Consumption of whole grain and cereal fiber with total and cause‐specific mortality: prospective analysis of 367,442 individuals (628.17)

Abstract

OBJECTIVE: To prospectively assess the associations of intakes of whole grain and cereal fiber with all causes and cause‐specific mortality.DESIGN, SETTING, AND PARTICIPANTS: The study included 367,442 participants from the prospective NIH‐AARP Diet and Health Study (enrolled in 1995 and followed through 2009). Participants with cancer, heart disease, stroke, diabetes, and self‐reported end‐stage renal disease at baseline were excluded.EXPOSURE: Baseline intakes of whole grain and cereal fiber.MAIN OUTCOME MEASURES: All‐cause mortality and death from CVD, cancer, diabetes, respiratory disease, and infections.RESULTS: Over an average of 14 years of follow‐up, in total 46,067 deaths were documented. Consumption of whole grain was inversely associated with risk of all‐cause mortality and death from cancer, CVD, diabetes, respiratory disease, and infections. In multivariable models, as compared with individuals with the lowest intakes, those in the highest intake of whole grain had a 17% (95% CI 14‐19%) lower risk of all‐cause mortality and 11‐48% lower risk of disease‐specific mortality (all P for trend < 0.023); those in the highest intake of cereal fiber had a 19% (95% CI 16‐21%) lower risk of all‐cause mortality and 15‐34% lower risk of disease‐specific mortality (all P for trend < 0.005). When cereal fiber was further adjusted, the associations of whole grain with death from CVD, respiratory disease and infections became not significant; the associations with all‐cause mortality and death from cancer and diabetes were attenuated but remained significant (P for trend < 0.029).CONCLUSION AND RELEVANCE: Consumption of whole grain and cereal fiber inversely associated with reduced total and cause‐specific mortality; and our data suggest cereal fiber is the potentially protective component.