Whole Grain Consumption Associated With Reduced Risk of Premature Coronary Artery Disease

High intake of refined grains linked to an increased risk of premature coronary artery disease.

A higher intake of refined grains is associated with an increased risk of premature coronary artery disease (PCAD), whereas eating whole grains was associated with a reduced risk, according to a recent study. These findings will be presented at the American College of Cardiology (ACC) Middle East 2022 Together with the 13th Emirates Cardiac Society Congress, taking place in Dubai, United Arab Emirates, October 7-9, 2022.

Prior epidemiological research noted an association between different types of grain intake with the risk of CAD. The current study examined the connection between refined and whole grain consumption and the risk of PCAD in an Iranian population.

PCAD is defined as the atherosclerotic narrowing of coronary arteries in males under 55 years of age or in females under 65 years of age. It is often asymptomatic early in the course of the disease, but can lead to chest pain and/or heart attack with the progressive development of stenosis or plaque rupture of the arterial wall. Risk factors for PCAD include smoking, high cholesterol, high blood pressure, and diabetes.

“There are many factors involved in why people may be consuming more refined grains as opposed to whole grains and these cases differ between people, but some of the most important factors to consider include the economy and income, job, education, culture, age and other similar factors,” lead study author Mohammad Amin Khajavi Gaskarei, MD, of the Isfahan Cardiovascular Research Center and Cardiovascular Research Institute at Isfahan University of Medical Sciences in Isfahan, Iran, said in a press release. “A diet that includes consuming a high amount of unhealthy and refined grains can be considered similar to consuming a diet containing a lot of unhealthy sugars and oils.”

Whole grains are described as, “containing the entire grain,” whereas refined grains are milled, ground into flour or meal to improve shelf life, but lose important nutrients in the process. According to the 2019 ACC/American Heart Association Guideline on the Primary Prevention of Cardiovascular Disease, it is highly recommended to consume vegetables, fruits, legumes, whole grains, and fish as a diet to decrease heart disease risk factors.

The study included 2099 individuals with PCAD from hospitals with catheterization labs in different cities and ethnicities throughout Iran who underwent coronary angiography. In all, 1168 patients with normal coronary arteries were included in the control group, whereas 1369 patients with CAD with obstruction equal or above 75% in at least a single coronary artery comprised the case group.

Each participant was given a food frequency questionnaire for dietary assessments to evaluate dietary behaviors and evaluate the association between whole grain and refined grain intake and the risk of PCAD in individuals without prior diagnoses of heart disease. The study indicated that a higher intake of refined grains was associated with an increased risk of PCAD, whereas whole grain intake was inversely related to reduced risk of PCAD.

“As more studies demonstrate an increase in refined grains consumption globally, as well as the impact on overall health, it is important that we find ways to encourage and educate people on the benefits of whole grain consumption,” Gaskarei said in the press release. “Tactics to consider include teaching improved dietary choices in schools and other public places in simple language the general population can understand, as well as on television programs and by continuing to do high level research that is presented at medical conferences and published in medical journals. Clinicians must also be having these conversations with each other and their patients.”


Which Grains You Eat Can Impact Your Risk of Getting Heart Disease Earlier. American College of Cardiology. October 3, 2022. Accessed October 5, 2022. https://www.acc.org/About-ACC/Press-Releases/2022/10/03/14/29/Which-Grains-You-Eat-Can-Impact-Your-Risk-of-Getting-Heart-Disease-Earlier