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Overview of the Composition of Whole Grains’ Phenolic Acids and Dietary Fibre and Their Effect on Chronic Non-Communicable Diseases. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19053042. [PMID: 35270737 PMCID: PMC8910396 DOI: 10.3390/ijerph19053042] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 02/22/2022] [Accepted: 02/26/2022] [Indexed: 02/01/2023]
Abstract
Chronic non-communicable diseases are the major cause of death globally. Whole grains are recommended in dietary guidelines worldwide due to increasing evidence that their consumption can improve health beyond just providing energy and nutrients. Epidemiological studies have suggested that the incorporation of whole grains, as part of a healthy diet, plays a key role in reducing one’s risk for cardiovascular diseases (CVDs), obesity, type 2 diabetes (T2D) and cancer. Phenolic acids and dietary fibre are important components found in whole grains that are largely responsible for these health advantages. Both phenolic acids and dietary fibre, which are predominantly present in the bran layer, are abundant in whole-grain cereals and pseudo-cereals. Several studies indicate that whole grain dietary fibre and phenolic acids are linked to health regulation. The main focus of this study is two-fold. First, we provide an overview of phenolic acids and dietary fibres found in whole grains (wheat, barley, oats, rice and buckwheat). Second, we review existing literature on the linkages between the consumption of whole grains and the development of the following chronic non-communicable diseases: CVDs, obesity, T2D and cancer. Altogether, scientific evidence that the intake of whole grains reduces the risk of certain chronic non-communicable disease is encouraging but not convincing. Based on previous studies, the current review encourages further research to cover the gap between the emerging science of whole grains and human health.
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Iqbal WA, Stewart GB, Smith A, Errington L, Seal CJ. PROTOCOL: The association between whole-grain dietary intake and noncommunicable diseases: A systematic review and meta-analysis. CAMPBELL SYSTEMATIC REVIEWS 2021; 17:e1186. [PMID: 37051450 PMCID: PMC8988836 DOI: 10.1002/cl2.1186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Our primary research questions are: (1) What is the association between whole grains (WG) intake and the prevalence of NCDs (i.e., type 2 diabetes, cardiovascular disease, obesity, cancer, mortality) and their biomarkers? (2) Which biomarker(s) has/have the greatest association with WG intake when combining multiple biomarkers together in the same analysis? Our secondary research question is: (3) Are there dose-response relationships between WG intake and biomarkers and prevalence of NCDs which could help inform a universal recommendation for WG intake?
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Yu EYW, Wesselius A, Mehrkanoon S, Brinkman M, van den Brandt P, White E, Weiderpass E, Le Calvez-Kelm F, Gunter M, Huybrechts I, Liedberg F, Skeie G, Tjonneland A, Riboli E, Giles GG, Milne RL, Zeegers MP. Grain and dietary fiber intake and bladder cancer risk: a pooled analysis of prospective cohort studies. Am J Clin Nutr 2020; 112:1252-1266. [PMID: 32778880 PMCID: PMC7657329 DOI: 10.1093/ajcn/nqaa215] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 07/08/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Higher intakes of whole grains and dietary fiber have been associated with lower risk of insulin resistance, hyperinsulinemia, and inflammation, which are known predisposing factors for cancer. OBJECTIVES Because the evidence of association with bladder cancer (BC) is limited, we aimed to assess associations with BC risk for intakes of whole grains, refined grains, and dietary fiber. METHODS We pooled individual data from 574,726 participants in 13 cohort studies, 3214 of whom developed incident BC. HRs, with corresponding 95% CIs, were estimated using Cox regression models stratified on cohort. Dose-response relations were examined using fractional polynomial regression models. RESULTS We found that higher intake of total whole grain was associated with lower risk of BC (comparing highest with lowest intake tertile: HR: 0.87; 95% CI: 0.77, 0.98; HR per 1-SD increment: 0.95; 95% CI: 0.91, 0.99; P for trend: 0.023). No association was observed for intake of total refined grain. Intake of total dietary fiber was also inversely associated with BC risk (comparing highest with lowest intake tertile: HR: 0.86; 95% CI: 0.76, 0.98; HR per 1-SD increment: 0.91; 95% CI: 0.82, 0.98; P for trend: 0.021). In addition, dose-response analyses gave estimated HRs of 0.97 (95% CI: 0.95, 0.99) for intake of total whole grain and 0.96 (95% CI: 0.94, 0.98) for intake of total dietary fiber per 5-g daily increment. When considered jointly, highest intake of whole grains with the highest intake of dietary fiber showed 28% reduced risk (95% CI: 0.54, 0.93; P for trend: 0.031) of BC compared with the lowest intakes, suggesting potential synergism. CONCLUSIONS Higher intakes of total whole grain and total dietary fiber are associated with reduced risk of BC individually and jointly. Further studies are needed to clarify the underlying mechanisms for these findings.
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Affiliation(s)
- Evan Y W Yu
- Department of Complex Genetics and Epidemiology, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, Netherlands
| | - Anke Wesselius
- Department of Complex Genetics and Epidemiology, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, Netherlands
| | - Siamak Mehrkanoon
- Department of Data Science and Knowledge Engineering, Maastricht University, Maastricht, Netherlands
| | - Maree Brinkman
- Department of Complex Genetics and Epidemiology, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, Netherlands
- Department of Clinical Studies and Nutritional Epidemiology, Nutrition Biomed Research Institute, Melbourne, Victoria, Australia
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Piet van den Brandt
- Department of Epidemiology, School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, Netherlands
- Department of Epidemiology, School for Public Health and Primary Care, Maastricht University Medical Centre, Maastricht, Netherlands
| | - Emily White
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | | | | | - Marc Gunter
- International Agency for Research on Cancer/WHO, Lyon, France
| | - Inge Huybrechts
- International Agency for Research on Cancer/WHO, Lyon, France
| | - Fredrik Liedberg
- Department of Urology, Skåne University Hospital, Malmö, Sweden
- Institution of Translational Medicine, Lund University, Malmö, Sweden
| | - Guri Skeie
- Department of Community Medicine, UIT The Arctic University of Norway, Tromsø, Norway
| | - Anne Tjonneland
- Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - Graham G Giles
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Roger L Milne
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Maurice P Zeegers
- Department of Complex Genetics and Epidemiology, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, Netherlands
- CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, Netherlands
- School of Cancer Sciences, University of Birmingham, Birmingham, United Kingdom
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Papanikolaou Y, Slavin JL, Clemens R, Brenna JT, Hayes D, Gaesser GA, Fulgoni VL. Do Refined Grains Have a Place in a Healthy Dietary Pattern: Perspectives from an Expert Panel Consensus Meeting. Curr Dev Nutr 2020; 4:nzaa125. [PMID: 33062912 PMCID: PMC7538308 DOI: 10.1093/cdn/nzaa125] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 06/17/2020] [Accepted: 07/14/2020] [Indexed: 11/14/2022] Open
Abstract
Although dietary guidance recommends increasing consumption of whole grains and concurrently limiting consumption of refined and/or enriched grain foods, emerging research suggests that certain refined grains may be part of a healthy dietary pattern. A scientific expert panel was convened to review published data since the release of 2015 dietary guidance in defined areas of grain research, which included nutrient intakes, diet quality, enrichment/fortification, and associations with weight-related outcomes. Based on a 1-d roundtable discussion, the expert panel reached consensus that 1) whole grains and refined grains can make meaningful nutrient contributions to dietary patterns, 2) whole and refined grain foods contribute nutrient density, 3) fortification and enrichment of grains remain vital in delivering nutrient adequacy in the American diet, 4) there is inconclusive scientific evidence that refined grain foods are linked to overweight and obesity, and 5) gaps exist in the scientific literature with regard to grain foods and health.
