Whole-grain intake and cancer: An expanded review and meta-analysis

David R. Jacobs, Leonard Marquart, Joanne Slavin, Lawrence H. Kushi

Research output: Contribution to journalArticle

319 Scopus citations

Abstract

Whole grains are nutrient rich and may protect against chronic disease. To study this, we previously reviewed 14 case-control studies of colorectal, gastric, and endometrial cancers and found consistently lower risk in those with high than in those with low whole-grain intake. Questions remained concerning other cancers, dietary assessment, quantity consumed, confounding, and differential study quality. Here we expand the review to 40 case-control studies of 20 cancers and colon polyps. Odds ratios are <1 for 46 of 51 mentions of whole-grain intake and for 43 of 45 after exclusion of 6 mentions with design/reporting flaws or low intake. The pooled odds ratio for high vs. low whole-grain intake among the 45 mentions was 0.66 (95% confidence interval = 0.60-0.72); they range from 0.59 to 0.78 across four types of dietary questionnaires. Odds ratios were <1 in 9 of 10 mentions of studies of colorectal cancers and polyps, 7 of 7 mentions of gastric and 6 of 6 mentions of other digestive tract cancers, 7 of 7 mentions of hormone-related cancers, 4 of 4 mentions of pancreatic cancer, and 10 of 11 mentions of 8 other cancers. Most pooled odds ratios for specific cancers were in the range of 0.5-0.8, notable exceptions being breast (0.86) and prostate (0.90). The pooled odds ratio was similar in studies that adjusted for few and many covariates. Dose-response associations were stronger in studies using food- frequency questionnaires than in more quantitative questionnaires. The case- control evidence is supportive of the hypothesis that whole-grain intake protects against various cancers.

Original languageEnglish (US)
Pages (from-to)85-96
Number of pages12
JournalNutrition and Cancer
Volume30
Issue number2
StatePublished - 1998
Externally publishedYes

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Oncology
  • Food Science

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    Jacobs, D. R., Marquart, L., Slavin, J., & Kushi, L. H. (1998). Whole-grain intake and cancer: An expanded review and meta-analysis. Nutrition and Cancer, 30(2), 85-96.