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Walter C Willett - One of the best experts on this subject based on the ideXlab platform.
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abstract 39 estimated risk of coronary heart disease associated with the replacement of various foods with vegetables in two large prospective cohorts
Circulation, 2016Co-Authors: Monica L Bertoia, Walter C Willett, Kenneth J Mukamal, Kim Overvad, Eric B RimmAbstract:Introduction: Previous studies show that higher fruit and vegetable intake is associated with a lower risk of coronary heart disease (CHD), but the magnitude of this association may vary depending on what foods are replaced. In a typical meal, vegetables may replace Grains or protein sources but the potential benefits of replacing specific foods with vegetables have not been quantified. Hypothesis: The replacement of Refined Grains and red or processed meat with vegetables will be associated with a lower risk of CHD. Methods: We identified incident cases of nonfatal myocardial infarction or fatal CHD in 41,983 men participating in the Health Professionals Follow-up Study and 77,347 women participating in the Nurses’ Health Study from 1986 to 2012 who were free of cardiovascular disease at baseline. Participants self-reported their usual diet at baseline and every four years over 26 years of follow-up. We used substitution models to estimate hazard ratios (HR) for total CHD, adjusting for age, total calories, smoking, alcohol, family history of MI, physical activity, aspirin use, BMI, and history of hypertension, high cholesterol, and diabetes. We pooled results using a meta-analysis with fixed effects. Results: We confirmed 4,220 incident CHD events among men and 3,199 among women. In fully adjusted models, combining men and women, replacing one serving/day of starchy vegetables (peas, corn, and potatoes) with one serving/day of non-starchy vegetables was associated with a 21% lower risk of CHD. Replacing one serving/day of Refined Grains with one serving/day of non-starchy vegetables was associated with a 4% lower risk of CHD, and replacing one serving/day of processed meats or unprocessed red meat with one serving/day of non-starchy vegetables was associated with a 23% lower risk of CHD. Conclusions: Consuming vegetables, especially non-starchy vegetables, in place of less healthy Refined Grains and red and processed meats, was associated with a lower risk of CHD.
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Abstract P313: Estimated Risk of Coronary Heart Disease Associated With the Replacement of Refined Grains With Whole Grains in Two Large Prospective Cohort Studies
Circulation, 2015Co-Authors: Monica L Bertoia, Walter C Willett, Kenneth J Mukamal, Kim Overvad, Mary Franz, Alan J. Flint, Eric B RimmAbstract:BACKGROUND: Whole Grains have been associated with a lower risk of coronary heart disease (CHD), in part through mechanisms related to fiber content and its impact on cholesterol levels. The 2010 US Dietary Guidelines recommend that at least 50% of grain intake should come from whole Grains, implying a health benefit for the replacement of Refined Grains with whole Grains on a national level. OBJECTIVE: To examine whether the replacement of Refined Grains with whole Grains is associated with a lower risk of CHD. We further explored if fiber content was an important characteristic of the major food sources of whole Grains. METHODS: We identified incident cases of nonfatal myocardial infarction (MI) or fatal CHD in 42,178 men participating in the Health Professionals Follow-up Study (HPFS) from 1986 to 2012 and 70,960 women participating in the Nurses’ Health Study (NHS) from 1984 to 2012. Participants self-reported their diet via validated FFQ at baseline and every four years for 26+ years of follow-up. We excluded individuals with a history of cardiovascular disease at baseline. We used substitution models to estimate hazard ratios (HR) for total CHD, adjusting for total calories, age, smoking, alcohol, family history of MI, physical activity, aspirin use, BMI, and history of hypertension, high cholesterol, and diabetes. RESULTS: We confirmed 2,136 incident CHD events among men and 1,950 among women. In fully adjusted models, we estimated that replacing one serving/day of Refined Grains (16 grams) with one serving/day of whole Grains was associated with a lower risk of CHD in men (HR 0.92, 95% CI 0.87 to 0.96) and women (HR 0.95, 95% CI 0.90 to 1.00). Cold cereals were a major source of whole and Refined Grains. Consuming cold cereals classified as a “high” source of fiber by the FDA (≥ 5 grams/serving, ≥ 20% RDA) vs. CONCLUSIONS: Overall, our results suggest that replacing Refined Grains with whole Grains is associated with a lower risk of CHD. For a main source of whole Grains, choosing cold breakfast cereals that are a good source of fiber was in general associated with a lower risk of CHD.
