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Whole-grain intake in mid-life and healthy ageing in the Danish Diet, Cancer and Health cohort

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Abstract

Purpose

Growing elderly populations worldwide have sparked interest in factors promoting healthy aging. Diet and other lifestyle patterns are key factors for healthy ageing; however, evidence is sparse for specific dietary guidelines that are easily implemented in everyday life. Whole grains constitute specific dietary components with unexplored potential in healthy ageing.

Methods

We applied an illness-death multistate model to assess the association between whole-grain intake and life expectancy, both with and without disease, over a 20-year period. Healthy ageing was defined as absence of cancer, ischemic heart disease, stroke, type 2 diabetes, asthma, chronic obstructive pulmonary disease, and dementia during follow-up.

Results

Based on information from 22,606 men and 25,468 women in the Danish Diet, Cancer and Health cohort, followed for an average of 13.8 and 17.5 years, respectively, a doubling in whole-grain intake was associated with 0.43 (95% CI: 0.33–0.52) and 0.15 (0.06–0.24) additional years without disease for men and women, respectively. Comparing the highest and lowest quartiles of whole-grain intake, with a special emphasis on men, we found that those with the highest intake lived, on average, one year longer without disease compared to those with the lowest intake. Additionally, although a high intake of whole grains yielded longer life expectancy, the duration of living with disease was shorter.

Conclusion

Intake of whole grains in mid-life was associated with healthy ageing looking 20 years ahead.

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Change history

  • 17 April 2024

    In affiliations 1 and 2 department have been moved in front of Danish Cancer Institute, adjusted the size of the figures 1, 2 and 3, figure 3 caption style updated, in table 1 “column heading” “Missing(n)” alignment and layout changes made and in tables 1 and 3, minimized the large empty spaces between columns

References

  1. Wang H, Abajobir AA, Abate KH, Abbafati C, Abbas KM, Abd-Allah F, et al. Global, regional, and national under-5 mortality, adult mortality, age-specific mortality, and life expectancy, 1970–2016: a systematic analysis for the Global Burden of Disease Study 2016. The Lancet. 2017;390(10100):1084 − 150. doi: 10.1016/S0140-6736(17)31833-0.

  2. Barnett K, Mercer SW, Norbury M, Watt G, Wyke S, Guthrie B (2012) Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study. Lancet (London England) 380(9836):37–43. https://doi.org/10.1016/s0140-6736(12)60240-2

    Article  PubMed  Google Scholar 

  3. Capocaccia R, Gatta G, Dal Maso L (2015) Life expectancy of colon, breast, and testicular cancer patients: an analysis of US-SEER population-based data. Ann Oncol 26(6):1263–1268. https://doi.org/10.1093/annonc/mdv131

    Article  CAS  PubMed  Google Scholar 

  4. Tancredi M, Rosengren A, Svensson AM, Kosiborod M, Pivodic A, Gudbjornsdottir S et al (2015) Excess mortality among persons with type 2 diabetes. N Engl J Med 373(18):1720–1732. https://doi.org/10.1056/NEJMoa1504347

    Article  CAS  PubMed  Google Scholar 

  5. Global Health Estimates (2020) : Deaths by Cause, Age, Sex, by Country and by Region, 2000–2019. World Health Organization. 2020 [cited 18-08-2022]

  6. Foreman KJ, Marquez N, Dolgert A, Fukutaki K, Fullman N, McGaughey M et al (2018) Forecasting life expectancy, years of life lost, and all-cause and cause-specific mortality for 250 causes of death: reference and alternative scenarios for 2016–40 for 195 countries and territories. Lancet 392(10159):2052–2090. https://doi.org/10.1016/S0140-6736(18)31694-5

    Article  PubMed  PubMed Central  Google Scholar 

  7. Stenholm S, Head J, Kivimäki M, Kawachi I, Aalto V, Zins M et al (2016) Smoking, physical inactivity and obesity as predictors of healthy and disease-free life expectancy between ages 50 and 75: a multicohort study. Int J Epidemiol 45(4):1260–1270. https://doi.org/10.1093/ije/dyw126

    Article  PubMed  PubMed Central  Google Scholar 

  8. Licher S, Heshmatollah A, van der Willik KD, Stricker BHC, Ruiter R, de Roos EW et al (2019) Lifetime risk and multimorbidity of non-communicable diseases and disease-free life expectancy in the general population: a population-based cohort study. PLoS Med 16(2):e1002741. https://doi.org/10.1371/journal.pmed.1002741

