Quintiles of whole grain intake

Figure 3 O adjusted HRR for age and total energy intake. * 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.

attenuated but remained significant. However, after further adjustment for assorted dietary variables (folate, vitamin E, fiber, magnesium, and potassium), the effect was no longer significant. Unlike previous studies, the authors defined the different categories of stroke and found that although risk of hemorrhagic stroke or incident fatal strokes did not appear to be influenced by whole-grain consumption, total stroke risk was inversely related to consumption of whole-grain foods.

It is notable that in many studies subjects with the highest intake of whole-grain foods also had the healthiest lifestyles and the relationship with whole-grain foods is attenuated after adjustment for other diet and lifestyle variables. The exact mechanisms of protection are unclear. Diets rich in whole-grain foods tend to reduce serum LDL-cholesterol and TAG levels whilst increasing HDL-cholesterol concentrations and blood pressure is lower. This may be due in part to the dietary fiber, but the effect usually persists after adjustment for fiber intake. Whole grains also contain a number of specific components that may have heart health benefits, including antioxidants (vitamin E and selenium), B vitamins, flavonoids, and indoles. These may reduce oxidative stress and homocysteine levels, and the iso-flavone content of these grains may positively influence vascular reactivity and the inflammatory state.

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