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Affiliation(s)
| | - Joanne L Slavin
- Department of Food Science and Nutrition, University of Minnesota, St. Paul, MN, USA
| | - Roger Clemens
- USC School of Pharmacy, University of Southern California, Los Angeles, CA, USA
| | - J Thomas Brenna
- Department of Pediatrics, Dell Medical School, University of Texas at Austin, Austin, TX, USA
| | | | - Glenn A Gaesser
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA
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Mousavi SM, Rigi S, Shayanfar M, Mohammad-Shirazi M, Sharifi G, Esmaillzadeh A. Refined grains consumption is associated with a greater odds of glioma. Nutr Neurosci 2020; 25:432-440. [DOI: 10.1080/1028415x.2020.1758889] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Seyed Mohammad Mousavi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
- Students’ Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran
| | - Somaye Rigi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Shayanfar
- Department of Clinical Nutrition and Dietetics, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Minoo Mohammad-Shirazi
- Department of Clinical Nutrition and Dietetics, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Giuve Sharifi
- Department of Neurosurgery, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ahmad Esmaillzadeh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Food Security Research Center, Department of Community Nutrition, Isfahan University of Medical Sciences, Isfahan, Iran
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Aune D. Plant Foods, Antioxidant Biomarkers, and the Risk of Cardiovascular Disease, Cancer, and Mortality: A Review of the Evidence. Adv Nutr 2019; 10:S404-S421. [PMID: 31728499 PMCID: PMC6855972 DOI: 10.1093/advances/nmz042] [Citation(s) in RCA: 95] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 03/15/2019] [Accepted: 03/28/2019] [Indexed: 12/14/2022] Open
Abstract
Although a high intake of plant foods such as fruits, vegetables, whole grains, nuts, and legumes has been recommended for chronic disease prevention, it has been unclear what is the optimal amount of intake of these foods and whether specific subtypes are particularly beneficial. The evidence from several recently published meta-analyses on plant foods and antioxidants and various health outcomes is reviewed as well as more recently published studies. In meta-analyses of prospective studies, inverse associations were observed between intake of fruits, vegetables, whole grains, and nuts and the risk of coronary artery disease, stroke, cardiovascular disease overall, total cancer, and all-cause mortality. The strongest reductions in risk were observed at an intake of 800 g/d for fruits and vegetables, 225 g/d for whole grains, and 15-20 g/d for nuts, respectively. Whole-grain and nut consumption was also inversely associated with mortality from respiratory disease, infections, and diabetes. Stronger and more linear inverse associations were observed between blood concentrations of antioxidants (vitamin C, carotenoids, vitamin E) and cardiovascular disease, cancer, and all-cause mortality than for dietary intake. Most studies that have since been published have been consistent with these results; however, further studies are needed on subtypes of plant foods and less common causes of death. These results strongly support dietary recommendations to increase intake of plant foods, and suggest optimal intakes for chronic disease prevention may be ∼800 g/d for intakes of fruits and vegetables, 225 g/d for whole grains, and 15-20 g/d for nuts. Diets high in plant foods could potentially prevent several million premature deaths each year if adopted globally.
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Affiliation(s)
- Dagfinn Aune
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
- Department of Nutrition, Bjørknes University College, Oslo, Norway
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
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Gaesser GA. Perspective: Refined Grains and Health: Genuine Risk, or Guilt by Association? Adv Nutr 2019; 10:361-371. [PMID: 30947337 PMCID: PMC6520038 DOI: 10.1093/advances/nmy104] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 10/24/2018] [Accepted: 11/01/2018] [Indexed: 01/07/2023] Open
Abstract
Refined grain intake is widely assumed to be associated with adverse health outcomes, including increased risk for cardiovascular disease (CVD), type 2 diabetes (T2D), and obesity. The 2015 Dietary Guidelines Advisory Committee recommended that to improve dietary quality, the US population should replace most refined grains with whole grains. This recommendation was based largely on results from studies that examined dietary patterns, not separate food groups. A Western dietary pattern typically includes red and processed meat, sugar-sweetened foods and beverages, French fries, and high-fat dairy products, as well as refined grains, and has been linked to increased risk of many chronic diseases. However, when evaluated as a distinct food category, 11 meta-analyses of prospective cohort studies, which included a total of 32 publications with data from 24 distinct cohorts, demonstrated that refined grain intake was not associated with all-cause mortality, T2D, CVD, coronary heart disease (CHD), stroke, hypertension, or cancer. By contrast, consumption of red and processed meat was consistently associated with increased risk of these same health outcomes. Refined grain consumption up to 6-7 servings/d (1 serving = 30 g) was not associated with higher risk of CHD, T2D, hypertension, or all-cause mortality. Moreover, total grain intake was not associated with risk of CVD, CHD, stroke, or cancer, but was associated with lower risk of all-cause mortality. Consequently, the recommendation to reduce refined grain intake based on results from studies linking a Western dietary pattern to numerous adverse health outcomes is contrary to a substantial body of published scientific evidence. Future research needs to better define refined grain intake to distinguish between staple grain foods and indulgent grain foods, and to better design randomized controlled trials to resolve discrepancies between results from observational studies and such trials with regard to determining the benefits of whole grains compared with refined grains.
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Affiliation(s)
- Glenn A Gaesser
- College of Health Solutions, Arizona State University, Phoenix, AZ,Address correspondence to GAG (e-mail: )
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Xu Y, Yang J, Du L, Li K, Zhou Y. Association of whole grain, refined grain, and cereal consumption with gastric cancer risk: A meta-analysis of observational studies. Food Sci Nutr 2019; 7:256-265. [PMID: 30680179 PMCID: PMC6341150 DOI: 10.1002/fsn3.878] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2018] [Revised: 10/05/2018] [Accepted: 10/11/2018] [Indexed: 02/05/2023] Open
Abstract
Many studies have analyzed the relationship between cereal, whole, or refined grain and the risk of gastric cancer (GC) and have yielded mixed results. Therefore, we performed a meta-analysis of observational studies to summarize the available evidence on this topic. Databases such as PubMed, EMBASE, Web of Science, MEDLINE, and the Cochrane Library were searched for studies focusing on these associations from inception to October 2017. Summary odd ratios (OR) and 95% confidence intervals (CI) were calculated by using either a random- or fixed-effect model according to the between-studies heterogeneity. Subgroup analysis was also performed. In total, eleven studies that included 530,176 participants were identified. In a pooled analysis of all studies, cereal exposure was not associated with GC risk (OR, 1.11, 95%CI, 0.85-1.36). Specific analyses indicated that whole grain consumption was associated with decreased GC risk (OR, 0.61, 95%CI, 0.40-0.83) and that refined grain consumption was associated with increased GC risk (OR, 1.65, 95%CI, 1.36-1.94). Higher whole grain and lower refined grain intake but not cereal consumption reduces GC risk. This study has been registered at ClinicalTrials.gov (ID: NCT03419663).
