title: Fiber from whole grains, but not refined grains, is inversely associated with all-cause mortality in older women: the Iowa women's health study.
abstract: BACKGROUND
  Inconsistencies in epidemiologic findings relating grain fiber to chronic disease may be explained by differentiating nutrient-rich fiber derived from whole grain vs. nutrient-poor fiber derived from refined grain.
  
  
  OBJECTIVE
  Given that phytochemicals are most varied and abundant in the outer layers of grains, we tested the hypothesis that whole grain fiber consumption is associated with a reduced mortality risk in comparison to a similar amount of refined grain fiber.
  
  
  METHODS
  11,040 postmenopausal women enrolled in the Iowa Women's Health Study, matched on total grain fiber intake, but differing in the proportion of fiber consumed from whole vs. refined grain, were followed from baseline in 1986 through 31 December, 1997, during which time 1,341 deaths occurred in 124,823 observed woman-years.
  
  
  RESULTS
  After multivariate adjustment in proportional hazards regression, women who consumed on average 1.9 g refined grain fiber/2,000 kcal and 4.7 g whole grain fiber/2,000 kcal had a 17% lower mortality rate (RR=0.83, 95% CI=0.73-0.94) than women who consumed predominantly refined grain fiber: 4.5 g/2,000 kcal, but only 1.3 g whole grain fiber/2,000 kcal.
  
  
  CONCLUSIONS
  Inferences from studies that have reported associations between grain fiber intake and morbidity or mortality may be limited by not differentiating fiber sources. Future studies should distinguish fiber from whole vs. refined grains. Public health policy should differentiate whole grains from refined, and recommend increased consumption of the former.
authors.affiliation: Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis, Minnesota 55454, USA.
authors.forename: D R
authors.initials: DR
authors.lastname: Jacobs
authors.forename: M A
authors.initials: MA
authors.lastname: Pereira
authors.forename: K A
authors.initials: KA
authors.lastname: Meyer
authors.forename: L H
authors.initials: LH
authors.lastname: Kushi
mesh_terms: D000368:Aged; D000375:Aging; D001824:Body Constitution; D015331:Cohort Studies; D004032:Diet; D004043:Dietary Fiber / Q000008:administration & dosage* / Q000032:analysis; D002523:Edible Grain; D004522:Educational Status; D015914:Estrogen Replacement Therapy; D015444:Exercise; D005260:Female; D005511:Food Handling; D006801:Humans; D007484:Iowa; D008019:Life Style; D008875:Middle Aged; D009026:Mortality; D017698:Postmenopause; D011446:Prospective Studies; D016387:Women's Health