Intakes of whole grains, bran, and germ and the risk of coronary heart disease in men

Background: Previous studies have suggested that a daily intake of 3 servings of whole-grain foods is associated with a reduced risk of coronary heart disease (CHD). However, methods for the assessment of whole-grain intake differ. Furthermore, any additional effects of added bran and germ, which are components of whole grains, have not been reported. Objective: The objective was to evaluate the association of wholegrain, bran, and germ intakes (with the use of new quantitative measures) with the incidence of CHD. Design: This was a prospective cohort study of 42 850 male health professionals aged 40-75 y at baseline in 1986 who were free from cardiovascular disease, cancer, and diabetes. Daily whole-grain, bran, and germ intakes were derived in grams per day from a detailed semiquantitative dietary questionnaire. Results: During 14 y of follow-up, we documented 1818 incident cases of CHD. After cardiovascular disease risk factors and the intakes of bran and germ added to foods were controlled for, the hazard ratio of CHD between extreme quintiles of whole-grain intake was 0.82 (95% CI: 0.70, 0.96; P for trend = 0.01). The hazard ratio of CHD in men with the highest intake of added bran was 0.70 (95% Cl: 0.60, 0.82) compared with men with no intake of added bran (P for trend less than or equal to 0.001). Added germ was not associated with CHD risk. Conclusion: This study supports the reported beneficial association of whole-grain intake with CHD and suggests that the bran component of whole grains could be a key factor in this relation.