Associations of cereal grains intake with cardiovascular disease and mortality across 21 countries in Prospective Urban and Rural Epidemiology study: prospective cohort study

AbstractObjectiveTo evaluate the association between intakes of refined grains, whole grains, and white rice with cardiovascular disease, total mortality, blood lipids, and blood pressure in the Prospective Urban and Rural Epidemiology (PURE) study.DesignProspective cohort study.SettingPURE study in...

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Veröffentlicht in:BMJ (Online) Jg. 372; S. m4948
Hauptverfasser: Swaminathan, Sumathi, Dehghan, Mahshid, Raj, John Michael, Thomas, Tinku, Rangarajan, Sumathy, Jenkins, David, Mony, Prem, Mohan, Viswanathan, Lear, Scott A, Avezum, Alvaro, Lopez-Jaramillo, Patricio, Rosengren, Annika, Lanas, Fernando, AlHabib, Khalid F, Dans, Antonio, Keskinler, Mirac Vural, Puoane, Thandi, Soman, Biju, Wei, Li, Zatonska, Katarzyna, Diaz, Rafael, Ismail, Noorhassim, Chifamba, Jephat, Kelishadi, Roya, Yusufali, Afzalhussein, Khatib, Rasha, Xiaoyun, Liu, Bo, Hu, Iqbal, Romaina, Yusuf, Rita, Yeates, Karen, Teo, Koon, Yusuf, Salim
Format: Journal Article
Sprache:Englisch
Veröffentlicht: England BMJ Publishing Group LTD 03.02.2021
BMJ Publishing Group Ltd
Schlagworte:
Adult
Aged
Bakeries
Barley
Blood pressure
Carbohydrates
Cardiovascular disease
Cardiovascular diseases
Cardiovascular Diseases - mortality
Cerebral infarction
Cohort analysis
Congestive heart failure
Diabetes
Diet
Diet Surveys
Dietary Carbohydrates - adverse effects
Energy Intake
Epidemiology
Feeding Behavior
Female
Flour
Food
Global Health
Grain
Humans
Lipids
Longitudinal Studies
Low income groups
Male
Middle Aged
Mortality
Myocardial infarction
Oryza - adverse effects
Proportional Hazards Models
Prospective Studies
Questionnaires
Rice
Risk Factors
Whole Grains
Canada
Argentina
Europe
Africa
Brazil
North America
South Asia
ISSN:1756-1833, 0959-8138, 1756-1833
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Zusammenfassung:AbstractObjectiveTo evaluate the association between intakes of refined grains, whole grains, and white rice with cardiovascular disease, total mortality, blood lipids, and blood pressure in the Prospective Urban and Rural Epidemiology (PURE) study.DesignProspective cohort study.SettingPURE study in 21 countries.Participants148 858 participants with median follow-up of 9.5 years.ExposuresCountry specific validated food frequency questionnaires were used to assess intakes of refined grains, whole grains, and white rice.Main outcome measureComposite of mortality or major cardiovascular events (defined as death from cardiovascular causes, non-fatal myocardial infarction, stroke, or heart failure). Hazard ratios were estimated for associations of grain intakes with mortality, major cardiovascular events, and their composite by using multivariable Cox frailty models with random intercepts to account for clustering by centre.ResultsAnalyses were based on 137 130 participants after exclusion of those with baseline cardiovascular disease. During follow-up, 9.2% (n=12 668) of these participants had a composite outcome event. The highest category of intake of refined grains (≥350 g/day or about 7 servings/day) was associated with higher risk of total mortality (hazard ratio 1.27, 95% confidence interval 1.11 to 1.46; P for trend=0.004), major cardiovascular disease events (1.33, 1.16 to 1.52; P for trend<0.001), and their composite (1.28, 1.15 to 1.42; P for trend<0.001) compared with the lowest category of intake (<50 g/day). Higher intakes of refined grains were associated with higher systolic blood pressure. No significant associations were found between intakes of whole grains or white rice and health outcomes.ConclusionHigh intake of refined grains was associated with higher risk of mortality and major cardiovascular disease events. Globally, lower consumption of refined grains should be considered.
Bibliographie:ObjectType-Article-1
SourceType-Scholarly Journals-1
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ISSN:1756-1833
0959-8138
1756-1833
DOI:10.1136/bmj.m4948