Whole-grain intake and the risk of type 2 diabetes: a prospective study in men.
BACKGROUND
Certain dietary components may play a role in the prevention of type 2 diabetes.


OBJECTIVE
We examined prospectively the associations between whole- and refined-grain intake and the risk of type 2 diabetes in a large cohort of men.


METHODS
Men from the Health Professionals Follow-up Study without a history of diabetes or cardiovascular disease in 1986 (n = 42898) were followed for </=12 y. Intakes of whole and refined grains, measured every 4 y by use of food-frequency questionnaires, were used to predict subsequent type 2 diabetes risk through multivariate analysis.


RESULTS
We ascertained 1197 cases of incident type 2 diabetes. After adjustment for age; physical activity; cigarette smoking; alcohol consumption; family history of diabetes; and fruit, vegetable, and energy intakes, the relative risk of type 2 diabetes was 0.58 (95% CI: 0.47, 0.70; P for trend < 0.0001) comparing the highest with the lowest quintile of whole-grain intake. The association was moderately attenuated when additionally adjusted for body mass index (relative risk: 0.70; 95% CI: 0.57, 0.85; P for trend = 0.0006). Intake of refined grains was not significantly associated with risk of type 2 diabetes. After further adjustment for magnesium intake, cereal fiber intake, and glycemic load, the association between whole grains and type 2 diabetes was attenuated and the trend no longer significant.


CONCLUSIONS
In men, a diet high in whole grains is associated with a reduced risk of type 2 diabetes in men that may be mediated by cereal fiber. Efforts should be made to replace refined-grain with whole-grain foods.
Fung
Teresa T
TT
Programs in Nutrition, Simmons College, Boston, MA 02115, USA. fung@simmons.edu
Hu
Frank B
FB
Pereira
Mark A
MA
Liu
Simin
S
Stampfer
Meir J
MJ
Colditz
Graham A
GA
Willett
Walter C
WC
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001786:Blood Glucose / Q000378:metabolism; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000517:prevention & control; D004032:Diet; D004043:Dietary Fiber / Q000008:administration & dosage; D002523:Edible Grain; D006801:Humans; D008274:Magnesium / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012306:Risk; D012307:Risk Factors
D001786:Blood Glucose; D004043:Dietary Fiber; D008274:Magnesium