Whole Grains, Refined Grains, and Cancer Risk: A Systematic Review of Meta-Analyses of Observational Studies
Abstract
:1. Introduction
2. Materials and Methods
3. Results
3.1. Whole Grain Intake and Total Cancer Risk
3.2. Whole Grain Intake and Site-Specific Cancer Risk
3.2.1. Colorectal, Colon, and Rectal Cancer
3.2.2. Gastric Cancer
3.2.3. Pancreatic Cancer
3.2.4. Prostate Cancer
3.2.5. Breast Cancer
3.2.6. Esophageal Cancer
3.2.7. Other Cancers
3.3. Refined Grain Intake and Cancer
3.3.1. Total Cancer
3.3.2. Colorectal Cancer
3.3.3. Gastric Cancer
4. Discussion
4.1. Mechanisms for Reduced Cancer Risk Associated with Whole Grain Intake
4.2. Strengths and Weaknesses of the Meta-Analyses
5. Conclusions
Supplementary Materials
Funding
Conflicts of Interest
References
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Meta-Analysis | Highest vs. Lowest Intakes | Dose Response | ||
---|---|---|---|---|
Number of Cohorts or Case-Control Studies Included [References] | Relative Risk or Odds Ratio (95% CI) | Number of Cohorts or Case-Control Studies Included [References] | Relative Risk or Odds Ratio (95% CI) | |
Jacobs et al., 1998 [24] | 45 [41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70,71,72,73,74,75,76,77,78,79,80] | 0.66 (0.60–0.72) | ||
Aune et al., 2016 [20] | 6 [81,82,83,84,85] | 0.89 (0.82–0.96) | 6 [81,82,83,84,85] | 0.85 (0.80–0.91) 90 g/day |
Benisi-Kohansel et al., 2016 [21] | 7 [81,82,83,85,86,87] | 0.94 (0.91–0.98) | 3 [82,83,85] | 0.90 (0.83–0.98) 90 g/day |
Chen et al., 2016 [22] | 8 [81,82,83,84,85,87,88] | 0.89 (0.84–0.95) | 6 [81,82,83,84,85] | 0.82 (0.69–0.86) 50 g/day |
Wei et al., 2016 [29] | 8 [81,82,83,84,85,87] | 0.89 (0.82–0.96) | 7 [81,82,83,84,85] | 0.91 (0.84–0.98) 90 g/day |
Zong et al., 2016 [33] | 10 [82,83,84,85,87,88] | 0.88 (0.83–0.94) | 10 [82,83,84,85,87,88] | 0.80 (0.72–0.89) 70 g/day 0.85 (0.76–0.94) 50 g/day 0.89 (0.79–0.99) 30 g/day 0.96 (0.91–1.01) 10 g/day |
Zhang et al., 2018 [31] | 14 [82,85,87,89,90,91,92,93,94,95,96,97] | 0.94 (0.87–1.01) | 14 [82,85,87,89,90,91,92,93,94,95,96,97] | 0.97 (0.95–0.99) 28 g/day |
Reynolds et al., 2019 [26] | 5 [81,82,83,84,85] | 0.84 (0.76–0.92) | 7 [81,82,83,84,85] | 0.95 (0.93–0.97) 15 g/day |
Meta-Analysis | Highest vs. Lowest Intakes | Dose Response | Cancer Site | ||
---|---|---|---|---|---|
Number of Cohorts or Case-Control Studies Included [References] | Relative Risk or Odds Ratio (95% CI) | Number of Cohorts or Case-Control Studies Included [References] | Relative Risk or Odds Ratio (95% CI) | ||
Jacobs et al., 1998 [24] | 7 [41,46,61,68,69,71,75] | 0.79 (0.69–0.89) | Colorectal | ||
Aune et al., 2011 [19] | 4 [95,98,99,100] | 0.79 (0.72–0.86) | 6 [95,98,99,100,101] | 0.83 (0.78–0.89) | Colorectal 90 g/day |
Vieira et al., 2017 [28] | 6 [94,95,100,102] | 0.83 (0.79–0.89) | Colorectal 90 g/day | ||
Schwingshackl et al., 2018 [16] | 10 [90,94,95,99,100,101,102,103,104] | 0.88 (0.83–0.94) | 9 [90,94,95,99,100,101,102,104] | 0.95 (0.93–0.97) | Colorectal 30 g/day |
Reynolds et al., 2019 [26] | 7 [90,94,95,98,101,102,105] | 0.87 (0.79–0.96) | 8 [90,94,95,98,101,102,105] | 0.97 (0.95–0.99) | Colorectal 15 g/day |
Zhang et al., 2020 [32] | 25 [46,68,71,90,94,95,98,99,100,101,105,106,107,108,109,110,111,112] | 0.89 (0.84–0.93) | Colorectal | ||
Aune et al., 2011 [19] | 5 [95,98,100,105,112] | 0.82 (0.72–0.92) | 4 [95,98,100,105] | 0.86 (0.79–0.94) | Colon 90 g/day |
Vieira et al., 2017 [28] | 4 [94,95,100,105] | 0.82 (0.73–0.92) | Colon 90 g/day | ||
