Whole-grain intake may reduce the risk of ischemic heart disease death in postmenopausal women: the Iowa Women's Health Study

Jacobs, David R.; Meyer, Katie A.; Kushi, Lawrence H.; Folsom, Aaron R.

doi:10.1093/ajcn/68.2.248

Cited by 558 publications

(344 citation statements)

References 41 publications

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“…This study ®nds reduced death rates in healthy, middleaged, Norwegian, whole grain eaters in several disease categories, suggestive of reduced chronic disease, in agreement with ®ndings concerning whole grain in women (Jacobs et al, 1998aMeyer et al, 2000;Liu et al, 1999;Fraser et al, 1992) and men (Fraser et al, 1992) in the United States and in male smokers in Finland (Pietinen et al, 1996). The ®ndings are also consonant Table 4 Proportional hazards regression analysis of mortality.…”

Section: Discussionsupporting

confidence: 85%

“…As in the United States (Jacobs et al, 1998a), whole grain bread intake in Norway is related to other positive health behaviors and to reduced blood pressure. The association of whole grain intake is partially attenuated after regression adjustment for these factors, but remains statistically signi®cantly inverse.…”

Section: Discussionmentioning

confidence: 99%

“…Prospective studies have found that habitual intake of whole grain foods is associated with reduced total, coronary heart disease, total cancer mortality (Jacobs et al, 1998a and incident diabetes in Iowa women, and with coronary heart disease mortality in nurses across the United States (Liu et al, 1999). Reduced risk of coronary heart disease was seen with higher rye bread consumption in Finland (Pietinen et al, 1996), increased cold breakfast cereal consumption in male health professionals and with preference for whole wheat bread in Seventh Day Adventist men and women (Fraser et al, 1992).…”

Section: Introductionmentioning

confidence: 99%

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Reduced mortality among whole grain bread eaters in men and women in the Norwegian County Study

2001

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Objective: To study whether mortality is reduced among whole grain eaters in Norway. Design: Non-interventional, prospective, baseline 1977 ± 1983, followed for mortality through to 1994. Setting: Three Norwegian counties. Subjects: A total of 16 933 men and 16 915 women; systematic screening of all residents aged 35 ± 56 y at baseline, not disabled and free of cardiovascular disease (79% response rate). Predictor variable: We combined self-report of type and number of bread slices (white, light whole grain, dense whole grain) to form a whole grain bread score, with range 0.05 (1 slice per day, made with 5% whole grain¯our) to 5.4 (9 slices per day, made with 60% whole grain¯our). Results: Norwegian whole grain bread eaters were less likely to be smokers, were more physically active, had lower serum cholesterol and systolic blood pressure, and ate less total and saturated fat as a proportion of energy intake than white bread eaters. After adjustment for age, energy intake, sex, serum cholesterol, systolic blood pressure, smoking, body mass index, physical activity at leisure and work, and use of cod liver oil or other vitamin supplements, hazard rate ratios (HRR) for total mortality were inverse and graded across whole grain bread score categories (category 5 vs category 1 HRR: 0.75, 95% con®dence interval 0.63 ± 0.89 in men and 0.66, 0.44 ± 0.98 in women).

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Reduced mortality among whole grain bread eaters in men and women in the Norwegian County Study

2001

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“…We used a procedure developed by Jacobs et al (1998) to classify foods as whole or refined grains. Specifically, wholegrain foods included dark breads (Sangak, Barbari, Taftoon), barley bread, popcorn, cornflakes (a whole-grain breakfast cereal), wheat germ and bulgur.…”

Section: Assessment Of Dietary Intakementioning

confidence: 99%

Whole-grain consumption and the metabolic syndrome: a favorable association in Tehranian adults

