Scientists from St John’s Research Institute found a high intake of highly processed (refined) grains is associated with a higher risk of heart disease and death than whole (unrefined) grains.
The research is published in The BMJ and was conducted by Sumathi Swaminathan et al.
Cereal grains, such as oats, rice, barley and wheat make up around 50% of daily caloric intake across the world and up to 70% in low and middle-income countries, particularly in Africa and South Asia.
Whole grains tend to be higher in dietary fiber, vitamins, minerals, and essential fatty acids than refined grains.
Previous studies have shown that higher whole grain intake is associated with a lower risk of heart disease and death, but no clear associations were found for refined grains.
To address this evidence gap, researchers set out to assess the association between intakes of refined grains, whole grains, and white rice with heart disease and mortality.
In the study, they used data from 137,130 people aged 35 to 70 years across 21 low-, middle- and high-income countries who had no history of heart disease.
They examined white rice separately from all other refined grains because more than 60% of the PURE population live in Asia where rice is a staple food.
After 9 years of follow-up, the team found that the highest category of intake of refined grains (at least 350 g or about 7 servings per day) was linked to a 27% higher risk of death and a 33% higher risk of serious heart disease compared with the lowest category of intake (less than 50 g per day).
Higher intakes of refined grains were also linked to higher blood pressure, but no strong associations were found between intakes of whole grains or white rice and health outcomes.
The team says with data from 21 countries across five continents, they were able to analyse broad patterns of diet, meaning the results are likely to be robust and widely applicable to populations across the world.
As such, they suggest that, globally, a lower intake of refined products should be encouraged while promoting a higher intake of whole grains.
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