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essentials of healthy eating a guide
Journal of Midwifery & Women's Health, 2010Co-Authors: P J Skerrett, Walter C WillettAbstract:Enough solid evidence now exists to offer women several fundamental strategies for healthy eating. They include emphasizing healthful unsaturated fats, whole Grains, good protein “packages,” and fruits and vegetables; limiting consumption of trans and saturated fats, highly Refined Grains, and sugary beverages; and taking a multivitamin with folic acid and extra vitamin D as a nutritional safety net. A diet based on these principles is healthy through virtually all life stages, from young adulthood through planning for pregnancy, pregnancy, and on into old age.
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Whole-grain intake and the risk of type 2 diabetes: A prospective study in men
The American Journal of Clinical Nutrition, 2002Co-Authors: Teresa T. Fung, Mark A Pereira, Frank B Hu, Graham A Colditz, Meir J Stampfer, Walter C WillettAbstract:Background: Certain dietary components may play a role in the prevention of type 2 diabetes. Objective: We examined prospectively the associations between whole- and Refined-grain intake and the risk of type 2 diabetes in a large cohort of men. Design: Men from the Health Professionals Follow-up Study without a history of diabetes or cardiovascular disease in 1986 (n = 42 898) were followed for ≤ 12 y. Intakes of whole and Refined Grains, measured every 4 y by use of food-frequency questionnaires, were used to predict subsequent type 2 diabetes risk through multivariate analysis. Results: We ascertained 1197 cases of incident type 2 diabetes. After adjustment for age; physical activity; cigarette smoking; alcohol consumption; family history of diabetes; and fruit, vegetable, and energy intakes, the relative risk of type 2 diabetes was 0.58 (95% CI: 0.47, 0.70; P for trend < 0.0001) comparing the highest with the lowest quintile of whole-grain intake. The association was moderately attenuated when additionally adjusted for body mass index (relative risk: 0.70; 95% CI: 0.57, 0.85; P for trend = 0.0006). Intake of Refined Grains was not significantly associated with risk of type 2 diabetes. After further adjustment for magnesium intake, cereal fiber intake, and glycemic load, the association between whole Grains and type 2 diabetes was attenuated and the trend no longer significant. Conclusions: In men, a diet high in whole Grains is associated with a reduced risk of type 2 diabetes in men that may be mediated by cereal fiber. Efforts should be made to replace Refined-grain with whole-grain foods. Am J Clin Nutr 2002;76:535‐40.
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Whole-grain intake and the risk of type 2 diabetes: A prospective study in men
The American Journal of Clinical Nutrition, 2002Co-Authors: Teresa T. Fung, Mark A Pereira, Frank B Hu, Graham A Colditz, Meir J Stampfer, Walter C WillettAbstract:Background: Certain dietary components may play a role in the prevention of type 2 diabetes. Objective: We examined prospectively the associations between whole- and Refined-grain intake and the risk of type 2 diabetes in a large cohort of men. Design: Men from the Health Professionals Follow-up Study without a history of diabetes or cardiovascular disease in 1986 (n = 42 898) were followed for ≤ 12 y. Intakes of whole and Refined Grains, measured every 4 y by use of food-frequency questionnaires, were used to predict subsequent type 2 diabetes risk through multivariate analysis. Results: We ascertained 1197 cases of incident type 2 diabetes. After adjustment for age; physical activity; cigarette smoking; alcohol consumption; family history of diabetes; and fruit, vegetable, and energy intakes, the relative risk of type 2 diabetes was 0.58 (95% CI: 0.47, 0.70; P for trend < 0.0001) comparing the highest with the lowest quintile of whole-grain intake. The association was moderately attenuated when additionally adjusted for body mass index (relative risk: 0.70; 95% CI: 0.57, 0.85; P for trend = 0.0006). Intake of Refined Grains was not significantly associated with risk of type 2 diabetes. After further adjustment for magnesium intake, cereal fiber intake, and glycemic load, the association between whole Grains and type 2 diabetes was attenuated and the trend no longer significant. Conclusions: In men, a diet high in whole Grains is associated with a reduced risk of type 2 diabetes in men that may be mediated by cereal fiber. Efforts should be made to replace Refined-grain with whole-grain foods. Am J Clin Nutr 2002;76:535‐40.
F Azizi - One of the best experts on this subject based on the ideXlab platform.