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Affiliation(s)
- Yujie Xu
- West China School of Nursing and Department of NursingWest China HospitalSichuan UniversityChengduChina
| | - Jie Yang
- Department of Gastrointestinal SurgeryWest China HospitalSichuan UniversityChengduChina
| | - Liang Du
- Chinese Evidence‐Based Medicine/Cochrane CenterChengduChina
| | - Ka Li
- Department of NursingWest China HospitalSichuan UniversityChengduChina
| | - Yong Zhou
- Department of Gastrointestinal SurgeryWest China HospitalSichuan UniversityChengduChina
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Makarem N, Bandera EV, Lin Y, McKeown NM, Hayes RB, Parekh N. Associations of Whole and Refined Grain Intakes with Adiposity-Related Cancer Risk in the Framingham Offspring Cohort (1991-2013). Nutr Cancer 2018; 70:776-786. [PMID: 29781707 PMCID: PMC7236605 DOI: 10.1080/01635581.2018.1470647] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Case-control studies suggest that higher whole grain and lower refined grain intakes are associated with reduced cancer risk, but longitudinal evidence is limited. The objective of this prospective cohort study is to evaluate associations between whole and refined grains and their food sources in relation to adiposity-related cancer risk. Participants were adults from the Framingham Offspring cohort (N = 3,184; ≥18 yr). Diet, measured using a food frequency questionnaire, medical and lifestyle data were collected at exam 5 (1991-95). Between 1991 and 2013, 565 adiposity-related cancers were ascertained using pathology reports. Cox proportional hazards models were used to estimate adjusted hazard ratios and 95% confidence intervals for associations of whole and refined grains with risk of adiposity-related cancers combined and with risk of breast and prostate cancers in exploratory site-specific analyses. Null associations between whole and refined grains and combined incidence of adiposity-related cancers were observed in multivariable-adjusted models (HR: 0.94; 95% CI: 0.71-1.23 and HR: 0.98; 95% CI: 0.70-1.38, respectively). In exploratory analyses, higher intakes of whole grains (oz eq/day) and whole grain food sources (servings/day) were associated with 39% and 47% lower breast cancer risk (HR: 0.61; 95% CI: 0.38-0.98 and HR: 0.53; 95% CI: 0.33-0.86, respectively). In conclusion, whole and refined grains were not associated with adiposity-related cancer risk. Whole grains may protect against breast cancer, but findings require confirmation within a larger sample and in other ethnic groups.
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Affiliation(s)
- Nour Makarem
- Department of Medicine, Columbia University Medical Center, New York, NY, USA
| | - Elisa V. Bandera
- Department of Epidemiology, Rutgers School of Public Health, Rutgers the State University of New Jersey, Piscataway, New Jersey, USA
| | - Yong Lin
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
| | - Nicola M. McKeown
- Jean Mayer USDA Human Nutrition Research Center on Aging, Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA
| | - Richard B. Hayes
- Department of Population Health, NYU Langone School of Medicine, New York, NY, USA
| | - Niyati Parekh
- Department of Public Health Nutrition, College of Global Public Health, New York University, New York, NY, USA
- Department of Population Health, NYU Langone School of Medicine, New York, NY, USA
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10
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Ma X, Tang WG, Yang Y, Zhang QL, Zheng JL, Xiang YB. Association between whole grain intake and all-cause mortality: a meta-analysis of cohort studies. Oncotarget 2018; 7:61996-62005. [PMID: 27566558 PMCID: PMC5308706 DOI: 10.18632/oncotarget.11491] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Accepted: 08/09/2016] [Indexed: 12/26/2022] Open
Abstract
Some observational studies have examined the association between dietary whole grain intake and all-cause mortality, but the results were inconclusive. We therefore conducted a meta-analysis to summarize the evidence from cohort studies regarding the association between whole grain intake and all-cause mortality. Pertinent studies were identified by searching PubMed, Embase and Web of Knowledge, up to February 28, 2016. Study-specific estimates were combined using random-effects models. Eleven prospective cohort studies involving 101,282 deaths and 843,749 participants were included in this meta-analysis. The pooled relative risk of all-cause mortality for the highest category of whole grain intake versus lowest category was 0.82 (95% confidence interval: 0.78, 0.87). There was a 7% reduction in risk associated with each 1 serving/day increase in whole grain intake (relative risk = 0.93; 95% confidence interval: 0.89, 0.97). No publication bias was found. This analysis indicates that higher intake of whole grain is associated with a reduced risk of all-cause mortality. The findings support current recommendations for increasing whole grain consumption to promote health and overall longevity.
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Affiliation(s)
- Xiao Ma
- State Key Laboratory of Oncogenes and Related Genes and Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Wei-Guo Tang
- State Key Laboratory of Oncogenes and Related Genes and Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yang Yang
- State Key Laboratory of Oncogenes and Related Genes and Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Qing-Li Zhang
- State Key Laboratory of Oncogenes and Related Genes and Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jia-Li Zheng
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| | - Yong-Bing Xiang
- State Key Laboratory of Oncogenes and Related Genes and Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
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11
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Champ M. Devrions-nous manger plus de céréales complètes ? CAHIERS DE NUTRITION ET DE DIETETIQUE 2018. [DOI: 10.1016/j.cnd.2017.12.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
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13
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Arzani A, Ashraf M. Cultivated Ancient Wheats (Triticumspp.): A Potential Source of Health-Beneficial Food Products. Compr Rev Food Sci Food Saf 2017; 16:477-488. [DOI: 10.1111/1541-4337.12262] [Citation(s) in RCA: 151] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Revised: 02/24/2017] [Accepted: 02/25/2017] [Indexed: 12/12/2022]
Affiliation(s)
- Ahmad Arzani
- Dept. of Agronomy and Plant Breeding, College of Agriculture; Isfahan Univ. of Technology; Isfahan 84156-83111 Iran
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14
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Makarem N, Nicholson JM, Bandera EV, McKeown NM, Parekh N. Consumption of whole grains and cereal fiber in relation to cancer risk: a systematic review of longitudinal studies. Nutr Rev 2016; 74:353-73. [PMID: 27257283 DOI: 10.1093/nutrit/nuw003] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 11/03/2015] [Indexed: 02/07/2023] Open
Abstract
CONTEXT Evidence from previous reviews is supportive of the hypothesis that whole grains may protect against various cancers. However, the reviews did not report risk estimates for both whole grains and cereal fiber and only case-control studies were evaluated. It is unclear whether longitudinal studies support this conclusion. OBJECTIVE To evaluate associations between whole grains and cereal fiber in relation to risk of lifestyle-related cancers data from longitudinal studies was evaluated. DATA SOURCES The following 3 databases were systematically searched: PubMed, EMBASE, and Cochrane CENTRAL. STUDY SELECTION A total of 43 longitudinal studies conducted in Europe and North America that reported multivariable-adjusted risk estimates for whole grains (n = 14), cereal fiber (n = 23), or both (n = 6) in relation to lifestyle-related cancers were included. DATA EXTRACTION Information on study location, cohort name, follow-up duration, sample characteristics, dietary assessment method, risk estimates, and confounders was extracted. DATA SYNTHESIS Of 20 studies examining whole grains and cancer, 6 studies reported a statistically significant 6%-47% reduction in risk, but 14 studies showed no association. Of 29 studies examining cereal fiber intake in relation to cancer, 8 showed a statistically significant 6%-49% reduction in risk, whereas 21 studies reported no association. CONCLUSIONS This systematic review concludes that most studies were suggestive of a null association. Whole grains and cereal fiber may protect against gastrointestinal cancers, but these findings require confirmation in additional studies.
