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Quintiles of intake

Figure 2 O (WG) and □ (refined) adjusted HRR for age and total energy intake. * (WG) and □ (refined) adjusted for age, energy intake, marital status, education, high blood pressure, diabetes, heart disease, cancer, BMI, WHR, physical activity, smoking, alcohol intake, use of vitamin supplements, HRT, total fat, saturated fat, intake of fruits and vegetables, intake of meat and intake of fish and seafood.

and red meat and fish consumption, the significant inverse relationship remained (P = 0.005). In contrast, refined grain intake was associated with increased mortality for those in the quintile of highest refined grain intake compared to those in the quintile of lowest intake (Figure 2).

Similarly in over 47000 men and women in Norway aged 35-56 years studied over 9 years, hazard rate ratios (HRR) for total mortality were inverse and graded across whole-grain bread score categories in men and women between the highest and lowest bread score after adjustment for a range of dietary and lifestyle factors. The bread score was calculated using number of slices consumed per day and the proportion of whole-grain flour used. The analysis found that both components of the whole grain scoring system contributed to these inverse trends (% deaths between highest and lowest

Table 1 Effect of whole-grain consumption on all cause mortality

Cohort

Measure of WG consumption

Reported association

Reference

Iowa Women

Norwegian County Study

Physician's Health Study

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