Higher Whole-Grain Intake Is Associated with Lower Risk of Type 2 Diabetes among Middle-Aged Men and Women: The Danish Diet, Cancer, and Health Cohort

J Nutr. 2018 Sep 1;148(9):1434-1444. doi: 10.1093/jn/nxy112.


Background: Type 2 diabetes is a major health concern worldwide. Whole grains and cereal fiber may offer protective effects on type 2 diabetes risk. However, few studies have been conducted in cohorts with detailed information on whole-grain cereal intakes and product types and with wide ranges of intake.

Objective: We investigated the associations between whole-grain intake, including intakes of different cereal types and products, and the risk of type 2 diabetes in a population with wide and diverse whole-grain intake.

Methods: We used data from the Danish Diet, Cancer, and Health cohort including 55,465 participants aged 50-65 y at baseline. Of these, 7417 participants were diagnosed with type 2 diabetes during follow-up (median: 15 y). Detailed information on the intake of whole-grain products was available from a food-frequency questionnaire, and total whole-grain intake and whole-grain cereal types (wheat, rye, oats) were calculated in grams per day. Associations were examined by using Cox proportional hazards models with adjustment for potential confounders.

Results: Whole-grain intake was associated with an 11% and 7% lower risk of type 2 diabetes per whole-grain serving (16 g) per day for men and women, respectively [HR (95% CI)-men: 0.89 (0.87, 0.91); women: 0.93 (0.91, 0.96)]. For men, the intake of all whole-grain cereal types investigated (wheat, rye, oats) was significantly associated with a lower risk of type 2 diabetes, but only wheat and oats intake was significantly associated for women. Among the different whole-grain products, rye bread, whole-grain bread, and oatmeal/muesli were significantly associated with a lower risk of type 2 diabetes for both men and women.

Conclusions: In this cohort study, we found consistent associations between high whole-grain intake and lower risk of type 2 diabetes. Overall, an association was found for all different cereals and whole-grain products tested.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Avena
  • Cohort Studies
  • Denmark / epidemiology
  • Diabetes Mellitus, Type 2 / epidemiology
  • Diabetes Mellitus, Type 2 / prevention & control*
  • Diet Records
  • Diet*
  • Female
  • Health Status
  • Humans
  • Male
  • Middle Aged
  • Neoplasms
  • Proportional Hazards Models
  • Risk Factors
  • Secale
  • Surveys and Questionnaires
  • Triticum
  • Whole Grains*