title: Whole-grain consumption and risk of coronary heart disease: results from the Nurses' Health Study.
abstract: BACKGROUND
  Although current dietary guidelines for Americans recommend increased intake of grain products to prevent coronary heart disease (CHD), epidemiologic data relating whole-grain intake to the risk of CHD are sparse.
  
  
  OBJECTIVE
  Our objective was to evaluate whether high whole-grain intake reduces risk of CHD in women.
  
  
  METHODS
  In 1984, 75521 women aged 38-63 y with no previous history of cardiovascular disease or diabetes completed a detailed, semiquantitative food-frequency questionnaire (SFFQ) and were followed for 10 y, completing SFFQs in 1986 and 1990. We used pooled logistic regression with 2-y intervals to model the incidence of CHD in relation to the cumulative average diet from all 3 cycles of SFFQs.
  
  
  RESULTS
  During 729472 person-years of follow-up, we documented 761 cases of CHD (208 of fatal CHD and 553 of nonfatal myocardial infarction). After adjustment for age and smoking, increased whole-grain intake was associated with decreased risk of CHD. For increasing quintiles of intake, the corresponding relative risks (RRs) were 1.0 (reference), 0.86, 0.82, 0.72, and 0.67 (95% CI comparing 2 extreme quintiles: 0.54, 0.84; P for trend < 0.001). After additional adjustment for body mass index, postmenopausal hormone use, alcohol intake, multivitamin use, vitamin E supplement use, aspirin use, physical activity, and types of fat intake, these RRs were 1.0, 0.92, 0.93, 0.83, and 0.75 (95% CI: 0.59, 0.95; P for trend = 0.01). The inverse relation between whole-grain intake and CHD risk was even stronger in the subgroup of never smokers (RR = 0. 49 for extreme quintiles; 95% CI: 0.30, 0.79; P for trend = 0.003). The lower risk associated with higher whole-grain intake was not fully explained by its contribution to intakes of dietary fiber, folate, vitamin B-6, and vitamin E.
  
  
  CONCLUSIONS
  Increased intake of whole grains may protect against CHD.
authors.affiliation: Division of Preventive Medicine and Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02215, USA. simin.liu@channing.harvard.edu
authors.forename: S
authors.initials: S
authors.lastname: Liu
authors.forename: M J
authors.initials: MJ
authors.lastname: Stampfer
authors.forename: F B
authors.initials: FB
authors.lastname: Hu
authors.forename: E
authors.initials: E
authors.lastname: Giovannucci
authors.forename: E
authors.initials: E
authors.lastname: Rimm
authors.forename: J E
authors.initials: JE
authors.lastname: Manson
authors.forename: C H
authors.initials: CH
authors.lastname: Hennekens
authors.forename: W C
authors.initials: WC
authors.lastname: Willett
mesh_terms: D000328:Adult; D003327:Coronary Disease / Q000517:prevention & control*; D004032:Diet; D004043:Dietary Fiber / Q000494:pharmacology; D002523:Edible Grain; D005260:Female; D005492:Folic Acid / Q000494:pharmacology; D006306:Health Surveys; D006801:Humans; D008875:Middle Aged; D009726:Nurses; D011446:Prospective Studies; D011736:Pyridoxine / Q000494:pharmacology; D012307:Risk Factors; D014810:Vitamin E / Q000494:pharmacology
chemical_list: D004043:Dietary Fiber; D014810:Vitamin E; D005492:Folic Acid; D011736:Pyridoxine