Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China.
Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China.
Am J Clin Nutr. 2023 Jan;117(1):149-159. doi: 10.1016/j.ajcnut.2022.10.010. Epub 2022 Dec 15.
Although relationships between the intake of whole grains and refined grains and the incidence of cardiovascular disease (CVD) events and all-cause mortality have been investigated, the conclusions have been inconclusive.
We aimed to comprehensively summarize the evidence about the correlation between consuming whole grains and refined grains and risks of CVD events and all-cause mortality and to evaluate the meta-evidence quality.
We searched PubMed, Embase, and Web of Science until 15 March, 2022. Random-effects models were employed to calculate summary relative risks (RRs) and 95% confidence intervals (CIs). We explored potential linear or nonlinear relationships using restricted cubic splines. The NutriGrade tool was employed to rate meta-evidence quality.
Twenty-four articles (68 studies; 46 for whole grains and 22 for refined grains) with 1,624,407 participants were included. Per 30-g increase in daily whole grain consumption, the RRs and 95% CIs of stroke, coronary heart disease (CHD), heart failure (HF), CVD, and all-cause mortality were 0.98 (0.96, 1.00), 0.94 (0.92, 0.97), 0.97 (0.89, 1.07), 0.92 (0.88, 0.96), and 0.94 (0.92, 0.97), respectively. Whole grain consumption was linearly associated with CHD (P = 0.231) and nonlinearly associated with CVD (P = 0.002) and all-cause mortality (P = 0.001). Except for a positive correlation between refined grain consumption and all-cause mortality in the restricted cubic spline, no significant influence of refined grain intake on stroke, CHD, HF, and CVD was detected. The meta-evidence quality for the association of whole grain consumption with stroke, CHD, HF, CVD, and all-cause mortality was moderate, moderate, low, high, and high, respectively. For refined grains, all meta-evidence was of low quality.
Consuming whole grains, rather than refined grains, can assist in preventing CHD, CVD, and all-cause mortality. Relationships between consumption of refined grains and health outcomes should be interpreted cautiously because of the low quality of meta-evidence.
尽管全谷物和精制谷物的摄入量与心血管疾病（CVD）事件和全因死亡率之间的关系已被研究，但结论尚无定论。
我们旨在全面总结关于食用全谷物和精制谷物与 CVD 事件和全因死亡率风险之间相关性的证据，并评估元证据质量。
我们检索了 PubMed、Embase 和 Web of Science，截至 2022 年 3 月 15 日。使用随机效应模型计算汇总相对风险（RR）和 95%置信区间（CI）。我们使用限制性立方样条探索潜在的线性或非线性关系。NutriGrade 工具用于评估元证据质量。
共纳入 24 篇文章（68 项研究；46 项全谷物，22 项精制谷物），涉及 1624407 名参与者。每日全谷物摄入量增加 30 克时，中风、冠心病（CHD）、心力衰竭（HF）、CVD 和全因死亡率的 RR 和 95%CI 分别为 0.98（0.96，1.00）、0.94（0.92，0.97）、0.97（0.89，1.07）、0.92（0.88，0.96）和 0.94（0.92，0.97）。全谷物的摄入量与 CHD 呈线性相关（P=0.231），与 CVD 和全因死亡率呈非线性相关（P=0.002 和 P=0.001）。除了在限制性立方样条中精制谷物摄入量与全因死亡率之间存在正相关外，没有发现精制谷物摄入与中风、CHD、HF 和 CVD 之间存在显著影响。全谷物摄入量与中风、CHD、HF、CVD 和全因死亡率之间关联的元证据质量分别为中度、中度、低、高和高。对于精制谷物，所有元证据质量均较低。
食用全谷物而非精制谷物有助于预防 CHD、CVD 和全因死亡率。由于元证据质量较低，应谨慎解释精制谷物摄入量与健康结果之间的关系。
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