Prostate Restored
Prostate Restored
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Prostate cancer RR for an increase of 25 g/d of oatmeal was 0·96 (95 % CI 0·88, 1·06). In the categorical analysis, a negative association was found between the oatmeal intake and the prostate cancer risk (Table 2).
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Read More »There is strong evidence for a protective effect of oats intake on CVD – and possibly other chronic diseases – from short-term dietary experimental and mechanistic studies in healthy volunteers, assessing cardiovascular risk factors including a decrease in serum LDL-cholesterol and blood pressure, and improvement in glucose and insulin response( Reference Harris and Kris-Etherton 1 – Reference Thies, Masson and Boffetta 3 ). Epidemiological studies are the best way to test the hypothesis of an association between diet and disease( Reference Willett and Willett 4 ), although their ability to assess the effects of specific food items is limited. They provide strong evidence for a protective effect of whole-grain intake against several diseases, including cancer, CVD and diabetes( Reference Gil, Ortega and Maldonado 5 – Reference Slavin 7 ). The role of specific whole-grain foods, such as oats, however, is less clear. The present study aims at reviewing the evidence from epidemiological studies on oats and oat-product intake and the risk of chronic disease and death. Methods Fig. 1 is a flow diagram showing how relevant articles were selected. A PubMed search was performed using the terms ‘oat*’ AND ‘disease’ OR ‘cardiovascular’ OR ‘cancer’ OR ‘mortality’ AND ‘humans’ OR ‘epidemiology’. The search identified 2100 references, whose titles were individually checked, which resulted in the exclusion of 1596 references in which the term ‘oat*’ did not refer to the cereal. Among the remaining 504 references, 399 were excluded after consideration of the abstract, because they concerned aspects of oats consumption not relevant to epidemiology (namely nutritional, animal or mechanistic studies). The remaining 105 references were reviewed in detail: six epidemiological studies were identified that reported results on disease incidence/mortality and dietary intake of oats, and the remaining ninety-nine studies were mainly clinical and experimental studies. A review of the lists of references of the epidemiological studies led to the identification of two additional investigations. For each epidemiological study, information on study characteristics (study design, population, methods for the assessment of dietary intake, confounder and outcome) and results was abstracted according to a standard format. Given the small number of studies for each type of cancer and the heterogeneity in the assessment of oats intake, no formal combination of results in a meta-analytic approach was performed. Results Seven of the studies reported results on cancer risk (two each on prostate and colorectal cancer, and one each on pancreatic, breast and endometrial cancer), and one study on overall mortality. Colorectal cancer In an analysis of 1025 cases of colorectal cancer diagnosed among 57 053 participants in the Danish Diet, Cancer and Health cohort study over a 13-year period, no association was found with the healthy Nordic food index, which includes oatmeal intake( Reference Kyrø, Skeie and Loft 8 ). Consumption of oatmeal was similar among those diagnosed with colorectal cancer and those who remained free of the disease. The HELGA cohort comprises 108 000 Danish, Swedish and Norwegian people (including the Danish Diet, Cancer and Health cohort), of whom 1123 developed colorectal cancer during a median of 11 years of follow-up. This cohort was analysed for the intake of whole-grain products, including whole-grain oats( Reference Kyrø, Skeie and Loft 9 ). The intake of whole-grain products was associated with a lower incidence of colorectal cancer; however, no consistent association was observed with the intake of whole-grain oats (Table 1). The relative risk (RR) for a 10-g increase in whole-grain oats intake was 1·00 (95 % CI 0·94, 1·06). Prostate cancer An analysis of whole-grain product intake and the risk of prostate cancer was conducted among 26 691 men aged 50–64 who participated in the Danish Diet, Cancer and Health cohort study( Reference Egeberg, Olsen and Christensen 10 ). During a median follow-up of 12·4 years, 1081 prostate cancer cases were diagnosed in the cohort. There was no association between the total intake of whole-grain products and the prostate cancer risk (RR/50 g per d 1·00; 95 % CI 0·96, 1·05). RR for an increase of 25 g/d of oatmeal was 0·96 (95 % CI 0·88, 1·06). In the categorical analysis, a negative association was found between the oatmeal intake and the prostate cancer risk (Table 2). In 2002–2006, 2268 men aged 67–96 reported their dietary habits in the AGES-Reykjavik cohort study( Reference Torfadottir, Valdimarsdottir and Mucci 11 ). Dietary habits were assessed for early-, mid- and current life using a validated FFQ. A total of 347 participants had or were diagnosed with prostate cancer during follow-up in 2009, sixty-three of whom had an advanced form of the disease (stage 3+ or died of prostate cancer). Oatmeal intake, either in adolescence or in midlife, was not associated with prostate cancer risk (Table 3). Results were similar when cases were stratified according to the disease stage. Pancreatic cancer Grain intake was examined in a population-based case–control study of pancreatic cancer conducted in the San Francisco Bay Area from 1995 to 1999( Reference Chan, Wang and Holly 12 ). A 131-item semiquantitative FFQ was administered to 532 cases and 1701 controls. People who consumed two or more servings of whole grains daily had a lower risk of pancreatic cancer than those who consumed less than one serving per d (OR 0·60, 95 % CI 0·31, 1·2). Surprisingly, the intake of cooked oatmeal or oat bran, on the other hand, was associated with a small but statistically significant increase in risk (Table 4), but this should be interpreted with caution because this may be due to recall bias. Breast cancer The association between the intake of whole-grain products and the risk of breast cancer was investigated among 25 278 postmenopausal women participating in the Danish Diet, Cancer and Health cohort study (1993–7)( Reference Egeberg, Olsen and Loft 13 ). During a mean follow-up time of 9·6 years, 978 breast cancer cases were diagnosed. There was no association between the intake of whole-grain products (and specifically oatmeal) and the risk of breast cancer. For each incremental increase in the intake of total whole-grain products of 50 g/d, the adjusted RR was 1·01 (95 % CI 0·96, 1·07). The median intake of oatmeal was 7 g/d in both cases and controls. Endometrial cancer The association between the intake of whole grains and the risk of endometrial cancer was investigated among 24 418 women aged 50–64 at enrolment in 1993–7 in the Danish Diet, Cancer and Health cohort( Reference Aarestrup, Kyrø and Christensen 14 ). A total of 217 women were diagnosed with endometrial cancer during a follow-up to 2009. No association was found with either the intake of oatmeal/muesli (RR for a 50 g/d increase 1·03; 95 % CI 0·67, 1·58) or the intake of whole oats (RR for a 5 g/d increase 0·99; 95 % CI 0·93, 1·06). Overall mortality Oatmeal was one of the components of the healthy Nordic food index, whose association with total mortality was investigated in the Danish Diet, Cancer and Health cohort study (57 053 subjects aged 50–64 at baseline)( Reference Olsen, Egeberg and Halkjær 15 ). During 12 years of follow-up, 4126 of the cohort participants died. A one-point increase in the index score was associated with a significantly lower mortality for both men (RR 0·96; 95 % CI 0·92, 0·99) and women (RR 0·96; 95 % CI 0·92, 1·00). Among the individual index components, whole-grain rye bread intake was the factor most consistently associated with lower mortality. An association was suggested for oatmeal intake: RR for >20 v. ≤20 g/d was 0·91 (95 % CI 0·81, 1·02) in men and 0·97 (95 % CI 0·84, 1·11) in women.
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