    Article  PubMed  PubMed Central  Google Scholar 

  9. Li Y, Schoufour J, Wang DD, Dhana K, Pan A, Liu X et al (2020) Healthy lifestyle and life expectancy free of cancer, cardiovascular disease, and type 2 diabetes: prospective cohort study. BMJ (Clinical Res ed) 368:l6669. https://doi.org/10.1136/bmj.l6669

    Article  Google Scholar 

  10. Nyberg ST, Singh-Manoux A, Pentti J, Madsen IEH, Sabia S, Alfredsson L et al (2020) Association of Healthy Lifestyle with years lived without Major Chronic diseases. JAMA Intern Med 180(5):760–768. https://doi.org/10.1001/jamainternmed.2020.0618

    Article  PubMed  Google Scholar 

  11. Health effects of dietary risks (2019) In 195 countries, 1990–2017: a systematic analysis for the global burden of Disease Study 2017. Lancet (London England) 393(10184):1958–1972. https://doi.org/10.1016/s0140-6736(19)30041-8

    Article  Google Scholar 

  12. Kyrø C, Tjønneland A, Overvad K, Olsen A, Landberg R (2018) 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 148(9):1434–1444. https://doi.org/10.1093/jn/nxy112

    Article  PubMed  Google Scholar 

  13. Helnaes A, Kyro C, Andersen I, Lacoppidan S, Overvad K, Christensen J et al (2016) Intake of whole grains is associated with lower risk of myocardial infarction: the Danish Diet, Cancer and Health Cohort. Am J Clin Nutr 103(4):999–1007. https://doi.org/10.3945/ajcn.115.124271

    Article  CAS  PubMed  Google Scholar 

  14. Aune D, Keum N, Giovannucci E, Fadnes LT, Boffetta P, Greenwood DC et al (2016) Whole grain consumption and risk of cardiovascular disease, cancer, and all cause and cause specific mortality: systematic review and dose-response meta-analysis of prospective studies. BMJ (Clinical Res ed) 353:i2716. https://doi.org/10.1136/bmj.i2716

    Article  Google Scholar 

  15. Jacobs DR Jr, Andersen LF, Blomhoff R (2007) Whole-grain consumption is associated with a reduced risk of noncardiovascular, noncancer death attributed to inflammatory diseases in the Iowa women’s Health Study. Am J Clin Nutr 85(6):1606–1614. https://doi.org/10.1093/ajcn/85.6.1606

    Article  CAS  PubMed  Google Scholar 

  16. Szmidt MK, Kaluza J, Harris HR, Linden A, Wolk A (2020) Long-term dietary fiber intake and risk of chronic obstructive pulmonary disease: a prospective cohort study of women. Eur J Nutr 59(5):1869–1879. https://doi.org/10.1007/s00394-019-02038-w

    Article  CAS  PubMed  Google Scholar 

  17. Andrianasolo RM, Hercberg S, Kesse-Guyot E, Druesne-Pecollo N, Touvier M, Galan P, Varraso R (2019) Association between dietary fibre intake and asthma (symptoms and control): results from the French national e-cohort NutriNet-Santé. Br J Nutr 122(9):1040–1051. https://doi.org/10.1017/S0007114519001843

    Article  CAS  PubMed  Google Scholar 

  18. Yamagishi K, Maruyama K, Ikeda A, Nagao M, Noda H, Umesawa M et al (2022) Dietary fiber intake and risk of incident disabling dementia: the circulatory risk in communities Study. Nutr Neurosci 1–8. https://doi.org/10.1080/1028415X.2022.2027592

  19. Foscolou A, D’Cunha NM, Naumovski N, Tyrovolas S, Chrysohoou C, Rallidis L et al (2019) The Association between Whole Grain products Consumption and successful aging: a combined analysis of MEDIS and ATTICA Epidemiological Studies. Nutrients 11(6). https://doi.org/10.3390/nu11061221

  20. Tyrovolas S, Haro JM, Mariolis A, Piscopo S, Valacchi G, Tsakountakis N et al (2014) Successful aging, dietary habits and health status of elderly individuals: a k-dimensional approach within the multi-national MEDIS study. Exp Gerontol 60:57–63. https://doi.org/10.1016/j.exger.2014.09.010

    Article  PubMed  Google Scholar 

  21. Tjonneland A, Olsen A, Boll K, Stripp C, Christensen J, Engholm G, Overvad K (2007) Study design, exposure variables, and socioeconomic determinants of participation in Diet, Cancer and Health: a population-based prospective cohort study of 57,053 men and women in Denmark. Scand J Public Health 35(4):432–441. https://doi.org/10.1080/14034940601047986

