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Adherence to a Healthy Nordic Diet and Risk of Stroke: A Danish Cohort Study.

https://arctichealth.org/en/permalink/ahliterature282576
Source
Stroke. 2017 Feb;48(2):259-264
Publication Type
Article
Date
Feb-2017
Author
Camilla Plambeck Hansen
Kim Overvad
Cecilie Kyrø
Anja Olsen
Anne Tjønneland
Søren Paaske Johnsen
Marianne Uhre Jakobsen
Christina Catherine Dahm
Source
Stroke. 2017 Feb;48(2):259-264
Date
Feb-2017
Language
English
Publication Type
Article
Keywords
Animals
Cohort Studies
Denmark - epidemiology
Diet, Mediterranean
Female
Fishes
Fruit
Health Promotion - methods
Healthy Diet - methods
Humans
Male
Middle Aged
Registries
Risk factors
Scandinavian and Nordic Countries - epidemiology
Stroke - diet therapy - epidemiology - prevention & control
Vegetables
Whole Grains
Abstract
Specific dietary patterns, including the Mediterranean diet, have been associated with stroke prevention. Our aim was to investigate whether adherence to a healthy Nordic diet, including fish, apples and pears, cabbages, root vegetables, rye bread, and oatmeal, was associated with risk of stroke.
Incident cases of stroke among 55?338 men and women from the Danish Diet, Cancer and Health cohort were identified from the Danish National Patient Register and verified by review of records. Cases of ischemic stroke were further subclassified based on etiology according to the TOAST classification system (Trial of Org 10172 in Acute Stroke Treatment). Information on diet was collected at baseline (1993-1997) using a semiquantitative food-frequency questionnaire. Cox proportional hazards models were used to estimate hazards ratios of total stroke and subtypes of ischemic and hemorrhagic stroke.
During a median follow-up of 13.5 years, 2283 cases of incident stroke were verified, including 1879 ischemic strokes. Adherence to a healthy Nordic diet, as reflected by a higher Healthy Nordic Food Index score, was associated with a lower risk of stroke. The hazards ratio comparing an index score of 4 to 6 (high adherence) with an index score of 0 to 1 (low adherence) was 0.86 (95% confidence interval 0.76-0.98) for total stroke. Inverse associations were observed for ischemic stroke, including large-artery atherosclerosis. No trend was observed for hemorrhagic stroke; however, a statistically insignificant trend was observed for intracerebral hemorrhage.
Our findings suggest that a healthy Nordic diet may be recommended for the prevention of stroke.
PubMed ID
28049735 View in PubMed
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Adherence to a healthy Nordic food index is associated with a lower incidence of colorectal cancer in women: the Diet, Cancer and Health cohort study.

https://arctichealth.org/en/permalink/ahliterature121827
Source
Br J Nutr. 2013 Mar 14;109(5):920-7
Publication Type
Article
Date
Mar-14-2013
Author
Cecilie Kyrø
Guri Skeie
Steffen Loft
Kim Overvad
Jane Christensen
Anne Tjønneland
Anja Olsen
Author Affiliation
Danish Cancer Society Research Center, Strandboulevarden 49, 2100 Copenhagen Ø, Denmark.
Source
Br J Nutr. 2013 Mar 14;109(5):920-7
Date
Mar-14-2013
Language
English
Publication Type
Article
Keywords
Animals
Avena sativa
Brassica
Bread
Cohort Studies
Colonic Neoplasms - epidemiology - prevention & control
Diet
Female
Fishes
Fruit
Health promotion
Humans
Male
Malus
Middle Aged
Norway
Pyrus
Rectal Neoplasms - epidemiology - prevention & control
Secale cereale
Vegetables
Abstract
Colorectal cancer (CRC) is a multi-factorial disease in which diet is believed to play a role. Little is known about the health effects of specific regional diets. The Nordic diet is high in fat and sugar but also includes a range of traditional products with anticipated health-promoting effects. The aim of this cohort study was to determine whether a healthy Nordic food index consisting of fish, cabbage, rye bread, oatmeal, apples, pears and root vegetables was related to CRC incidence. Data were obtained from a prospective cohort study of 57,053 Danish men and women aged 50-64 years, of whom 1025 developed CRC (13 years' follow-up). Incidence rate ratios (IRR) with 95 % CI were calculated from Cox proportional hazard models. Women who strongly adhered to a healthy Nordic food index had a 35 % lower incidence of CRC than women with poor adherence (adjusted IRR, 0·65; 95 % CI 0·46, 0·94); a similar tendency was found for men. Women had a 9 % lower incidence of CRC per point adherence to the healthy Nordic food index, but no significant effect was found for men. A regional diet based on healthy Nordic food items was therefore associated with a lower incidence of CRC in women. The protective effect was of the same magnitude as previously found for the Mediterranean diet, suggesting that healthy regional diets should be promoted in order to ensure health; this will also preserve cultural heredity and the environment.
Notes
Erratum In: Br J Nutr. 2014 Feb;111(4):758-9
PubMed ID
22874538 View in PubMed
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Adherence to a Healthy Nordic Food Index Is Associated with a Lower Risk of Type-2 Diabetes--The Danish Diet, Cancer and Health Cohort Study.

