Estimating effects of whole grain consumption on type 2 diabetes, colorectal cancer and cardiovascular disease: a burden of proof study.

IF 4.4 2区医学 Q1 NUTRITION & DIETETICS Nutrition Journal Pub Date : 2024-05-14 DOI:10.1186/s12937-024-00957-x

Houpu Liu, Jiahao Zhu, Rui Gao, Lilu Ding, Ye Yang, Wenxia Zhao, Xiaonan Cui, Wenli Lu, Jing Wang, Yingjun Li

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Abstract

Background: Previous studies on whole grain consumption had inconsistent findings and lacked quantitative assessments of evidence quality. Therefore, we aimed to summarize updated findings using the Burden of Proof analysis (BPRF) to investigate the relationship of whole grain consumption on type 2 diabetes (T2D), colorectal cancer (CRC), stroke, and ischemic heart disease (IHD).

Methods: We conducted a literature search in the Medline and Web of Science up to June 12, 2023, to identify related cohort studies and systematic reviews. The mean RR (relative risk) curve and uncertainty intervals (UIs), BPRF function, risk-outcome score (ROS), and the theoretical minimum risk exposure level (TMREL) were estimated to evaluate the level of four risk-outcome pairs.

Results: In total, 27 prospective cohorts were included in our analysis. Consuming whole grain at the range of TMREL (118.5-148.1 g per day) was associated with lower risks: T2D (declined by 37.3%, 95% UI: 5.8 to 59.5), CRC (declined by 17.3%, 6.5 to 27.7), stroke (declined by 21.8%, 7.3 to 35.1), and IHD (declined by 36.9%, 7.1 to 58.0). For all outcomes except stroke, we observed a non-linear, monotonic decrease as whole grain consumption increased; For stroke, it followed a J-shaped curve (the greatest decline in the risk of stroke at consuming 100 g whole grain for a day). The relationships between whole grain consumption and four diseases are all two-star pairs (ROS: 0.087, 0.068, 0.062, 0.095 for T2D, CRC, stroke, and IHD, respectively).

Conclusion: Consuming 100 g of whole grains per day offers broad protective benefits. However, exceeding this threshold may diminish the protective effects against stroke. Our findings endorse replacing refined grains with whole grains as the main source of daily carbohydrates. REGISTRY AND REGISTRY NUMBER FOR SYSTEMATIC REVIEWS OR META-ANALYSES: We have registered our research in PROSPERO, and the identifier of our meta-analyses is CRD42023447345.

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估算全谷物消费对 2 型糖尿病、结直肠癌和心血管疾病的影响：举证责任研究。

背景：以往关于全谷物消费的研究结果不一致，而且缺乏对证据质量的定量评估。因此，我们旨在利用证据负担分析（BPRF）总结最新研究结果，以调查全谷物消费与 2 型糖尿病（T2D）、结直肠癌（CRC）、中风和缺血性心脏病（IHD）之间的关系：我们在 Medline 和 Web of Science（截至 2023 年 6 月 12 日）上进行了文献检索，以确定相关的队列研究和系统综述。我们估算了平均 RR（相对风险）曲线和不确定区间（UIs）、BPRF 函数、风险-结果评分（ROS）和理论最低风险暴露水平（TMREL），以评估四种风险-结果对的水平：结果：共有 27 个前瞻性队列纳入了我们的分析。在理论最低风险暴露水平范围内（每天 118.5-148.1 克）食用全谷物与较低的风险相关：T2D（下降 37.3%，95% UI：5.8 至 59.5）、CRC（下降 17.3%，6.5 至 27.7）、中风（下降 21.8%，7.3 至 35.1）和 IHD（下降 36.9%，7.1 至 58.0）。在除中风以外的所有结果中，我们观察到随着全谷物摄入量的增加，中风的风险呈非线性单调下降；在中风方面，中风风险呈 "J "形曲线（每天摄入 100 克全谷物，中风风险下降幅度最大）。全谷物摄入量与四种疾病之间的关系均为二星对（ROS：T2D、CRC、中风和 IHD 分别为 0.087、0.068、0.062 和 0.095）：结论：每天摄入 100 克全谷物具有广泛的保护作用。结论：每天摄入 100 克全谷物可提供广泛的保护性益处，然而，超过这一阈值可能会降低对中风的保护作用。我们的研究结果支持以全谷物代替精制谷物作为日常碳水化合物的主要来源。系统综述或荟萃分析的注册表和注册号：我们已在 PROSPERO 注册了我们的研究，荟萃分析的标识符为 CRD42023447345。

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来源期刊

Nutrition Journal NUTRITION & DIETETICS-

CiteScore

9.80

自引率

0.00%

发文量

审稿时长

4-8 weeks

期刊介绍： Nutrition Journal publishes surveillance, epidemiologic, and intervention research that sheds light on i) influences (e.g., familial, environmental) on eating patterns; ii) associations between eating patterns and health, and iii) strategies to improve eating patterns among populations. The journal also welcomes manuscripts reporting on the psychometric properties (e.g., validity, reliability) and feasibility of methods (e.g., for assessing dietary intake) for human nutrition research. In addition, study protocols for controlled trials and cohort studies, with an emphasis on methods for assessing dietary exposures and outcomes as well as intervention components, will be considered. Manuscripts that consider eating patterns holistically, as opposed to solely reductionist approaches that focus on specific dietary components in isolation, are encouraged. Also encouraged are papers that take a holistic or systems perspective in attempting to understand possible compensatory and differential effects of nutrition interventions. The journal does not consider animal studies. In addition to the influence of eating patterns for human health, we also invite research providing insights into the environmental sustainability of dietary practices. Again, a holistic perspective is encouraged, for example, through the consideration of how eating patterns might maximize both human and planetary health.