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

Benisi-Kohansal, Sanaz; Saneei, Parvane; Salehi-Marzijarani, Mohammad; Larijani, Bagher; Esmaillzadeh, Ahmad

doi:10.3945/an.115.011635

Cited by 94 publications

(63 citation statements)

References 64 publications

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“…A metaanalysis of 18 prospective studies showed that higher whole grain intake was associated with a reduced risk of CHD (RR 0.79; 95% 0.74, 0.83) [88]. 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].…”

Section: Replacement Of Sfa With N-3 Pufamentioning

confidence: 99%

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

Briggs¹,

Petersen²,

Kris‐Etherton³

2017

Preprint

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Dietary recommendations to decrease the risk of cardiovascular disease (CVD) have focused on reducing intake of saturated fatty acids (SFA) for more than 50 years. While the 2015-2020 Dietary Guidelines for Americans advise substituting both monounsaturated and polyunsaturated fatty acids for SFA, evidence supports other nutrient substitutions that will also reduce CVD risk. For example, replacing SFA with whole grains, but not refined carbohydrates, reduces CVD risk. Replacing SFA with protein, especially plant protein may also reduce CVD risk. While dairy fat (milk, cheese) is associated with a slightly lower CVD risk compared to meat, dairy fat results in a significantly greater CVD risk relative to unsaturated fatty acids. As research continues, we will refine our understanding of dietary patterns associated with lower CVD risk.

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Section: Replacement Of Sfa With N-3 Pufamentioning

confidence: 99%

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

Briggs¹,

Petersen²,

Kris‐Etherton³

2017

Preprint

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“…A large, recent systematic review and meta‐analysis of prospective cohort studies explored the relationship between wholegrain intake and risk of mortality from all causes, CVD, and total and specific cancers (Benisi Kohansal et al . ). In total, data from 2 282 603 participants from 20 studies were included.…”

Section: Why Should We Be Consuming Wholegrains?mentioning

confidence: 97%

“…Whilst all wholegrains contain fibre, the proportion and type of fibre in a wholegrain fluctuate greatly from one grain to the next (Kelloggs 2010). Wholegrains also provide other nutrients such as B vitamins, vitamin E, magnesium, zinc, iron, copper, selenium and other bioactive compounds (EUFIC 2015;BDA 2016;Benisi Kohansal et al 2016). It is this nutrient package that has been associated with the food groups' health promoting properties, and subsequently led to public health recommendations to consume more.…”

Section: Introductionmentioning

confidence: 99%

The challenge of increasing wholegrain intake in the UK

Robinson

Chambers

2018

Nutrition Bulletin

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While fibre and wholegrains are often discussed simultaneously, they are distinct with the former classified as a nutrient and the latter as a food group that provides fibre, along with other important nutrients. Wholegrains are an integral part of a healthy, balanced diet and have been linked to several health benefits, including reduced risk of cardiovascular disease, type 2 diabetes and colorectal cancer. Yet consumption in the UK is low, and barriers to increasing wholegrain intake exist among the UK population. These include confusion around how much to consume, which foods contain wholegrains and how they are beneficial to health, acceptance of the organoleptic properties (e.g. taste, texture) of wholegrain foods, lack of knowledge about how to cook wholegrains and negative perceptions about starchy carbohydrates. The absence of a standardised wholegrains definition and a quantified wholegrain intake recommendation in the UK remains a challenge for consumers and industry, and may limit the impact of public health messages. The Healthgrain Forum has recently proposed definitions for ‘wholegrains’ and ‘wholegrain foods’ that are readily useable by the food industry and regulatory bodies. To help increase wholegrain intake in the UK, co‐operation and collaboration is required by stakeholders to educate consumers about wholegrains and inform initiatives. Food retailers have an important role to play in making wholegrains more accessible, convenient and palatable through actions such as product development and wholegrain labelling.

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“…Studies that report separate summary ratios for male and female will be combined using a fixed-effect model before being compiled in a random effects model as described in previous reviews (Benisi-Kohansal et al, 2016).…”

Section: Statistical Procedures and Conventionsmentioning

confidence: 99%

“…When the highest bound is open ended it will be assumed that it is the same as the adjacent interval. When the lower bound is open ended it will be assumed that it begins from 0 (Benisi- Kohansal et al, 2016). Statistical analysis will be conducted by two authors (G.S and W.I.)…”

Section: Statistical Procedures and Conventionsmentioning

confidence: 99%

Protocol: The effect of whole-grain dietary intake on non-communicable diseases: A systematic review, multivariate meta-analysis and dose-response of prospective cohorts, cross-sectional, case-control and intervention studies

Iqbal

Stewart

Smith

et al. 2018

Preprint

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The proposed protocol is for a systematic review and meta-analysis on the effects of whole-grains (WG) on non-communicable diseases such as type 2 diabetes, cardiovascular disease, hypertension and obesity. The primary objectives is to explore the mechanisms of WG intake on multiple biomarkers of NCDs such as fasting glucose, fasting insulin and many others. The secondary objective will look at the dose-response relationship between these various mechanisms. The protocol outlines the motive and scope for the review, and methodology including the risk of bias, statistical analysis, screening and study criteria. The problem, condition or issueCereal grains contribute up to 300 million tons of world food supplies annually (eurostat, 2016). This has lead to a considerable interest in the effects of grains on human health, in particular whole-grains (WG). With non-communicable diseases (NCDs) such as diabetes, cardiovascular disease (CVD) and cancer accounting for 77% of burden of disease, WG consumption may mitigate the effects of NCDs (WHO, 2016). However, with a number of studies showing both a weak and strong association of WGs with NCDs, there is still speculation surrounding the effects of WG (McRae, 2016). Existing reviews mostly look at risk ratios not biomarkers of diseases. Although they provide valuable information, they often limit readers understanding, can be falsely interpreted, and do not provide information on underlying mechanisms (Knol et al, 2012). Most NCDs such as metabolic syndrome are diagnosed based on a cluster of biomarkers such as impaired glucose homeostasis, obesity and dyslipidemia (Alberti et al, 2005); Biomarkers may provide a more accurate way of assessing the effects of WG on NCDs.Another reason for varying results may also be attributed to the definition of WG which varies in a number of regions (Van der Kamp et al, 2014;Ross et al, 2017). The proposed review not only aims to elucidate the overall effect of WGs but encourage governments to adopt similar definitions and set new targets for WG consumption in order to improve population health. Whole-grain consumption and interventionsMost current interventions and cohorts consider WG intake as foods containing 25% or 30% WG weight depending on the definition adopted (Jacobs et al, 2007; Liu et al, 1999;Liu et al 2003). WGs are defined in all countries as containing all of the anatomical components of the grain, including the bran, germ and endosperm (Van der Kamp, 2014;Ross et al, 2017). Familiar grains such as rye, oats, wheat, barley, maize and rice are all considered WGs. While legumes and oilseeds are not (Van der Kamp, 2014). Over the years, WG consumption has been monitored in individuals with NCDs (e.g. diabetes) to assess the longitudinal effect of WG (Nimptsch et al, 2011). Similarly, there have been many interventions (e.g. random control trials) involving WG foods such as bread, cereals, or snacks in healthy individuals and individuals with NCDs (e.g. hypertension) (Kirwan et al, 2016). Cohorts attempt to measure ...

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

Cited by 94 publications

References 64 publications

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

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

The challenge of increasing wholegrain intake in the UK

Protocol: The effect of whole-grain dietary intake on non-communicable diseases: A systematic review, multivariate meta-analysis and dose-response of prospective cohorts, cross-sectional, case-control and intervention studies

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