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American Journal of Clinical Nutrition, Vol. 77, No. 3, 622-629, March 2003
© 2003 American Society for Clinical Nutrition


Original Research Communication

Whole-grain and fiber intake and the incidence of type 2 diabetes1,2

Jukka Montonen, Paul Knekt, Ritva Järvinen, Arpo Aromaa and Antti Reunanen

1 From the National Public Health Institute, Helsinki (JM, PK, AA, and AR); the Social Insurance Institution, Helsinki and Turku (PK); and the Department of Clinical Nutrition, University of Kuopio (RJ), Finland.

Background: Epidemiologic evidence of a preventive effect of whole grain against type 2 diabetes is mainly based on data from women. Information specific to men and women is needed.

Objective: The objective was to study the relation between the intake of whole grain and fiber and the subsequent incidence of type 2 diabetes.

Design: The design was a cohort study of 2286 men and 2030 women aged 40–69 y and initially free of diabetes. Food consumption data were collected from 1966 through 1972 with the use of a dietary history interview covering the habitual diet during the previous year. During a 10-y follow-up, incident type 2 diabetes cases were identified in 54 men and 102 women from a nationwide register.

Results: Whole-grain consumption was associated with a reduced risk of type 2 diabetes. The relative risk (adjusted for age, sex, geographic area, smoking status, body mass index, energy intake, and intakes of vegetables, fruit, and berries) between the highest and lowest quartiles of whole-grain consumption was 0.65 (95% CI: 0.36, 1.18; P for trend = 0.02). Cereal fiber intake was also associated with a reduced risk of type 2 diabetes. The relative risk between the extreme quartiles of cereal fiber intake was 0.39 (95% CI: 0.20, 0.77; P = 0.01).

Conclusions: An inverse association between whole-grain intake and the risk of type 2 diabetes was found. The similar result for cereal fiber intake suggests that the whole-grain association is due to cereal fiber or another factor related to cereal fiber intake.

Key Words: WORDSDiet • grain • whole grains • fiber • diabetes • epidemiology


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