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Whole grain intake, compared to refined grain, improves postprandial glycemia and insulinemia: a systematic review and meta-analysis of randomized controlled trials.
Crit Rev Food Sci Nutr. 2023; 63(21):5339-5357.CR

Abstract

Whole grain (WG) intake has been associated with reduced risk of type 2 diabetes (T2D) and may protect against T2D by lowering postprandial glycemia and insulinemia and improving insulin sensitivity. The objective of this systematic review and meta-analysis was to evaluate the effect of WG intake, compared to refined grain (RG) intake, on postprandial glycemia and insulinemia and markers of glycemic control and insulin resistance in randomized controlled trials (RCTs) in adults. A search of PubMed and Scopus yielded 80 relevant RCTs. Compared to RG, WG intake significantly reduced postprandial glycemia (SMD: -0.30; 95% CI: -0.43, -0.18; P < 0.001), insulinemia (SMD: -0.23; 95% CI: -0.35, -0.10; P < 0.001) and glycated hemoglobin (HbA1c) (SMD: -0.21; 95% CI: -0.37, -0.06; P = 0.007). There was no effect of WG on fasting glucose, fasting insulin, or homeostatic model assessment of insulin resistance (HOMA-IR). These results suggest WG foods improve short-term glycemia and insulinemia, which may improve HbA1c, a marker of long-term glycemic control. This may partially explain the inverse association between WG intake and risk of T2D, but further investigations are needed to understand if short-term reductions in glycemia translate to longer term benefits in reducing the risk of T2D.Systematic Review Registration: PROSPERO Registration CRD42020180069.Supplemental data for this article is available online at https://doi.org/10.1080/10408398.2021.2017838.

Authors+Show Affiliations

Midwest Biomedical Research, Addison, IL, USA.Bell Institute of Health and Nutrition, General Mills, Inc, Minneapolis, MN, USA.Midwest Biomedical Research, Addison, IL, USA.Bell Institute of Health and Nutrition, General Mills, Inc, Minneapolis, MN, USA.Midwest Biomedical Research, Addison, IL, USA. Department of Applied Health Science, School of Public Health, Indiana University, Bloomington, IN, USA.

Pub Type(s)

Meta-Analysis
Systematic Review
Journal Article

Language

eng

PubMed ID

34930065

Citation

Sanders, Lisa M., et al. "Whole Grain Intake, Compared to Refined Grain, Improves Postprandial Glycemia and Insulinemia: a Systematic Review and Meta-analysis of Randomized Controlled Trials." Critical Reviews in Food Science and Nutrition, vol. 63, no. 21, 2023, pp. 5339-5357.
Sanders LM, Zhu Y, Wilcox ML, et al. Whole grain intake, compared to refined grain, improves postprandial glycemia and insulinemia: a systematic review and meta-analysis of randomized controlled trials. Crit Rev Food Sci Nutr. 2023;63(21):5339-5357.
Sanders, L. M., Zhu, Y., Wilcox, M. L., Koecher, K., & Maki, K. C. (2023). Whole grain intake, compared to refined grain, improves postprandial glycemia and insulinemia: a systematic review and meta-analysis of randomized controlled trials. Critical Reviews in Food Science and Nutrition, 63(21), 5339-5357. https://doi.org/10.1080/10408398.2021.2017838
Sanders LM, et al. Whole Grain Intake, Compared to Refined Grain, Improves Postprandial Glycemia and Insulinemia: a Systematic Review and Meta-analysis of Randomized Controlled Trials. Crit Rev Food Sci Nutr. 2023;63(21):5339-5357. PubMed PMID: 34930065.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Whole grain intake, compared to refined grain, improves postprandial glycemia and insulinemia: a systematic review and meta-analysis of randomized controlled trials. AU - Sanders,Lisa M, AU - Zhu,Yong, AU - Wilcox,Meredith L, AU - Koecher,Katie, AU - Maki,Kevin C, Y1 - 2021/12/20/ PY - 2023/7/21/medline PY - 2021/12/22/pubmed PY - 2021/12/21/entrez KW - Glucose KW - insulin KW - meta-analysis KW - randomized controlled trials KW - whole grain SP - 5339 EP - 5357 JF - Critical reviews in food science and nutrition JO - Crit Rev Food Sci Nutr VL - 63 IS - 21 N2 - Whole grain (WG) intake has been associated with reduced risk of type 2 diabetes (T2D) and may protect against T2D by lowering postprandial glycemia and insulinemia and improving insulin sensitivity. The objective of this systematic review and meta-analysis was to evaluate the effect of WG intake, compared to refined grain (RG) intake, on postprandial glycemia and insulinemia and markers of glycemic control and insulin resistance in randomized controlled trials (RCTs) in adults. A search of PubMed and Scopus yielded 80 relevant RCTs. Compared to RG, WG intake significantly reduced postprandial glycemia (SMD: -0.30; 95% CI: -0.43, -0.18; P < 0.001), insulinemia (SMD: -0.23; 95% CI: -0.35, -0.10; P < 0.001) and glycated hemoglobin (HbA1c) (SMD: -0.21; 95% CI: -0.37, -0.06; P = 0.007). There was no effect of WG on fasting glucose, fasting insulin, or homeostatic model assessment of insulin resistance (HOMA-IR). These results suggest WG foods improve short-term glycemia and insulinemia, which may improve HbA1c, a marker of long-term glycemic control. This may partially explain the inverse association between WG intake and risk of T2D, but further investigations are needed to understand if short-term reductions in glycemia translate to longer term benefits in reducing the risk of T2D.Systematic Review Registration: PROSPERO Registration CRD42020180069.Supplemental data for this article is available online at https://doi.org/10.1080/10408398.2021.2017838. SN - 1549-7852 UR - https://www.unboundmedicine.com/medline/citation/34930065/Whole_grain_intake_compared_to_refined_grain_improves_postprandial_glycemia_and_insulinemia:_a_systematic_review_and_meta_analysis_of_randomized_controlled_trials_ DB - PRIME DP - Unbound Medicine ER -