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Original Research Communication |
1 From the Programs in Nutrition, Simmons College, Boston (TTF); the Departments of Nutrition (TTF, FBH, MJS, and WCW) and Epidemiology (FBH, MJS, GAC, and WCW), Harvard School of Public Health, Boston; the Department of Pediatrics, Harvard Medical School, and the Department of Medicine, Children’s Hospital, Boston (MAP); and the Division of Preventive Medicine (SL) and the Channing Laboratory, Department of Medicine (FBH, MJS, GAC, and WCW), Brigham and Women’s Hospital, Harvard Medical School, Boston.
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 = 42898) 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.
Key Words: Type 2 diabetes • whole grains • refined grains • men
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