Heart Care Info - Heart Disease Prevention & Treatment

... to Letter Regarding Article," Whole-Grain, Cereal Fiber, Bran, and Germ Intake and the Risks of All-Cause and Cardiovascular Disease-Specific Mortality Among ...

M He, RM van Dam, E Rimm, FB Hu... - Circulation, 2011 - Am Heart Assoc Kluwer Health, 351 West Camden Street, Baltimore, MD 21202-2436. Phone: 410-528-4050. Permissions: Permissions & Rights Desk, Lippincott Williams & Wilkins, a division of Wolters ... Response to Letter Regarding Article, Whole-Grain, Cereal Fiber, Bran, and ...

We appreciate the interest of Dr Thornton in our analyses on the intakes of whole grain and its components in relation to all-cause and cardiovascular disease (CVD)-specific mortality among women with type 2 diabetes.1 In his letter, Dr Thornton noted that high fluid intake might decrease insulin resistance, improve cardiovascular regulation, and lead to decreased cardiovascular mortality. One potential mechanism is that increasing fluid intake increases blood volume, which in turn lowers plasma levels of the vasoactive peptide hormones angiotensin and vasopressin as well as of the steroid hormone aldosterone.2

Dr Thornton posited that “it would not be surprising to find that the increased fluid intake associated with an increased dietary fiber intake would be cardioprotective.” In our study samples; however, there was no evidence that intakes of whole grain were associated with total fluid or water consumption. Also, we did not observe significant relation between total water intake and all-cause and CVD-specific mortality. Similar observations were also reported in nondiabetic populations.3 It appears that specific beverage consumption may be more relevant to disease and mortality risk.3,4

An important issue is whether fluid intake may confound the relation of whole grain and components with all-cause and CVD-specific mortality. When intakes of total water was adjusted as a covariate in the Cox proportional hazards regression model, the associations of intakes of whole grain and major components, including bran, germ, and cereal fiber with these outcomes, were not appreciably changed. In addition, we did not observe ...