Whole-grain Cereal Intake Research Articles

Is intake of breakfast cereals related to total and cause-specific mortality in men?

Prospective studies suggested that substituting whole-grain products for refined-grain products lowers the risks of type 2 diabetes and cardiovascular disease (CVD) in women. Although breakfast cereals are a major source of whole and refined grains, little is known about their direct association with the risk of premature mortality. We prospectively evaluated the association between whole- and refined-grain breakfast cereal intakes and total and CVD-specific mortality in a cohort of US men. We examined 86,190 US male physicians aged 40-84 y in 1982 who were free of known CVD and cancer at baseline. During 5.5 y, we documented 3114 deaths from all causes, including 1381 due to CVD (488 myocardial infarctions and 146 strokes). Whole-grain breakfast cereal intake was inversely associated with total and CVD-specific mortality, independent of age; body mass index; smoking; alcohol intake; physical activity; history of diabetes, hypertension, or high cholesterol; and use of multivitamins. Compared with men who rarely or never consumed whole-grain cereal, men in the highest category of whole-grain cereal intake (> or = 1 serving/d) had multivariate-estimated relative risks of total and CVD-specific mortality of 0.83 (95% CI: 0.73, 0.94; P for trend < 0.001) and 0.80 (0.66, 0.97; P for trend < 0.001), respectively. In contrast, total and refined-grain breakfast cereal intakes were not significantly associated with total and CVD-specific mortality. These findings persisted in analyses stratified by history of type 2 diabetes, hypertension, and high cholesterol. Both total mortality and CVD-specific mortality were inversely associated with whole-grain but not refined-grain breakfast cereal intake. These prospective data highlight the importance of distinguishing whole-grain from refined-grain cereals in the prevention of chronic diseases.

Part II. Challenges in educating patients

To study the association of the adherence to the Mediterranean diet (MD) and tobacco consumption with body composition during perimenopause.A cross-sectional study in 176 perimenopausal women from the FLAMENCO project. A food frequency questionnaire and the Mediterranean Diet Score were assessed. Body composition was measured using dual-energy X-ray absorptiometry.Body mass index (BMI), fat mass (FM), ratio of gynecoid to total fat mass (G/T), ratio of android to gynecoid fat mass (A/G), visceral adipose tissue (VAT) and waist circumference (WC).Intake of whole-grain cereals was associated with lower WC, FM percentage, android FM, VAT and higher G/T (all p < 0.05). Intake of nuts was associated with lower BMI and FM percentage and intake of fruits with lower BMI, WC, total and android FM, FM percentage, A/G, VAT and higher G/T (all p < 0.05). Intake of pulses was associated with lower weight, BMI and android FM. Intake of whole dairy products was associated with lower weight, BMI, WC, total and android FM and VAT (all p < 0.05). Intake of olive oil was associated with lower WC and FM percentage (all p < 0.05). Intake of sweetened beverages was associated with higher weight, BMI, WC, FM percentage, android FM, VAT and total FM (all, p < 0.05). Smokers had a lower MD adherence (p < 0.05). Finally, a greater MD adherence was associated with higher G/T (p < 0.01) and lower A/G (p < 0.05).A higher MD adherence, avoiding tobacco, an increased consumption of whole-grain cereals, nuts, fruits, pulses, whole dairy products and olive oil, and a lower consumption of sweetened beverages might contribute to a healthier body composition during perimenopause.

Nutrition and human cancer.

It is now widely accepted that nutrition is as important as tobacco as a cause of human cancer. However, whereas we can dispense with tobacco with general benefit to health, we cannot do without food. It is, therefore, necessary to determine the pattern of nutrition that is associated with the lowest overall cancer risk. This is made more difficult by the fact that some kinds of cancer are associated with overnutrition (e.g., that of the colon, breast, and prostate) and some with poor nutrition (e.g., esophagus, stomach, and liver). The tools to determine this are epidemiology, animal models, in vitro studies, and dietary intervention studies. These all have their strengths and weaknesses, which will be discussed. It is concluded that the major nutrition factors associated with increased cancer risk are: (a) overweight [as a surrogate for excess energy intake]; (b) low intake of fresh fruit; (c) low intake intake of vegetables; and (d) low intake of whole-grain cereals. There have been many other associations with cancer at specific sites noted in the literature. However, it is the overall risk of cancer that must be minimized.

THE EPIDEMIOLOGY OF CHILDHOOD APPENDICITIS: A CASE-CONTROL STUDY

To better understand the etiology of childhood appendicitis, a case-control study of this disease was conducted among 135 children who underwent an appendectomy between November 1980 and December 1982. Two hundred twelve comparison children, matched to these cases by age, sex, and admission date, were selected from the orthopedic and short stay services of the same hospital. Children having one or more first degree relatives with a positive history of appendectomy for appendicitis were 1.2 times more likely to develop appendicitis (p > 0.10) than children without this history. No significant increase in risk for appendicitis was noted in children having parents with a positive history of appendectomy for appendicitis, but children with one or more siblings affected by this disease were 9.5 time more likely to have appendicitis (p < 0.05). As the proportion of family members with a positive history of appendectomy increased, the risk of childhood appendicitis increased (p = 0.002). A significant protective effect was demonstrated between intake of cereal fiber in the upper 50th percentile and risk of appendicitis (relative risk: 0.53, p < 0.05). A significant "dose-response" effect was also noted between increasing levels of whole-grain cereal intake and decreasing risk of appendicitis (p = 0.024). The roles of birthweight, growth indices, allergies, laxatives, and constipation were also investigated, and none of these factors was associated with childhood appendicitis.