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Affiliation(s)
- Nour Makarem
- N. Makarem is with the Department of Nutrition, Food Studies and Public Health, New York University, New York, New York, USA. J.M. Nicholson is with the Department of Medical Library, New York University School of Medicine, New York, New York, USA. E.V. Bandera is with the Rutgers School of Public Health, Rutgers-The State University of New Jersey, and the Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA. N.M. McKeown is with the Jean Mayer USDA Human Nutrition Research Center on Aging and Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA. N. Parekh is with the College of Global Public Health, Department of Nutrition, Food Studies and Public Health, and Department of Population Health, New York University, New York, New York, USA
| | - Joseph M Nicholson
- N. Makarem is with the Department of Nutrition, Food Studies and Public Health, New York University, New York, New York, USA. J.M. Nicholson is with the Department of Medical Library, New York University School of Medicine, New York, New York, USA. E.V. Bandera is with the Rutgers School of Public Health, Rutgers-The State University of New Jersey, and the Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA. N.M. McKeown is with the Jean Mayer USDA Human Nutrition Research Center on Aging and Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA. N. Parekh is with the College of Global Public Health, Department of Nutrition, Food Studies and Public Health, and Department of Population Health, New York University, New York, New York, USA
| | - Elisa V Bandera
- N. Makarem is with the Department of Nutrition, Food Studies and Public Health, New York University, New York, New York, USA. J.M. Nicholson is with the Department of Medical Library, New York University School of Medicine, New York, New York, USA. E.V. Bandera is with the Rutgers School of Public Health, Rutgers-The State University of New Jersey, and the Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA. N.M. McKeown is with the Jean Mayer USDA Human Nutrition Research Center on Aging and Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA. N. Parekh is with the College of Global Public Health, Department of Nutrition, Food Studies and Public Health, and Department of Population Health, New York University, New York, New York, USA
| | - Nicola M McKeown
- N. Makarem is with the Department of Nutrition, Food Studies and Public Health, New York University, New York, New York, USA. J.M. Nicholson is with the Department of Medical Library, New York University School of Medicine, New York, New York, USA. E.V. Bandera is with the Rutgers School of Public Health, Rutgers-The State University of New Jersey, and the Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA. N.M. McKeown is with the Jean Mayer USDA Human Nutrition Research Center on Aging and Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA. N. Parekh is with the College of Global Public Health, Department of Nutrition, Food Studies and Public Health, and Department of Population Health, New York University, New York, New York, USA
| | - Niyati Parekh
- N. Makarem is with the Department of Nutrition, Food Studies and Public Health, New York University, New York, New York, USA. J.M. Nicholson is with the Department of Medical Library, New York University School of Medicine, New York, New York, USA. E.V. Bandera is with the Rutgers School of Public Health, Rutgers-The State University of New Jersey, and the Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA. N.M. McKeown is with the Jean Mayer USDA Human Nutrition Research Center on Aging and Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA. N. Parekh is with the College of Global Public Health, Department of Nutrition, Food Studies and Public Health, and Department of Population Health, New York University, New York, New York, USA
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Tajaddini A, Pourzand A, Sanaat Z, Pirouzpanah S. Dietary resistant starch contained foods and breast cancer risk: a case-control study in northwest of Iran. Asian Pac J Cancer Prev 2016; 16:4185-92. [PMID: 26028070 DOI: 10.7314/apjcp.2015.16.10.4185] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A protective effect of resistant starch (RS) containing foods on carcinogenesis has been shown from several lines of experimental evidence for gastrointestinal cancers. Therefore, we aimed to investigate the association between RS contained foods and breast cancer (BC) risk in a hospital-based, age- and origin- matched, case-control study. MATERIALS AND METHODS A validated, semi-quantitative, food frequency questionnaire (FFQ) was completed by 306 women newly diagnosed with BC aged 25 to 65 years, and 309 healthy women as matched controls. Odds ratios (ORs) and 95% confidence intervals (95%CI) were estimated using conditional logistic regression models. RESULTS Reduced BC risk was associated with the highest tertile of whole-wheat bread and boiled potato consumption with adjusted ORs at 0.34 (95%CI: 0.19-0.59) and 0.61 (95%CI: 0.37- 0.99), respectively. Among consumers of whole-wheat bread consumers were considered, the protective role of cereals remained relatively apparent at higher intakes level of fiber rich breads at adjusted models (OR=0.53, 95%CI: 0.28-1.01). Moreover, high intake of legumes was found out to be a significant protective dietary factor against risk of BC development with an OR of 0.01 (95%CI: 0.03-0.13). However, consumption of white bread and biscuits was positively related to BC risk. CONCLUSIONS Our results show that certain RS containing foods, in particular whole wheat bread, legumes and boiled potato may reduce BC risk, whereas higher intake of white bread and biscuits may be related to increased BC risk.
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Affiliation(s)
- Aynaz Tajaddini
- Nutrition Research Center, Tabriz University of Medical Sciences, Tabriz, Iran E-mail : ,
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Gong TT, Wang YL, Ma XX. Age at menarche and endometrial cancer risk: a dose-response meta-analysis of prospective studies. Sci Rep 2015; 5:14051. [PMID: 26360785 PMCID: PMC4566123 DOI: 10.1038/srep14051] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Accepted: 08/17/2015] [Indexed: 11/09/2022] Open
Abstract
Evidence between age at menarche and endometrial cancer risk have been controversial. Therefore, we conducted a meta-analysis of prospective studies to analyze the aforementioned association. Relevant studies were identified by searching PubMed and EMBASE databases until the end of June 2015. A random-effects model was used to estimate summary relative risks (RRs) and 95% confidence intervals (CIs) for associations between menarcheal age and endometrial cancer risk. Our meta-analysis included eight prospective studies involving 4553 subjects with endometrial cancer. The summarized RRs of endometrial cancer for menarcheal age were 0.68 (95%CI = 0.58-0.81, I(2) = 41.9%, P = 0.099, n = 8) when comparing women with oldest category of menarcheal age with women with youngest category of menarcheal age. Notably, there was an 4% reduction in risk for per 2 years delay in menarcheal age (summarized RR = 0.96; 95%CI = 0.94-0.98, I(2) = 45.7%, P = 0.101, n = 6). Additionally, significant inverse associations were consistent within all stratified analyses. There was no evidence of publication bias or significant heterogeneity between subgroups detected by meta-regression analyses. Our findings support the hypothesis that late menarcheal age is inversely associated with endometrial cancer risk. Further larger prospective or pooled studies are warranted to fully adjust for potential confounders and distinguish whether the associations differ by histological subtypes of endometrial cancer.
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Affiliation(s)
- Ting-Ting Gong
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yong-Lai Wang
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xiao-Xin Ma
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
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17
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Wu H, Flint AJ, Qi Q, van Dam RM, Sampson LA, Rimm EB, Holmes MD, Willett WC, Hu FB, Sun Q. Association between dietary whole grain intake and risk of mortality: two large prospective studies in US men and women. JAMA Intern Med 2015; 175:373-84. [PMID: 25559238 PMCID: PMC4429593 DOI: 10.1001/jamainternmed.2014.6283] [Citation(s) in RCA: 131] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Higher intake of whole grains has been associated with a lower risk of major chronic diseases, such as type 2 diabetes mellitus and cardiovascular disease (CVD), although limited prospective evidence exists regarding whole grains' association with mortality. OBJECTIVE To examine the association between dietary whole grain consumption and risk of mortality. DESIGN, SETTING, AND PARTICIPANTS We investigated 74 341 women from the Nurses' Health Study (1984-2010) and 43 744 men from the Health Professionals Follow-Up Study (1986-2010), 2 large prospective cohort studies. All patients were free of CVD and cancer at baseline. MAIN OUTCOMES AND MEASURES Hazard ratios (HRs) for total mortality and mortality due to CVD and cancer according to quintiles of whole grain consumption, which was updated every 2 or 4 years by using validated food frequency questionnaires. RESULTS We documented 26 920 deaths during 2 727 006 person-years of follow-up. After multivariate adjustment for potential confounders, including age, smoking, body mass index, physical activity, and modified Alternate Healthy Eating Index score, higher whole grain intake was associated with lower total and CVD mortality but not cancer mortality: the pooled HRs for quintiles 1 through 5, respectively, of whole grain intake were 1 (reference), 0.99 (95% CI, 0.95-1.02), 0.98 (95% CI, 0.95-1.02), 0.97 (95% CI, 0.93-1.01), and 0.91 (95% CI, 0.88-0.95) for total mortality (P fortrend < .001); 1 (reference), 0.94 (95% CI, 0.88-1.01), 0.94 (95% CI, 0.87-1.01), 0.87 (95% CI, 0.80-0.94), and 0.85 (95% CI, 0.78-0.92) for CVD mortality (P fortrend < .001); and 1 (reference), 1.02 (95% CI, 0.96-1.08), 1.05 (95% CI, 0.99-1.12), 1.04 (95% CI, 0.98-1.11), and 0.97 (95% CI, 0.91-1.04) for cancer mortality (P fortrend = .43). We further estimated that every serving (28 g/d) of whole grain consumption was associated with a 5% (95% CI, 2%-7%) lower total morality or a 9% (95% CI, 4%-13%) lower CVD mortality, whereas the same intake level was nonsignificantly associated with lower cancer mortality (HR, 0.98; 95% CI, 0.94-1.02). Similar inverse associations were observed between bran intake and CVD mortality, with a pooled HR of 0.80 (95% CI, 0.73-0.87; P fortrend < .001), whereas germ intake was not associated with CVD mortality after adjustment for bran intake. CONCLUSIONS AND RELEVANCE These data indicate that higher whole grain consumption is associated with lower total and CVD mortality in US men and women, independent of other dietary and lifestyle factors. These results are in line with recommendations that promote increased whole grain consumption to facilitate disease prevention.