https://arctichealth.org/en/permalink/ahliterature273886
Source
Nutrients. 2015 Oct;7(10):8633-44
Publication Type
Article
Date
Oct-2015
Author
Sandra Amalie Lacoppidan
Cecilie Kyrø
Steffen Loft
Anne Helnæs
Jane Christensen
Camilla Plambeck Hansen
Christina Catherine Dahm
Kim Overvad
Anne Tjønneland
Anja Olsen
Source
Nutrients. 2015 Oct;7(10):8633-44
Date
Oct-2015
Language
English
Publication Type
Article
Keywords
Denmark
Diabetes Mellitus, Type 2 - prevention & control
Diet - ethnology - standards
Female
Food Habits
Humans
Male
Middle Aged
Proportional Hazards Models
Prospective Studies
Risk factors
Sex Factors
Abstract
Type-2 diabetes (T2D) prevalence is rapidly increasing worldwide. Lifestyle factors, in particular obesity, diet, and physical activity play a significant role in the etiology of the disease. Of dietary patterns, particularly the Mediterranean diet has been studied, and generally a protective association has been identified. However, other regional diets are less explored.
The aim of the present study was to investigate the association between adherence to a healthy Nordic food index and the risk of T2D. The index consists of six food items: fish, cabbage, rye bread, oatmeal, apples and pears, and root vegetables.
Data was obtained from a prospective cohort study of 57,053 Danish men and women aged 50-64 years, at baseline, of whom 7366 developed T2D (median follow-up: 15.3 years). The Cox proportional hazards model was used to assess the association between the healthy Nordic food index and risk of T2D, adjusted for potential confounders.
Greater adherence to the healthy Nordic food index was significantly associated with lower risk of T2D after adjusting for potential confounders. An index score of 5-6 points (high adherence) was associated with a statistically significantly 25% lower T2D risk in women (HR: 0.75, 95%CI: 0.61-0.92) and 38% in men (HR: 0.62; 95%CI: 0.53-0.71) compared to those with an index score of 0 points (poor adherence).
Adherence to a healthy Nordic food index was found to be inversely associated with risk of T2D, suggesting that regional diets other than the Mediterranean may also be recommended for prevention of T2D.
Notes
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PubMed ID
26506373 View in PubMed
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Consumption of Whole-Grain Bread and Risk of Colorectal Cancer among Norwegian Women (the NOWAC Study).

