Whole Grain Consumption and Risk of Ischemic Stroke in Women: A Prospective Study
Open accessAbstract
CONTEXT: Although increased intake of grain products has been recommended to prevent cardiovascular disease (CVD), prospective data examining the relation of whole grain intake to risk of ischemic stroke are sparse, especially among women. OBJECTIVE: To examine the hypothesis that higher whole grain intake reduces the risk of ischemic stroke in women. DESIGN, SETTING, AND PARTICIPANTS: A prospective cohort of 75,521 US women aged 38 to 63 years without previous diagnosis of diabetes mellitus, coronary heart disease, stroke, or other CVDs in 1984, who completed detailed food frequency questionnaires (FFQs) in 1984, 1986, 1990, and 1994, and were followed up for 12 years as part of the Nurses' Health Study. MAIN OUTCOME MEASURE: Incidence of ischemic stroke, confirmed by medical records, by quintile of whole grain intake according to FFQ responses. RESULTS: During 861,900 person-years of follow-up, 352 confirmed incident cases of ischemic stroke occurred. We observed an inverse association between whole grain intake and ischemic stroke risk. The age-adjusted relative risks (RRs) from the lowest to highest quintiles of whole grain intake were 1.00 (referent), 0.68 (95% confidence interval [CI], 0.49-0.94), 0.69 (95% CI, 0.51-0.95), 0.49 (95% CI, 0.35-0.69), and 0.57 (95% CI, 0.42-0.78; P =.003 for trend). Adjustment for smoking modestly attenuated this association (RR comparing extreme quintiles, 0.64; 95% CI, 0.47-0.89). This inverse association remained essentially unchanged with further adjustment for known CVD risk factors, including saturated fat and transfatty acid intake (multivariate-adjusted RR comparing extreme quintiles, 0.69; 95% CI, 0.50-0.98). The inverse relation between whole grain intake and risk of ischemic stroke was also consistently observed among subgroups of women who never smoked, did not drink alcohol, did not exercise regularly, or who did not use postmenopausal hormones. No significant association was observed between total grain intake and risk of ischemic stroke. CONCLUSIONS: In this cohort, higher intake of whole grain foods was associated with a lower risk of ischemic stroke among women, independent of known CVD risk factors. These prospective data support the notion that higher intake of whole grains may reduce the risk of ischemic stroke.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Dietary fiber may promote satiety by slowing gastric emptying, decreasing calorie intake.
“Dietary fiber may promote satiety by slowing gastric emptying, leading to an overall decrease in calorie intake.40,41”
From Diet and Lifestyle Recommendations Revision 2006: A Scientific Statement From the American Heart Association Nutrition Committee (2006) · cites this paper as [40]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
The citation lists haven’t been fetched yet
References 27 · Cited by 303
Research works printed but not linked: 6
- Achievements in public health, 1900-1999: de- cline in deaths from heart disease and stroke- United States, 1900-1999. MMWR Morb Mortal Wkly Rep. 1999;48:649-656.
- Bronner LL, Kanter DS, Manson JE. Primary preven- tion of stroke. N Engl J Med. 1995;333:1392-1400.
- Rimm EB, Stampfer MJ, Ascherio A, Giovannucci E, Colditz GA, Willett WC. Dietary antioxidant intake and risk of coronary heart disease among men. N Engl J Med. 1993;328:1450-1456.
- Slavin J, Jacobs D, Marquart L. Whole-grain con- sumption and chronic disease: protective mecha- nism. Nutr Cancer. 1997;27:14-21.
- Willett WC. Nutritional Epidemiology. 2nd ed. New York, NY: Oxford University Press; 1998.
- Liu S, Manson JE, Stampfer M, et al. Dietary gly- cemic load assessed by food frequency questionnaire in relation to plasma high-density lipoprotein choles- terol and fasting triglycerides among postmeno- pausal women. Am J Clin Nutr. In press.
- Authors
- Liu, S., Manson, J. E., Stampfer, M. J., Rexrode, K. M., Hu, F. B., Rimm, E. B., & Willett, W. C.
- Affiliations
- Brigham and Women's Hospital (US)
- ORCID
- Venue
- JAMA
- Publisher
- American Medical Association (AMA)
- Published
- 2000-09-27
- Volume
- 284
- Issue
- 12
- Pages
- 1534
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- OpenAlex
- W2008485758
- Cited by
- 303
- References
- 27
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 1 · 2023: 1 · 2022: 5 · 2021: 5 · 2020: 6 · 2019: 4 · 2018: 6 · 2017: 6 · 2016: 17 · 2015: 11 · 2014: 14 · 2013: 16 · 2012: 19
- FWCI
- 21.49
- Type
- journal article
- Language
- en
- Open access
- green
- doi.org
- Locations
- JAMA (publishedVersion)
- PubMed (publishedVersion)
- Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion)
- Funders
- National Institutes of Health (HL24074, CA40356)
- National Heart, Lung, and Blood Institute (HL24704, HL34594, R01HL034594)
- National Cancer Institute (CA-40356)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Nursing › Nutrition and Dietetics › Food composition and properties
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Keywords
- whole grain intake, ischemic stroke, stroke risk, women, Nurses' Health Study, dietary factors, cardiovascular disease prevention, smoking, saturated fat, trans fatty acids, postmenopausal hormone use, alcohol consumption, physical activity, dietary fiber, cereals, Fabaceae, nuts, seeds, soy products, dietary cholesterol, dietary sodium, potassium intake, dietary calcium, dietary magnesium
- MeSH terms
- Adult, Edible Grain, Diet, Diet Surveys, Female, Humans, Middle Aged, Prospective Studies, Risk Factors, Multivariate Analysis, Stroke
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
