title: Effects of whole grains on coronary heart disease risk.
abstract: Characterizing which types of carbohydrates, including whole grains, reduce the risk for coronary heart disease (CHD) is challenging. Whole grains are characterized as being high in resistant carbohydrates as compared with refined grains, meaning they typically are high in fiber, nutrients, and bound antioxidants. Whole grain intake consistently has been associated with improved cardiovascular disease outcomes, but also with healthy lifestyles, in large observational studies. Intervention studies that assess the effects of whole grains on biomarkers for CHD have mixed results. Due to the varying nutrient compositions of different whole grains, each could potentially affect CHD risk via different mechanisms. Whole grains high in viscous fiber (oats, barley) decrease serum low-density lipoprotein cholesterol and blood pressure and improve glucose and insulin responses. Grains high in insoluble fiber (wheat) moderately lower glucose and blood pressure but also have a prebiotic effect. Obesity is inversely related to whole grain intake, but intervention studies with whole grains have not produced weight loss. Visceral fat, however, may be affected favorably. Grain processing improves palatability and can have varying effects on nutrition (e.g., the process of milling and grinding flour increases glucose availability and decreases phytochemical content whereas thermal processing increases available antioxidants). Understanding how individual grains, in both natural and processed states, affect CHD risk can inform nutrition recommendations and policies and ultimately benefit public health.
authors.affiliation: Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA 16802, USA.
authors.forename: Kristina A
authors.initials: KA
authors.lastname: Harris
authors.forename: Penny M
authors.initials: PM
authors.lastname: Kris-Etherton
mesh_terms: D002784:Cholesterol / Q000097:blood; D003327:Coronary Disease / Q000178:diet therapy*; D004040:Dietary Carbohydrates / Q000008:administration & dosage*; D004043:Dietary Fiber / Q000008:administration & dosage*; D002523:Edible Grain; D006801:Humans; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D004040:Dietary Carbohydrates; D004043:Dietary Fiber; D002784:Cholesterol
references.citation: Br J Nutr. 2007 Aug;98(2):397-405
references.pmid: 17391554
references.citation: Am J Clin Nutr. 2010 Jun;91(6):1764-8
references.pmid: 20375186
references.citation: Eur J Clin Nutr. 2009 Feb;63(2):229-37
references.pmid: 17882134
references.citation: Am J Clin Nutr. 2003 Nov;78(5):957-64
references.pmid: 14594782
references.citation: J Am Coll Nutr. 2001 Feb;20(1):50-7
references.pmid: 11293468
references.citation: Curr Atheroscler Rep. 2004 Nov;6(6):415-23
references.pmid: 15485586
references.citation: Am J Clin Nutr. 2007 Dec;86(6):1745-53
references.pmid: 18065595
references.citation: Appl Physiol Nutr Metab. 2010 Feb;35(1):9-16
references.pmid: 20130660
references.citation: J Am Diet Assoc. 2006 Sep;106(9):1445-9
references.pmid: 16963350
references.citation: Am J Clin Nutr. 2010 Mar;91(3):535-46
references.pmid: 20071648
references.citation: Br J Nutr. 2009 Feb;101(3):391-8
references.pmid: 18570696
references.citation: J Nutr. 2009 Oct;139(10):1950-5
references.pmid: 19726588
references.citation: Nature. 2006 Dec 21;444(7122):1027-31
references.pmid: 17183312
references.citation: J Am Coll Nutr. 2004 Feb;23(1):55-62
references.pmid: 14963054
references.citation: J Am Diet Assoc. 2010 Feb;110(2):205-14
references.pmid: 20102847
references.citation: PLoS Med. 2007 Aug;4(8):e261
references.pmid: 17760498
references.citation: Am J Clin Nutr. 2004 Dec;80(6):1492-9
references.pmid: 15585760
references.citation: J Am Coll Nutr. 2000 Jun;19(3 Suppl):320S-325S
references.pmid: 10875604
references.citation: Eur J Clin Nutr. 2007 Dec;61 Suppl 1:S19-39
references.pmid: 17992185
references.citation: Am J Clin Nutr. 2007 Aug;86(2):472-9
references.pmid: 17684221
