Whole-grain intake and carotid artery atherosclerosis in a multiethnic cohort: the Insulin Resistance Atherosclerosis Study

Am J Clin Nutr. 2007 Jun;85(6):1495-502. doi: 10.1093/ajcn/85.6.1495.


Background: Whole-grain intake has been shown to be inversely associated with cardiovascular events, but an association with atherosclerosis is less well established.

Objective: We sought to evaluate the association of whole-grain intake with carotid intimal medial thickness (IMT) and IMT progression in a multiethnic cohort.

Design: This study evaluated 1178 participants in the Insulin Resistance Atherosclerosis Study. Baseline whole-grain intake was estimated on the basis of intake of dark breads, cooked cereals, and high-fiber cereals assessed with a validated food-frequency questionnaire. Bilateral carotid IMT was evaluated ultrasonographically, yielding 16 IMT measures at baseline and year 5. Multivariate models evaluated the independent association of whole-grain intake with common carotid artery (CCA) and internal carotid artery (ICA) IMT and IMT progression.

Results: The cohort had a mean (+/-SD) age of 55.2 +/- 8.4 y and was 56% female. The baseline median whole-grain intake was 0.79 servings/d. Whole-grain intake was inversely associated with CCA IMT (beta +/- SE: -0.043 +/- 0.013, P = 0.005) and IMT progression (beta +/- SE: -0.019 +/- 0.011, P = 0.09) in models adjusted for demographics, energy intake, energy expenditure, cardiovascular disease risk factors, and medication use. This association was less significant for ICA IMT (beta +/- SE: -0.049 +/- 0.023, P = 0.05) and not significant for ICA IMT progression (beta +/- SE: -0.013 +/- 0.014, P = 0.35). The relation between whole-grain intake and CCA IMT remained significant after adjustment for mediating pathways (lipids, adiposity, and insulin resistance), nutrient constituents, and a principal components-derived healthy dietary pattern.

Conclusions: Whole-grain intake is inversely associated with CCA IMT, and this relation is not attributable to individual risk intermediates, single nutrient constituents, or larger dietary patterns.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Atherosclerosis / pathology
  • Atherosclerosis / prevention & control*
  • Carotid Artery Diseases / pathology
  • Carotid Artery Diseases / prevention & control*
  • Carotid Artery, Common / anatomy & histology*
  • Carotid Artery, Common / diagnostic imaging
  • Carotid Artery, Internal / anatomy & histology
  • Carotid Artery, Internal / diagnostic imaging
  • Confounding Factors, Epidemiologic
  • Diet
  • Dietary Fiber / administration & dosage*
  • Disease Progression
  • Edible Grain*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Observation
  • Surveys and Questionnaires
  • Tunica Intima / anatomy & histology*
  • Ultrasonography, Interventional