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Randomized Controlled Trial
. 2016 Nov;146(11):2244-2251.
doi: 10.3945/jn.116.230508. Epub 2016 Oct 19.

A Whole-Grain Diet Reduces Cardiovascular Risk Factors in Overweight and Obese Adults: A Randomized Controlled Trial

John P Kirwan  1   2 , Steven K Malin  3 , Amanda R Scelsi  3 , Emily L Kullman  3 , Sankar D Navaneethan  4 , Mangesh R Pagadala  2 , Jacob M Haus  3 , Julianne Filion  3 , Jean-Philippe Godin  5 , Sunil Kochhar  5 , Alastair B Ross  5   6
Affiliations
Randomized Controlled Trial

A Whole-Grain Diet Reduces Cardiovascular Risk Factors in Overweight and Obese Adults: A Randomized Controlled Trial

John P Kirwan et al. J Nutr. 2016 Nov.

Abstract

Background: Increased dietary whole-grain intake may protect against cardiovascular disease (CVD).

Objective: The objective was to evaluate the efficacy of whole grains compared with refined grains on body composition, hypertension, and related mediators of CVD in overweight and obese adults.

Methods: We conducted a double-blind, randomized, controlled crossover trial in 40 overweight or obese men and women aged <50 y with no known history of CVD. Complete whole-grain and refined-grain diets were provided for two 8-wk periods, with a 10-wk washout between diets. Macronutrient composition was matched, except for the inclusion of either whole grains or refined grains (50 g/1000 kcal in each diet). Measurements included blood pressure, body composition, blood lipids and adiponectin, and markers of inflammation and glycemia.

Results: Thirty-three participants (6 men and 27 women) completed the trial [mean ± SD age: 39 ± 7 y; mean ± SD body mass index (in kg/m2): 33.1 ± 4.3]. Decreases in diastolic blood pressure were -5.8 mm Hg (95% CI: -7.7, -4.0 mm Hg) after the whole-grain diet and -1.6 mm Hg (95% CI: -4.4, 1.3 mm Hg) after the control diet (between effect, P = 0.01). Decreases in plasma adiponectin were -0.1 (95% CI: -0.9, 0.7) after the whole-grain diet and -1.4 (95% CI: -2.6, -0.3) after the control diet (between effect, P = 0.05). Decreases in diastolic blood pressure correlated with the circulating adiponectin concentration (r = 0.35, P = 0.04). Substantial reductions in body weight, fat loss, systolic blood pressure, total cholesterol, and LDL cholesterol were observed during both diet periods, with no relevant difference between them.

Conclusions: The improvement in diastolic blood pressure was >3-fold greater in overweight and obese adults when they consumed a whole-grain compared with a refined-grain diet. Because diastolic blood pressure predicts mortality in adults aged <50 y, increased whole-grain intake may provide a functional approach to control hypertension. This may benefit patients at risk of vascular-related morbidity and mortality. This trial was registered at clinicaltrials.gov as NCT01411540.

Keywords: blood pressure; cardiovascular disease; diet; obesity; whole grain.

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Conflict of interest statement

2Author disclosures: J-P Godin, S Kochhar, and AB Ross are employed by the Nestlé Research Center. JP Kirwan, SK Malin, AR Scelsi, EL Kullman, SD Navaneethan, MR Pagadala, JM Haus, and J Filion, no conflicts of interest. Nestlé marketing provided no input on the final data analysis, interpretation, or writing of this article.

Figures

FIGURE 1
FIGURE 1
Participant flow diagram.
FIGURE 2
FIGURE 2
Changes in SBP (A and B) and DBP (C and D) in overweight and obese adults who consumed WG and RG diets, each for 8 wk. Values are means ± SEMs, n = 33. DBP, diastolic blood pressure; RG, refined grain; SBP, systolic blood pressure; WG, whole grain.
FIGURE 3
FIGURE 3
Changes (%) in plasma adiponectin (A and B) and correlations between plasma adiponectin and body fat (C) or blood pressure (D) in overweight and obese adults who consumed whole- and refined-grain diets, each for 8 wk. Values are means ± SEMs, n = 33. DBP, diastolic blood pressure; RG, refined grain; WG, whole grain.
See this image and copyright information in PMC

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