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Original Research Communications |
1 From the Division of Preventive Medicine and Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, and the Departments of Epidemiology and Nutrition, Harvard School of Public Health, Boston.
Background: Although current dietary guidelines for Americans recommend increased intake of grain products to prevent coronary heart disease (CHD), epidemiologic data relating whole-grain intake to the risk of CHD are sparse.
Objective: Our objective was to evaluate whether high whole-grain intake reduces risk of CHD in women.
Design: In 1984, 75521 women aged 38–63 y with no previous history of cardiovascular disease or diabetes completed a w2detailed, semiquantitative food-frequency questionnaire (SFFQ) and were followed for 10 y, completing SFFQs in 1986 and 1990. We used pooled logistic regression with 2-y intervals to model the incidence of CHD in relation to the cumulative average diet from all 3 cycles of SFFQs.
Results: During 729472 person-years of follow-up, we documented 761 cases of CHD (208 of fatal CHD and 553 of nonfatal myocardial infarction). After adjustment for age and smoking, increased whole-grain intake was associated with decreased risk of CHD. For increasing quintiles of intake, the corresponding relative risks (RRs) were 1.0 (reference), 0.86, 0.82, 0.72, and 0.67 (95% CI comparing 2 extreme quintiles: 0.54, 0.84; P for trend < 0.001). After additional adjustment for body mass index, postmenopausal hormone use, alcohol intake, multivitamin use, vitamin E supplement use, aspirin use, physical activity, and types of fat intake, these RRs were 1.0, 0.92, 0.93, 0.83, and 0.75 (95% CI: 0.59, 0.95; P for trend = 0.01). The inverse relation between whole-grain intake and CHD risk was even stronger in the subgroup of never smokers (RR = 0.49 for extreme quintiles; 95% CI: 0.30, 0.79; P for trend = 0.003). The lower risk associated with higher whole-grain intake was not fully explained by its contribution to intakes of dietary fiber, folate, vitamin B-6, and vitamin E.
Conclusions: Increased intake of whole grains may protect against CHD.
Key Words: Diet • whole grain • refined grain • coronary heart disease • women • myocardial infarction • smoking • risk factors • Nurses' Health Study • food-frequency questionnaire
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