title: Breakfast cereals and risk of type 2 diabetes in the Physicians' Health Study I.
abstract: OBJECTIVE
  To examine the association between breakfast cereal consumption and the risk of type 2 diabetes (DM).
  
  
  METHODS
  We analyzed prospectively data from 21,152 male participants of the Physicians' Health Study I. Consumption of breakfast cereals was estimated using an abbreviated food questionnaire, and incident DM was ascertained through yearly follow-up questionnaires.
  
  
  RESULTS
  The average age was 53.6 +/- 9.4 years (range, 39.7 to 85.9) during the initial assessment of cereal intake (1981 to 1983). During a mean follow-up of 19.1 years, 1958 cases of DM occurred. The crude incidence rates of DM were 57.7, 53.8, 43.5, and 35.4 cases/10,000 person-years for people reporting breakfast cereal intake of 0, <or=1, 2 to 6, and >or=7 servings/wk, respectively. In a Cox regression model adjusting for age, cigarette smoking, BMI, physical activity, vegetable consumption, and alcohol intake, hazard ratios (95% confidence interval) for DM were 1.0 (reference), 0.89 (0.79 to 1.00), 0.76 (0.67 to 0.86), and 0.63 (0.55 to 0.72) from the lowest to the highest category of cereal consumption, respectively (p for trend < 0.0001). In secondary analyses, the inverse association between cereal intake and DM was stronger with whole-grain than refined cereals.
  
  
  CONCLUSIONS
  These results suggest that intake of breakfast cereals might confer a lower risk of DM. Consumption of whole-grain products may help lower the risk of DM.
authors.affiliation: Division of Aging, Brigham and Women's Hospital and Harvard Medical School, 1620 Tremont Street, 3rd Floor, Boston MA 02120, USA.
authors.forename: Jinesh
authors.initials: J
authors.lastname: Kochar
authors.forename: Luc
authors.initials: L
authors.lastname: Djoussé
authors.forename: J Michael
authors.initials: JM
authors.lastname: Gaziano
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D002523:Edible Grain / Q000378:metabolism*; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D014481:United States