12 January - 20 June 2016

Should we be eating more whole grains?

A review published in the European Journal of Clinical Nutrition has assessed the dose-response relationship of whole grain intake with risk of total and cause-specific mortality.

Government officials, scientists and medical staff should promote whole grain intake according to a study which found that whole grain intake is associated with lower total, CVD and cancer mortality.  Whole grains are rich in dietary, fibre, minerals and antioxidants, with the gran and germ containing many phytochemicals and the endosperm containing a large amount of starch.  A review published in the European Journal of Clinical Nutrition has assessed the dose-response relationship of whole grain intake with risk of total and cause-specific mortality.

Wang et al. carried out a literature search using PubMed database, and the Web of Science database for studies which focused on whole grains consumption in combination with mortality or cardiovascular disease or cancer.  The studies had to be prospective cohort studies and examine whole grain intake on human mortality. 

Wang et al. included 19 prospective cohort studies in their meta-analysis, from 17 publications.  Of these 9 studies reported on whole grain intake and total mortality (661,752 participants and 84,464 deaths), 8 prospective cohort studies including 595,485 participants and 23,482 CVD deaths for whole grain intake and cardiovascular mortality, and 14 studies with 832,935 participants and 41,715 deaths reported data for whole grain intake and cancer mortality.

The team found that "whole grain intake may have a beneficial effect on all-cause, cardiovascular and cancer mortality." They report that each 28g serving per day was associated with a 9% reduced risk of total mortality, 14% reduced risk of cardiovascular mortality and 3% reduced risk of cancer mortality.  Wang et al.  note that “our findings reported a high intake of whole grain could respectively lower 16% and 17% mortality risk from all-cause and cardiovascular disease comparing the highest category with the lowest, and were consistent with the existing evidence from some prospective studies.”

The team report that the association between wholegrain intake and cancer outcome was "not sufficiently clear". They cite a study that found that cancer mortality was only reduced when daily whole grain consumption was over 30 g/d.   They state “highest whole grain intake was associated with 16% lower mortality risk of colorectal cancer comparing the lowest and that was consistent with the existing prospective studies.”, whilst whole grain intake had no effect on prostate cancer, endometrial cancer or breast cancer risk. 

Wang et al. discuss whole grains’ protective effect, noting that whole grains contain phytoestrogens, vitamins, antioxidants and micro elements that have been found to be beneficial on colorectal cancer, respiratory system disease and chronic inflammatory condition.  Whilst the authors report that their review contains a number of limitations, such as the limited number of cohort studies, they state that it contains a large number of populations.  The study concludes by stating "Our results support current dietary guidelines to increase the intake of whole grains."

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