https://arctichealth.org/en/permalink/ahliterature276559
Source
Nutrients. 2016 Jan;8(1)
Publication Type
Article
Date
Jan-2016
Author
Toril Bakken
Tonje Braaten
Anja Olsen
Cecilie Kyrø
Eiliv Lund
Guri Skeie
Source
Nutrients. 2016 Jan;8(1)
Date
Jan-2016
Language
English
Publication Type
Article
Keywords
Aged
Bread
Colorectal Neoplasms - epidemiology - prevention & control
Diet - statistics & numerical data
Diet Records
Eating
Female
Follow-Up Studies
Food Habits
Humans
Incidence
Middle Aged
Norway - epidemiology
Prospective Studies
Risk factors
Whole Grains
Abstract
There is evidence that consumption of foods containing dietary fiber decreases the risk of colorectal cancer (CRC). Whole grains contain dietary fiber, as well as a range of micronutrients and bioactive compounds, but the association between the consumption of whole grains and the risk of CRC remains less studied. The aim of the present study was to investigate the association between whole-grain bread consumption and CRC incidence among Norwegian women, using data from a prospective cohort study (the Norwegian Women and Cancer Study). Dietary intake was estimated from the food-frequency questionnaires of 78,254 women in the cohort (median age: 55 years), and these women were then followed up for CRC incidence. During the 9 years of median follow-up, 795 women were diagnosed with CRC (316 proximal, 193 distal, 218 rectal). Associations between whole-grain bread consumption and the risk of CRC (including colorectal subsites) were investigated using Cox proportional hazards regression models. When compared to the low consumption group, the hazard ratio for CRC was 0.89 (95% confidence interval (CI): 0.72-1.09) for the high consumption group and 0.86 (95% CI: 0.72-1.02) for the medium consumption group in a multivariable model. Overall, no association between whole-grain bread consumption and CRC was found.
Notes
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PubMed ID
26771634 View in PubMed
Less detail

Higher Whole-Grain Intake Is Associated with Lower Risk of Type 2 Diabetes among Middle-Aged Men and Women: The Danish Diet, Cancer, and Health Cohort.

https://arctichealth.org/en/permalink/ahliterature299891
Source
J Nutr. 2018 09 01; 148(9):1434-1444
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
09-01-2018
Author
Cecilie Kyrø
Anne Tjønneland
Kim Overvad
Anja Olsen
Rikard Landberg
Author Affiliation
Danish Cancer Society Research Center, Copenhagen, Denmark.
Source
J Nutr. 2018 09 01; 148(9):1434-1444
Date
09-01-2018
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Aged
Avena
Cohort Studies
Denmark - epidemiology
Diabetes Mellitus, Type 2 - epidemiology - prevention & control
Diet
Diet Records
Female
Health status
Humans
Male
Middle Aged
Neoplasms
Proportional Hazards Models
Risk factors
Secale
Surveys and Questionnaires
Triticum
Whole Grains
Abstract
Type 2 diabetes is a major health concern worldwide. Whole grains and cereal fiber may offer protective effects on type 2 diabetes risk. However, few studies have been conducted in cohorts with detailed information on whole-grain cereal intakes and product types and with wide ranges of intake.
We investigated the associations between whole-grain intake, including intakes of different cereal types and products, and the risk of type 2 diabetes in a population with wide and diverse whole-grain intake.
We used data from the Danish Diet, Cancer, and Health cohort including 55,465 participants aged 50-65 y at baseline. Of these, 7417 participants were diagnosed with type 2 diabetes during follow-up (median: 15 y). Detailed information on the intake of whole-grain products was available from a food-frequency questionnaire, and total whole-grain intake and whole-grain cereal types (wheat, rye, oats) were calculated in grams per day. Associations were examined by using Cox proportional hazards models with adjustment for potential confounders.
Whole-grain intake was associated with an 11% and 7% lower risk of type 2 diabetes per whole-grain serving (16 g) per day for men and women, respectively [HR (95% CI)-men: 0.89 (0.87, 0.91); women: 0.93 (0.91, 0.96)]. For men, the intake of all whole-grain cereal types investigated (wheat, rye, oats) was significantly associated with a lower risk of type 2 diabetes, but only wheat and oats intake was significantly associated for women. Among the different whole-grain products, rye bread, whole-grain bread, and oatmeal/muesli were significantly associated with a lower risk of type 2 diabetes for both men and women.
In this cohort study, we found consistent associations between high whole-grain intake and lower risk of type 2 diabetes. Overall, an association was found for all different cereals and whole-grain products tested.
PubMed ID
30016529 View in PubMed
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Intake of whole grain in Scandinavia: intake, sources and compliance with new national recommendations.

