Whole Grain Intake and Mortality From All Causes, Cardiovascular Disease, and Cancer

Abstract

Background Current findings on associations between whole grain (WG) intake and mortality are inconsistent and have not been summarized by meta-analysis. Methods and Results We searched for prospective cohort studies reporting associations between WG and mortality from all causes, CVD, and cancer through February 2016 in Medline, Embase, and clinicaltrials.gov, and further included unpublished results from National Health and Nutrition Examination Survey (NHANES) III and NHANES 1999–2004. Fourteen studies were eligible for analysis, which included 786,076 participants, 97,867 total deaths, 23,957 CVD deaths, and 37,492 cancer deaths. Pooled relative risks (RR, 95% confidence intervals [95%CIs]) comparing extreme WG categories (high vs. low) were 0.84 (0.80, 0.88; P<0.001, I2=74%, Pheterogeneity<0.001) for total mortality, 0.82 (0.79, 0.85; P<0.001, I2=0%, Pheterogeneity=0.53) for CVD mortality, and 0.88 (0.83, 0.94; P<0.001, I2=54%, Pheterogeneity=0.02) for cancer mortality. Intakes of WG ingredients in dry weight were estimated among studies reporting RRs for ≥3 quantitative WG categories, which were <50 grams/day among most study populations. The two-stage dose-response random-effects meta-analysis showed monotonic associations between WG intake and mortality (Pnonlinearity>0.05). For each 16 grams/day increase in WG (approximately 1 serving/day), RRs (95%CIs) of total, CVD, and cancer mortality were 0.93 (0.92, 0.94, P<0.001), 0.91 (0.90, 0.93, P<0.001), and 0.95 (0.94, 0.96, P<0.001), respectively. Conclusions Our meta-analysis demonstrated inverse associations of WG intake with total and cause-specific mortality, and findings were particularly strong and robust for CVD mortality. These findings further support current Dietary Guidelines for Americans, which recommends at least 3 servings/day of WG intake.

Youth Chef Academy: Pilot Results From a Plant‐Based Culinary and Nutrition Literacy Program for Sixth and Seventh Graders

“…2 Healthy eating can lower the risk of obesity and related conditions 3,4 and a critical component of a healthy diet is consumption of plant-based foods. 5 Fruit and vegetable (F/V) 6,7 and whole grain (WG) consumption 8,9 have been linked to reduced risk of heart disease and all-cause mortality. Whole grain consumption has also been linked to reduced risk of cancer8 and type 2 diabetes.…”

“…2 Healthy eating can lower the risk of obesity and related conditions 3,4 and a critical component of a healthy diet is consumption of plant-based foods. 5 Fruit and vegetable (F/V) 6,7 and whole grain (WG) consumption 8,9 have been linked to reduced risk of heart disease and all-cause National data confirm that youth are not eating recommended amounts of F/V, legumes, and WG. 4,[18][19][20][21][22] National Health and Nutrition Examination Survey (NHANES) data from 2003 to 2010 show that while whole fruit consumption increased across this time period, total vegetable and vegetable subgroup intake did not increase over time and no sociodemographic group met Healthy People 2020 targets for F/V consumption.…”

The Dietary Fibers–FODMAPs Controversy

“…Accordingly, regular whole grain consumption is related to favorable modifications in gut microbiota, reduces low-grade inflammation, and leads to significant risk reductions for diabetes mellitus, cardiovascular disease, and colon cancer (3,28,33,44,46). Thus, avoiding whole grain foods because they contain FODMAPs would result in a significant reduction in intake of these components and should only be recommended when there is a therapeutic need and appropriate dietary guidance.…”

Correção de medidas de associação pela variação do dia a dia no consumo alimentar: avaliação do desempenho por meio de simulação

“…The extent to which a reduction in sample size will increase the probability of type error 2 (not rejecting the null hypothesis when it is false) will depend on the true coefficient's effect size and precision 16 . In a real scenario, in which the effect of diet on health outcomes are usually small 17,18 , any loss of precision may decrease the probability of rejecting the null hypothesis, even if it is false. In this simulation, while n = 1,000 would be sufficient to find an association with usual intake, drawing on correction with two or more intake days, the estimated necessary size was 2,400.…”