Djoussé Luc, Gaziano J Michael
Division of Aging, Brigham and Women's Hospital and Harvard Medical School, 1620 Tremont St, Third Floor, Boston, MA 02120, USA.
Arch Intern Med. 2007 Oct 22;167(19):2080-5. doi: 10.1001/archinte.167.19.2080.
Heart failure (HF) is the leading cause of hospitalization among the elderly population in the United States. Consumption of grain products and dietary fiber has been shown to reduce the risk of hypertension and myocardial infarction. However, it is not known whether a higher consumption of breakfast cereals is associated with risk of HF.
This study evaluated prospectively the association between breakfast cereal intake and incident HF among 21 376 participants of the Physicians' Health Study I. Cereal consumption was estimated using a semiquantitative food frequency questionnaire. Incident HF was ascertained through annual follow-up questionnaires and validated using Framingham criteria. We used Cox regression models to estimate adjusted relative risk of HF across categories of cereal intake.
During an average follow-up of 19.6 years, 1018 incident cases of HF occurred. For average weekly cereal consumption of 0 servings, 1 or fewer, 2 to 6, and 7 or more, hazard ratios (95% confidence intervals) for HF were 1 (reference), 0.92 (0.78-1.09), 0.79 (0.67-0.93), and 0.71 (0.60-0.85), respectively (P<.001 for trend), adjusting for age, smoking, alcohol consumption, vegetable consumption, use of multivitamins, exercise, and history of atrial fibrillation, valvular heart disease, and left ventricular hypertrophy. However, the association was limited to the intake of whole grain cereals (P <.001 for trend) but not refined cereals (P = .70 for trend).
Our data demonstrate that a higher intake of whole grain breakfast cereals is associated with a lower risk of HF. Additional studies are warranted to confirm these findings and determine specific nutrients that are responsible for such a protection.
心力衰竭（HF）是美国老年人群住院的主要原因。食用谷物产品和膳食纤维已被证明可降低高血压和心肌梗死的风险。然而，早餐谷物摄入量较高是否与心力衰竭风险相关尚不清楚。
本研究前瞻性评估了医师健康研究I的21376名参与者中早餐谷物摄入量与新发心力衰竭之间的关联。使用半定量食物频率问卷估计谷物消费量。通过年度随访问卷确定新发心力衰竭，并使用弗雷明汉标准进行验证。我们使用Cox回归模型估计不同谷物摄入量类别中HF的调整后相对风险。
在平均19.6年的随访期间，发生了1018例新发心力衰竭病例。对于平均每周谷物消费量为0份、1份或更少、2至6份以及7份或更多的情况，HF的风险比（95%置信区间）分别为1（参考值）、0.92（0.78 - 1.09）、0.79（0.67 - 0.93）和0.71（0.60 - 0.85）（趋势P<.001），对年龄、吸烟、饮酒、蔬菜消费、多种维生素使用、运动以及心房颤动、瓣膜性心脏病和左心室肥厚病史进行了调整。然而，这种关联仅限于全谷物谷物的摄入量（趋势P<.001），而与精制谷物无关（趋势P = 0.70）。
我们的数据表明，全谷物早餐谷物摄入量较高与较低的HF风险相关。需要进一步的研究来证实这些发现，并确定负责这种保护作用的特定营养素。
