Abstract
Background: Increased dietary whole-grain intake may protect against cardiovascular disease (CVD).Objective: The objective was to evaluate the efficacy of whole grains compared with refined grains on body composition, hypertension, and related mediators of CVD in overweight and obese adults.Methods: We conducted a double-blind, randomized, controlled crossover trial in 40 overweight or obese men and women aged <50 y with no known history of CVD. Complete whole-grain and refined-grain diets were provided for two 8-wk periods, with a 10-wk washout between diets. Macronutrient composition was matched, except for the inclusion of either whole grains or refined grains (50 g/1000 kcal in each diet). Measurements included blood pressure, body composition, blood lipids and adiponectin, and markers of inflammation and glycemia.Results: Thirty-three participants (6 men and 27 women) completed the trial [mean ± SD age: 39 ± 7 y; mean ± SD body mass index (in kg/m2): 33.1 ± 4.3]. Decreases in diastolic blood pressure were −5.8 mm Hg (95% CI: −7.7, −4.0 mm Hg) after the whole-grain diet and −1.6 mm Hg (95% CI: −4.4, 1.3 mm Hg) after the control diet (between effect, P = 0.01). Decreases in plasma adiponectin were −0.1 (95% CI: −0.9, 0.7) after the whole-grain diet and −1.4 (95% CI: −2.6, −0.3) after the control diet (between effect, P = 0.05). Decreases in diastolic blood pressure correlated with the circulating adiponectin concentration (r = 0.35, P = 0.04). Substantial reductions in body weight, fat loss, systolic blood pressure, total cholesterol, and LDL cholesterol were observed during both diet periods, with no relevant difference between them.Conclusions: The improvement in diastolic blood pressure was >3-fold greater in overweight and obese adults when they consumed a whole-grain compared with a refined-grain diet. Because diastolic blood pressure predicts mortality in adults aged <50 y, increased whole-grain intake may provide a functional approach to control hypertension. This may benefit patients at risk of vascular-related morbidity and mortality. This trial was registered at http://clinicaltrials.gov as NCT01411540.
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