Schwingshackl et al., 2018 [16] | 7 [90,94,95,100,104,105,112] | 0.85 (0.77–0.93) | 6 [90,94,95,100,104] | 0.97 (0.95–0.99) | Colon 30 g/day |
Aune et al., 2011 [19] | 3 [95,98,100] | 0.80 (0.59–1.07) | 3 [95,98,100] | 0.80 (0.56–1.14) | Rectal 90 g/day |
Vieira et al., 2017 [28] | 3 [94,95,100] | 0.81 (0.54–1.20) | Rectal 90 g/day | ||
Schwingshackl et al., 2018 [16] | 5 [90,94,95,100,104] | 0.80 (0.64–0.98) | 5 [90,94,95,100,104] | 0.94 (0.88–1.01) | Rectal 30 g/day |
Jacobs et al., 1998 [24] | 7 [42,43,54,59,74,76,79] | 0.57 (0.47–0.67) | Gastric | ||
Wang et al., 2020 [35] | 5 [42,43,113,114,115] | 0.87 (0.79–0.95) | Gastric | ||
Xu et al., 2019 [36] | 3 [116,117,118] | 0.61 (0.40–0.83) | Gastric | ||
Zhang et al., 2020 [32] | 12 [42,43,54,79,113,115,116,117,118,119,120] | 0.64 (0.53–0.79) | Gastric | ||
Jacobs et al., 1998 [24] | 4 [45,52,65,67] | 0.70 (0.54–0.86) | Pancreatic | ||
Lei et al., 2016 [25] | 5 [24,121,122,123,124] | 0.76 (0.64–0.91) | Pancreatic | ||
Wang et al., 2015 [34] | 8 [91,96,125,126,127,128,129,130] | 1.13 (0.98–1.30) | Prostate | ||
Reynolds et al., 2019 [26] | 3 [91,96,127] | 1.10 (1.02–1.19) | 2 [91,96,127] | 1.02 (0.98–1.05) | Prostate 15 g/day |
Jacobs et al., 1998 [24] | 2 [56,64] | 0.86 (0.67–1.05) | Breast | ||
Xiao et al., 2018 [30] | 11 [56,64,92,125,131,132,133,134,135,136,137] | 0.84 (0.74–0.96) | 6 [92,131,132,135,136,137] | 0.83 (0.73–0.93) | Breast 50 g/day |
Jacobs et al., 1998 [24] | 2 [47,80] | 0.52 (0.09–0.95) | Esophageal | ||
Zhang et al., 2020 [32] | 7 [117,138,139,140,141,142] | 0.54 (0.44–0.67) | Esophageal | ||
Jacobs et al., 1998 [24] | 4 [48,58,66,77] | 0.57 (0.38–0.76) | Oral | ||
Jacobs et al., 1998 [24] | 2 [44,51] | 0.67 (0.48–0.86) | Brain | ||
Jacobs et al., 1998 [24] | 3 [53,55,63] | 0.55 (0.41–0.69) | Endometrial | ||
Jacobs et al., 1998 [24] | 2 [50,73] | 0.41 (0.37–0.45) | Non-Hodgkin’s lymphoma |
Meta-Analysis | Highest vs. Lowest Intakes | Dose Response | Cancer | ||
---|---|---|---|---|---|
Number of Cohorts or Case-Control Studies Included [References] | Relative Risk or Odds Ratio (95% CI) | Number of Cohorts or Case-Control Studies Included [References] | Relative Risk or Odds Ratio (95% CI) | ||
Aune et al., 2016 [20] | 2 [83,85] | 0.94 (0.90–0.99) | Total cancer 90 g/day | ||
Schwingshackl et al., 2018 [16] | 2 [95,103] | 1.46 (0.80–2.67) | Colorectal | ||
Schwingshackl et al., 2018 [16] | 2 [95,112] | 1.27 (1.02–1.57) | Colon | ||
Xu et al., 2019 [36] | 3 [116,117,118] | 1.65 (1.36–1.94) | Gastric | ||
Wang et al., 2020 [35] | 18 [54,59,113,114,116,118,143,144,145,146,147,148,149,150,151,152] | 1.36 (1.21–1.54) | Gastric |
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Gaesser, G.A. Whole Grains, Refined Grains, and Cancer Risk: A Systematic Review of Meta-Analyses of Observational Studies. Nutrients 2020, 12, 3756. https://doi.org/10.3390/nu12123756
Gaesser GA. Whole Grains, Refined Grains, and Cancer Risk: A Systematic Review of Meta-Analyses of Observational Studies. Nutrients. 2020; 12(12):3756. https://doi.org/10.3390/nu12123756
Chicago/Turabian StyleGaesser, Glenn A. 2020. "Whole Grains, Refined Grains, and Cancer Risk: A Systematic Review of Meta-Analyses of Observational Studies" Nutrients 12, no. 12: 3756. https://doi.org/10.3390/nu12123756
APA StyleGaesser, G. A. (2020). Whole Grains, Refined Grains, and Cancer Risk: A Systematic Review of Meta-Analyses of Observational Studies. Nutrients, 12(12), 3756. https://doi.org/10.3390/nu12123756