Associations of Cereal Grains Intake With Cardiovascular Disease and Mortality Across 21 Countries in Prospective Urban and Rural Epidemiology Study: Prospective Cohort Study

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Associations of Cereal Grains Intake With Cardiovascular Disease and Mortality Across 21 Countries in Prospective Urban and Rural Epidemiology Study: Prospective Cohort Study Publisher Pubmed

Swaminathan S¹ ; Dehghan M² ; Raj JM³ ; Thomas T³ ; Rangarajan S² ; Jenkins D^{4, 5} ; Mony P¹ ; Mohan V⁶ ; Lear SA⁷ ; Avezum A^{8, 9} ; Lopezjaramillo P¹⁰ ; Rosengren A^{11, 12} ; Lanas F¹³ ; Alhabib KF¹⁴ Show All Authors

Swaminathan S¹
Dehghan M²
Raj JM³
Thomas T³
Rangarajan S²
Jenkins D^{4, 5}
Mony P¹
Mohan V⁶
Lear SA⁷
Avezum A^{8, 9}
Lopezjaramillo P¹⁰
Rosengren A^{11, 12}
Lanas F¹³
Alhabib KF¹⁴
Dans A¹⁵
Keskinler MV¹⁶
Puoane T¹⁷
Soman B^{18, 19}
Wei L²⁰
Zatonska K²¹
Diaz R²²
Ismail N²³
Chifamba J²⁴
Kelishadi R²⁵
Yusufali A²⁶
Khatib R^{27, 28}
Xiaoyun L²⁰
Bo H²⁰
Iqbal R²⁹
Yusuf R³⁰
Yeates K^{31, 32}
Teo K²
Yusuf S²

Show Affiliations

1. St John's Research Institute, Bangalore, India
2. Population Health Research Institute (PHRI), McMaster University, Hamilton Health Sciences, Hamilton, ON, Canada
3. St John's Medical College, Bangalore, India
4. Department of Nutritional Sciences, Canada
5. Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
6. Madras Diabetes Research Foundation, Dr Mohan's Diabetes Specialities Centre, Chennai, India
7. Faculty of Health Sciences, Simon Fraser University, Vancouver, BC, Canada
8. International Research Centre, Hospital Alemao Oswaldo Cruz, Sao Paulo, Brazil
9. Universidade Santo Amaro (UNISA), Sao Paulo, Brazil
10. Masira Research Institute, Medical School, Santander University (UDES), Colombia
11. Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
12. Sahlgrenska University Hospital, Gothenburg, Sweden
13. Universidad de La Frontera, Temuco, Chile
14. Department of Cardiac Sciences, King Fahad Cardiac Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
15. University of Philippines, Section of Adult Medicine and Medical Research Unit, Manila, Philippines
16. Department of Internal Medicine, Istanbul Medeniyet University, Goztepe Training and Research Hospital, Istanbul, Turkey
17. University of the Western Cape, Bellville, South Africa
18. Health Action by People, Thiruvananthapuram, Kerala, India
19. Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
20. National Centre for Cardiovascular Diseases, Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, China
21. Wroclaw Medical University, Department of Social Medicine, Wroclaw, Poland
22. Estudios Clinicos Latinoamerica ECLA, Rosario, Santa Fe, Argentina
23. Department of Community Health, Faculty of Medicine, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia
24. Physiology Department, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
25. Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
26. Dubai Medical University, Hatta Hospital, Dubai Health Authority, Dubai, United Arab Emirates
27. Institute for Community and Public Health, Birzeit University, Birzeit, Palestine
28. Advocate Research Institute, Advocate Health Care, Illinois, United States
29. Departments of Community Health Sciences and Medicine, Aga Khan University, Karachi, Pakistan
30. School of Life Sciences, Independent University, Bangladesh, Dhaka, Bangladesh
31. Department of Medicine, Queen's University, Kingston, ON, Canada
32. New York University, College of Global Public Health, NY, United States

