Whole grain, bran, and germ intake and risk of type 2 diabetes: a prospective cohort study and systematic review - PubMed (original) (raw)
Whole grain, bran, and germ intake and risk of type 2 diabetes: a prospective cohort study and systematic review
Jeroen S L de Munter et al. PLoS Med. 2007 Aug.
Abstract
Background: Control of body weight by balancing energy intake and energy expenditure is of major importance for the prevention of type 2 diabetes, but the role of specific dietary factors in the etiology of type 2 diabetes is less well established. We evaluated intakes of whole grain, bran, and germ in relation to risk of type 2 diabetes in prospective cohort studies.
Methods and findings: We followed 161,737 US women of the Nurses' Health Studies (NHSs) I and II, without history of diabetes, cardiovascular disease, or cancer at baseline. The age at baseline was 37-65 y for NHSI and 26-46 y for NHSII. Dietary intakes and potential confounders were assessed with regularly administered questionnaires. We documented 6,486 cases of type 2 diabetes during 12-18 y of follow-up. Other prospective cohort studies on whole grain intake and risk of type 2 diabetes were identified in searches of MEDLINE and EMBASE up to January 2007, and data were independently extracted by two reviewers. The median whole grain intake in the lowest and highest quintile of intake was, respectively, 3.7 and 31.2 g/d for NHSI and 6.2 and 39.9 g/d for NHSII. After adjustment for potential confounders, the relative risks (RRs) for the highest as compared with the lowest quintile of whole grain intake was 0.63 (95% confidence interval [CI] 0.57-0.69) for NHSI and 0.68 (95% CI 0.57-0.81) for NHSII (both: p-value, test for trend <0.001). After further adjustment for body mass index (BMI), these RRs were 0.75 (95% CI 0.68-0.83; p-value, test for trend <0.001) and 0.86 (95% CI 0.72-1.02; p-value, test for trend 0.03) respectively. Associations for bran intake were similar to those for total whole grain intake, whereas no significant association was observed for germ intake after adjustment for bran. Based on pooled data for six cohort studies including 286,125 participants and 10,944 cases of type 2 diabetes, a two-serving-per-day increment in whole grain consumption was associated with a 21% (95% CI 13%-28%) decrease in risk of type 2 diabetes after adjustment for potential confounders and BMI.
Conclusions: Whole grain intake is inversely associated with risk of type 2 diabetes, and this association is stronger for bran than for germ. Findings from prospective cohort studies consistently support increasing whole grain consumption for the prevention of type 2 diabetes.
Conflict of interest statement
Competing Interests: The authors have declared that no competing interests exist.
Figures
Figure 1. Flow Diagram of the Selection of Studies for the Meta-Analysis
Figure 2. Forest Plot Showing the Multivariate-Adjusted RR of Type 2 Diabetes for a Two-Servings-per-Day Increment in Whole Grain Intake for Individual Cohort Studies and All Studies Combined
Bars and the diamond indicate 95% CIs. The size of the squares corresponds to the weight of the study in the meta-analysis.
Similar articles
- Whole-grain, cereal fiber, bran, and germ intake and the risks of all-cause and cardiovascular disease-specific mortality among women with type 2 diabetes mellitus.
He M, van Dam RM, Rimm E, Hu FB, Qi L. He M, et al. Circulation. 2010 May 25;121(20):2162-8. doi: 10.1161/CIRCULATIONAHA.109.907360. Epub 2010 May 10. Circulation. 2010. PMID: 20458012 Free PMC article. - Intakes of whole grains, bran, and germ and the risk of coronary heart disease in men.
Jensen MK, Koh-Banerjee P, Hu FB, Franz M, Sampson L, Grønbaek M, Rimm EB. Jensen MK, et al. Am J Clin Nutr. 2004 Dec;80(6):1492-9. doi: 10.1093/ajcn/80.6.1492. Am J Clin Nutr. 2004. PMID: 15585760 - Relation between changes in intakes of dietary fiber and grain products and changes in weight and development of obesity among middle-aged women.
Liu S, Willett WC, Manson JE, Hu FB, Rosner B, Colditz G. Liu S, et al. Am J Clin Nutr. 2003 Nov;78(5):920-7. doi: 10.1093/ajcn/78.5.920. Am J Clin Nutr. 2003. PMID: 14594777 - Whole grain and refined grain consumption and the risk of type 2 diabetes: a systematic review and dose-response meta-analysis of cohort studies.
Aune D, Norat T, Romundstad P, Vatten LJ. Aune D, et al. Eur J Epidemiol. 2013 Nov;28(11):845-58. doi: 10.1007/s10654-013-9852-5. Epub 2013 Oct 25. Eur J Epidemiol. 2013. PMID: 24158434 Review. - Greater whole-grain intake is associated with lower risk of type 2 diabetes, cardiovascular disease, and weight gain.
Ye EQ, Chacko SA, Chou EL, Kugizaki M, Liu S. Ye EQ, et al. J Nutr. 2012 Jul;142(7):1304-13. doi: 10.3945/jn.111.155325. Epub 2012 May 30. J Nutr. 2012. PMID: 22649266 Free PMC article. Review.
Cited by
- Initial implicit association between whole grains and taste does not predict consumption of whole grains in low-whole grain consumers: a pilot randomized controlled trial.
De Leon A, Burnett DJ, Rust B, Lyly M, Keim NL. De Leon A, et al. Front Nutr. 2024 Sep 30;11:1408256. doi: 10.3389/fnut.2024.1408256. eCollection 2024. Front Nutr. 2024. PMID: 39403397 Free PMC article. - The effects of MIND diet and propolis supplementation on metabolic syndrome: A randomized controlled clinical trial.
Gholami Z, Maracy MR, Paknahad Z. Gholami Z, et al. Heliyon. 2024 Jul 14;10(16):e34493. doi: 10.1016/j.heliyon.2024.e34493. eCollection 2024 Aug 30. Heliyon. 2024. PMID: 39220895 Free PMC article. - Effect of Dietary Approaches to Stop Hypertension (DASH) on Patients with Metabolic Syndrome and Its Potential Mechanisms.
Lv Y, Aihemaiti G, Guo H. Lv Y, et al. Diabetes Metab Syndr Obes. 2024 Aug 23;17:3103-3110. doi: 10.2147/DMSO.S477739. eCollection 2024. Diabetes Metab Syndr Obes. 2024. PMID: 39206416 Free PMC article. Review. - Effects of Short-Term Gluten-Free Diet on Cardiovascular Biomarkers and Quality of Life in Healthy Individuals: A Prospective Interventional Study.
Lange S, Tsohataridis S, Boland N, Ngo L, Hahad O, Münzel T, Wild P, Daiber A, Schuppan D, Lurz P, Keppeler K, Steven S. Lange S, et al. Nutrients. 2024 Jul 13;16(14):2265. doi: 10.3390/nu16142265. Nutrients. 2024. PMID: 39064708 Free PMC article.
References
- Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: Estimates for the year 2000 and projections for 2030. Diabetes Care. 2004;27:1047–1053. - PubMed
- Steyn NP, Mann J, Bennett PH, Temple N, Zimmet P, et al. Diet, nutrition and the prevention of type 2 diabetes. Public Health Nutr. 2004;7:147–165. - PubMed
- Jacobs DR, Jr, Marquart L, Slavin J, Kushi LH. Whole-grain intake and cancer: An expanded review and meta-analysis. Nutr Cancer. 1998;30:85–96. - PubMed
- Jacobs DR, Jr, Gallaher DD. Whole grain intake and cardiovascular disease: A review. Curr Atheroscler Rep. 2004;6:415–423. - PubMed
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical