Abstract
Cereals are one of staple foods in human diet, mainly consumed as refined grains. Nonetheless, epidemiological data indicate that whole grain (WG) intake is inversely related to risk of type 2 diabetes, cardiovascular disease, and several cancer types, as well as to all-cause mortality. Particularly responsive to WG positive action is the gastrointestinal tract, daily exposed to bioactive food components. Herein, we shall provide an up-to-date overview on relationship between WG intake and prevention of gastrointestinal tumors, with a particular focus on colorectal, stomach, and esophagus cancers. Unlike refined counterparts, WG consumption is inversely associated with risk of these gastrointestinal cancers, most consistently with the risk of colorectal tumor. Some WG effects may be mediated by beneficial constituents (such as fiber and polyphenols) that are reduced/lost during milling process. Beside health-promoting action, WGs are still under-consumed in most countries; therefore, World Health Organization and other public/private stakeholders should cooperate to implement WG consumption in the whole population, in order to reach nutritionally effective intakes.
Highlights
Cereals, plant species belonging to the Poaceae family, are grasses producing edible grains
Scientific interest in health properties of whole grain (WG) began in the late 1970s, when the surgeon Denis Parsons Burkitt, noting the difference in disease incidence in rural Africa and the UK, brought together data coming from several disciplines and launched the dietary fiber hypothesis; he and other researchers, noted that a diet highly refined and lacking WG foods might be involved in several diseases, including coronary heart disease, obesity, diabetes, dental caries, as well as in some cancer types, such as gastric and colon tumors [5]
Protective roles of apigenin have been confirmed in esophageal tumors: in in vitro and in vivo experimental models, this flavonoid has been reported to (i) induce apoptosis of tumor cells, (ii) inhibit tumor-dependent angiogenesis, and (iii) attenuate inflammatory responses, by inhibiting gene expression of the pro-inflammatory cytokine interleukin-6, whose levels are elevated in tumor tissues [192,193]
Summary
Plant species belonging to the Poaceae family, are grasses producing edible grains Scientific interest in health properties of WGs began in the late 1970s, when the surgeon Denis Parsons Burkitt, noting the difference in disease incidence in rural Africa and the UK, brought together data coming from several disciplines and launched the dietary fiber hypothesis; he and other researchers, noted that a diet highly refined and lacking WG foods might be involved in several diseases, including coronary heart disease, obesity, diabetes, dental caries, as well as in some cancer types, such as gastric and colon tumors [5] Since both epidemiological and interventional studies have reported potential health effects of unrefined grains [6,7,8,9,10,11,12,13,14]. Consumption Survey (INRAN-SCAI, 2005–2006) reported average values of 3.7 g/day for adults/older adults and 2.1 g/day for children/adolescents [26]; as recently emerged from the Italian Nutrition and Health Survey (INHES, 2010–2013), only 27.2% of adults and 21.9% of children/adolescents consume WG foods (mainly bread) at least once per week [27]
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