Table 9.
Association between whole and refined grains (cereal grains) intake and incidences of some major chronic diseases/mortality of major disease groups (RR, 95% C.I.). The dose-response meta-analysis always refers to an additional serving of a food per day relative to the average intake of that food observed in a cohort study (30 g for whole and refined grains).
| Health Outcomes | Unit of Intake | RR (95% C.I.) | N° of Prospective Studies | References |
|---|---|---|---|---|
| Whole Grains | ||||
| All-cause mortality |
Highest vs. Lowest | 0.88 (0.84–0.92) | 19 | [114] |
| Dose-Response | 0.92 (0.89–0.95) | 11 / |
[114] [115] |
|
| Total CVDs mortality |
Highest vs. Lowest | 0.79 (0.73–0.85) a | 11 | [130] |
| Dose-Response | No data | |||
| CHD | Highest vs. Lowest | 0.81 (0.75–0.86) | 7 | [131] |
| 0.85 (0.81–0.90) | 7 | [118] | ||
| Dose-Response | 0.95 (0.92–0.98) | 5 / |
[118] [115] |
|
| Stroke | Highest vs. Lowest | 0.83 (0.68–1.02) a | 4 | [130] |
| 0.91 (0.82–1.02) | 7 | [118] | ||
| Dose-Response | 0.99 (0.95–1.03) | 4 / |
[118] [115] |
|
| HBP | Highest vs. Lowest | 0.86 (0.79–0.93) | 4 | [120] |
| Dose-Response | 0.92 (0.87–0.98) | 4 | ||
| CHF | Highest vs. Lowest | 0.91 (0.85–0.97) | 5 | [118] |
| Dose-Response | 0.96 (0.95–0.97) | 2 | ||
| T2D | Highest vs. Lowest | No data | ||
| Dose-Response | 0.79 (0.72–0.87) b | 6 | [130] | |
| 0.88 (0.83–0.93) | / | [115] | ||
| 0.87 (0.82–0.93) | 12 | [122] | ||
| Overweight/Obesity | Highest vs. Lowest | 0.85 (0.79–0.91) | 5 | [123] |
| Dose-Response | 0.93 (0.89–0.96) | 3 | ||
| MetS | Highest vs. Lowest | No data | ||
| Dose-Response | No data | |||
| Total cancer mortality |
Highest vs. Lowest | No data | ||
| Dose-Response | No data | |||
| Total cancer incidence |
Highest vs. Lowest | 0.93 (0.88–0.98) | / | [90] |
| Dose-Response | No data | |||
| CRC | Highest vs. Lowest | 0.88 (0.83–0.94) | 10 | [124] |
| Dose-Response | 0.83 (0.79–0.89) | 6 | [125] | |
| 0.95 (0.93–0.97) | 2 / |
[124] [115] |
||
| Breast cancer | Highest vs. Lowest | No data | ||
| Dose-Response | No data | |||
| Gastric cancer | Highest vs. Lowest | No data | ||
| Dose-Response | 0.83 (0.78–0.89) c | 6 | [196] | |
| Refined Grains | ||||
| All-cause mortality |
Highest vs. Lowest | / | 4 | [114] |
| Dose-Response | 0.99 (0.97–1.01) | 4 / |
[114] [115] |
|
| Total CVDs mortality |
Highest vs. Lowest | No data | ||
| Dose-Response | No data | |||
| CHD | Highest vs. Lowest | 1.11 (0.99–1.25) | 5 | [118] |
| Dose-Response | 1.01 (0.99–1.04) | 4 / |
[118] [115] |
|
| Stroke | Highest vs. Lowest | / | 6 | [118] |
| Dose-Response | / / |
4 / |
[118] [115] |
|
| HBP | Highest vs. Lowest | 0.95 (0.88–1.03) | 3 | [120] |
| Dose-Response | / | 3 | ||
| CHF | Highest vs. Lowest | / | 1 | [118] |
| Dose-Response | / | 1 | ||
| T2D | Highest vs. Lowest | No data | ||
| Dose-Response | 1.01 (1.00–1.03) | 14 | [122] | |
| 0.98 (0.96–1.01) | / | [115] | ||
| Overweight/Obesity | Highest vs. Lowest | / | 3 | [123] |
| Dose-Response | 1.05 (1.00–1.10) | 3 | ||
| MetS | Highest vs. Lowest | No data | ||
| Dose-Response | No data | |||
| Total cancer mortality |
Highest vs. Lowest | No data | ||
| Dose-Response | No data | |||
| Total cancer incidence |
Highest vs. Lowest | No data | ||
| Dose-Response | No data | |||
| CRC | Highest vs. Lowest | / | 9 | [124] |
| Dose-Response | No data | |||
| Breast cancer | Highest vs. Lowest | No data | ||
| Dose-Response | No data | |||
| Gastric cancer | Highest vs. Lowest | No data | ||
| Dose-Response | No data | |||
a 2.5 vs. 0.2 servings/day; b each, 2 servings/day; c for an increment of three servings daily.