TABLE 2.

Study design details, population characteristics, and key findings from randomized controlled trials assessing the effects of whole-grain intake on cognition, mood, anxiety, and depression outcomes

Author, year	Country	N	Design	Mean age [range], y	% Male	Racial or ethnic background	Health status	Dietary whole-grain intervention	Comparator	Total trial duration	Outcome assessment method	Outcome analyzed	Key findings1
Cognition
Kuroda, 2019 [50]	Japan	52	Parallel	72.9 [NR]	48.1	100% Japanese	100% healthy	100 g/d of ultrahigh hydrostatic pressurizing brown rice (UHHPBR)	100 g/d of white rice	24 mo	Cognition: HDS-R; MMSE; Frontal Assessment Battery (FAB); and the Cognitive Assessment for Dementia, iPad version (CADi). Mental health: Japanese version of Starktein’s Apathy Scale and Zung Self-Rating Depression Scale (SDS).	Cognition: HDS-R score, MMSE score, FAB score, CADi score, $\Delta$ FAB scores on “conceptualization,” and $\Delta$CADi scores on “time required” (s) Mental health: apathy score, SDS score, $\Delta$ apathy scores	Cognition: HDS-R score: 0; MMSE score: 0; FAB score: 0; CADi score: 0; $\Delta$ FAB scores: ++; and $\Delta$CADi scores: −− Mental health: apathy score: −−; SDS score: −−; and $\Delta$ apathy scores: −−
Uenobe, 20192 [30]	Japan	31	Crossover	84.1 [NR]	22.6	100% Japanese	100% healthy	3 meals/d of dewaxed brown rice	3 meals/d of white rice	12 mo (Period I and II: 6 mo each)	HDS-R	$\Delta$ HDS-R score among those in group A, group B, group A + B, and the low cognitive function group3	$\Delta$ HDS-R score: group A: 0; group B: 0; group A + B: 0; and low cognitive function group: ++
Mood, anxiety, and depression
Esmaeilpour, 2019 [40]	Iran	100	Parallel	31 [[19], [20], [21], [22], [23], [24], [25], [26], [27], [28], [29], [30], [31], [32], [33], [34], [35], [36], [37], [38], [39], [40], [41], [42], [43], [44], [45]]	0	NR	100% healthy	Diet enriched with whole grains4	Usual diet	3 mo	Daily symptom record. Three subgroups measured, including mood symptoms (restlessness; irritability; anxiety; depression or sadness; crying; and feeling of isolation).	Mean of PMS score (mood)	Mood score: −−
Sakamoto, 2007 [41]	Japan	41	Parallel	32.2 [NR]	0	100% Japanese	100% healthy	Pregerminated brown rice (average intake: 238 ± 35.3 g)	White rice (average intake: 270 ± 57.6 g)	2 wk	The Profiles of Mood States (POMS): brief form Japanese version	Total mood disturbance (TMD) score POMS parameters: tension-anxiety, depression, anger-hostility, vigor, fatigue, and confusion	TMD score: −− POMS parameters: tension-anxiety: 0; depression: −−; anger-hostility: −−; vigor: 0; fatigue: −−; confusion: 0

Abbreviations: HDS-R, Revised Hasegawa Dementia Scale; N, number of individuals randomly assigned; NR, not reported; PMS, premenstrual syndrome.

¹Key findings’ symbols: ++ significant positive effect (P ≤ 0.05); + marginally significant positive effect (0.05 < P < 0.1); 0 no effect; − marginally significant inverse effect (0.05 < P < 0.1); −− significant inverse effect (P ≤ 0.05).

²This article reported both cognition and mood, anxiety, and depression outcomes.

³Group A: received dewaxed brown rice for the first 6 mo then received white rice for the remaining 6 mo; group B: received white rice for the first 6 mo then received dewaxed brown rice for the remaining 6 mo; low cognitive function group had a total HDS-R score of 1 or more and <10 points (HDS-R is out of 30 points).

⁴Replaced ≥4 servings of daily refined grains with whole grains. Given a whole-grain food list that included whole-wheat bread, brown rice, brown spaghetti, and homemade cakes and cookies using whole-wheat flour. Individuals were also given 840 g of whole-grain bread each week to replace their daily consumption of refined bread with 120 g of whole-grain bread.