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Nutrition Journal

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Open Access 01-12-2024 | Type 2 Diabetes | Research

Effects of whole grains on glycemic control: a systematic review and dose-response meta-analysis of prospective cohort studies and randomized controlled trials

Authors: Tao Ying, Jianheng Zheng, Juntao Kan, Wenyun Li, Kun Xue, Jun Du, Yuwei Liu, Gengsheng He

Published in: Nutrition Journal | Issue 1/2024

Abstract

Purpose

Whole grains have recently been promoted as beneficial to diabetes prevention. However, the evidence for the glycemic benefits of whole grains seems to conflict between the cohort studies and randomized control trials (RCTs). To fill the research gap, we conducted a meta-analysis to determine the effects of whole grains on diabetes prevention and to inform recommendations.

Methods

We searched PubMed, Clarivate Web of Science, and Cochrane Library until March 2024. We used the risk ratio (RR) of type 2 diabetes to represent the clinical outcomes for cohort studies, while the biomarkers, including fasting blood glucose and insulin, HbA_1C, and HOMA-IR, were utilized to show outcomes for RCTs. Dose-response relationships between whole grain intakes and outcomes were tested with random effects meta-regression models and restricted cubic splines models. This study is registered with PROSPERO, CRD42021281639.

Results

Ten prospective cohort studies and 37 RCTs were included. Cohort studies suggested a 50 g/day whole grain intake reduced the risk of type 2 diabetes (RR = 0.761, 95% CI: 0.700 to 0.828, I² = 72.39%, P < 0.001) and indicated a monotonic inverse relationship between whole grains and type 2 diabetes rate. In RCTs, whole grains significantly reduced fasting blood glucose (Mean difference (MD) = -0.103 mmol/L, 95% CI: -0.178 to -0.028; I² = 72.99%, P < 0.01) and had modest effects on HbA_1C (MD = -0.662 mmol/mol (-0.06%), 95% CI: -1.335 to 0.010; I² = 64.55%, P = 0.05) and HOMA-IR (MD = -0.164, 95% CI: -0.342 to 0.013; I² = 33.38%, P = 0.07). The intake of whole grains and FBG, HbA_1C, and HOMA-IR were significantly dose-dependent. The restricted spline curves remained flat up to 150 g/day and decreased afterward. Subgroup analysis showed that interventions with multiple whole-grain types were more effective than those with a single type.

Conclusion

Our study findings suggest that a daily intake of more than 150 g of whole grain ingredients is recommended as a population approach for diabetes prevention.

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Title: Effects of whole grains on glycemic control: a systematic review and dose-response meta-analysis of prospective cohort studies and randomized controlled trials
Authors: Tao Ying
Jianheng Zheng
Juntao Kan
Wenyun Li
Kun Xue
Jun Du
Yuwei Liu
Gengsheng He
Publication date: 01-12-2024
Publisher: BioMed Central
Keyword: Type 2 Diabetes
Published in: Nutrition Journal / Issue 1/2024
Electronic ISSN: 1475-2891
DOI: https://doi.org/10.1186/s12937-024-00952-2

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