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Affiliation(s)
- Hongyu Wu
- Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts
| | - Alan J Flint
- Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts
| | - Qibin Qi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Rob M van Dam
- Saw Swee Hock School of Public Health and Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore4National University Health System, Singapore, Republic of Singapore
| | - Laura A Sampson
- Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts5The Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| | - Eric B Rimm
- Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts5The Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts6Department of Epidemiology, Harvard School of Public Hea
| | - Michelle D Holmes
- The Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts6Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts
| | - Walter C Willett
- Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts5The Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts6Department of Epidemiology, Harvard School of Public Hea
| | - Frank B Hu
- Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts5The Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts6Department of Epidemiology, Harvard School of Public Hea
| | - Qi Sun
- Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts5The Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts
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Dalton SM, Probst YC, Batterham MJ, Tapsell LC. Compilation of an Australian database of manufactured and packaged food products containing wholegrain ingredients. J Food Compost Anal 2014. [DOI: 10.1016/j.jfca.2014.04.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Ragaee S, Seetharaman K, Abdel-Aal ESM. The impact of milling and thermal processing on phenolic compounds in cereal grains. Crit Rev Food Sci Nutr 2014; 54:837-49. [PMID: 24499063 DOI: 10.1080/10408398.2011.610906] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Consumption of wholegrain foods has been recommended for healthy diets. The beneficial health properties of wholegrain products have been associated with the presence of higher amounts of dietary fiber and antioxidants and lower calories as compared to their respective refined ones. Phenolic compounds are mainly attributed to antioxidant properties of wholegrain foods. This review article provides a single comprehensive source that describes effects of milling and thermal processing on phenolic compounds and antioxidant properties in cereals. In general, milling and pearling processes affect the distribution of phenolic, compounds and thus antioxidant properties vary among the milling fractions. Thermal processes such as baking and extrusion could cause negative or positive effects on phenolic compounds and antioxidant properties of the end product subject to grain type and processing conditions. Thus factors that enhance health benefits of wholegrain cereal products have been discussed.
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Affiliation(s)
- Sanaa Ragaee
- a Department of Food Science , Ontario College of Agriculture, University of Guelph , Guelph , Ontario , N1G 2W1 , Canada
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20
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Aarestrup J, Kyrø C, Christensen J, Kristensen M, Würtz AML, Johnsen NF, Overvad K, Tjønneland A, Olsen A. Whole grain, dietary fiber, and incidence of endometrial cancer in a Danish cohort study. Nutr Cancer 2013; 64:1160-8. [PMID: 23163844 DOI: 10.1080/01635581.2012.723786] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Whole grains and dietary fiber might be inversely associated with endometrial cancer risk through their effects on sex hormone metabolism and body fat. We investigated whether a higher intake of whole grains and dietary fiber was associated with a lower incidence of endometrial cancer in the Diet, Cancer and Health cohort of 29,875 women aged 50-64 years at enrollment in 1993-1997. Information on diet and lifestyle was derived from self-administered questionnaires. The incidence rate ratios and 95% confidence intervals were estimated based on a Cox proportional hazards model. Of the 24,418 women included as cohort members, 217 had a diagnosis of endometrial cancer. No clear associations were found between intake of whole grains or dietary fiber and the incidence of endometrial cancer.
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Wholegrain cereals and bread: a duet of the Mediterranean diet for the prevention of chronic diseases. Public Health Nutr 2012; 14:2316-22. [PMID: 22166190 DOI: 10.1017/s1368980011002576] [Citation(s) in RCA: 97] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The promotion of healthy lifestyles is one of the major goals of governments and international agencies all over the world. Wholegrain cereals are rich in nutrients and many phytochemical compounds, with recognised benefits for health, including dietary fibre, a number of phenolic compounds, lignans, vitamins and minerals and other bioactive components. The aim of the present work is to review the fundamental studies that support the consumption of wholegrain cereals and bread to prevent chronic diseases. DESIGN Descriptive review considering human studies. SETTING AND SUBJECTS Subjects included in randomised intervention trials and cohort studies from different countries published up to 2010. RESULTS Several studies show consistently that subjects who ingest three or more portions of foods per day based on wholegrain cereals have a 20-30 % lower risk of CVD than subjects who ingest low quantities of cereals. This level of protection is not observed with the ingestion of refined cereals, these being even higher than with the intake of fruit and vegetables. Likewise, high intake of wholegrain cereals and their products, such as whole-wheat bread, is associated with a 20-30 % reduction in the risk of type 2 diabetes. Finally, protection against the risk of colorectal cancer and polyps, other cancers of the digestive tract, cancers related to hormones and pancreatic cancer has been associated with the regular consumption of wholegrain cereals and derived products. CONCLUSIONS The regular intake of wholegrain cereals can contribute to reduction of risk factors related to non-communicable chronic diseases.
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Je Y, Giovannucci E. Coffee consumption and risk of endometrial cancer: Findings from a large up-to-date meta-analysis. Int J Cancer 2012; 131:1700-10. [DOI: 10.1002/ijc.27408] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2011] [Accepted: 12/09/2011] [Indexed: 12/21/2022]
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23
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Williams PG. Evaluation of the evidence between consumption of refined grains and health outcomes. Nutr Rev 2012; 70:80-99. [DOI: 10.1111/j.1753-4887.2011.00452.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Intake of whole-grain products and risk of prostate cancer among men in the Danish Diet, Cancer and Health cohort study. Cancer Causes Control 2011; 22:1133-9. [DOI: 10.1007/s10552-011-9789-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2011] [Accepted: 05/26/2011] [Indexed: 11/30/2022]
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25
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Intake of whole grains in Scandinavia is associated with healthy lifestyle, socio-economic and dietary factors. Public Health Nutr 2011; 14:1787-95. [DOI: 10.1017/s1368980011000206] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractObjectiveTo identify the dietary, lifestyle and socio-economic factors associated with the intake of whole grains (WG) in Norway, Sweden and Denmark.DesignA cross-sectional study.SettingSubsample of the Scandinavian cohort ‘HELGA’ consisting of three prospective cohorts: The Norwegian Women and Cancer Study; The Northern Sweden Health and Disease Study; and the Danish Diet, Cancer and Health Study.SubjectsA total of 8702 men and women aged 30–65 years. Dietary data are from one 24 h dietary recall and data on socio-economic status and lifestyle factors including anthropometric values are from the baseline collection of data.ResultsVegetables, fruits, dairy products, fish and shellfish, coffee, tea and margarine were directly associated with the intake of WG, whereas red meat, white bread, alcohol and cakes and biscuits were inversely associated. Smoking and BMI were consistently inversely associated with the intake of WG. Furthermore, length of education was directly associated with the intake of WG among women.ConclusionsThe intake of WG was found to be directly associated with healthy diet, lifestyle and socio-economic factors and inversely associated with less healthy factors, suggesting that these factors are important for consideration as potential confounders when studying WG intake and disease associations.
