Whole-grain intake and total, cardiovascular, and cancer mortality: a systematic review and meta-analysis of prospective studies12

• Published in: The American journal of clinical nutrition Vol. 104; no. 1; pp. 164 - 172
• Main Authors: Chen, Guo-Chong, Tong, Xing, Xu, Jia-Ying, Han, Shu-Fen, Wan, Zhong-Xiao, Qin, Jia-Bi, Qin, Li-Qiang
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01.07.2016
• Subjects: cancer; cardiovascular disease; meta-analysis; mortality; whole grain; CVD; cardiovascular disease; RCT; whole grain; IHD; mortality; meta-analysis; cancer
• ISSN: 0002-9165; 1938-3207
• DOI: 10.3945/ajcn.115.122432

Background: The potential role of whole grain in preventing various mortality outcomes has been inconsistently reported in a wealth of prospective observational studies. Objective: We evaluated the relations between whole-grain intake and risks of dying from any cause, cardiovascular disease (CVD), and cancer through a meta-analytic approach. Design: Relevant studies were identified by searching PubMed and EMBASE databases and bibliographies of retrieved full publications. Summary RRs with 95% CIs were calculated with a random-effects model. Results: Thirteen studies on total mortality (104,061 deaths), 12 on CVD mortality (26,352 deaths), and 8 on cancer mortality (34,797 deaths) were included. Three studies reported whole-grain intake, and the remaining studies reported whole-grain product intake. In the dose-response analysis in which the intake of whole-grain products was converted to the amount of whole grain, the summary RRs for an increment in whole-grain intake of 50 g/d were 0.78 (95% CI: 0.67, 0.91) for total mortality, 0.70 (95% CI: 0.61, 0.79) for CVD mortality, and 0.82 (95% CI: 0.69, 0.96) for cancer mortality. A similar reduction was observed for the mortality from ischemic heart disease (RR: 0.68; 95% CI: 0.55, 0.84) but not from stroke (RR: 0.93; 95% CI: 0.54, 1.62). There was evidence of nonlinear associations of whole-grain intake with total (P-nonlinearity < 0.001) and CVD mortality (P-nonlinearity <0.001), but not with cancer mortality (P-nonlinearity = 0.12), with the curves for the associations appearing slightly steeper at lower ranges (<35 g/d) of the intake than at higher ranges. Conclusions: Our findings suggest significant inverse relations between whole-grain intake and mortality due to any cause, CVD, or cancer. The findings support the recommendation of increasing whole-grain intake to improve public health.