• Teresa T Fung, Frank B Hu, Mark A Pereira, Simin Liu, Meir J Stampfer, Graham A Colditz, and Walter C Willett.
• Programs in Nutrition, Simmons College, Boston, MA 02115, USA. fung@simmons.edu
• Am. J. Clin. Nutr. 2002 Sep 1; 76 (3): 535-40.

BackgroundCertain dietary components may play a role in the prevention of type 2 diabetes.ObjectiveWe examined prospectively the associations between whole- and refined-grain intake and the risk of type 2 diabetes in a large cohort of men.DesignMen from the Health Professionals Follow-up Study without a history of diabetes or cardiovascular disease in 1986 (n = 42898) were followed for ResultsWe ascertained 1197 cases of incident type 2 diabetes. After adjustment for age; physical activity; cigarette smoking; alcohol consumption; family history of diabetes; and fruit, vegetable, and energy intakes, the relative risk of type 2 diabetes was 0.58 (95% CI: 0.47, 0.70; P for trend < 0.0001) comparing the highest with the lowest quintile of whole-grain intake. The association was moderately attenuated when additionally adjusted for body mass index (relative risk: 0.70; 95% CI: 0.57, 0.85; P for trend = 0.0006). Intake of refined grains was not significantly associated with risk of type 2 diabetes. After further adjustment for magnesium intake, cereal fiber intake, and glycemic load, the association between whole grains and type 2 diabetes was attenuated and the trend no longer significant.ConclusionsIn men, a diet high in whole grains is associated with a reduced risk of type 2 diabetes in men that may be mediated by cereal fiber. Efforts should be made to replace refined-grain with whole-grain foods.

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