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Whole-grain consumption and the metabolic syndrome: a favorable association in Tehranian adults
European Journal of Clinical Nutrition, 2005Co-Authors: Ahmad Esmaillzadeh, Parvin Mirmiran, F AziziAbstract:Background: Although dietary guidelines recommend increased intake of grain products to prevent chronic diseases, epidemiologic data regarding whole-grain intake association with metabolic syndrome are sparse. Objective: To evaluate the relationship between whole-grain intakes, metabolic syndrome and metabolic risk factors in Tehranian adults. Design: Population-based cross-sectional study. Setting: Tehran, the capital of Iran. Subjects: A representative sample of 827 subjects (357 men and 470 women) aged 18–74 y. Methods: Usual dietary intake was assessed using a food frequency questionnaire. The procedure developed by Jacobs et al was used to classify grain products into whole and Refined Grains. Weight and height were measured according to standard protocols and body mass index was calculated. Fasting blood samples were taken for biochemical measurements and blood pressure was assessed according to standard methods. Hypertriglyceridemia, hypercholestrolemia, high LDL, low HDL and metabolic syndrome were defined according to ATP III guidelines and hypertension based on JNC VI. Diabetes was defined as fasting plasma glucose level of ≥126 mg/dl or 2-h postchallenge blood glucose level of ≥200 mg/dl. Subjects were categorized based on quartile cut-points of whole- and Refined-grain intake. Results: Mean (±s.d.) consumptions of whole and Refined Grains were 93±29 and 201±57 g/day, respectively. Both men and women reported higher intakes of Refined grain than of whole Grains. Compared with subjects in the lower quartile category, those in the upper category of whole-grain intake had lower prevalence of metabolic risk factors. Conversely, those in the higher category of Refined-grain intake had higher prevalence of metabolic risk factors, except for diabetes. After controlling for confounders, a significantly decreasing trend was observed for the risk of having hypertriglyceridemia (odds ratios among quartiles: 1.00, 0.89, 0.74, 0.61, respectively), hypertension (1.00, 0.99, 0.93, 0.84) and metabolic syndrome (1.00, 0.84, 0.76, 0.68). Higher consumption of Refined Grains was associated with higher odds of having hypercholestrolemia (1.00, 1.07, 1.19, 1.23), hypertriglyceridemia (1.00, 1.17, 1.49, 2.01), hypertension (1.00, 1.22, 1.48, 1.69) and metabolic syndrome (1.00, 1.68, 1.92, 2.25). Conclusion: Whole-grain intake is inversely and Refined-grain intake is positively associated with the risk of having metabolic syndrome. Recommendations to increase whole-grain intake may reduce this risk. Sponsorship: Endocrine Research Center, Shaheed Beheshti University of Medical Sciences.
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Whole-grain intake and the prevalence of hypertriglyceridemic waist phenotype in Tehranian adults.
The American Journal of Clinical Nutrition, 2005Co-Authors: Ahmad Esmaillzadeh, Parvin Mirmiran, F AziziAbstract:BACKGROUND: Although dietary guidelines recommend increased intake of grain products to prevent chronic diseases, no epidemiologic data associate whole-grain intake with hypertriglyceridemic waist (HW) phenotype. OBJECTIVE: We aimed to evaluate the relation between whole-grain intakes and the prevalence of HW phenotype in adults in Tehran, Iran. DESIGN: Whole-grain intake, serum triacylglycerol concentration, and waist circumference (WC) were assessed in a population-based, cross-sectional study of 827 Iranian subjects (357 men and 470 women) aged 18-74 y. HW phenotype was defined as serum triacylglycerol concentrations > or =150 mg/dL and concurrent WC > or = 80 cm (men) and > or =79 cm (women). RESULTS: Mean (+/-SD) consumption of whole and Refined Grains was 93 +/- 29 and 201 +/- 57 g/d, respectively. Subjects in the highest quartile of whole-grain intake had a significantly lower prevalence of HW (29%) than did those in the lowest quartile (44%; P < 0.05). Conversely, those in the highest quartile of Refined-grain intake had a significantly higher prevalence of HW (45%) than did those in the lowest quartile (27%; P < 0.05). After control for potential confounding factors, a significantly decreasing trend was observed for the risk of HW phenotype across quartiles of whole-grain intake (odds ratios among quartiles: 1.00, 0.95, 0.90, and 0.78, respectively; P for trend = 0.02). Higher consumption of Refined Grains was associated with better odds of HW phenotype (by quartile: 1.00, 1.38, 1.65, and 2.1; P for trend = 0.01). CONCLUSION: Whole-grain intake is inversely and Refined-grain intake is positively associated with the risk of HW.