Source: The BMJ Published:2021

Abstract

Objective To evaluate the association between intakes of refined grains, whole grains, and white rice with cardiovascular disease, total mortality, blood lipids, and blood pressure in the Prospective Urban and Rural Epidemiology (PURE) study. Design Prospective cohort study. setting PURE study in 21 countries. ParticiPants 148 858 participants with median follow-up of 9.5 years. exPOsures Country specific validated food frequency questionnaires were used to assess intakes of refined grains, whole grains, and white rice. Main OutcOMe Measure Composite of mortality or major cardiovascular events (defined as death from cardiovascular causes, nonfatal myocardial infarction, stroke, or heart failure). Hazard ratios were estimated for associations of grain intakes with mortality, major cardiovascular events, and their composite by using multivariable Cox frailty models with random intercepts to account for clustering by centre. results Analyses were based on 137 130 participants after exclusion of those with baseline cardiovascular disease. During follow-up, 9.2% (n=12 668) of these participants had a composite outcome event. The highest category of intake of refined grains (≥350 g/ day or about 7 servings/day) was associated with higher risk of total mortality (hazard ratio 1.27, 95% confidence interval 1.11 to 1.46; P for trend=0.004), major cardiovascular disease events (1.33, 1.16 to 1.52; P for trend<0.001), and their composite (1.28, 1.15 to 1.42; P for trend<0.001) compared with the lowest category of intake (<50 g/day). Higher intakes of refined grains were associated with higher systolic blood pressure. No significant associations were found between intakes of whole grains or white rice and health outcomes. cOnclusiOn High intake of refined grains was associated with higher risk of mortality and major cardiovascular disease events. Globally, lower consumption of refined grains should be considered. © Publications

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Style	Citing Format
MLA	Swaminathan S, et al.. "Associations of Cereal Grains Intake With Cardiovascular Disease and Mortality Across 21 Countries in Prospective Urban and Rural Epidemiology Study: Prospective Cohort Study." The BMJ, vol. 372, no. , 2021, pp. -.
APA	Swaminathan S, Dehghan M, Raj JM, Thomas T, Rangarajan S, Jenkins D, Mony P, Mohan V, Lear SA, Avezum A, Lopezjaramillo P, Rosengren A, Lanas F, Alhabib KF, Dans A, Keskinler MV, Puoane T, Soman B, Wei L, ... Yusuf S (2021). Associations of Cereal Grains Intake With Cardiovascular Disease and Mortality Across 21 Countries in Prospective Urban and Rural Epidemiology Study: Prospective Cohort Study. The BMJ, 372(), -.
Chicago	Swaminathan S, Dehghan M, Raj JM, Thomas T, Rangarajan S, Jenkins D, Mony P, et al.. "Associations of Cereal Grains Intake With Cardiovascular Disease and Mortality Across 21 Countries in Prospective Urban and Rural Epidemiology Study: Prospective Cohort Study." The BMJ 372, no. (2021): -.
Harvard	Swaminathan S et al. (2021) 'Associations of Cereal Grains Intake With Cardiovascular Disease and Mortality Across 21 Countries in Prospective Urban and Rural Epidemiology Study: Prospective Cohort Study', The BMJ, 372(), pp. -.
Vancouver	Swaminathan S, Dehghan M, Raj JM, Thomas T, Rangarajan S, Jenkins D, et al.. Associations of Cereal Grains Intake With Cardiovascular Disease and Mortality Across 21 Countries in Prospective Urban and Rural Epidemiology Study: Prospective Cohort Study. The BMJ. 2021;372():-.
BibTex	@article{ author = {Swaminathan S and Dehghan M and Raj JM and Thomas T and Rangarajan S and Jenkins D and Mony P and Mohan V and Lear SA and Avezum A and Lopezjaramillo P and Rosengren A and Lanas F and Alhabib KF and Dans A and Keskinler MV and Puoane T and Soman B and Wei L and Zatonska K and Diaz R and Ismail N and Chifamba J and Kelishadi R and Yusufali A and Khatib R and Xiaoyun L and Bo H and Iqbal R and Yusuf R and Yeates K and Teo K and Yusuf S}, title = {Associations of Cereal Grains Intake With Cardiovascular Disease and Mortality Across 21 Countries in Prospective Urban and Rural Epidemiology Study: Prospective Cohort Study}, journal = {The BMJ}, volume = {372}, number = {}, pages = {-}, year = {2021} }
RIS	TY - JOUR AU - Swaminathan S AU - Dehghan M AU - Raj JM AU - Thomas T AU - Rangarajan S AU - Jenkins D AU - Mony P AU - Mohan V AU - Lear SA AU - Avezum A AU - Lopezjaramillo P AU - Rosengren A AU - Lanas F AU - Alhabib KF AU - Dans A AU - Keskinler MV AU - Puoane T AU - Soman B AU - Wei L AU - Zatonska K AU - Diaz R AU - Ismail N AU - Chifamba J AU - Kelishadi R AU - Yusufali A AU - Khatib R AU - Xiaoyun L AU - Bo H AU - Iqbal R AU - Yusuf R AU - Yeates K AU - Teo K AU - Yusuf S TI - Associations of Cereal Grains Intake With Cardiovascular Disease and Mortality Across 21 Countries in Prospective Urban and Rural Epidemiology Study: Prospective Cohort Study JO - The BMJ VL - 372 IS - SP - EP - PY - 2021 ER -

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