2004

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Background: Although dietary guidelines recommend increased intake of grain products to prevent chronic diseases, epidemiologic data regarding whole-grain intake association with metabolic syndrome are sparse. Objective: To evaluate the relationship between whole-grain intakes, metabolic syndrome and metabolic risk factors in Tehranian adults. Design: Population-based cross-sectional study. Setting: Tehran, the capital of Iran. Subjects: A representative sample of 827 subjects (357 men and 470 women) aged 18-74 y. Methods: Usual dietary intake was assessed using a food frequency questionnaire. The procedure developed by Jacobs et al was used to classify grain products into whole and refined grains. Weight and height were measured according to standard protocols and body mass index was calculated. Fasting blood samples were taken for biochemical measurements and blood pressure was assessed according to standard methods. Hypertriglyceridemia, hypercholestrolemia, high LDL, low HDL and metabolic syndrome were defined according to ATP III guidelines and hypertension based on JNC VI. Diabetes was defined as fasting plasma glucose level of Z126 mg/dl or 2-h postchallenge blood glucose level of Z200 mg/dl. Subjects were categorized based on quartile cut-points of whole-and refined-grain intake. Results: Mean (7s.d.) consumptions of whole and refined grains were 93729 and 201757 g/day, respectively. Both men and women reported higher intakes of refined grain than of whole grains. Compared with subjects in the lower quartile category, those in the upper category of whole-grain intake had lower prevalence of metabolic risk factors. Conversely, those in the higher category of refined-grain intake had higher prevalence of metabolic risk factors, except for diabetes. After controlling for confounders, a significantly decreasing trend was observed for the risk of having hypertriglyceridemia (odds ratios among quartiles: 1.00, 0.89, 0.74, 0.61, respectively), hypertension (1.00, 0.99, 0.93, 0.84) and metabolic syndrome (1.00, 0.84, 0.76, 0.68). Higher consumption of refined grains was associated with higher odds of having hypercholestrolemia

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“…This may outweigh any beneficial effect of grain fiber observed in other populations. Wholegrain intake lowered cardiovascular risk in several studies (Jacobs et al, 1998(Jacobs et al, , 2001Liu et al, 1999), and in the Iowa Women's Health Study cohort whole grain, but not refined grain, was inversely related to all-cause mortality .…”

Section: Fiber and Myocardial Infarctionmentioning

confidence: 95%

Fiber intake and risk of nonfatal acute myocardial infarction

et al. 2003

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Objective: To investigate the association between fiber intake and risk of acute myocardial infarction (AMI), also according to type and source of fiber, in a Mediterranean country. Design: Hospital-based case-control study. Setting: Northern Italy. Subjects: A total of 507 cases of first nonfatal AMI and 478 controls in hospital for acute conditions. Interventions: Subjects were interviewed with a questionnaire that included a validated food frequency section. Odds ratios (OR) were obtained using multiple logistic regression, and adjusted for several recognized risk factors for AMI. Fiber was measured as non-starch polysaccharides. Results: Compared with the lowest one, the OR in the highest tertile was 0.72 for total fiber, 0.64 for soluble fiber, 0.77 for total insoluble fiber, 0.71 for cellulose, 0.81 for insoluble non-cellulosic polysaccharides, 0.82 for vegetable fiber, 0.64 for fruit fiber and 1.11 for cereal fiber, and the estimates were statistically significant for soluble and fruit fiber. When further adjusted for bcarotene, vitamin C and vitamin E intake, the fruit fiber still showed the strongest inverse relation, although the association was no longer significant. The protective effect of fiber was more marked in, or restricted to, subjects with other AMI risk factors, such as smokers, diabetics and hypertensives. Conclusions: Though an inverse association between fiber intake and AMI risk appears established, the causality of this association is still open to debate. In this population, cereal fiber derives chiefly from refined grains, and this may explain the lack of protection by this type of fiber. Sponsorship: Partially supported by the Italian Ministry of Health.

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Whole-grain intake may reduce the risk of ischemic heart disease death in postmenopausal women: the Iowa Women's Health Study

Cited by 558 publications

References 41 publications

Reduced mortality among whole grain bread eaters in men and women in the Norwegian County Study

Reduced mortality among whole grain bread eaters in men and women in the Norwegian County Study

Whole-grain consumption and the metabolic syndrome: a favorable association in Tehranian adults

Fiber intake and risk of nonfatal acute myocardial infarction

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