Iran: A recent study has shown an association between consuming refined grains and an increased risk of premature coronary artery disease (PCAD). In contrast, the intake of whole grain was linked with reduced risk.
The researchers stated, "diet including consumption of a high amount of unhealthy and refined grains can be considered equivalent to consuming a diet containing a lot of unhealthy sugars and oils." Whole grains contain the entire grain, whereas refined grains have been milled and ground into flour or meal to improve shelf life, but essential nutrients get lost in the process.
The findings, based on a food questionnaire provided to more than 4600 Iranians (including some with PCAD, those deemed healthy, and others diagnosed with coronary artery disease), were presented at the American College of Cardiology (ACC) Middle East 2022 Together with the 13th Emirates Cardiac Society Congress, taking place in Dubai, United Arab Emirates, October 7-9, 2022.
Previous epidemiological studies have shown an association between the intake of different grain types and coronary artery disease (CAD) risk. Mohammad Amin Khajavi Gaskarei of the Isfahan Cardiovascular Research Center and Cardiovascular Research Institute at Isfahan University of Medical Sciences in Isfahan, Iran, and colleagues evaluated the association between refined and whole grains consumption and the risk of PCAD in an Iranian population.
Premature coronary artery disease is the atherosclerotic narrowing of coronary arteries in males below 55 years old or in females below 65 years of age. Early in the course of the disease, it is often asymptomatic. Still, it may lead to angina (chest pain) and heart attack with progressive stenosis (narrowing) development or plaque rupture of the arterial wall. PCAD's risk factors include high blood pressure, high cholesterol, diabetes, and smoking.
The researchers recruited 2099 people with PCAD from hospitals with cath labs in different ethnicities and cities throughout Iran who underwent coronary angiography (women aged ≤ 70 and men ≤ 60). The control group comprised 1,168 patients with normal coronary arteries. In comparison, the case group included 1,369 patients with CAD with obstruction equal to or above 75% in at least a single coronary artery or ≥ 50% in the left main coronary artery.
Participants were provided with a food frequency questionnaire for dietary assessments to assess dietary behaviours and determine the association between the intake of whole grain and refined grain and the risk of PCAD in people without a prior diagnoses of heart disease. After adjustment for confounders, a higher intake of refined grains was linked with an increased PCAD risk, while whole grain intake was inversely related to reduced PCAD risk.