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Association of whole grain intake with all-cause, cardiovascular, and cancer mortality: a systematic review and dose–response meta-analysis from prospective cohort studies

European Journal of Clinical Nutrition volume 72, pages 5765 (2018) | Download Citation

Abstract

Background/objectives:

Whole grains are rich source of nutrients and have shown beneficial effects on human health. This study was designed to systematically review the existing results and quantitatively assess the dose–response relationship of whole grain intake with all-cause and cause-specific mortality.

Subjects/methods:

We searched ‘whole grain’ or ‘whole grains’ in combination with ‘mortality’’ or ‘cardiovascular disease’ or ‘cancer’ through the Web of Science and PubMed databases till 20 January 2016. To be eligible for inclusion, publications should be prospective cohort studies and reported the influence of whole grain intake on human mortality. Relative risks (RRs) and 95% confidence intervals (CIs) from the included studies were pooled by a random effects model or fixed effect model.

Results:

We included 19 cohort studies from 17 articles, with 1 041 692 participants and 96 710 deaths in total, in the analyses. We observed an inverse relationship of whole grain intake with risk of total, cardiovascular disease and cancer mortality. The pooled RR was 0.84 (95% CI 0.81–0.88, n=9) for total mortality, 0.83 (95% CI 0.79–0.86, n=8) for CVD mortality and 0.94 (95% CI 0.87–1.01, n=14) for cancer mortality, comparing the highest intake of whole grain with the lowest category. For dose–response analysis, we found a nonlinear relationship of whole grain intake with risk of total, cardiovascular and cancer mortality. Each 28 g/d intake of whole grains was associated with a 9% (pooled RR: 0.91 (0.90–0.93)) lower risk for total mortality, 14% (pooled RR: 0.86 (0.83–0.89)) lower risk for CVD mortality and 3% (pooled RR: 0.97 (0.95–0.99)) lower risk for cancer mortality.

Conclusions:

Our study shows that whole grain intake was inversely associated with risk of total, CVD and cancer mortality. Our results support current dietary guidelines to increase the intake of whole grains. Government officials, scientists and medical staff should take actions to promote whole grains intake.

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Acknowledgements

This work was sponsored by National Natural Science Foundation (NSFC 81370966) of China.

Author contributions

Baihui Zhang, Qingxia Zhao and Wenwen Guo organized the data and drew up the article. Xia Wang and Wei Bao designed the study and conduct technical review for the manuscript. All authors agreed to the last draft.

Author information

Affiliations

  1. Department of Women and Children Health, School of Public Health, Shandong University of Medicine, Jinan, Shandong, China

    • B Zhang
    • , W Guo
    •  & X Wang
  2. Department of Obstetrics and Gynecology, Qilu Hospital, Shandong University, Jinan, Shandong, China

    • Q Zhao
  3. Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, USA

    • W Bao

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Competing interests

The authors declare no conflict of interest.

Corresponding author

Correspondence to X Wang.

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DOI

https://doi.org/10.1038/ejcn.2017.149

Supplementary Information accompanies this paper on European Journal of Clinical Nutrition website (http://www.nature.com/ejcn)