NFI - SISA

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

Mellen PB, Liese AD, Tooze JA, Vitolins MZ, Wagenknecht LE, Herrington DM
Am J Clin Nutr. 2007 Jun;85(6):1495-502

Il consumo di cereali integrali è stato associato alla riduzione del rischio cardiovascolare, tuttavia, ancora non è stato stabilito il ruolo di tali alimenti nella prevenzione dell’aterosclerosi. Uno studio pubblicato sull’American Journal of Clinical Nutrition ha verificato la relazione tra il consumo di cereali integrali e lo spessore del complesso intima-media della carotide che rappresenta un indicatore della presenza di malattia aterosclerotica dell’organismo e correla anche con l’aterosclerosi a livello coronarico. L’indagine ha coinvolto quasi 1200 uomini e donne di età media 55,2 anni, i quali hanno compilato un questionario alimentare per valutare le quantità di cereali integrali consumate (in media 0,79 porzioni al giorno), inoltre, all’inizio dello studio e dopo 5 anni a tutti i partecipanti è stato misurato lo spessore della parete carotidea. L’analisi dei dati ottenuti ha evidenziato un minore spessore della parete carotidea e, quindi, una riduzione del rischio di aterosclerosi, in coloro che consumavano le maggiori quantità di cereali integrali.

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.