title: Is intake of breakfast cereals related to total and cause-specific mortality in men?
abstract: BACKGROUND
  Prospective studies suggested that substituting whole-grain products for refined-grain products lowers the risks of type 2 diabetes and cardiovascular disease (CVD) in women. Although breakfast cereals are a major source of whole and refined grains, little is known about their direct association with the risk of premature mortality.
  
  
  OBJECTIVE
  We prospectively evaluated the association between whole- and refined-grain breakfast cereal intakes and total and CVD-specific mortality in a cohort of US men.
  
  
  METHODS
  We examined 86,190 US male physicians aged 40-84 y in 1982 who were free of known CVD and cancer at baseline.
  
  
  RESULTS
  During 5.5 y, we documented 3114 deaths from all causes, including 1381 due to CVD (488 myocardial infarctions and 146 strokes). Whole-grain breakfast cereal intake was inversely associated with total and CVD-specific mortality, independent of age; body mass index; smoking; alcohol intake; physical activity; history of diabetes, hypertension, or high cholesterol; and use of multivitamins. Compared with men who rarely or never consumed whole-grain cereal, men in the highest category of whole-grain cereal intake (> or = 1 serving/d) had multivariate-estimated relative risks of total and CVD-specific mortality of 0.83 (95% CI: 0.73, 0.94; P for trend < 0.001) and 0.80 (0.66, 0.97; P for trend < 0.001), respectively. In contrast, total and refined-grain breakfast cereal intakes were not significantly associated with total and CVD-specific mortality. These findings persisted in analyses stratified by history of type 2 diabetes, hypertension, and high cholesterol.
  
  
  CONCLUSIONS
  Both total mortality and CVD-specific mortality were inversely associated with whole-grain but not refined-grain breakfast cereal intake. These prospective data highlight the importance of distinguishing whole-grain from refined-grain cereals in the prevention of chronic diseases.
authors.affiliation: Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02215, USA. simin.liu@channing.harvard.edu
authors.forename: Simin
authors.initials: S
authors.lastname: Liu
authors.forename: Howard D
authors.initials: HD
authors.lastname: Sesso
authors.forename: JoAnn E
authors.initials: JE
authors.lastname: Manson
authors.forename: Walter C
authors.initials: WC
authors.lastname: Willett
authors.forename: Julie E
authors.initials: JE
authors.lastname: Buring
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000401:mortality*; D002423:Cause of Death; D015331:Cohort Studies; D004043:Dietary Fiber / Q000008:administration & dosage; D004311:Double-Blind Method; D002523:Edible Grain; D005247:Feeding Behavior; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010919:Placebos; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
chemical_list: D004043:Dietary Fiber; D010919:Placebos