https://arctichealth.org/en/permalink/ahliterature130708
Source
Scand J Public Health. 2012 Feb;40(1):76-84
Publication Type
Article
Date
Feb-2012
Author
Cecilie Kyrø
Guri Skeie
Lars O Dragsted
Jane Christensen
Kim Overvad
Göran Hallmans
Ingegerd Johansson
Eiliv Lund
Nadia Slimani
Nina F Johnsen
Jytte Halkjær
Anne Tjønneland
Anja Olsen
Author Affiliation
Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark. ceciliek@cancer.dk
Source
Scand J Public Health. 2012 Feb;40(1):76-84
Date
Feb-2012
Language
English
Publication Type
Article
Keywords
Adult
Cereals
Diet - statistics & numerical data
Diet Surveys
Female
Guideline Adherence - statistics & numerical data
Guidelines as Topic
Humans
Male
Middle Aged
Nutrition Policy
Prospective Studies
Scandinavia
Abstract
The aim of the present study was to describe the intake of whole grain (WG) in Norway, Sweden and Denmark, and to investigate what proportion of the study population that met the new WG recommendation (75?g WG/day per 10?MJ).
Descriptive study. Data is from one 24h dietary recall (24HDR) collected in 1995-2000 from a subset (n?=?8,702) of the large Scandinavian cohort "HELGA" consisting of participants aged 30-65 years from three cohorts.
The mean WG intake was far below the recommended level. Between 16% (Danish men) and 35% (Norwegian women) consumed at least the recommended intake of WG. Among women, the median intake of WG products (g WG products/day) was 114?g/day in Norway and 108?g/day in Denmark, whereas the intake was much lower in Sweden (64?g/day). For women, the median intake of WG in absolute amounts (g WG/day) was again highest in Norway (44?g/day), but lower in both Sweden (35?g/day) and Denmark (31?g/day). For men (no data available for Norwegian men), the intake of WG products was higher in Denmark (138?g/day) compared to Sweden (79?g/day), but when looking at the WG intake in absolute amounts, the intake was highest in Sweden (49?g/day) compared to Denmark (41?g/day).
The present study described the intake of WG as well as the sources of WG in Norway, Sweden and Denmark. Between 16% and 35% met the new recommendations on intake of WG.
PubMed ID
21976053 View in PubMed
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Intake of whole grains and incidence of oesophageal cancer in the HELGA Cohort.

https://arctichealth.org/en/permalink/ahliterature285601
Source
Eur J Epidemiol. 2016 Apr;31(4):405-14
Publication Type
Article
Date
Apr-2016
Author
Guri Skeie
Tonje Braaten
Anja Olsen
Cecilie Kyrø
Anne Tjønneland
Rikard Landberg
Lena Maria Nilsson
Maria Wennberg
Kim Overvad
Lene Angell Åsli
Elisabete Weiderpass
Eiliv Lund
Source
Eur J Epidemiol. 2016 Apr;31(4):405-14
Date
Apr-2016
Language
English
Publication Type
Article
Keywords
Adenocarcinoma - epidemiology - prevention & control
Adult
Aged
Aged, 80 and over
Carcinoma, Squamous Cell - epidemiology - prevention & control
Denmark - epidemiology
Diet
Dietary Fiber - administration & dosage
Esophageal Neoplasms - epidemiology - prevention & control
Feeding Behavior
Female
Humans
Incidence
Male
Middle Aged
Norway - epidemiology
Proportional Hazards Models
Prospective Studies
Risk factors
Sweden
Whole Grains
Abstract
Few prospective studies have investigated the association between whole-grain consumption and incidence of oesophageal cancer. In the Scandinavian countries, consumption of whole grains is high and the incidence of oesophageal cancer comparably low. The aim of this paper was to study the associations between consumption of whole grains, whole-grain products and oesophageal cancer, including its two major histological subtypes. The HELGA cohort is a prospective cohort study consisting of three sub-cohorts in Norway, Sweden and Denmark. Information regarding whole-grain consumption was collected through country-specific food frequency questionnaires. Cancer cases were identified through national cancer registries. Cox proportional hazards ratios were calculated in order to assess the associations between whole grains and oesophageal cancer risk. The analytical cohort had 113,993 members, including 112 cases, and median follow-up time was 11 years. When comparing the highest tertile of intake with the lowest, the oesophageal cancer risk was approximately 45 % lower (adjusted HR 0.55, 95 % CI 0.31-0.97 for whole grains, HR 0.51, 95 % CI 0.30-0.88 for whole-grain products). Inverse associations were also found in continuous analyses. Whole-grain wheat was the only grain associated with lower risk (HR 0.32, 95 % CI 0.16-0.63 highest vs. lowest tertile). Among whole-grain products, the results were less clear, but protective associations were seen for the sum of whole-grain products, and whole-grain bread. Lower risk was seen in both histological subtypes, but particularly for squamous cell carcinomas. In this study, whole-grain consumption, particularly whole-grain wheat, was inversely associated with risk of oesophageal cancer.
PubMed ID
26092139 View in PubMed
Less detail

