Wholegrain Intake and Long-term Weight Change in Men and Women in the REGARDS Study Pubblico
Yan, Ming (Spring 2019)
Abstract
Background: Wholegrain products are recommended to maintain healthy body weight and lower the risk of several diseases. Prospective cohort studies that examine the association between wholegrain intake and long-term weight change among both genders are limited.
Objective: This study aimed to assess the association between wholegrain intake and weight change over 10-years follow-up among men and women in the REGARDS (Reasons for Geographic and Racial Differences in Stroke) study.
Methods: A total of 3,911 women and 2,850 men aged 45 years or older, with repeated measurements of body weight and wholegrain intake between 2006 and 2016, were included in the analysis, after excluding those with cancer, diabetes and kidney failure at baseline. Dietary information was collected via Block98 FFQ. Associations between wholegrain intake and long-term weight change and obesity were assessed using longitudinal analysis methods, controlling for multiple confounders.
Results: Participants in the highest tertile of baseline wholegrain intake tended to be heavier and had less weight gain over 10 years compared with those in the lowest tertile of intake. In multivariable models, reduced weight gain in the highest, compared to the lowest, tertiles of wholegrain intake was » 0.66 kg for women (T3 vs. T1, -1.11 ± 0.29 kg vs. -0.45 ± 0.28 kg) and » 1.14 for men (T3 vs. T1, -1.18 ± 0.33 kg vs. -0.04 ± 0.74 kg). People who consumed more wholegrain foods at baseline had » 15% lower risk of developing obesity during the follow-up (T3 vs. T1, women: OR= 0.85, 95% CI: 0.62, 1.16; men: OR= 0.86, 95% CI: 0.61, 1.23).
Conclusion: Dietary wholegrain consumption was inversely associated with long-term weight gain and the development of obesity. The protective effect of wholegrain on 10-year weight gain was stronger among men than women (P- interaction < 0.05). Future high-quality, prospective cohort studies and clinical trials that directly measure this association are needed.
Table of Contents
Introduction 1
Methods 4
Results 9
Discussion 13
Future Directions 18
References 19
Tables 25
Table 1. Characteristics of Eligible Female REGARDSs Participants by Tertiles of Wholegrain Intake 25
Table 2. Average Mean Weight Change (kg) Over 10 Years According to Tertiles (T) of Baseline Wholegrain Intake in the REGARDS Study 27
Table 3. ORs (95% CIs) of Incidence of Obesity (BMI 30) by Tertiles of Baseline Wholegrain Intake for Participants in REGARDs Study 28
Figures 29
Figure 1. Flow chart to determine the analytic cohort of 6,717 REGARDS participants without self-reported cancer, diabetes, kidney failure at baseline, with data at both time points and plausible dietary energy intake. REGARDS, Reasons for Geographic and Racial Differences in Stroke 29
Figure 2. A: Mean weight in 2006 and 2016 according to tertiles of wholegrain intake for women. B: Mean weight in 2006 and 2016 according to tertiles of wholegrain intake for men 30
Figure 3. Multivariate-adjusted average weight change (kg) over time across tertiles (T) of baseline wholegrain intake for women and men (P for trend < 0.01 for both genders); Covariates adjusted for were (Model 3): age, race, education, total calorie, fat, protein intake, smoking, alcohol intake, baseline BMI, disease development during follow-up and dietary fiber for men, and additional adjustment of hormone replacement therapy use for women 31
Appendices 32
Supplementary Table 1. Characteristics of Eligible Male REGARDSs Participants by Tertiles of Wholegrain Intake 32
Supplementary Table 2. Average Mean Weight Change (kg) Over 10 Years According to Tertiles (T) of Baseline Wholegrain Intake of middle-aged participants in the REGARDS Study 1 34
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