Whole-grain consumption and cardiometabolic risk: a meta-analysis of randomized trials
File(s)
Published online version
Author(s)
Type
Journal Article
Abstract
Background and Aims
Evidence suggests that higher whole-grain intake is associated with lower cardiometabolic disease risks, but underlying mechanisms remain unclear.
Methods
Randomized trials evaluating the effects of whole grains on cardiometabolic risk factors were included. Random-effects meta-analyses were used to estimate mean differences (MDs) with 95% confidence intervals (CIs) per 48 g/day increment of whole grains (dry weight; equivalent to ∼90 g or 3 servings of fresh weight).
Results
Eighty-seven trials (101 publications) were included. Each 48 g/day whole-grain intake was associated with reductions in body weight (MD: −.20 kg; 95% CI: −.31 to −.09; n = 41), waist circumference (−.22 cm; 95% CI: −.39 to −.06; n = 27), total cholesterol (−.10 mmol/L; 95% CI: −.13 to −.07; n = 54), and interleukin-6 (MD: −.12 pg/mL; 95% CI: −.23 to −.00; n = 12), with high certainty; low-density lipoprotein cholesterol (−.07 mmol/L; 95% CI: −.10 to −.05; n = 52), triglycerides (−.04 mmol/L; 95% CI: −.06 to −.02; n = 52), fasting plasma glucose (−.03 mmol/L; 95% CI: −.06 to −.00; n = 44), and systolic blood pressure (−.82 mmHg; 95% CI: −1.49 to −.15; n = 32), with moderate certainty. Non-linear analyses indicated greatest effects at 60–100 g/day for most outcomes, but at higher intakes (up to 180–220 g/day) for a few outcomes.
Conclusions
Whole-grain intake was associated with improvements in multiple cardiometabolic risk factors, with larger effects generally observed at intakes of ∼60–100 g/day. However, the certainty of evidence varied across outcomes, and sparse data at higher intake levels limit firm conclusions regarding dose thresholds.
Evidence suggests that higher whole-grain intake is associated with lower cardiometabolic disease risks, but underlying mechanisms remain unclear.
Methods
Randomized trials evaluating the effects of whole grains on cardiometabolic risk factors were included. Random-effects meta-analyses were used to estimate mean differences (MDs) with 95% confidence intervals (CIs) per 48 g/day increment of whole grains (dry weight; equivalent to ∼90 g or 3 servings of fresh weight).
Results
Eighty-seven trials (101 publications) were included. Each 48 g/day whole-grain intake was associated with reductions in body weight (MD: −.20 kg; 95% CI: −.31 to −.09; n = 41), waist circumference (−.22 cm; 95% CI: −.39 to −.06; n = 27), total cholesterol (−.10 mmol/L; 95% CI: −.13 to −.07; n = 54), and interleukin-6 (MD: −.12 pg/mL; 95% CI: −.23 to −.00; n = 12), with high certainty; low-density lipoprotein cholesterol (−.07 mmol/L; 95% CI: −.10 to −.05; n = 52), triglycerides (−.04 mmol/L; 95% CI: −.06 to −.02; n = 52), fasting plasma glucose (−.03 mmol/L; 95% CI: −.06 to −.00; n = 44), and systolic blood pressure (−.82 mmHg; 95% CI: −1.49 to −.15; n = 32), with moderate certainty. Non-linear analyses indicated greatest effects at 60–100 g/day for most outcomes, but at higher intakes (up to 180–220 g/day) for a few outcomes.
Conclusions
Whole-grain intake was associated with improvements in multiple cardiometabolic risk factors, with larger effects generally observed at intakes of ∼60–100 g/day. However, the certainty of evidence varied across outcomes, and sparse data at higher intake levels limit firm conclusions regarding dose thresholds.
Date Issued
2026-09-15
Date Acceptance
2026-06-17
Citation
European Heart Journal, 2026
ISSN
0195-668X
Publisher
Oxford University Press
Journal / Book Title
European Heart Journal
Copyright Statement
© The Author(s) 2026. Published by Oxford University Press on behalf of the European Society of Cardiology. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
License URL
Publication Status
Published online
Article Number
ehag519
Date Publish Online
2026-09-15