Intake of whole grains from different cereal and food sources and incidence of colorectal cancer in the Scandinavian HELGA cohort.

https://arctichealth.org/en/permalink/ahliterature114323
Source
Cancer Causes Control. 2013 Jul;24(7):1363-74
Publication Type
Article
Date
Jul-2013
Author
Cecilie Kyrø
Guri Skeie
Steffen Loft
Rikard Landberg
Jane Christensen
Eiliv Lund
Lena M Nilsson
Richard Palmqvist
Anne Tjønneland
Anja Olsen
Author Affiliation
Danish Cancer Society Research Center, Copenhagen Ø, Denmark. ceciliek@cancer.dk
Source
Cancer Causes Control. 2013 Jul;24(7):1363-74
Date
Jul-2013
Language
English
Publication Type
Article
Keywords
Adult
Cereals
Cohort Studies
Colorectal Neoplasms - epidemiology - prevention & control
Dietary Fiber - administration & dosage
Female
Food Habits
Humans
Incidence
Male
Middle Aged
Proportional Hazards Models
Risk factors
Scandinavia - epidemiology
Abstract
A high intake of whole grains has been associated with a lower incidence of colorectal cancer, but few studies are available on the association with whole grains from different cereals, for example, wheat, rye and oats, and none has addressed these separately. The objective of this study was to investigate the association between whole-grain intake and colorectal cancer.
We used data from the large population-based Scandinavian cohort HELGA consisting of 108,000 Danish, Swedish, and Norwegian persons, of whom 1,123 developed colorectal cancer during a median of 11 years of follow-up. Detailed information on daily intake of whole-grain products, including whole-grain bread, crispbread, and breakfast cereals, was available, and intakes of total whole grains and specific whole-grain species (wheat, rye, and oats) were estimated. Associations between these whole-grain variables and the incidence of colorectal cancer were investigated using Cox proportional hazards models. Intake of whole-grain products was associated with a lower incidence of colorectal cancer per 50-g increment (incidence rate ratio [IRR], 0.94; 95% confidence interval [CI], 0.89, 0.99), and the same tendency was found for total whole-grain intake (IRR pr. 25-g increment, 0.94; 95% CI, 0.88, 1.01). Intake of whole-grain wheat was associated with a lower incidence of colorectal cancer (IRR for highest versus lowest quartile of intake, 0.66; 95% CI, 0.51, 0.85), but no statistical significant linear trend was observed (p for trend: 0.18). No significant association was found for whole-grain rye or oats.
Whole-grain intake was associated with a lower incidence of colorectal cancer.
PubMed ID
23624874 View in PubMed
Less detail

Intake of whole grains in Scandinavia is associated with healthy lifestyle, socio-economic and dietary factors.