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Whole-grain intake and the prevalence of hypertriglyceridemic waist phenotype in Tehranian adults.
The American Journal of Clinical Nutrition, 2005Co-Authors: Ahmad Esmaillzadeh, Parvin Mirmiran, F AziziAbstract:BACKGROUND: Although dietary guidelines recommend increased intake of grain products to prevent chronic diseases, no epidemiologic data associate whole-grain intake with hypertriglyceridemic waist (HW) phenotype. OBJECTIVE: We aimed to evaluate the relation between whole-grain intakes and the prevalence of HW phenotype in adults in Tehran, Iran. DESIGN: Whole-grain intake, serum triacylglycerol concentration, and waist circumference (WC) were assessed in a population-based, cross-sectional study of 827 Iranian subjects (357 men and 470 women) aged 18-74 y. HW phenotype was defined as serum triacylglycerol concentrations > or =150 mg/dL and concurrent WC > or = 80 cm (men) and > or =79 cm (women). RESULTS: Mean (+/-SD) consumption of whole and Refined Grains was 93 +/- 29 and 201 +/- 57 g/d, respectively. Subjects in the highest quartile of whole-grain intake had a significantly lower prevalence of HW (29%) than did those in the lowest quartile (44%; P < 0.05). Conversely, those in the highest quartile of Refined-grain intake had a significantly higher prevalence of HW (45%) than did those in the lowest quartile (27%; P < 0.05). After control for potential confounding factors, a significantly decreasing trend was observed for the risk of HW phenotype across quartiles of whole-grain intake (odds ratios among quartiles: 1.00, 0.95, 0.90, and 0.78, respectively; P for trend = 0.02). Higher consumption of Refined Grains was associated with better odds of HW phenotype (by quartile: 1.00, 1.38, 1.65, and 2.1; P for trend = 0.01). CONCLUSION: Whole-grain intake is inversely and Refined-grain intake is positively associated with the risk of HW.
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THE RELATIONSHIP BETWEEN WHOLE-GRAIN CONSUMPTION, THE METABOLIC SYNDROME AND CARDIOVASCULAR RISK FACTORS IN TEHRAN ADULTS POPULATION
Journal of diabetes and metabolic disorders, 2004Co-Authors: A Esmaeilzadeh, Mirmiran Parvin, M Mirhosseini, F AziziAbstract:Background: Although dietary guidelines recommend increased intake of grain products to prevent chronic diseases, epidemiologic data regarding whole-grain intake associated with metabolic syndrome is sparse. This study was undertaken to evaluate the relationship between whole-grain intake, metabolic syndrome and metabolic risk factors in Tehran adults population. Methods: In this cross-sectional study, 827 subjects aged 18-74 were randomly selected from participants of the Tehran Lipid and Glucose Study. Usual dietary intake was assessed using a semi-quantitative food frequency questionnaire and two 24-hour dietary recalls. BMI, FBS, blood pressure, hypertriglyceridemia, hypercholesterolemia, high LDL, low LDL, metabolic syndrome (according to ATP III guidelines) and hypertension (based on JNC VI) were assessed subjects were categorized on quartile cut-points of whole and Refined grain intake. Results: Mean (±SD) consumptions of whole- and Refined Grains were 93±29 and 201±57 g/d, respectively. Compared with subjects in the lower quartile category, those in the upper category of whole-grain intake had lower prevalence of metabolic risks. Conversely, those in the higher category of Refined grain intake had higher prevalence of metabolic risk factors, except for diabetes. After controlling for confounders, a significant decreasing trend was observed for the risk of having hypertriglyceridemia [odds ratios among quartiles: 1.00,0.89, 0.74, 0.61, respectively], hypertension and metabolic syndrome. Higher consumption of Refined Grains were associated with higher risk of having hypercholestrolemia [1.00, 1.07, 1.19, 1.23), hypertriglyceridemia [1.00, 1.17, 1.49, 2.01), hypertension and metabolic syndrome. Conclusion: Whole grain intake is inversely and Refined grain intake is positively associated with the risk of developing metabolic syndrome. Recommendations to increase whole-grain intake may reduce the risk of developing metabolic syndrome.