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Uccella S, Mariani A, Wang AH, Vierkant RA, Robien K, Anderson KE, Cerhan JR. Dietary and supplemental intake of one-carbon nutrients and the risk of type I and type II endometrial cancer: a prospective cohort study. Ann Oncol 2011; 22:2129-2136. [PMID: 21324952 DOI: 10.1093/annonc/mdq724] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Type I and II endometrial cancer are biologically and clinically distinct, with type II cancers having a high frequency of p53 mutations and an association with chromosomal instability. This raises the hypothesis that one-carbon nutrients (folate, methionine, and the enzymic cofactors vitamins B2, B6, and B12), which mediate chromosomal stability and DNA methylation, may be protective for type II but not type I endometrial cancer. METHODS Using a prospective cohort of 23 356 postmenopausal women followed 20 years, we estimated the relative risks (RRs) of type I (N = 471) and II (N = 71) endometrial cancers according to intake of one-carbon nutrients, adjusting for confounders. RESULTS No associations were observed between dietary or supplemental intake of any one-carbon nutrient and risk of type I cancer. For type II cancer, positive associations were due to supplemental, rather than dietary, intake of these nutrients: supplemental folate (RR = 1.80 for >228.6 versus 0 μg/day; P trend = 0.027) and vitamins B2 (RR = 1.94 for >1.70 versus 0 mg/day; P trend = 0.011), B6 (RR = 2.08 for >2.00 versus 0 mg/day; P trend = 0.012), and B12 (RR = 2.10 for >3.43 versus 0 μg/day; P trend = 0.0060). CONCLUSION Contrary to our hypothesis, use of supplements containing folate and vitamins B2, B6, and B12 was associated with an increased risk of type II endometrial cancer.
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Affiliation(s)
- S Uccella
- Department of Obstetrics and Gynecology, Division of Gynecologic Surgery
| | - A Mariani
- Department of Obstetrics and Gynecology, Division of Gynecologic Surgery
| | - A H Wang
- Department of Health Sciences Research, Division of Biomedical Statistics and Informatics, Mayo Clinic College of Medicine, Rochester
| | - R A Vierkant
- Department of Health Sciences Research, Division of Biomedical Statistics and Informatics, Mayo Clinic College of Medicine, Rochester
| | - K Robien
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis
| | - K E Anderson
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis
| | - J R Cerhan
- Department of Health Sciences Research, Division of Epidemiology, Mayo Clinic College of Medicine, Rochester, USA.
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Landberg R, Andersson SO, Zhang JX, Johansson JE, Stenman UH, Adlercreutz H, Kamal-Eldin A, Aman P, Hallmans G. Rye whole grain and bran intake compared with refined wheat decreases urinary C-peptide, plasma insulin, and prostate specific antigen in men with prostate cancer. J Nutr 2010; 140:2180-6. [PMID: 20980650 DOI: 10.3945/jn.110.127688] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Rye whole grain and bran intake has shown beneficial effects on prostate cancer progression in animal models, including lower tumor take rates, smaller tumor volumes, and reduced prostate specific antigen (PSA) concentrations. A human pilot study showed increased apoptosis after consumption of rye bran bread. In this study, we investigated the effect of high intake of rye whole grain and bran on prostate cancer progression as assessed by PSA concentration in men diagnosed with prostate cancer. Seventeen participants were provided with 485 g rye whole grain and bran products (RP) or refined wheat products with added cellulose (WP), corresponding to ~50% of daily energy intake, in a randomized controlled, crossover design. Blood samples were taken from fasting men before and after 2, 4, and 6 wk of treatment and 24-h urine samples were collected before the first intervention period and after treatment. Plasma total PSA concentrations were lower after treatment with RP compared with WP, with a mean treatment effect of -14% (P = 0.04). Additionally, fasting plasma insulin and 24-h urinary C-peptide excretion were lower after treatment with RP compared with WP (P < 0.01 and P = 0.01, respectively). Daily excretion of 5 lignans was higher after the RP treatment than after the WP treatment (P < 0.001). We conclude that whole grain and bran from rye resulted in significantly lower plasma PSA compared with a cellulose-supplemented refined wheat diet in patients with prostate cancer. The effect may be related to inhibition of prostate cancer progression caused by decreased exposure to insulin, as indicated by plasma insulin and urinary C-peptide excretion.
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Affiliation(s)
- Rikard Landberg
- Department of Food Science, Swedish University of Agriculture Science, Uppsala, Sweden.
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Abstract
A whole grain consists of the intact, ground, cracked, or flaked caryopsis, whose principal anatomical components--the starchy endosperm, germ, and bran--are present in the same relative proportions as they exist in the intact caryopsis. Whole grain food products can be intact, consisting of the original composition of bran, germ, and endosperm, throughout the entire lifetime of the product, or reconstituted, in which one or more of the original components of a whole grain is recombined to the relative proportion naturally occurring in the grain kernel. Increased consumption of whole grains has been associated with reduced risk of major chronic diseases including cardiovascular disease, type II diabetes, and some cancers. Whole grain foods offer a wide range of phytochemicals with health benefits that are only recently becoming recognized. The unique phytochemicals in whole grains are proposed to be responsible for the health benefits of whole grain consumption. In this paper, whole grain phytochemicals and the health benefits associated with their consumption are reviewed.
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Affiliation(s)
- Neal Okarter
- Department of Food Science, Cornell University, Ithaca, NY 14853-7201, USA
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Abstract
A high intake of whole-grain foods may protect against endometrial cancer, but the existing literature is both limited and inconsistent. A significant reason for the inconsistent evidence could be methodological problems regarding accurate assessment of whole-grain intake. Alkylresorcinol (AR) has been suggested as a reliable biomarker of whole-grain wheat and rye intake. Our aim was to overcome the methodological problems in previous questionnaire-based studies, by using AR as exposure measurement when studying the incidence of endometrial cancer. ARs were measured by gas chromatography-mass spectrometry in stored plasma samples from 177 endometrial cancer cases and a subcohort of 152 women, all originating from the same prospective cohort study. Incidence of endometrial cancer according to plasma levels of AR was estimated in a Cox regression model. No associations between plasma levels of AR and endometrial cancer were observed. Body mass index or use of hormone replacement therapy of the participants did not modify the association. This is the first study to associate the whole-grain wheat and rye biomarker AR to a cancer endpoint. No association was found, but more studies are warranted to further explore AR as a marker of whole-grain exposure in relation to cancer and other disease endpoints.
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30
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Seal CJ, Brownlee IA. Whole Grains and Health, Evidence from Observational and Intervention Studies. Cereal Chem 2010. [DOI: 10.1094/cchem-87-2-0167] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Chris J. Seal
- Human Nutrition Research Centre, School of Agriculture, Food & Rural Development, Newcastle University, Newcastle upon Tyne NE1 7RU, UK
- Corresponding author. Phone: +44-191-222-7650. Fax: +4-191-222-6720. E-mail:
| | - Iain A. Brownlee
- Human Nutrition Research Centre, School of Agriculture, Food & Rural Development, Newcastle University, Newcastle upon Tyne NE1 7RU, UK
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Abstract
Epidemiological studies find that whole-grain intake is protective against cancer, CVD, diabetes, and obesity. Despite recommendations to consume three servings of whole grains daily, usual intake in Western countries is only about one serving/d. Whole grains are rich in nutrients and phytochemicals with known health benefits. Whole grains have high concentrations of dietary fibre, resistant starch, and oligosaccharides. Whole grains are rich in antioxidants including trace minerals and phenolic compounds and these compounds have been linked to disease prevention. Other protective compounds in whole grains include phytate, phyto-oestrogens such as lignan, plant stanols and sterols, and vitamins and minerals. Published whole-grain feeding studies report improvements in biomarkers with whole-grain consumption, such as weight loss, blood-lipid improvement, and antioxidant protection. Although it is difficult to separate the protective properties of whole grains from dietary fibre and other components, the disease protection seen from whole grains in prospective epidemiological studies far exceeds the protection from isolated nutrients and phytochemicals in whole grains.