references.citation: Am J Clin Nutr. 2010 Feb;91(2):329-36
references.pmid: 20016015
references.citation: Cochrane Database Syst Rev. 2007 Apr 18;(2):CD005051
references.pmid: 17443567
references.citation: J Nutr. 2010 Mar;140(3):587-94
references.pmid: 20089789
references.citation: J Am Coll Nutr. 1999 Dec;18(6):591-7
references.pmid: 10613410
references.citation: J Agric Food Chem. 2002 Aug 14;50(17):4959-64
references.pmid: 12166989
references.citation: Nature. 2006 Dec 21;444(7122):1022-3
references.pmid: 17183309
references.citation: J Am Coll Nutr. 2000 Jun;19(3 Suppl):291S-299S
references.pmid: 10875600
references.citation: Curr Opin Lipidol. 2002 Feb;13(1):61-7
references.pmid: 11790964
references.citation: J Am Coll Nutr. 2008 Feb;27(1):80-7
references.pmid: 18460485
references.citation: J Am Diet Assoc. 2008 Nov;108(11):1881-7
references.pmid: 18954578
references.citation: Am J Clin Nutr. 2009 Sep;90(3):493-8
references.pmid: 19571218
references.citation: Am J Clin Nutr. 2002 May;75(5):848-55
references.pmid: 11976158
references.citation: J Agric Food Chem. 2002 Oct 9;50(21):6182-7
references.pmid: 12358499
references.citation: Crit Rev Food Sci Nutr. 2010 Mar;50(3):193-208
references.pmid: 20301011
references.citation: Plant Foods Hum Nutr. 2008 Mar;63(1):21-5
references.pmid: 18074229
references.citation: N Engl J Med. 1997 Apr 17;336(16):1117-24
references.pmid: 9099655
references.citation: Curr Gastroenterol Rep. 2009 Aug;11(4):307-13
references.pmid: 19615307
references.citation: Am J Public Health. 2000 Sep;90(9):1409-15
references.pmid: 10983198
references.citation: Diabetes Care. 2007 Jun;30(6):1412-7
references.pmid: 17384339
references.citation: Am J Clin Nutr. 2002 Aug;76(2):390-8
references.pmid: 12145012
references.citation: J Agric Food Chem. 2005 Mar 23;53(6):2297-306
references.pmid: 15769171
references.citation: Am J Clin Nutr. 1988 Mar;47(3):428-32
references.pmid: 3279746
references.citation: J Fam Pract. 2002 Apr;51(4):353-9
references.pmid: 11978259
references.citation: Am J Clin Nutr. 2006 Jan;83(1):124-31
references.pmid: 16400060
references.citation: J Nutr. 1995 Jun;125(6):1401-12
references.pmid: 7782892
references.citation: Eur J Clin Nutr. 2007 Dec;61 Suppl 1:S40-74
references.pmid: 17992186
references.citation: J Fam Pract. 2002 Apr;51(4):369
references.pmid: 11978262
references.citation: Am J Clin Nutr. 1991 Nov;54(5):846-54
references.pmid: 1951155
references.citation: Eur J Nutr. 2005 Mar;44(3):163-73
references.pmid: 15309429
references.citation: Am J Clin Nutr. 2004 Nov;80(5):1237-45
references.pmid: 15531671
references.citation: Am J Clin Nutr. 2002 Sep;76(3):535-40
references.pmid: 12197996
references.citation: Gastroenterology. 2010 Jan;138(1):65-72.e1-2
references.pmid: 19931537
references.citation: World J Gastroenterol. 2009 Jan 7;15(1):81-5
references.pmid: 19115471
references.citation: Am J Clin Nutr. 1999 Sep;70(3):412-9
references.pmid: 10479204
references.citation: Eur J Clin Nutr. 2009 Jan;63(1):31-8
references.pmid: 17895913
references.citation: Crit Rev Biotechnol. 2001;21(1):49-66
references.pmid: 11307845
references.citation: Diabetes Care. 2006 Feb;29(2):207-11
references.pmid: 16443861
references.citation: Diabetes. 1997 Jan;46(1):57-62
references.pmid: 8971082
references.citation: Am J Clin Nutr. 1998 Aug;68(2):248-57
references.pmid: 9701180
references.citation: Am J Clin Nutr. 2009 Nov;90(5):1160-6
references.pmid: 19793854
references.citation: Am J Clin Nutr. 2003 Sep;78(3):383-90
references.pmid: 12936919
references.citation: BMJ. 1988 Oct 15;297(6654):958-60
references.pmid: 3142566
references.citation: Eur J Nutr. 2008 Sep;47(6):294-300
references.pmid: 18633670
references.citation: Br J Nutr. 2010 Jul;104(1):125-34
references.pmid: 20307353
references.citation: Br J Nutr. 2010 Jan;103(1):82-90
references.pmid: 19664300
references.citation: J Nutr. 2007 Jun;137(6):1401-7
references.pmid: 17513398
references.citation: Am J Clin Nutr. 2008 Jan;87(1):79-90
references.pmid: 18175740