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The Role of Whole Grains in Disease Prevention

      Abstract

      Despite universal acceptance of the importance of whole grains in the diet, consumer knowledge of the benefits of whole grains and intake of these foods are low. This review summarizes the research supporting whole-grain consumption and gives practical suggestions about how to increase whole-grain intake. Whole-grain foods are valuable sources of nutrients that are lacking in the American diet, including dietary fiber, B vitamins, vitamin E, selenium, zinc, copper, and magnesium. Whole-grain foods also contain phytochemicals, such as phenolic compounds, that together with vitamins and minerals play important roles in disease prevention. The exact mechanisms linking whole grains to disease prevention are not known but may include gastrointestinal effects, antioxidant protection, and intake of phytoestrogens. Dietary intake studies indicate that consumption of whole grains is far less than the recommended intake of 3 servings a day, with an average daily intake of 1 or fewer servings a day. A new whole-grains health claim, allowed in July 1999 by the Food and Drug Administration, and inclusion of a whole-grain recommendation in the 2000 revision of the US Dietary Guidelines for Americans, should help increase whole-grain consumption. J Am Diet Assoc. 2001; 101:780–785.
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      References

        • Johnson R.K
        • Kennedy E
        The 2000 Dietary Guidelines for Americans.
        J Am Diet Assoc. 2000; 100: 769-774
        • Pedersen B
        • Knudsen K.E
        • Eggum B.O
        Nutritive value of cereal products with emphasis on the effect of milling.
        World Rev Nutr Diet. 1989; 60: 1-91
        • Adams J.F
        • Engstrom A
        Dietary intake of whole grain vs recommendations.
        Cereal Foods World. 2000; 45: 75-78
        • Jacobs D.R
        • Meyer K.A
        • Kushi L.H
        • Folsom A.R
        Whole-grain intake may reduce the risk of ischemic heart disease death in postmenopausal women.
        Am J Clin Nutr. 1998; 68: 248-257
        • Jacobs D.R
        • Meyer K.A
        • Kushi L.H
        • Folsom A.R
        Is whole-grain intake associated with reduced total and cause-specific death rates in older women? The Iowa Women’s Health Study.
        Am J Public Health. 1999; 89: 322-329
      1. Slavin JL, Martini PC, Jacobs D., Marquart L. Plausible mechanisms for protectiveness of whole grains. Am J Clin Nutr. 459S–463S. 1999

