Cardiovascular disease

• Intake of whole grain cereals is probably associated with decreased risk of cardiovascular disease.

• There is moderate evidence that there is an adverse relationship between higher consumption of whole grains and cardiovascular disease.

• There is moderate evidence that whole grains are associated with protection against cardiovascular disease.

• 'Some evidence indicates that whole grain intake may be associated with reduced risk of cardiovascular disease'.

Coronary heart disease

• 'There is probable evidence regarding primary prevention of CHD by increasing the consumption of whole-grain products'.

• There is reason to believe that dietary fibre from whole-grain cereal products and fruit is particularly effective in reducing the risk of coronary heart disease.

Stroke

• Limited evidence to support that whole grain consumption is associated with reduced incidence of stroke.

Blood pressure

• There is no significant relationship between whole grain intake and blood pressure.
• Limited evidence to support that higher consumption of whole grain is associated with reduced incidence of hypertension.

• 'there is probable evidence that increased dietary fibre consumption in a population with different blood pressure levels lowers the risk of hypertension. This also applies to the food group of whole-grain products'.

Blood lipids

• There is adequate evidence to support lack of correlation between whole grain consumption and fasting cholesterol and triacylglycerol levels.

• 'There is convincing evidence that an increased consumption of whole-grain products reduces the plasma levels of total and LDL cholesterol'.
• 'There is convincing evidence that there is no association between the consumption of whole-grain products and plasma triglyceride concentrations'.

• There is moderate evidence that whole grains are associated with protection against type-2 diabetes.

• There is moderate evidence that higher consumption of whole grain is adversely associated with the incidence of type 2 diabetes mellitus.
• Whole grain consumption has no significant effect on fasting blood glucose concentration, fasting blood insulin concentration and insulin sensitivity.

• 'Prospective cohort studies indicate with high consistency that high intake of whole-grain products or dietary fibre from cereal products, respectively, causes a lower risk of diabetes. The evidence regarding this association is judged as probable'.

• 'There are also strong indications that high consumption of many whole-grain cereal products can reduce the risk of type 2 diabetes mellitus'.

• There is limited evidence that whole grains could protect against colorectal cancer.

• Limited evidence supporting that higher whole grain intake is associated with reduced incidence of colon cancer.
• Limited evidence of no association between whole grain intake and colorectal cancer.

• Foods high in dietary fibre, such as whole grain cereals and vegetables, promote satiety and therefore may influence weight regulation by improving appetite regulation and tending to constrain excess energy consumption.

• Limited evidence suggesting that higher whole grain consumption is related with reduced energy intake.

• In adults, 'increased whole grain product intake is accompanied by a reduced risk of obesity. The overall evidence is judged as possible'.
• 'For children and adolescents, the evidence regarding the role of whole-grain product intake in the development of obesity is insufficient'.

• 'Some evidence indicates that whole grain intake is associated with lower body weight'.

• 'Because there is only 1 prospective study available, the evidence regarding an association between the consumption of whole-grain products or refined grain products and the metabolic syndrome is judged as insufficient'.