Dataset Information

Associations of Whole and Refined Grain Intakes with Adiposity-Related Cancer Risk in the Framingham Offspring Cohort (1991-2013).

ABSTRACT: Case-control studies suggest that higher whole grain and lower refined grain intakes are associated with reduced cancer risk, but longitudinal evidence is limited. The objective of this prospective cohort study is to evaluate associations between whole and refined grains and their food sources in relation to adiposity-related cancer risk. Participants were adults from the Framingham Offspring cohort (N = 3,184; ?18 yr). Diet, measured using a food frequency questionnaire, medical and lifestyle data were collected at exam 5 (1991-95). Between 1991 and 2013, 565 adiposity-related cancers were ascertained using pathology reports. Cox proportional hazards models were used to estimate adjusted hazard ratios and 95% confidence intervals for associations of whole and refined grains with risk of adiposity-related cancers combined and with risk of breast and prostate cancers in exploratory site-specific analyses. Null associations between whole and refined grains and combined incidence of adiposity-related cancers were observed in multivariable-adjusted models (HR: 0.94; 95% CI: 0.71-1.23 and HR: 0.98; 95% CI: 0.70-1.38, respectively). In exploratory analyses, higher intakes of whole grains (oz eq/day) and whole grain food sources (servings/day) were associated with 39% and 47% lower breast cancer risk (HR: 0.61; 95% CI: 0.38-0.98 and HR: 0.53; 95% CI: 0.33-0.86, respectively). In conclusion, whole and refined grains were not associated with adiposity-related cancer risk. Whole grains may protect against breast cancer, but findings require confirmation within a larger sample and in other ethnic groups.

SUBMITTER: Makarem N

PROVIDER: S-EPMC7236605 | biostudies-literature | 2018 Jul

REPOSITORIES: biostudies-literature

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Associations of Whole and Refined Grain Intakes with Adiposity-Related Cancer Risk in the Framingham Offspring Cohort (1991-2013).

Makarem Nour N Bandera Elisa V EV Lin Yong Y McKeown Nicola M NM Hayes Richard B RB Parekh Niyati N

Nutrition and cancer 20180521 5

Case-control studies suggest that higher whole grain and lower refined grain intakes are associated with reduced cancer risk, but longitudinal evidence is limited. The objective of this prospective cohort study is to evaluate associations between whole and refined grains and their food sources in relation to adiposity-related cancer risk. Participants were adults from the Framingham Offspring cohort (N = 3,184; ≥18 yr). Diet, measured using a food frequency questionnaire, medical and lifestyle d ...[more]

PMID: 29781707

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Project description:BackgroundGreater whole grain (WG) consumption is associated with reduced risk of cardiovascular disease (CVD); however, few prospective studies have examined WG or refined grain (RG) intake and intermediate cardiometabolic risk factors.ObjectivesWe examined the longitudinal association between WG and RG intake on changes in waist circumference (WC); fasting HDL cholesterol, triglyceride, and glucose concentrations; and blood pressure.MethodsSubjects were participants in the Framingham Offspring cohort study [n = 3121; mean ± SD baseline age: 54.9 ± 0.2 y; BMI (kg/m2) 27.2 ± 0.1]. FFQ, health, and lifestyle data were collected approximately every 4 y over a median 18-y follow-up. Repeated measure mixed models were used to estimate adjusted mean changes per 4-y interval in risk factors across increasing categories of WG or RG intake.ResultsGreater WG intake was associated with smaller increases in WC (1.4 ± 0.2 compared with 3.0 ± 0.1 cm in the highest compared with the lowest category, respectively; P-trend < 0.001), fasting glucose concentration (0.7 ± 0.4 compared with 2.6 ± 0.2 mg/dL; P-trend < 0.001), and systolic blood pressure (SBP; 0.2 ± 0.5 compared with 1.4 ± 0.3 mm Hg; P-trend < 0.001) per 4-y interval. When stratified by sex, a stronger association with WC was observed among females than males. Higher intake of WG was associated with greater increases in HDL cholesterol and declines in triglyceride concentrations; however, these differences did not remain significant after adjustment for change in WC. Conversely, greater RG intake was associated with greater increases in WC (2.7 ± 0.2 compared with 1.8 ± 0.1 cm, P-trend < 0.001) and less decline in triglyceride concentration (-0.3 ± 1.3 compared with -7.0 ± 0.7 mg/dL, P-trend < 0.001).ConclusionsAmong middle- to older-age adults, replacing RG with WG may be an effective dietary modification to attenuate abdominal adiposity, dyslipidemia, and hyperglycemia over time, thereby reducing the risk of cardiometabolic diseases.