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Affiliation(s)
- Joanne Slavin
- Department of Food Science and Nutrition, University of Minnesota, 1334 Eckles Avenue, St Paul, MN 55108, USA.
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Bravi F, Scotti L, Bosetti C, Zucchetto A, Talamini R, Montella M, Greggi S, Pelucchi C, Negri E, Franceschi S, La Vecchia C. Food groups and endometrial cancer risk: a case-control study from Italy. Am J Obstet Gynecol 2009; 200:293.e1-7. [PMID: 19091304 DOI: 10.1016/j.ajog.2008.09.015] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2008] [Revised: 07/22/2008] [Accepted: 09/11/2008] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Although several studies have been conducted on the relation between dietary habits and endometrial cancer risk, the evidence for specific food groups is still controversial. STUDY DESIGN We analyzed data from an Italian case-control study including 454 women with histologically confirmed endometrial cancer and 908 controls admitted to the same hospitals for acute, nonneoplastic conditions. Multivariate odds ratios (ORs) were obtained after allowance for major potential confounding factors. RESULTS A significant increase in risk was observed for red meat, with an OR of 2.07 for an increment of 1 serving per day. Inverse associations were observed for coffee (OR, 0.83), cereals (OR, 0.92), and vegetables (OR, 0.83). CONCLUSION Our results support the existence of a relation between dietary habits and endometrial cancer risk and in particular suggest that a diet rich in red meat and poor in vegetables may have an unfavorable effect.
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Maras JE, Newby PK, Bakun PJ, Ferrucci L, Tucker KL. Whole grain intake: The Baltimore Longitudinal Study of Aging. J Food Compost Anal 2009; 22:53-58. [PMID: 20126297 DOI: 10.1016/j.jfca.2008.10.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Our objective was to identify major dietary sources of whole grains and to describe the construction of a database of whole grain content of foods. Dietary information was collected with 7-d food records from men and women in the Baltimore Longitudinal Study of Aging, mean age 62.1 +/- 16.0 years, who participated in the dietary assessment portion of the study (n = 1516), and estimates of whole grain intake were obtained from a newly developed database. The Pyramid Servings database and 1994-1996 Continuing Survey of Food Intakes by Individuals (CSFII) recipe ingredients database were then used to calculate both servings and gram weights of whole grain intakes. Mean intakes of whole grains, refined grains, and total grains, as well as frequency of intake for major whole grain food groups and whole grain content for each group, were calculated. Top contributors of whole grains were ready-to-eat breakfast cereals (made with whole grain as well as bran), hot breakfast cereals (made with whole grain), multi-grain bread, and whole wheat bread. While more research is needed to better understand the benefits of whole grains, the development of research tools, including databases to accurately assess whole grain intake, is a critical step in completing such research.
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Affiliation(s)
- Janice E Maras
- Dietary Assessment and Epidemiology Research Program, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, 711 Washington St., Boston, MA 02111, United States
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Yeh M, Moysich KB, Jayaprakash V, Rodabaugh KJ, Graham S, Brasure JR, McCann SE. Higher intakes of vegetables and vegetable-related nutrients are associated with lower endometrial cancer risks. J Nutr 2009; 139:317-22. [PMID: 19074206 DOI: 10.3945/jn.108.099960] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
A limited number of studies have investigated diet in association with endometrial cancer (EC). We examined the association between intakes of selected food groups and nutrients with EC risk among 541 women with histologically confirmed EC and 541 women with an intact uterus and noncancer diagnoses seen at Roswell Park Cancer Institute between 1982 and 1998. Self-reported dietary and other epidemiologic data were collected by questionnaire. Unconditional logistic regression was used to estimate odds ratios (OR) and 95% CI, adjusting for age, BMI, hormone replacement therapy use, cigarette smoking, lifetime duration of menstruation, and total energy intake. We observed significant inverse associations for women in the highest vs. lowest quartiles of intake of total vegetables (OR, 0.51; 95% CI, 0.34-0.75), vitamin E (OR, 0.44; 95% CI, 0.27-0.70), dietary fiber (OR, 0.60; 95% CI, 0.39-0.94), beta-carotene (OR, 0.55; 95% CI, 0.37-0.82), lutein (OR, 0.52; 95% CI, 0.34-0.78), and folate (OR, 0.57; 95% CI, 0.36-0.91). Our results support that vegetables and related nutrients are associated with decreased risk of EC.
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Affiliation(s)
- Michael Yeh
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY 14263, USA
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Shimazu T, Inoue M, Sasazuki S, Iwasaki M, Kurahashi N, Yamaji T, Tsugane S. Coffee consumption and risk of endometrial cancer: A prospective study in Japan. Int J Cancer 2008; 123:2406-10. [DOI: 10.1002/ijc.23760] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Serpen A, Gökmen V, Karagöz A, Köksel H. Phytochemical quantification and total antioxidant capacities of emmer (Triticum dicoccon Schrank) and einkorn (Triticum monococcum L.) wheat landraces. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2008; 56:7285-92. [PMID: 18593174 DOI: 10.1021/jf8010855] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
In this study, samples of 18 ancient wheat (12 emmer, 6 einkorn) and 2 bread wheat varieties grown in different regions of Turkey were examined for their total phenolics and flavonoids, phenolic acids, lutein, total yellow pigment, and total radical scavenging capacities against ABTS cation. Results showed that health beneficial phytochemicals and total antioxidant capacities were generally significantly different in emmer and einkorn wheat groups. Remarkably higher total antioxidant activity (18.31 +/- 1.31 micromol Trolox equiv/g), total phenolics (6.33 +/- 0.98 micromol gallic acid equiv/g), ferulic acid (662.95 +/- 61.07 microg/g), and flavonoids (1.61 +/- 0.34 micromol catechin equiv/g) content were detected in emmer wheat samples (n = 12), suggesting that they may have high potential for utilization as a novel grain, rich in natural antioxidants. In addition, quite high levels of lutein (7.33 +/- 2.43 microg/g) of einkorn samples (n = 6) hold the potential of developing high-lutein bakery products to considerably raise the dietary intake of carotenoids. These findings for ancient wheat varieties are considered to be very useful in breeding programs for selecting and breeding wheat varieties for higher concentration and better composition of health-beneficial phytochemicals.
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Affiliation(s)
- Arda Serpen
- Department of Food Engineering, Hacettepe University, 06800 Beytepe, Ankara, Turkey
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Key TJ, Spencer EA. Carbohydrates and cancer: an overview of the epidemiological evidence. Eur J Clin Nutr 2008; 61 Suppl 1:S112-21. [PMID: 17992182 DOI: 10.1038/sj.ejcn.1602941] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To assess the epidemiological evidence on dietary carbohydrates and the risk of developing cancer. METHOD Review of published studies, concentrating on recent systematic reviews, meta-analyses and large prospective studies. CONCLUSIONS Carbohydrates have not been intensively investigated in epidemiological studies of diet and cancer. There is a moderately large amount of data on the possible association between dietary fibre and the risk for colorectal cancer; the results of studies have varied and no firm conclusion can be drawn, but the available data suggest that high intakes of dietary fibre possibly reduce the risk for colorectal cancer. There are also limited data which suggest that high intakes of sucrose might increase the risk for colorectal cancer and that high intakes of lactose might increase the risk for ovarian cancer. For other components of carbohydrates and other types of cancer, the available data are too sparse to draw even tentative conclusions. Further research is needed on the possible associations of carbohydrates with cancer risk.