    Article  PubMed  Google Scholar 

  22. Lauritsen J (1998) Foodcalc 1.3. Computer Program. Available at: http://www.foodcalc.dk

  23. Gjerstorff ML (2011) The Danish Cancer Registry. Scand J Public Health 39(7 Suppl):42–45. https://doi.org/10.1177/1403494810393562

    Article  PubMed  Google Scholar 

  24. Schmidt M, Schmidt SAJ, Sandegaard JL, Ehrenstein V, Pedersen L, Sørensen HT (2015) The Danish National Patient Registry: a review of content, data quality, and research potential. Clin Epidemiol 7:449–490. https://doi.org/10.2147/CLEP.S91125

    Article  PubMed  PubMed Central  Google Scholar 

  25. Lynge E, Sandegaard JL, Rebolj M (2011) The Danish National Patient Register. Scand J Public Health 39(7 Suppl):30–33. https://doi.org/10.1177/1403494811401482

    Article  PubMed  Google Scholar 

  26. Danish Health Data Authority. Documentation of registries https://www.esundhed.dk/Dokumentation/DocumentationExtended?id=292017

  27. Pottegård A, Schmidt SA, Wallach-Kildemoes H, Sørensen HT, Hallas J, Schmidt M (2017) Data resource profile: the Danish national prescription Registry. Int J Epidemiol 46(3):798–798f. https://doi.org/10.1093/ije/dyw213

    Article  PubMed  Google Scholar 

  28. Helweg-Larsen K (2011) The Danish Register of causes of Death. Scand J Public Health 39(7 Suppl):26–29. https://doi.org/10.1177/1403494811399958

    Article  PubMed  Google Scholar 

  29. Thygesen LC, Daasnes C, Thaulow I, Bronnum-Hansen H (2011) Introduction to Danish (nationwide) registers on health and social issues: structure, access, legislation, and archiving. Scand J Public Health 39(7 Suppl):12–16. https://doi.org/10.1177/1403494811399956

    Article  PubMed  Google Scholar 

  30. Grand MK, Putter H (2016) Regression models for expected length of stay. Stat Med 35(7):1178–1192. https://doi.org/10.1002/sim.6771

    Article  PubMed  Google Scholar 

  31. Hollaender PL, Ross AB, Kristensen M (2015) Whole-grain and blood lipid changes in apparently healthy adults: a systematic review and meta-analysis of randomized controlled studies. Am J Clin Nutr 102(3):556–572. https://doi.org/10.3945/ajcn.115.109165

    Article  CAS  PubMed  Google Scholar 

  32. Roager HM, Vogt JK, Kristensen M, Hansen LBS, Ibrugger S, Maerkedahl RB et al (2019) Whole grain-rich diet reduces body weight and systemic low-grade inflammation without inducing major changes of the gut microbiome: a randomised cross-over trial. Gut 68(1):83–93. https://doi.org/10.1136/gutjnl-2017-314786

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

Data manager, Peter Fjeldstad Hendriksen, and all participants in the Diet, Cancer and Health cohort, which was funded by the Danish Cancer Society, Denmark.

Author information

Authors and Affiliations

  1. Diet, Cancer and Health, Danish Cancer Institute, Copenhagen, Denmark

    Anne Kirstine Eriksen, Cecilie Kyrø, Anne Tjønneland & Anja Olsen

  2. Statistics and Data Analysis, Danish Cancer Institute, Copenhagen, Denmark

    Mia Klinten Grand

  3. Cancer Epidemiology and Surveillance, Danish Cancer Institute, Copenhagen, Denmark

    Jan Wohlfahrt

  4. Department of Public Health, Aarhus University, Aarhus, Denmark

    Kim Overvad & Anja Olsen

  5. Department of Public Health, University of Copenhagen, Copenhagen, Denmark

    Anne Tjønneland

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  1. Anne Kirstine Eriksen
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Contributions

A.O, A.T and K.O contributed to the study concept and design. M.K.G contributed to statistical methods, analysis and -support. A.K.E conducted the data analysis and drafted the manuscript. A.K.E, A.O, A.T, C.K, J.W, K.O and M.K.G critically reviewed the final draft of the manuscript.

Corresponding author

Correspondence to Anne Kirstine Eriksen.

Ethics declarations

Ethics approval and consent to participate

The study was approved by the regional ethical committees on human studies [File (KF)11–037/01] and by the Danish Data Protection Agency. All study participants gave written informed consent.

Competing interests

The authors declare that they have no conflict of interest.

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Eriksen, A.K., Grand, M.K., Kyrø, C. et al. Whole-grain intake in mid-life and healthy ageing in the Danish Diet, Cancer and Health cohort. Eur J Nutr (2024). https://doi.org/10.1007/s00394-024-03357-3

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