Cereal intake and mortality in older Chinese: a 15-year follow-up of a prospective cohort study

Abstract

<h3>Purpose</h3><p>We examined the association between whole grain and refined grain intake with all-cause, cancer and cardiovascular disease (CVD) mortality using the data from the Guangzhou Biobank Cohort Study.</p><h3>Methods</h3><p>19,597 participants aged 50+ years were recruited from 2003 to 2006 and followed-up until April 2021. Multivariable Cox regression was used to calculate hazard radios (HRs) and 95% confidence intervals (CIs). Substitution analysis was used to replace a serving (50 g/day) of whole grain with a serving of refined grain.</p><h3>Results</h3><p>During 286,821 person-years of follow-up, 4385 deaths occurred, including 1450 from cancer, 1678 from CVD and 1257 from other causes. Compared with never whole grain intake, the highest intake category of whole grain (> 300 g/week) was associated with lower risk of all-cause (HR 0.90, 95% CI 0.82–0.98) and CVD mortality (HR 0.85, 0.74–0.98). Compared with the low-intake category of refined grain (< 500 g/day), the highest intake category (> 900 g/week) was associated with a lower risk of cancer mortality (HR 0.76, 0.62–0.95), but a higher risk of CVD mortality (HR 1.25, 1.03–1.51). No significant associations were found between whole grain intake and cancer mortality nor refined grain and all-cause mortality. The <em>HR</em>s of all-cause, cancer and CVD mortality substituting a serving of whole grain for refined grain were 0.96 (0.94–0.99), 1.01 (0.99–1.02) and 0.95 (0.90–0.99), respectively.</p><h3>Conclusion</h3><p>We have first shown that in older Chinese, whole grain intake was associated with lower risk of all-cause and CVD mortality. Our results suggest that intake of whole grain of at least 300 g/week and refined grain of ≤ 900 g/day might be suitable for older Asian. Substituting 50 g/day of whole grain for refined grain was associated with a 4–5% lower risk of all-cause and CVD mortality.</p>