https://arctichealth.org/en/permalink/ahliterature136847
Source
Public Health Nutr. 2011 Oct;14(10):1787-95
Publication Type
Article
Date
Oct-2011
Author
Cecilie Kyrø
Guri Skeie
Lars O Dragsted
Jane Christensen
Kim Overvad
Göran Hallmans
Ingegerd Johansson
Eiliv Lund
Nadia Slimani
Nina F Johnsen
Jytte Halkjær
Anne Tjønneland
Anja Olsen
Author Affiliation
Institute of Cancer Epidemiology, Danish Cancer Society, Strandboulevarden 49, 2100 Copenhagen, Denmark. ceciliek@cancer.dk
Source
Public Health Nutr. 2011 Oct;14(10):1787-95
Date
Oct-2011
Language
English
Publication Type
Article
Keywords
Adult
Aged
Body mass index
Cereals
Cross-Sectional Studies
Diet
Eating - psychology
Energy intake
Female
Food
Food Habits
Food Preferences - psychology
Humans
Interviews as Topic
Life Style
Linear Models
Male
Middle Aged
Multivariate Analysis
Prospective Studies
Scandinavia
Smoking
Socioeconomic Factors
Abstract
To identify the dietary, lifestyle and socio-economic factors associated with the intake of whole grains (WG) in Norway, Sweden and Denmark.
A cross-sectional study.
Subsample of the Scandinavian cohort 'HELGA' consisting of three prospective cohorts: The Norwegian Women and Cancer Study; The Northern Sweden Health and Disease Study; and the Danish Diet, Cancer and Health Study.
A total of 8702 men and women aged 30-65 years. Dietary data are from one 24 h dietary recall and data on socio-economic status and lifestyle factors including anthropometric values are from the baseline collection of data.
Vegetables, fruits, dairy products, fish and shellfish, coffee, tea and margarine were directly associated with the intake of WG, whereas red meat, white bread, alcohol and cakes and biscuits were inversely associated. Smoking and BMI were consistently inversely associated with the intake of WG. Furthermore, length of education was directly associated with the intake of WG among women.
The intake of WG was found to be directly associated with healthy diet, lifestyle and socio-economic factors and inversely associated with less healthy factors, suggesting that these factors are important for consideration as potential confounders when studying WG intake and disease associations.
PubMed ID
21338557 View in PubMed
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Intake of whole grains is associated with lower risk of myocardial infarction: the Danish Diet, Cancer and Health Cohort.

https://arctichealth.org/en/permalink/ahliterature275372
Source
Am J Clin Nutr. 2016 Apr;103(4):999-1007
Publication Type
Article
Date
Apr-2016
Author
Anne Helnæs
Cecilie Kyrø
Ingelise Andersen
Sandra Lacoppidan
Kim Overvad
Jane Christensen
Anne Tjønneland
Anja Olsen
Source
Am J Clin Nutr. 2016 Apr;103(4):999-1007
Date
Apr-2016
Language
English
Publication Type
Article
Keywords
Avena - chemistry
Denmark - epidemiology
Diet
Female
Food Habits
Humans
Male
Middle Aged
Myocardial Infarction - epidemiology
Neoplasms - epidemiology
Nutrition Assessment
Proportional Hazards Models
Prospective Studies
Risk factors
Secale - chemistry
Surveys and Questionnaires
Triticum - chemistry
Whole Grains - chemistry
Abstract
High intake of whole grains has been associated with lower risk of coronary heart disease; however, the research that has been used to evaluate different effects of different whole-grain cereals (e.g., wheat, rye, and oats) has been sparse.
We investigated the association between whole-grain intake in terms of total intake and intakes of different cereals and myocardial infarction.
This prospective study included 54,871 Danish adults aged 50-64 y, of whom 2329 individuals developed myocardial infarction (13.6 y of follow-up). Detailed information on daily intake of whole-grain products was available from a self-administered food-frequency questionnaire, and intakes of total whole grain and whole-grain species (wheat, rye, and oats) were estimated. The association between intake of whole grains and risk of myocardial infarction was examined with the use of a Cox proportional hazards model adjusted for potential confounders.
For both men and women with total whole-grain intake in the highest quartile, lower risks of myocardial infarction were shown [HRs: 0.75 (95% CI: 0.65, 0.86) and 0.73 (95% CI: 0.58, 0.91), respectively] than for individuals with intake in the lowest quartile. When the specific cereal species were considered, rye and oats, but not wheat, were associated with lower myocardial infarction risk in men. No significant associations were seen in women. For total whole-grain products, significantly lower myocardial infarction risks were seen with higher intakes in both men and women. Rye bread (in men and women) and oatmeal (in men) were associated with significantly lower risk of myocardial infarction, whereas no significant association was shown for whole-grain bread, crispbread, and wheat.
In this study, we provide support for the hypothesis that whole-grain intake is related to lower risk of myocardial infarction and suggest that the cereals rye and oats might especially hold a beneficial effect.
PubMed ID
26888710 View in PubMed
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