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Original Research Communication |
1 From the Division of Preventive Medicine (SL, HDS, JAEM, and JEB) and Channing Laboratory (JAEM and WCW), Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston; the Department of Ambulatory Care and Prevention, Harvard Medical School, Boston (JEB); and the Departments of Epidemiology (SL, HDS, JAEM, WCW, and JEB) and Nutrition (WCW), Harvard School of Public Health, Boston.
Background: Prospective studies suggested that substituting whole-grain products for refined-grain products lowers the risks of type 2 diabetes and cardiovascular disease (CVD) in women. Although breakfast cereals are a major source of whole and refined grains, little is known about their direct association with the risk of premature mortality.
Objective: We prospectively evaluated the association between whole- and refined-grain breakfast cereal intakes and total and CVD-specific mortality in a cohort of US men.
Design: We examined 86 190 US male physicians aged 40–84 y in 1982 who were free of known CVD and cancer at baseline.
Results: During 5.5 y, we documented 3114 deaths from all causes, including 1381 due to CVD (488 myocardial infarctions and 146 strokes). Whole-grain breakfast cereal intake was inversely associated with total and CVD-specific mortality, independent of age; body mass index; smoking; alcohol intake; physical activity; history of diabetes, hypertension, or high cholesterol; and use of multivitamins. Compared with men who rarely or never consumed whole-grain cereal, men in the highest category of whole-grain cereal intake (
1 serving/d) had multivariate-estimated relative risks of total and CVD-specific mortality of 0.83 (95% CI: 0.73, 0.94; P for trend < 0.001) and 0.80 (0.66, 0.97; P for trend < 0.001), respectively. In contrast, total and refined-grain breakfast cereal intakes were not significantly associated with total and CVD-specific mortality. These findings persisted in analyses stratified by history of type 2 diabetes, hypertension, and high cholesterol.
Conclusions: Both total mortality and CVD-specific mortality were inversely associated with whole-grain but not refined-grain breakfast cereal intake. These prospective data highlight the importance of distinguishing whole-grain from refined-grain cereals in the prevention of chronic diseases.
Key Words: Whole-grain cereals • refined-grain cereals • prospective study • cardiovascular diseases • mortality • men • Physicians’ Health Study
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