Lars J Vatten - One of the best experts on this subject based on the ideXlab platform.
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Whole grain and Refined grain consumption and the risk of type 2 diabetes: a systematic review and dose–response meta-analysis of cohort studies
European Journal of Epidemiology, 2013Co-Authors: Dagfinn Aune, Teresa Norat, Pal Romundstad, Lars J VattenAbstract:Several studies have suggested a protective effect of intake of whole Grains, but not Refined Grains on type 2 diabetes risk, but the dose–response relationship between different types of Grains and type 2 diabetes has not been established. We conducted a systematic review and meta-analysis of prospective studies of grain intake and type 2 diabetes. We searched the PubMed database for studies of grain intake and risk of type 2 diabetes, up to June 5th, 2013. Summary relative risks were calculated using a random effects model. Sixteen cohort studies were included in the analyses. The summary relative risk per 3 servings per day was 0.68 (95 % CI 0.58–0.81, I^2 = 82 %, n = 10) for whole Grains and 0.95 (95 % CI 0.88–1.04, I^2 = 53 %, n = 6) for Refined Grains. A nonlinear association was observed for whole Grains, p _nonlinearity
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whole grain and Refined grain consumption and the risk of type 2 diabetes a systematic review and dose response meta analysis of cohort studies
European Journal of Epidemiology, 2013Co-Authors: Dagfinn Aune, Teresa Norat, Pal Romundstad, Lars J VattenAbstract:Several studies have suggested a protective effect of intake of whole Grains, but not Refined Grains on type 2 diabetes risk, but the dose–response relationship between different types of Grains and type 2 diabetes has not been established. We conducted a systematic review and meta-analysis of prospective studies of grain intake and type 2 diabetes. We searched the PubMed database for studies of grain intake and risk of type 2 diabetes, up to June 5th, 2013. Summary relative risks were calculated using a random effects model. Sixteen cohort studies were included in the analyses. The summary relative risk per 3 servings per day was 0.68 (95 % CI 0.58–0.81, I2 = 82 %, n = 10) for whole Grains and 0.95 (95 % CI 0.88–1.04, I2 = 53 %, n = 6) for Refined Grains. A nonlinear association was observed for whole Grains, p nonlinearity < 0.0001, but not for Refined Grains, p nonlinearity = 0.10. Inverse associations were observed for subtypes of whole Grains including whole grain bread, whole grain cereals, wheat bran and brown rice, but these results were based on few studies, while white rice was associated with increased risk. Our meta-analysis suggests that a high whole grain intake, but not Refined Grains, is associated with reduced type 2 diabetes risk. However, a positive association with intake of white rice and inverse associations between several specific types of whole Grains and type 2 diabetes warrant further investigations. Our results support public health recommendations to replace Refined Grains with whole Grains and suggest that at least two servings of whole Grains per day should be consumed to reduce type 2 diabetes risk.
Ahmad Esmaillzadeh - One of the best experts on this subject based on the ideXlab platform.
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Refined Grains consumption is associated with a greater odds of glioma.
Nutritional Neuroscience, 2020Co-Authors: Seyed Mohammad Mousavi, Somaye Rigi, Mehdi Shayanfar, Minoo Mohammad-shirazi, Giuve Sharifi, Ahmad EsmaillzadehAbstract:Objective: Grain consumption has been associated with brain carcinogenesis in earlier studies, however, no data are available examining the association between Refined Grains consumption and risk o...
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The association of whole and Refined Grains consumption with psychological disorders among Iranian adults
European Journal of Nutrition, 2017Co-Authors: Omid Sadeghi, Ahmad Esmaillzadeh, Ammar Hassanzadeh-keshteli, Hamid Afshar, Peyman AdibiAbstract:Purpose Although several studies have examined the link between different types of carbohydrate consumption and depression and anxiety, limited data are available linking whole and Refined Grains consumption to psychological disorders. We aimed to investigate the association of whole and Refined Grains consumption with psychological disorders among Iranian adults.
