Whole grain intake and cardiovascular disease: A meta-analysis
Abstract
Background and aims Whole grain food sources have been associated with lowered risk of cardiovascular disease (CVD). Studies in recent years have strengthened this observation and elucidated potential mechanisms for this association. This study sought to quantitate the available observational evidence on whole grain intake and clinical cardiovascular events.Methods and results Seven prospective cohort studies with quantitative measures of dietary whole grains and clinical cardiovascular outcomes were identified from MEDLINE searches and a review of the literature. Based on event estimates adjusted for cardiovascular risk factors, greater whole grain intake (pooled average 2.5 servings/d vs. 0.2 servings/d) was associated with a 21% lower risk of CVD events [OR 0.79 (95% CI: 0.73-0.85)]. Similar estimates were noted for different CVD outcomes (heart disease, stroke, fatal CVD) and in sex-specific analyses. Conversely, refined grain intake was not associated with incident CVD events [1.07 (0.94-1.22)].Conclusions There is a consistent, inverse association between dietary whole grains and incident cardiovascular disease in epidemiological cohort studies. In light of this evidence, policy-makers, scientists, and clinicians should redouble efforts to incorporate clear messages on the beneficial effects of whole grains into public health and clinical practice endeavors.
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Most previous meta-analyses considered only selected disease endpoints and did not conduct dose-response analyses.
“most previous meta-analyses considered only selected disease endpoints and did not conduct dose-response analyses.6 30”
Two previous meta-analyses suggested an inverse association between high versus low intake of whole grains and coronary heart disease, but no dose-response analyses were conducted.
“Although two previous meta-analyses suggested an inverse association between high versus low intake of whole grains and coronary heart disease,6 30 no dose-response analyses were conducted”
In RCTs, whole grain consumption improves glucose-insulin homeostasis and endothelial function and possibly reduces inflammation and improves weight loss.
“In RCTs, consumption of whole grains improves glucose-insulin homeostasis and endothelial function and possibly reduces inflammation and improves weight loss.34–36”
From Components of a Cardioprotective Diet: New Insights (2011) · cites this paper as [35]
Total carbohydrate consumption has little relation to cardiometabolic health.
“While total carbohydrate consumption has little relation to cardiometabolic health, the quality of carbohydrate-rich foods is linked to risk (Figure 6, Figure 7).152-160”
From Dietary and Policy Priorities for Cardiovascular Disease, Diabetes, and Obesity: A Comprehensive Review (2016) · cites this paper as [154]
The quality of carbohydrate-rich foods is linked to cardiometabolic risk.
“the quality of carbohydrate-rich foods is linked to risk (Figure 6, Figure 7).152-160”
From Dietary and Policy Priorities for Cardiovascular Disease, Diabetes, and Obesity: A Comprehensive Review (2016) · cites this paper as [154]
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- Authors
- Mellen, P. B., Walsh, T. F., & Herrington, D. M.
- Affiliations
- Wake Forest University Health Sciences (US)
- ORCID
- Herrington, David M.
- Venue
- Nutrition, Metabolism and Cardiovascular Diseases
- Publisher
- Elsevier BV
- Published
- 2008-05
- Volume
- 18
- Issue
- 4
- Pages
- 283-290
- ISSN
- 0939-4753 (ISSN-L)
- OpenAlex
- W2061816970
- Cited by
- 515
- References
- 56
- Citations by year
- 2026: 9 · 2025: 10 · 2024: 16 · 2023: 17 · 2022: 25 · 2021: 17 · 2020: 29 · 2019: 25 · 2018: 23 · 2017: 42 · 2016: 39 · 2015: 41 · 2014: 51 · 2013: 38 · 2012: 45
- FWCI
- 3.18
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Nutrition Metabolism and Cardiovascular Diseases (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health
- National Heart, Lung, and Blood Institute (T32 HL76132, T32HL076132)
- 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, cardiovascular disease, refined grains, dietary fiber, heart disease, stroke, fatal cardiovascular events, prospective cohort, cardiovascular risk factors
- MeSH terms
- Adult, Aged, Aged, 80 and over, Cardiovascular Diseases, Edible Grain, Diet, Diet Surveys, Female, Humans, Male, Middle Aged, Prospective Studies, Risk Factors, Meta-Analysis as Topic, Cohort Studies, Multicenter Studies as Topic
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 ›
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