        • Slavin J.L
        Health benefits of oligosaccharides.
        J Nutraceut, Functional & Medical Foods. 1999; 1: 43-53
        • Cook S.I
        Sellin Jl Review article.
        Aliment Pharm Ther. 1998; 12: 499-507
        • Jacobs D
        • Pereira M
        • Slavin J
        • Marquart L
        Defining the impact of whole-grain intake on chronic disease.
        Cereal Foods World. 2000; 45: 51-53
        • Morris J.N
        • Marr J.W
        • Clayton D.G
        Diet and heart.
        Br Med J. 1977; 2: 1307-1314
        • Brown L
        • Rosner B
        • Willett W.W
        • Sacks F.M
        Cholesterol-lowering effects of dietary fiber.
        Am J Clin Nutr. 1999; 69: 30-42
        • Pietinen P
        • Rimm E.B
        • Korhonen P
        • Hartman A.M
        • Willett W.C
        • Albanes D
        • Virtamo J
        Intake of dietary fiber and risk of coronary heart disease in a cohort of Finnish men The Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study.
        Circulation. 1996; 94: 2720-2727
        • Rimm E.B
        • Ascherio A
        • Giovannucci E
        • Spiegelman D
        • Stampfer M.J
        • Willett W.C
        Vegetable, fruit and cereal fiber intake and risk of coronary heart disease among men.
        JAMA. 1996; 275: 447-451
        • Liu S.M
        • Stampfer M.J
        • Hu F.B
        • Giovannucci E
        • Rimm E
        • Manson J.E
        • Hennekens C.H
        • Willett W.C
        Whole-grain consumption and risk of coronary heart disease.
        Am J Clin Nutr. 1999; 70: 412-429
        • Jones P.J
        • MacDougall D.E
        • Ntanios F
        • Vanstone C.A
        Dietary phytoesterols as cholesterol-lowering agents in humans.
        Can J Physiol Pharmacol. 1997; 75: 217-227
        • Hara H
        • Haga S
        • Aoyama Y
        • Kiriyama S
        Short-chain fatty acids suppress cholesterol synthesis in rat liver and intestine.
        J Nutr. 1999; 129: 942-948
        • Jacobs D.R
        • Marquart L
        • Slavin J.L
        • Kushi L.H
        Whole-grain intake and cancer.
        Nutr Cancer. 1998; 30: 85-96
        • Chatenoud L
        • Tavani A
        • La Vecchia C
        • Jacobs D.R
        • Negri E
        • Levi F
        • Franceschi S
        Whole-grain food intake and cancer risk.
        Int J Cancer. 1998; 77: 24-28
        • Wattenberg L.W
        Chemoprevention of cancer.
        Cancer Res. 1985; 45: 1-8
        • Clark L.C
        • Combs C.F
        • Turnbull B.W
        • Slate E.H
        • Chalker D.K
        • Chow J
        • Davis L.S
        • Glover R.A
        • Graham G.F
        • Gross E.G
        • Krongrad A
        • Lesher J.L
        • Park H.K
        • Sanders B.B
        • Smith C.L
        • Taylor J.R
        Effects of selenium supplementation for cancer prevention in patients with carcinoma of the skin. A randomized controlled trial. Nutritional Prevention of Cancer Study Group.
        J Am Med Assoc. 1996; 276: 1957-1963
        • Adlercreutz H
        • Mazur W
        Phytoestrogens and Western diseases.
        Ann Med. 1997; 29: 95-120
        • Manson M.M
        • Gescher A
        • Hudson E.A
        • Plummer S.M
        • Squires M.S
        • Prigent S.A
        Blocking and suppressing mechanisms of chemoprevention by dietary constitutents.
        Toxicology Lett. 2000; 112-113: 499-505
        • Klaunig J.E
        • Xu Y
        • Isenberg J.S
        • Bachowski S
        • Kolaja K.L
        • Jiang J
        • Stevenson D.E
        • Walborg E.F
        The role of oxidative stress in chemical carcinogenesis.
        Environ Health Persp. 1998; 106S: 289-295
        • Hallifrisch J
        • Behall K.M
        Improvements in insulin and glucose responses related to grains.
        Cereal Foods World. 2000; 45: 66-69
        • Jenkins D.J.A
        • Wesson V
        • Wolever T.M
        • Jenkins A.L
        • Kalmusky J
        • Gidici S
        • Csima A
        • Josse R.G
        • Wong G.S
        Whole meal versus whole-grain breads.
        Br Med J. 1988; 297: 958-960
        • Pereira M.A
        • Jacobs D.R
        • Slattery M.L
        • Ruth K.J
        • Van Horn L
        • Hilner J.E
        • Kushi L.H
        The association of whole-grain intake and fasting insulin in a biracial cohort of young adults.
        CVD Prevention. 1998; 1: 231-242
        • Salmeron J
        • Aserio A
        • Rimm E.B
        • Colditz G.A
        • Spiegelman D
        • Jenkins D.J
        • Stampfer M.J
        • Wing A.L
        • Willett W.C
        Dietary fiber, glycemic load, and risk of NIDDM in men.
        Diabetes Care. 1997; 20: 545-550
        • Salmeron J
        • Manson J.E
        • Stampfer M.J
        • Colditz G.A
        • Wing A.L
        • Willett W.C
        Dietary fiber, glycemic load, and risk of non-insulin-dependent diabetes mellitus in women.
        JAMA. 1997; 277: 472-477
        • Meyer K.A
        • Kushi L.H
        • Jacobs D.R
        • Slavin J
        • Sellers T.A
        • Folsom A.R
        Carbohydrates, dietary fiber, and incident type 2 diabetes in older women.
        Am J Clin Nutr. 2000; 71: 921-930
        • Bjorck I
        • Granfeldt Y
        • Lillejeberg H
        • Tovar J
        • Asp N
        Food properties affecting the digestion and absorption of carbohydrates.
        Am J Clin Nutr. 1994; 59S: 688S-705S
        • Bruce B
        • Spiller G.A
        • Klevay L.M
        • Gallagher S.K
        A diet high in whole and unrefined foods favorably alters lipids, antioxidant defenses, and colon function.
        J Am Coll Nutr. 2000; 19: 61-67
        • Cleveland L.E
        • Moshfegh A.J
        • Alberson A.M
        • Goldman J.D
        Dietary intake of whole grains.
        J Am Coll Nutr. 2000; 19: 331S-338S