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The association of whole and Refined Grains consumption with psychological disorders among Iranian adults
European Journal of Nutrition, 2017Co-Authors: Omid Sadeghi, Ahmad Esmaillzadeh, Ammar Hassanzadeh-keshteli, Hamid Afshar, Peyman AdibiAbstract:PURPOSE Although several studies have examined the link between different types of carbohydrate consumption and depression and anxiety, limited data are available linking whole and Refined Grains consumption to psychological disorders. We aimed to investigate the association of whole and Refined Grains consumption with psychological disorders among Iranian adults. METHODS A total of 3172 adult people with age range of 18-55 years were included in this cross-sectional study. Data on Grains consumption were collected using a validated dish-based 106-item semi-quantitative food frequency questionnaire. To assess depression and anxiety, Iranian validated version of Hospital Anxiety and Depression Scale (HADS) was applied. Furthermore, psychological distress was examined using General Health Questionnaire (GHQ). Psychological disorders were defined based on standard criteria. RESULTS Mean age of participants was 36.5 ± 7.9 years. Women in the third quartile of whole Grains consumption had lower odds for having anxiety (OR 0.62, 95% CI 0.45-0.85) compared with those in the first quartile. This relationship was also seen even after controlling for potential confounders (OR 0.65, 95% CI 0.44-0.96). In contrast, compared with the first quartile, women in the highest quartile of Refined Grains consumption had greater odds to have depression (OR 1.76, 95% CI 1.00-3.09) and anxiety (OR 2.03, 95% CI 1.00-4.10) after adjusting for covariates. Such relationships were not observed among men. CONCLUSION Moderate consumption of whole grain foods was inversely associated with anxiety in women, but not in men. Furthermore, we found a significant positive association between Refined Grains consumption, depression and anxiety in women.
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The association of whole and Refined Grains consumption with psychological disorders among Iranian adults
European journal of nutrition, 2017Co-Authors: Omid Sadeghi, Ahmad Esmaillzadeh, Ammar Hassanzadeh-keshteli, Hamid Afshar, Peyman AdibiAbstract:Although several studies have examined the link between different types of carbohydrate consumption and depression and anxiety, limited data are available linking whole and Refined Grains consumption to psychological disorders. We aimed to investigate the association of whole and Refined Grains consumption with psychological disorders among Iranian adults. A total of 3172 adult people with age range of 18–55 years were included in this cross-sectional study. Data on Grains consumption were collected using a validated dish-based 106-item semi-quantitative food frequency questionnaire. To assess depression and anxiety, Iranian validated version of Hospital Anxiety and Depression Scale (HADS) was applied. Furthermore, psychological distress was examined using General Health Questionnaire (GHQ). Psychological disorders were defined based on standard criteria. Mean age of participants was 36.5 ± 7.9 years. Women in the third quartile of whole Grains consumption had lower odds for having anxiety (OR 0.62, 95% CI 0.45–0.85) compared with those in the first quartile. This relationship was also seen even after controlling for potential confounders (OR 0.65, 95% CI 0.44–0.96). In contrast, compared with the first quartile, women in the highest quartile of Refined Grains consumption had greater odds to have depression (OR 1.76, 95% CI 1.00–3.09) and anxiety (OR 2.03, 95% CI 1.00–4.10) after adjusting for covariates. Such relationships were not observed among men. Moderate consumption of whole grain foods was inversely associated with anxiety in women, but not in men. Furthermore, we found a significant positive association between Refined Grains consumption, depression and anxiety in women.
