Coarse Grain Consumption and Risk of Cardiometabolic Diseases: A Prospective Cohort Study of Chinese Adults.
Yang J., Du H., Guo Y., Bian Z., Yu C., Chen Y., Yang L., Liu J., Han X., Chen J., Lv J., Li L., Chen Z., China Kadoorie Biobank Collaborative Group None.
BACKGROUND: Lower consumption of whole grains is associated with higher risks of diabetes and coronary heart disease in Western populations, but evidence is still limited for stroke. Moreover, little is known in China, where the rates of cardiometabolic diseases are high and grain types consumed are different from Western countries. OBJECTIVES: To examine the associations between coarse grain (e.g., millet, corn and sorghum) consumption and incident cardiometabolic diseases among Chinese adults. METHODS: The prospective China Kadoorie Biobank enrolled > 0.5 million adults aged 30-79 years from ten urban and rural areas during 2004-2008. At baseline, consumption frequencies (in 5 categories from never to daily) of 12 major food groups, including coarse grains, were collected using a validated food frequency questionnaire. After a median of 11 years of follow-up, 17,149 cases of diabetes, 29,876 ischemic strokes, 6097 hemorrhagic strokes, and 6704 major coronary events were recorded among 461,047 participants without prevalence of major chronic diseases at baseline. Cox regression analyses were used to yield adjusted hazard ratios (HRs) for each disease associated with coarse grain consumption. RESULTS: Overall, 13.8% of participants reported regular consumption (i.e., ≥4 days/week, regular consumers) and 29.4% reported never or rarely consumption of coarse grains (i.e., non-consumers) at baseline. Compared with non-consumers, regular consumers had lower risks of diabetes (adjusted HR: 0.88; 95% CI: 0.78, 0.98) and ischemic stroke (0.86; 0.81, 0.93), but not hemorrhagic stroke (0.96; 0.76, 1.20) and major coronary events (0.95; 0.81, 1.12). For diabetes and ischemic stroke, each 100 g/day higher usual intake of coarse grains was associated with 14% (0.86; 0.76, 0.97) and 13% (0.87; 0.81, 0.94) lower risks, respectively, which were similar in various subgroups. CONCLUSIONS: In Chinese adults, higher coarse grain consumption is associated with lower risks of diabetes and ischemic stroke, supporting the promotion of coarse grain consumption in China.