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Association of Whole and Refined Grains Food Consumption With Coronary Artery Disease in a Multi-Center, Case-Control Study of Iranian Adults: Iran Premature Coronary Artery Disease (Ipad) Publisher



Tabesh F1 ; Maleki F2 ; Nouri F3 ; Zarepur E3 ; Haghighatdoost F4 ; Ghaffari S5 ; Salehi N6 ; Lotfizadeh M7 ; Azdaki N8 ; Assareh A9 ; Gholipour M10 ; Maleki Z11 ; Mohammadifard N3 ; Sarrafzadegan N3, 12
Authors
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Authors Affiliations
  1. 1. Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
  2. 2. Department of Cardiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
  3. 3. Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
  4. 4. Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
  5. 5. Cardiovascular Research Center, Tabriz University of Medical sciences, Tabriz, Iran
  6. 6. Cardiovascular Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
  7. 7. School of Health, Shahrekord University of Medical Sciences, Shahrekord, Iran
  8. 8. Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
  9. 9. Atherosclerosis Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
  10. 10. Department of Cardiology, Healthy Heart Research Center, Heshmat Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
  11. 11. Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
  12. 12. Faculty of Medicine, School of Population and Public Health, University of British Columbia, Vancouver, Canada

Source: Nutrition, Metabolism and Cardiovascular Diseases Published:2025


Abstract

Background and aims: Low whole grain food consumption is the leading cause of coronary artery disease (CAD) burden in middle-East countries. However, investigations examining the association of whole and refined grain foods and CAD are scarce in this region. We aimed to investigate the association of whole and refined grain foods with CAD in Iranians with different ethnicities. Methods and results: This was a multi-center case-control study among Iranian ethnicities consisting of Fars, Azari, Kurd, Arab, Lor, Gilak, Qashqaei, and Bakhtiari within the framework of the Iran premature coronary artery disease (IPAD) project. The data were collected from hospitals with catheterization laboratories. Cases were 2099 patients with a stenosis ≥75 % in at least one vessel or ≥50 % in the left main artery. Control group were 1168 individuals with normal angiography test. Grains intake was assessed using a validated semi-quantitative food frequency questionnaire. Compared with those with the lowest intake of whole grain foods, subjects in the top quartile had lower risk of CAD (OR = 0.54, 95 % CI: 0.40, 0.72; P < 0.001) after full adjustment. However, a significant direct link was found between higher refined grain foods consumption and the risk of CAD (OR = 1.43, 95 % CI: 0.91–1.84; P = 0.013). Conclusion: Our findings support dietary recommendations to increase whole grain foods and mitigating refined grain food consumption to reduce the risk of CAD and its severity. © 2025 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University
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