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Whole-grain consumption and the metabolic syndrome: a favorable association in Tehranian adults
European Journal of Clinical Nutrition, 2005Co-Authors: Ahmad Esmaillzadeh, Parvin Mirmiran, F AziziAbstract:Background: Although dietary guidelines recommend increased intake of grain products to prevent chronic diseases, epidemiologic data regarding whole-grain intake association with metabolic syndrome are sparse. Objective: To evaluate the relationship between whole-grain intakes, metabolic syndrome and metabolic risk factors in Tehranian adults. Design: Population-based cross-sectional study. Setting: Tehran, the capital of Iran. Subjects: A representative sample of 827 subjects (357 men and 470 women) aged 18–74 y. Methods: Usual dietary intake was assessed using a food frequency questionnaire. The procedure developed by Jacobs et al was used to classify grain products into whole and Refined Grains. Weight and height were measured according to standard protocols and body mass index was calculated. Fasting blood samples were taken for biochemical measurements and blood pressure was assessed according to standard methods. Hypertriglyceridemia, hypercholestrolemia, high LDL, low HDL and metabolic syndrome were defined according to ATP III guidelines and hypertension based on JNC VI. Diabetes was defined as fasting plasma glucose level of ≥126 mg/dl or 2-h postchallenge blood glucose level of ≥200 mg/dl. Subjects were categorized based on quartile cut-points of whole- and Refined-grain intake. Results: Mean (±s.d.) consumptions of whole and Refined Grains were 93±29 and 201±57 g/day, respectively. Both men and women reported higher intakes of Refined grain than of whole Grains. Compared with subjects in the lower quartile category, those in the upper category of whole-grain intake had lower prevalence of metabolic risk factors. Conversely, those in the higher category of Refined-grain intake had higher prevalence of metabolic risk factors, except for diabetes. After controlling for confounders, a significantly decreasing trend was observed for the risk of having hypertriglyceridemia (odds ratios among quartiles: 1.00, 0.89, 0.74, 0.61, respectively), hypertension (1.00, 0.99, 0.93, 0.84) and metabolic syndrome (1.00, 0.84, 0.76, 0.68). Higher consumption of Refined Grains was associated with higher odds of having hypercholestrolemia (1.00, 1.07, 1.19, 1.23), hypertriglyceridemia (1.00, 1.17, 1.49, 2.01), hypertension (1.00, 1.22, 1.48, 1.69) and metabolic syndrome (1.00, 1.68, 1.92, 2.25). Conclusion: Whole-grain intake is inversely and Refined-grain intake is positively associated with the risk of having metabolic syndrome. Recommendations to increase whole-grain intake may reduce this risk. Sponsorship: Endocrine Research Center, Shaheed Beheshti University of Medical Sciences.
Dagfinn Aune - One of the best experts on this subject based on the ideXlab platform.
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Whole grain and Refined grain consumption and the risk of type 2 diabetes: a systematic review and dose–response meta-analysis of cohort studies
European Journal of Epidemiology, 2013Co-Authors: Dagfinn Aune, Teresa Norat, Pal Romundstad, Lars J VattenAbstract:Several studies have suggested a protective effect of intake of whole Grains, but not Refined Grains on type 2 diabetes risk, but the dose–response relationship between different types of Grains and type 2 diabetes has not been established. We conducted a systematic review and meta-analysis of prospective studies of grain intake and type 2 diabetes. We searched the PubMed database for studies of grain intake and risk of type 2 diabetes, up to June 5th, 2013. Summary relative risks were calculated using a random effects model. Sixteen cohort studies were included in the analyses. The summary relative risk per 3 servings per day was 0.68 (95 % CI 0.58–0.81, I^2 = 82 %, n = 10) for whole Grains and 0.95 (95 % CI 0.88–1.04, I^2 = 53 %, n = 6) for Refined Grains. A nonlinear association was observed for whole Grains, p _nonlinearity
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whole grain and Refined grain consumption and the risk of type 2 diabetes a systematic review and dose response meta analysis of cohort studies
European Journal of Epidemiology, 2013Co-Authors: Dagfinn Aune, Teresa Norat, Pal Romundstad, Lars J VattenAbstract:Several studies have suggested a protective effect of intake of whole Grains, but not Refined Grains on type 2 diabetes risk, but the dose–response relationship between different types of Grains and type 2 diabetes has not been established. We conducted a systematic review and meta-analysis of prospective studies of grain intake and type 2 diabetes. We searched the PubMed database for studies of grain intake and risk of type 2 diabetes, up to June 5th, 2013. Summary relative risks were calculated using a random effects model. Sixteen cohort studies were included in the analyses. The summary relative risk per 3 servings per day was 0.68 (95 % CI 0.58–0.81, I2 = 82 %, n = 10) for whole Grains and 0.95 (95 % CI 0.88–1.04, I2 = 53 %, n = 6) for Refined Grains. A nonlinear association was observed for whole Grains, p nonlinearity < 0.0001, but not for Refined Grains, p nonlinearity = 0.10. Inverse associations were observed for subtypes of whole Grains including whole grain bread, whole grain cereals, wheat bran and brown rice, but these results were based on few studies, while white rice was associated with increased risk. Our meta-analysis suggests that a high whole grain intake, but not Refined Grains, is associated with reduced type 2 diabetes risk. However, a positive association with intake of white rice and inverse associations between several specific types of whole Grains and type 2 diabetes warrant further investigations. Our results support public health recommendations to replace Refined Grains with whole Grains and suggest that at least two servings of whole Grains per day should be consumed to reduce type 2 diabetes risk.