Whole grain and body weight changes in apparently healthy adults: a systematic review and meta-analysis of randomized controlled studies

Pol, Korrie; Christensen, Robin; Bartels, Else Marie; Raben, A; Tetens, Inge; Kristensen, Mette

doi:10.3945/ajcn.113.064659

Cited by 177 publications

(90 citation statements)

References 53 publications

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“…Previous meta-analyses of intervention evidence show that existing evidence does not consistently support improved outcome measures as result of WG food-based intervention on body weight, indices of body fatness or blood pressure, although some improvements to the blood lipid profiles were evident (10,19) . Many of the previous population-based studies have suggested that a daily intake of WG, equivalent to about three slices of wholemeal bread, is associated with a reduced risk or prevalence of cardiovascular outcomes.…”

Section: Whole Grains and Cardiovascular/metabolic Healthmentioning

confidence: 99%

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Whole-grain foods and chronic disease: evidence from epidemiological and intervention studies

2015

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Cereal-based foods are key components of the diet and they dominate most food-based dietary recommendations in order to achieve targets for intake of carbohydrate, protein and dietary fibre. Processing (milling) of grains to produce refined grain products removes key nutrients and phytochemicals from the flour and although in some countries nutrients may be replaced with mandatory fortification, overall this refinement reduces their potential nutritional quality. There is increasing evidence from both observational and intervention studies that increased intake of less-refined, whole-grain (WG) foods has positive health benefits. The highest WG consumers are consistently shown to have lower risk of developing CVD, type 2 diabetes and some cancers. WG consumers may also have better digestive health and are likely to have lower BMI and gain less weight over time. The bulk of the evidence for the benefits of WG comes from observational studies, but evidence of benefit in intervention studies and potential mechanisms of action is increasing. Overall this evidence supports the promotion of WG foods over refined grain foods in the diet, but this would require adoption of standard definitions of 'whole grain' and 'whole-grain foods' which will enable innovation by food manufacturers, provide clarity for the consumer and encourage the implementation of food-based dietary recommendations and public health strategies.

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Section: Whole Grains and Cardiovascular/metabolic Healthmentioning

confidence: 99%

“…The recent meta-analysis of Pol et al (19) noted a lack of effect of WG on the reduction of body weight. At the same time, a number of studies have highlighted changes to some (but not all) measures of body fatness as a result of WG-based interventions.…”

Section: Whole Grains and Body Weight Or Body Fatnessmentioning

confidence: 99%

Whole-grain foods and chronic disease: evidence from epidemiological and intervention studies

2015

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“…Earlier epidemiologic studies consistently demonstrated that a higher intake of whole grains was associated with lower body weight, BMI, waist circumference, abdominal adiposity, and weight gain (58). However, a meta-analysis of 26 randomized controlled trials revealed that whole-grain consumption did not result in decreased body weight, but, rather a small beneficial effect on total body fat (59). In the present meta-analysis, most included studies (n = 13) adjusted for BMI, which is overadjustment.…”

Section: Discussionmentioning

confidence: 99%

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

Saneei

Salehi-Marzijarani

et al. 2016

Advances in Nutrition

135

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No conclusive information is available about the relation between the consumption of whole grains and the risk of mortality. We aimed to conduct a meta-analysis of prospective cohort studies to summarize the relation between whole-grain intake and risk of mortality from all causes, cardiovascular disease, and total and specific cancers. A systematic search of the literature published earlier than March 2015 was conducted in Medline and PubMed, SCOPUS, EMBASE, and Cochrane Library to identify relevant articles. Prospective cohort studies that examined the association of total whole-grain intake or specific whole-grain foods with risk of mortality from all causes, cardiovascular disease, and total and specific cancers were considered. Twenty prospective cohort studies were included in the systematic review: 9 studies reported total whole-grain intake and 11 others reported specific whole-grain food intake. In a follow-up period of 5.5 to 26 y, there were 191,979 deaths (25,595 from cardiovascular disease, 32,746 from total cancers, and 2671 from specific cancers) in 2,282,603 participants. A greater intake of both total whole grains and specific whole-grain foods was significantly associated with a lower risk of all-cause mortality in the meta-analysis. The pooled RR for all-cause mortality for an increase of 3 servings total whole grains/d (90 g/d) was 0.83 (95% CI: 0.79, 0.88). Total whole-grain intake (0.84; 95% CI: 0.76, 0.93) and specific whole-grain foods (0.82; 95% CI: 0.75, 0.90) were also associated with a reduced risk of mortality from cardiovascular disease. Each additional 3 servings total whole grains/d was associated with a 25% lower risk of mortality from cardiovascular disease. An inverse association was observed between whole-grain intake and risk of mortality from total cancers (0.94; 95% CI: 0.91, 0.98). We found an inverse association between whole-grain intake and mortality from all causes, cardiovascular disease, and total cancers. Adv Nutr 2016;7:1052-65.

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“…A meta-analysis of twenty-four RCT showed that the consumption of whole-grain diets compared with control diets reduces LDL-cholesterol (LDL-C) and total cholesterol (TC), but not HDL-cholesterol (HDL-C) or TAG (80) , whereas other meta-analyses showed a reduction in fasting glucose (FG), but no effect on diastolic blood pressure and systolic blood pressure (SBP), respectively, or body weight (81,82) . A Cochrane review of ten RCT L. Schwingshackl et al 438 focusing on interventions to increase fruit and vegetable consumption showed reductions in diastolic blood pressure, SBP and LDL-C, but analyses were based on only two trials (83) .…”

Section: Meta-analyses Of Randomised Controlled Trialsmentioning

confidence: 99%

Generating the evidence for risk reduction: a contribution to the future of food-based dietary guidelines

et al. 2018

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A major advantage of analyses on the food group level is that the results are better interpretable compared with nutrients or complex dietary patterns. Such results are also easier to transfer into recommendations on primary prevention of non-communicable diseases. As a consequence, food-based dietary guidelines (FBDG) are now the preferred approach to guide the population regarding their dietary habits. However, such guidelines should be based on a high grade of evidence as requested in many other areas of public health practice. The most straightforward approach to generate evidence is meta-analysing published data based on a careful definition of the research question. Explicit definitions of study questions should include participants, interventions/exposure, comparisons, outcomes and study design. Such type of meta-analyses should not only focus on categorical comparisons, but also on linear and non-linear dose-response associations. Risk of bias of the individual studies of the meta-analysis should be assessed, rated and the overall credibility of the results scored (e.g. using NutriGrade). Tools such as a measurement tool to assess systematic reviews or ROBIS are available to evaluate the methodological quality/risk of bias of meta-analyses. To further evaluate the complete picture of evidence, we propose conducting network meta-analyses (NMA) of intervention trials, mostly on intermediate disease markers. To rank food groups according to their impact, disability-adjusted life years can be used for the various clinical outcomes and the overall results can be compared across the food groups. For future FBDG, we recommend to implement evidence from pairwise and NMA and to quantify the health impact of diet-disease relationships.

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Whole grain and body weight changes in apparently healthy adults: a systematic review and meta-analysis of randomized controlled studies

Cited by 177 publications

References 53 publications

Whole-grain foods and chronic disease: evidence from epidemiological and intervention studies

Whole-grain foods and chronic disease: evidence from epidemiological and intervention studies

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

Generating the evidence for risk reduction: a contribution to the future of food-based dietary guidelines

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