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Affiliation(s)
- T J Key
- Cancer Research UK Epidemiology Unit, University of Oxford, Oxford, UK.
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Cust AE, Slimani N, Kaaks R, van Bakel M, Biessy C, Ferrari P, Laville M, Tjønneland A, Olsen A, Overvad K, Lajous M, Clavel-Chapelon F, Boutron-Ruault MC, Linseisen J, Rohrmann S, Nöthlings U, Boeing H, Palli D, Sieri S, Panico S, Tumino R, Sacerdote C, Skeie G, Engeset D, Gram IT, Quirós JR, Jakszyn P, Sánchez MJ, Larrañaga N, Navarro C, Ardanaz E, Wirfält E, Berglund G, Lundin E, Hallmans G, Bueno-de-Mesquita HB, Du H, Peeters PHM, Bingham S, Khaw KT, Allen NE, Key TJ, Jenab M, Riboli E. Dietary carbohydrates, glycemic index, glycemic load, and endometrial cancer risk within the European Prospective Investigation into Cancer and Nutrition cohort. Am J Epidemiol 2007; 166:912-23. [PMID: 17670911 DOI: 10.1093/aje/kwm161] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
The associations of dietary total carbohydrates, overall glycemic index, total dietary glycemic load, total sugars, total starch, and total fiber with endometrial cancer risk were analyzed among 288,428 women in the European Prospective Investigation into Cancer and Nutrition cohort (1992-2004), including 710 incident cases diagnosed during a mean 6.4 years of follow-up. Cox proportional hazards models were used to estimate relative risks and 95% confidence intervals. There were no statistically significant associations with endometrial cancer risk for increasing quartile intakes of any of the exposure variables. However, in continuous models calibrated by using 24-hour recall values, the multivariable relative risks were 1.61 (95% confidence interval: 1.06, 2.45) per 100 g/day of total carbohydrates, 1.40 (95% confidence interval: 0.99, 1.99) per 50 units/day of total dietary glycemic load, and 1.36 (95% confidence interval: 1.05, 1.76) per 50 g/day of total sugars. These associations were stronger among women who had never used postmenopausal hormone therapy compared with ever users (total carbohydrates p(heterogeneity) = 0.04). Data suggest no association of overall glycemic index, total starch, and total fiber with risk, and a possible modest positive association of total carbohydrates, total dietary glycemic load, and total sugars with risk, particularly among never users of hormone replacement therapy.
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Affiliation(s)
- Anne E Cust
- Nutrition and Hormones Unit, International Agency for Research on Cancer, Lyon, France.
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Zhou K, Hao J, Griffey C, Chung H, O'Keefe SF, Chen J, Hogan S. Antioxidant properties of Fusarium head blight-resistant and -susceptible soft red winter wheat grains grown in Virginia. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2007; 55:3729-36. [PMID: 17411070 DOI: 10.1021/jf070147a] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Fusarium head blight (FHB) has emerged as a major threat to wheat crops around the world, and it has been hypothesized that wheat antioxidants may play a role against Fusarium infections. The current study aimed to determine antioxidant properties of FHB-resistant wheat grains as compared to susceptible wheat. The wheat samples were collected from a single growing location (Warsaw, VA) and the same growing season. The results showed that both FHB-resistant and -susceptible wheat grains exerted strong radical scavenging activities against DPPH* radical [0.91-1.53 micromol of Trolox equivalents (TE)/g], peroxyl radical (15.5-24.5 micromol of TE/g), and hydroxyl radical (15.7-35.8 micromol of TE/g). Their total phenolic contents ranged from 888 to 1117 microg of gallic acid equivalents (GAE)/g. Five phenolic acids including ferulic, syringic, vanillic, caffeic, and p-coumaric acids were determined in soluble and insoluble fractions of wheat grains, altogether with a range of 219-389 microg/g. On average, the FHB-resistant wheat group showed significantly higher average values in DPPH* and hydroxyl radicals scavenging activities (30 and 41% higher, respectively) than the FHB-susceptible wheat group.
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Affiliation(s)
- Kequan Zhou
- Department of Food Science and Technology, Virginia Polytechnic Institute and State University, Blacksburg, Virginia 24061, USA.
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Rondini L, Peyrat-Maillard MN, Marsset-Baglieri A, Fromentin G, Durand P, Tomé D, Prost M, Berset C. Bound ferulic acid from bran is more bioavailable than the free compound in rat. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2004; 52:4338-4343. [PMID: 15212489 DOI: 10.1021/jf0348323] [Citation(s) in RCA: 124] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Ferulic acid (FA) is reported as a good antioxidant absorbed by human or rat but only few data deal with the influence of the food matrix on its bioavailability and with its potential protection against cardiovascular diseases and cancer. Wheat bran is used as a source of ferulic acid, the compound being mainly bound to arabinoxylans of the plant cell walls. Pharmacokinetic profiles of FA and its metabolites are established in rats. Free and conjugated FA quickly appear in plasma, reach a plateau 1 h after intake and remain approximately constant at 1 microM up to 24 h. 2.3% of FA are eliminated in urine. Compared with results obtained after intake of free FA, the presence of FA-arabinoxylans bonds in the food matrix increases the occurrence time of FA in the organism and decreases the level of urinary excretion in 24 h. Nevertheless, sulfated FA is still the main plasmatic form. The antioxidant activity of plasmas of rats fed with a standard diet (containing no FA), pure ferulic acid (5.15 mg FA/kg bw) or bran (4.04 mg FA/kg bw) are measured in an ex vivo test using AAPH as free radical inducer. Plasmas of rats fed with bran show a better antioxidant activity than the control group and the pure FA supplemented group, increasing the resistance of erythrocytes to hemolysis by factors of 2 and 1.5, respectively. These results show the good bioavailability of FA from bran and its potential efficiency to protect organism against pathology involving radical steps of development.
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Affiliation(s)
- Ludovic Rondini
- Département Science de l'Aliment, Laboratoire de Chimie des Substances Naturelles: Antioxydants, Arômes, Colorants, 1 avenue des Olympiades, 91744 Massy Cedex, France
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Augustin LSA, Gallus S, Bosetti C, Levi F, Negri E, Franceschi S, Dal Maso L, Jenkins DJA, Kendall CWC, La Vecchia C. Glycemic index and glycemic load in endometrial cancer. Int J Cancer 2003; 105:404-7. [PMID: 12704677 DOI: 10.1002/ijc.11089] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Glycemic index (GI) and glycemic load (GL) are measures of the metabolic effects of dietary carbohydrates. The higher their value, the greater the glucose and insulin responses. Raised insulin levels are associated with endometrial cancer and with its risk factors including obesity, diabetes and hypertension. To study the role of the GI and GL we analyzed the data of two hospital-based case-control studies on endometrial cancer conducted between 1988-98 in Italy and Switzerland, including a total of 410 women with incident, histologically confirmed endometrial cancer and 753 controls admitted for acute, non-neoplastic diseases. A food frequency questionnaire was used to assess the subjects usual diet and to derive estimates of dietary GI and GL. The odds ratios (OR) of endometrial cancer, after adjustment for major risk factors, for the highest versus the lowest quintile of dietary GI and GL were 2.1 (95% confidence interval [CI] = 1.4-3.2) and 2.7 (95% CI = 1.8-4.2), respectively. The associations were stronger in older women, in those with higher body mass index and in hormone replacement therapy users. Our study supports the hypothesis of a direct association between GI and endometrial cancer risk.
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Affiliation(s)
- Livia S A Augustin
- Servizio di Epidemiologia, Centro di Riferimento Oncologico, Pordenone, Italy
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