0.87; I2=9%, n=7 studies) for coronary heart disease, 0.88 (0.75 to 1.03; I2=56%, n=6) for stroke, and 0.78 (0.73 to 0.85; I2=40%, n=10) for cardiovascular disease, with similar results when studies were stratified by whether the outcome was incidence or mortality. The relative risks for morality were 0.85 (0.80 to 0.91; I2=37%, n=6) for total cancer, 0.83 (0.77 to 0.90; I2=83%, n=11) for all causes, 0.78 (0.70 to 0.87; I2=0%, n=4) for respiratory disease, 0.49 (0.23 to 1.05; I2=85%, n=4) for diabetes, 0.74 (0.56 to 0.96; I2=0%, n=3) for infectious diseases, 1.15 (0.66 to 2.02; I2=79%, n=2) for diseases of the nervous system disease, and 0.78 (0.75 to 0.82; I2=0%, n=5) for all non-cardiovascular, non-cancer causes. Reductions in risk were observed up to an intake of 210-225 g/day (seven to seven and a half servings per day) for most of the outcomes. Intakes of specific types of whole grains including whole grain bread, whole grain breakfast cereals, and added bran, as well as total bread and total breakfast cereals were also associated with reduced risks of cardiovascular disease and/or all cause mortality, but there was little evidence of an association with refined grains, white rice, total rice, or total grains.Conclusions This meta-analysis provides further evidence that whole grain intake is associated with a reduced risk of coronary heart disease, cardiovascular disease, and total cancer, and mortality from all causes, respiratory diseases, infectious diseases, diabetes, and all non-cardiovascular, non-cancer causes. These findings support dietary guidelines that recommend increased intake of whole grain to reduce the risk of chronic diseases and premature mortality.

Dietary Approach to Stop Hypertension (DASH) diet and risk of renal function decline and all-cause mortality in renal transplant recipients

“…We found that a high intake of fruit was associated with a lower risk of renal function decline and all‐cause mortality when compared to a low intake of fruit. Previous prospective cohort‐studies showed that high intake of fruits, vegetables, and whole grains is inversely associated with kidney function decline30 and all‐cause mortality in the general population 35, 36. For the consumption of fruit, this is in agreement with our study, but not for the intake of vegetables and whole grains.…”

Barley grass extract causes apoptosis of cancer cells by increasing intracellular reactive oxygen species production

“…Bex is one of the ingredients in cereal and the anti-cancer effect of peptides from cereal has previously been demonstrated (33). Furthermore, meta-analyses indicated that cereal reduces cancer risk (34,35). Thus, the present study provides evidence that dietary components are beneficial for cancer prevention and treatment.…”

Saturated Fatty Acids and Cardiovascular Disease: Replacements for Saturated Fat to Reduce Cardiovascular Risk

“…In a more recent analysis, Benisi-Kohansal et al showed that greater consumption of whole grains was associated with an 11% reduction in all-cause mortality (RR 0.89; 95% 0.84, 0.94), and a 16% reduction in CVD mortality (RR 0.84; 95% CI 0.76, 0.93) [89]. Similarly, Aune et al showed in a meta-analysis of prospective cohort studies that there was an inverse association between whole grain intake and CHD, CVD, and mortality from CHD, stroke and all-causes [90]. In this meta-analysis, the effect of refined grains was also examined.…”