Abstract
BackgroundIntakes of whole grains and cereal fiber have been inversely associated with the risk of chronic diseases; however, their relation with total and disease-specific mortality remain unclear. We aimed to prospectively assess the association of whole grains and cereal fiber intake with all causes and cause-specific mortality.MethodsThe 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.ResultsOver an average of 14 years of follow-up, a total of 46,067 deaths were documented. Consumption of whole grains were inversely associated with risk of all-cause mortality and death from cancer, cardiovascular disease (CVD), diabetes, respiratory disease, infections, and other causes. In multivariable models, as compared with individuals with the lowest intakes, those in the highest intake of whole grains 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 grains 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).ConclusionsConsumption of whole grains and cereal fiber was inversely associated with reduced total and cause-specific mortality. Our data suggest cereal fiber is one potentially protective component.
Highlights
Intakes of whole grains and cereal fiber have been inversely associated with the risk of chronic diseases; their relation with total and disease-specific mortality remain unclear
Whole grains and cereal fiber intake with total mortality In age- and gender-adjusted analysis (Model 1), we found that intake of whole grains were inversely associated with all-cause mortality (Table 2)
When the models further included race/ethnicity, education, marital status, self-rated health status, obesity, physical activity, use of menopausal hormone therapy, and intake of alcohol, red meat, fruits, vegetables, and total energy (Model 3), the highest quintile of whole grain intake was associated with 17% lower risk of all-cause mortality (P trend
Summary
Intakes of whole grains and cereal fiber have been inversely associated with the risk of chronic diseases; their relation with total and disease-specific mortality remain unclear. We aimed to prospectively assess the association of whole grains and cereal fiber intake with all causes and cause-specific mortality. Called cereals, are the seeds of plants cultivated for food. When whole, they include the germ, bran, and endosperm [1]. Several recent meta-analyses taking into account a large number of subjects and prospective studies showed significant and consistent protective effects of high intake of whole grains and cereal fiber on type 2 diabetes [5], cardiovascular disease (CVD) [6], and certain cancers (e.g., colorectal cancer) [7]. The National Institutes of Health (NIH)-AARP Diet and Health Study previously reported that dietary
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