Breakfast cereals and risk of heart failure in the Physicians' Health Study I
ABSTRACT 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.
Full-textDOI: · Available from: Luc Djoussé, Apr 06, 2015
SourceAvailable from: Peter Williams[Show abstract] [Hide abstract]
ABSTRACT: There have been no comprehensive reviews of the relation of breakfast cereal consumption to nutrition and health. This systematic review of all articles on breakfast cereals to October 2013 in the Scopus and Medline databases identified 232 articles with outcomes related to nutrient intake, weight, diabetes, cardiovascular disease, hypertension, digestive health, dental and mental health, and cognition. Sufficient evidence was available to develop 21 summary evidence statements, ranked from A (can be trusted to guide practice) to D (weak and must be applied with caution). Breakfast cereal consumption is associated with diets higher in vitamins and minerals and lower in fat (grade B) but is not associated with increased intakes of total energy or sodium (grade C) or risk of dental caries (grade B). Most studies on the nutritional impact are cross-sectional, with very few intervention studies, so breakfast cereal consumption may be a marker of an overall healthy lifestyle. Oat-, barley-, or psyllium-based cereals can help lower cholesterol concentrations (grade A), and high-fiber, wheat-based cereals can improve bowel function (grade A). Regular breakfast cereal consumption is associated with a lower body mass index and less risk of being overweight or obese (grade B). Presweetened breakfast cereals do not increase the risk of overweight and obesity in children (grade C). Whole-grain or high-fiber breakfast cereals are associated with a lower risk of diabetes (grade B) and cardiovascular disease (grade C). There is emerging evidence of associations with feelings of greater well-being and a lower risk of hypertension (grade D), but more research is required.Advances in Nutrition 09/2014; 5(5):636S-73S. DOI:10.3945/an.114.006247 · 4.90 Impact Factor
01/2013; 3(1). DOI:10.5772/56209