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Cited by 774Nutritional Studies and DietFood composition and propertiesCardiovascular Health and Risk Factors

Whole-grain consumption and risk of coronary heart disease: results from the Nurses' Health Study

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Liu, Simin, Stampfer, Meir J, Hu, Frank B, Giovannucci, Edward, Rimm, Eric, Manson, JoAnn E, Hennekens, Charles H, Willett, Walter C·1999·The American Journal of Clinical Nutrition
DOI 10.1093/ajcn/70.3.412
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Abstract

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 detailed, 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.

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  • Several previous prospective studies have found a lower risk of coronary heart disease, stroke, cardiovascular disease, and all cause mortality associated with a high intake of whole grains, though not all studies reported a clear association.

    “Several previous prospective studies have found a lower risk of coronary heart disease,4 9 15 16 17 stroke,16 18 cardiovascular disease,4 19 20 and all cause mortality4 9 16 20 21 22 associated with a high intake of whole grains, though not all studies reported a clear association.23 24 25 26 27”

    From Whole grain consumption and risk of cardiovascular disease, cancer, and all cause and cause specific mortality: systematic review and dose-response meta-analysis of prospective studies (2016) · cites this paper as [15]

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Research works printed but not linked: 3

  1. Rimm E, Ascherio A, Giovannucci E, Stampfer M, Willett W. Dietary fiber intake and risk of coronary heart disease among a large popula- tion of US men. Am J Epidemiol 1995;141:S17 (abstr).
  2. Liu S, Stampfer MJ, Manson JE, et al. A prospective study of glycemic load and risk of myocardial infarction in women. FASEB J 1998;12: A260 (abstr).
  3. Liu S, Sampson L, Hu F, Willett W. Methodological considerations in applying metabolic data to an epidemiologic study using a semi-quan- titative food frequency questionnaire. Eur J Clin Nutr 1998;52:S87 (abstr).

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Authors
Liu, S., Stampfer, M. J., Hu, F. B., Giovannucci, E., Rimm, E., Manson, J. E., Hennekens, C. H., & Willett, W. C.
Affiliations
Brigham and Women's Hospital (US)
Corresponding author
Liu, Simin
ORCID
Venue
The American Journal of Clinical Nutrition
Publisher
Elsevier BV
Published
1999-09
Volume
70
Issue
3
Pages
412-419
ISSN
0002-9165 (ISSN-L)
DOI
10.1093/ajcn/70.3.412
OpenAlex
W2140438357
Cited by
774
References
20
Citations by year
2026: 3 · 2025: 5 · 2024: 10 · 2023: 13 · 2022: 18 · 2021: 16 · 2020: 19 · 2019: 24 · 2018: 18 · 2017: 27 · 2016: 26 · 2015: 28 · 2014: 37 · 2013: 42 · 2012: 41
FWCI
40.87
Type
journal article
Language
en
Open access
Licence
Locations
  • American Journal of Clinical Nutrition (publishedVersion)
  • PubMed (publishedVersion)
  • Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
Funders
  • University of Minnesota
  • National Institutes of Health (HL24074, CA40356)
  • National Heart, Lung, and Blood Institute (HL24074, HL34594, R01HL034594)
  • National Cancer Institute (CA-40356)
  • National Institute of Diabetes and Digestive and Kidney Diseases (T32DK007703)
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, coronary artery disease, myocardial infarction, dietary fiber, women, Nurses' Health Study, cardiovascular risk, never smokers, folic acid, vitamin E, dietary supplements, postmenopausal hormone use, body mass index, physical activity, dietary fat intake, aspirin use, multivitamin use, alcohol consumption, dietary guidelines, food frequency questionnaire
MeSH terms
Adult, Edible Grain, Coronary Disease, Diet, Dietary Fiber, Female, Folic Acid, Health Surveys, Humans, Middle Aged, Nurses, Prospective Studies, Pyridoxine, Risk Factors, Vitamin E

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