title: A Whole-Grain Diet Reduces Cardiovascular Risk Factors in Overweight and Obese Adults: A Randomized Controlled Trial.
abstract: BACKGROUND
  Increased dietary whole-grain intake may protect against cardiovascular disease (CVD).
  
  
  OBJECTIVE
  The objective was to evaluate the efficacy of whole grains compared with refined grains on body composition, hypertension, and related mediators of CVD in overweight and obese adults.
  
  
  METHODS
  We conducted a double-blind, randomized, controlled crossover trial in 40 overweight or obese men and women aged <50 y with no known history of CVD. Complete whole-grain and refined-grain diets were provided for two 8-wk periods, with a 10-wk washout between diets. Macronutrient composition was matched, except for the inclusion of either whole grains or refined grains (50 g/1000 kcal in each diet). Measurements included blood pressure, body composition, blood lipids and adiponectin, and markers of inflammation and glycemia.
  
  
  RESULTS
  Thirty-three participants (6 men and 27 women) completed the trial [mean ± SD age: 39 ± 7 y; mean ± SD body mass index (in kg/m2): 33.1 ± 4.3]. Decreases in diastolic blood pressure were -5.8 mm Hg (95% CI: -7.7, -4.0 mm Hg) after the whole-grain diet and -1.6 mm Hg (95% CI: -4.4, 1.3 mm Hg) after the control diet (between effect, P = 0.01). Decreases in plasma adiponectin were -0.1 (95% CI: -0.9, 0.7) after the whole-grain diet and -1.4 (95% CI: -2.6, -0.3) after the control diet (between effect, P = 0.05). Decreases in diastolic blood pressure correlated with the circulating adiponectin concentration (r = 0.35, P = 0.04). Substantial reductions in body weight, fat loss, systolic blood pressure, total cholesterol, and LDL cholesterol were observed during both diet periods, with no relevant difference between them.
  
  
  CONCLUSIONS
  The improvement in diastolic blood pressure was >3-fold greater in overweight and obese adults when they consumed a whole-grain compared with a refined-grain diet. Because diastolic blood pressure predicts mortality in adults aged <50 y, increased whole-grain intake may provide a functional approach to control hypertension. This may benefit patients at risk of vascular-related morbidity and mortality. This trial was registered at clinicaltrials.gov as NCT01411540.
authors: Department of Pathobiology, Lerner Research Institute, kirwanj@ccf.org.|Department of Gastroenterology and Hepatology, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH.
authors: John P
authors: http://orcid.org/0000-0001-7321-9917
authors: JP
authors: Kirwan
authors: Department of Pathobiology, Lerner Research Institute.
authors: Steven K
authors: SK
authors: Malin
authors: Department of Pathobiology, Lerner Research Institute.
authors: Amanda R
authors: AR
authors: Scelsi
authors: Department of Pathobiology, Lerner Research Institute.
authors: Emily L
authors: EL
authors: Kullman
authors: Department of Nephrology and Hypertension, Glickman Urological and Kidney Institute, and.
authors: Sankar D
authors: SD
authors: Navaneethan
authors: Department of Gastroenterology and Hepatology, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH.
authors: Mangesh R
authors: MR
authors: Pagadala
authors: Department of Pathobiology, Lerner Research Institute.
authors: Jacob M
authors: JM
authors: Haus
authors: Department of Pathobiology, Lerner Research Institute.
authors: Julianne
authors: J
authors: Filion
authors: Analytical Sciences Department, Nestlé Research Center, Lausanne, Switzerland; and.
authors: Jean-Philippe
authors: JP
authors: Godin
authors: Analytical Sciences Department, Nestlé Research Center, Lausanne, Switzerland; and.
authors: Sunil
authors: S
authors: Kochhar
authors: Analytical Sciences Department, Nestlé Research Center, Lausanne, Switzerland; and.|Division of Food and Nutrition Science, Department of Biology and Biological Engineering, Chalmers University of Technology, Gothenberg, Sweden.
authors: Alastair B
authors: AB
authors: Ross
mesh_terms: D000328:Adult; D001786:Blood Glucose; D001794:Blood Pressure; D001823:Body Composition; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D004032:Diet; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D050177:Overweight; D012307:Risk Factors; D000067348:Whole Grains
chemical_list: D001786:Blood Glucose; D008055:Lipids
keywords: blood pressure; cardiovascular disease; diet; obesity; whole grain