Project description:BackgroundThere are limited data from randomized control trials to support or refute the contention that whole-grains can enhance protein metabolism in humans.ObjectivesTo examine: 1) the clinical effects of a whole-grain diet on whole-body protein turnover; 2) the cellular effects of whole-grains on protein synthesis in skeletal muscle cells; and 3) the population effects of whole-grain intake on age-related muscle loss.MethodsAdults with overweight/obesity (n = 14; age = 40 ± 7 y; BMI = 33 ± 5 kg/m2) were recruited into a crossover, randomized controlled trial (NCT01411540) in which isocaloric, macronutrient-matched whole-grain and refined-grain diets were fully provisioned for two 8-wk periods. Diets differed only in the presence of whole-grains (50 g/1000 kcal). Whole-body protein kinetics were assessed at baseline and after each diet in the fasted-state (13C-leucine) and integrated over 24 h (15N-glycine). In vitro studies using C2C12 cells assessed global protein synthesis by surface sensing of translation and anabolic signaling by Western blot. Complementary epidemiological assessments using the NHANES database assessed the effect of whole-grain intake on muscle function assessed by gait speed in older adults (n = 2783).ResultsIntegrated 24-h net protein balance was 3-fold higher on a whole-grain diet compared with a refined-grain diet (P = 0.04). A whole-grain wheat extract increased submaximal rates of global protein synthesis (27%, P < 0.05) in vitro. In a large sample of older adults, whole-grain intake was associated with greater muscle function (OR = 0.92; 95% CI: 0.86, 0.98).ConclusionsConsuming 50 g/1000 kcal whole-grains per day promotes greater protein turnover and enhances net protein balance in adults. Whole-grains impact skeletal muscle at the cellular level, and are associated with greater muscle function in older adults. Collectively, these data point to a new mechanism whereby whole-grain consumption favorably enhances protein turnover and improves health outcomes.This clinical trial is registered on clinicaltrials.gov (identifier: NCT01411540).

Project description:Abstract Objectives We investigated the effect of consuming a whole-grain diet on whole-body protein metabolism compared to a macronutrient-matched refined-grain diet in adults with overweight/obesity using labelled amino acids (ClinicalTrials.gov Identifier: NCT01411540). Methods We conducted a randomized, controlled crossover trial in 14 adults with overweight/obesity (age: 40 ± 7 yrs, BMI: 33 ± 5 kg/m2) in which isocaloric, macronutrient-matched whole-grain (WG) and refined-grain (RG) diets were fully provided for two 8-week periods (with a 10-week washout period). Diets differed only in the inclusion of whole grains (50 g/1000 kcal). Body composition was measured via DEXA. Whole-body protein kinetics were assessed before and after each diet in the fasted state (13C-Leucine, primed, constant infusion) and over 24 hours (15N-Glycine, bolus). Protein kinetics were normalized to fat-free mass (FFM). Results Both diets resulted in mild weight loss (WG: −2.0 ± 2.5 kg; RG: −2.9 ± 3.3 kg; both P = 0.01 compared to baseline). Fasted-state leucine kinetics revealed greater protein synthesis (WG: 205 ± 61 µmol/kgFFM/hr; RG: 178 ± 36 µmol/kgFFM/hr; P = 0.04) and protein breakdown (WG: 235 ± 68 µmol/kgFFM/hr; RG: 203 ± 40 µmol/kgFFM/hr, P = 0.03) on a WG vs RG diet. This resulted in a more negative fasted-state net balance on a WG diet (WG: −30 ± 8 µmol/kg/hr; RG: −25 ± 6 µmol/kg/hr, P = 0.02). In contrast, 24-hour whole-body protein turnover measured by the end-product method (15N-Glycine), revealed greater protein synthesis (WG: 316 ± 135 mg protein/kgFFM/hr; RG: 250 ± 94 mg protein/kgFFM/hr) with no difference in protein breakdown, yielding a more positive 24-hr net balance on a WG diet (WG: 31 ± 21 mg protein/kgFFM/hr; RG: 10 ± 34 mg protein/kgFFM/hr). Conclusions A whole-grain diet increases whole-body leucine flux and results in a greater 24-hr net protein balance in adults with overweight/obesity compared to a refined-grain diet. This trial suggests whole-grains have an independent effect on protein metabolism and may benefit adults with overweight/obesity. Funding Sources This research was supported by the NIH (UL1 RR024989, T32DK007319 (JPK); T32AT004094 (JTM – trainee)) and an investigator-initiated grant from Nestle (JPK). Nestle Product Technology Center and Cereal Partners Worldwide provided the study meals and foods.

Project description:Within epidemiological and intervention studies, whole grain consumption has generally shown positive associations with reductions in markers of overweight and obesity. However, studies use varied methods of determining whole grain intake, including different definitions of a whole grain food, which may explain varied results. This systematic review aimed to identify how different methods of reporting and calculating whole grain intake, including whole grain food definitions, affect reported associations between whole grain intake and body weight measures in adults. Systematic searching of PubMed, Scopus, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Central Register for Controlled Trials (CENTRAL), and MEDLINE (all years to 11 June, 2020) identified eligible studies. Cohort and cross-sectional studies assessing whole grain intake and body weight measures in adults were included. Studies that did not specify methods used to calculate whole grain intake were excluded. Twenty-one cross-sectional studies (from 24 articles) and 9 prospective cohort studies (from 7 articles) were included in the review. Many cross-sectional studies showed whole grain intake was, to some degree, significantly associated with body weight measures, whereas associations varied greatly among cohort studies. Studies calculating whole grain intake using total grams of intake, USDA databases, or ≥25% whole grain in combination with listing specific foods, showed consistent beneficial effects of increasing whole grain intake on body weight. Studies with general lists of foods included as "whole grain foods" or lower cut-offs for whole grain content were inconsistent. The majority of studies reported whole grain intake as servings/day or grams whole grain/day. This review suggests that an association between whole grain and body weight measures remains likely, although precise associations are difficult to determine due to heterogeneity in methodologies and an inability to formally compare studies. Moving forward, application of a standardized methodology to calculate whole grain intake is essential.

Dataset Information

Associations of Whole and Refined Grain Intakes with Adiposity-Related Cancer Risk in the Framingham Offspring Cohort (1991-2013).

Publications

Associations of Whole and Refined Grain Intakes with Adiposity-Related Cancer Risk in the Framingham Offspring Cohort (1991-2013).

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