Intervention Review

Whole grain foods for the prevention of type 2 diabetes mellitus

  1. Marion Priebe1,*,
  2. Jaap van Binsbergen2,
  3. Rien de Vos3,
  4. Roel J Vonk1

Editorial Group: Cochrane Metabolic and Endocrine Disorders Group

Published Online: 23 JAN 2008

Assessed as up-to-date: 30 MAY 2006

DOI: 10.1002/14651858.CD006061.pub2

How to Cite

Priebe M, van Binsbergen J, de Vos R, Vonk RJ. Whole grain foods for the prevention of type 2 diabetes mellitus. Cochrane Database of Systematic Reviews 2008, Issue 1. Art. No.: CD006061. DOI: 10.1002/14651858.CD006061.pub2.

Author Information

  1. 1

    University Medical Centre Groningen (UMCG), Department of Medical Biomics, Laboratory Nutrition and Metabolism, Groningen, Netherlands

  2. 2

    University Medical Centre, Department of General Practice, Nijmegen, Netherlands

  3. 3

    Academic Medical Centre, University of Amsterdam, Department of Clinical Epidemiology and Biostatistics, Amsterdam, Netherlands

*Marion Priebe, Department of Medical Biomics, Laboratory Nutrition and Metabolism, University Medical Centre Groningen (UMCG), Antonius Deusinglaan 1, Building 3215 4th floor, Groningen, 9713 AV, Netherlands.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 23 JAN 2008




  1. Top of page
  2. Abstract
  3. Plain language summary
  4. アブストラクト
  5. 摘要
  6. Laički sažetak


Diet as one aspect of lifestyle is thought to be one of the modifiable risk factors for the development of type 2 diabetes mellitus (T2DM). Information is needed as to which components of the diet could be protective for this disease.


To asses the effects of whole-grain foods for the prevention of T2DM.

Search methods


Selection criteria

We selected cohort studies with a minimum duration of five years that assessed the association between intake of whole-grain foods or cereal fibre and incidence of T2DM. Randomised controlled trials lasting at least six weeks were selected that assessed the effect of a diet rich in whole-grain foods compared to a diet rich in refined grain foods on T2DM and its major risk factors.

Data collection and analysis

Two authors independently selected the studies, assessed study quality and extracted data. Data of studies were not pooled because of methodological diversity.

Main results

One randomised controlled trial and eleven prospective cohort studies were identified. The randomised controlled trial, which was of low methodological quality, reported the change in insulin sensitivity in 12 obese hyperinsulinemic participants after six-week long interventions. Intake of whole grain foods resulted in a slight improvement of insulin sensitivity and no adverse effects. Patient satisfaction, health related quality of life, total mortality and morbidity was not reported.
Four of the eleven cohort studies measured cereal fibre intake, three studies whole grain intake and two studies both. Two studies measured the change in whole grain food intake and one of them also change in cereal fibre intake. The incidence of T2DM was assessed in nine studies and changes in weight gain in two studies. The prospective studies consistently showed a reduced risk for high intake of whole grain foods (27% to 30%) or cereal fibre (28% to 37%) on the development of T2DM.

Authors' conclusions

The evidence from only prospective cohort trials is considered to be too weak to be able to draw a definite conclusion about the preventive effect of whole grain foods on the development of T2DM. Properly designed long-term randomised controlled trials are needed. To facilitate this, further mechanistic research should focus on finding a set of relevant intermediate endpoints for T2DM and on identifying genetic subgroups of the population at risk that are most susceptible to dietary intervention.


Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. アブストラクト
  5. 摘要
  6. Laički sažetak

Whole grain foods for the prevention of type 2 diabetes mellitus

Food products derived from cereal grains as wheat, rice, corn, rye, oat, and barley constitute a major part of the daily diet in many countries. In refined-grain products, the bran and germ of the grain, which contain the major amount of nutrients and dietary fibre, have been removed and only the starchy inner part of the grain (ca. 80% of the whole grain) is used. Whole grain foods contain either intact, flaked or broken grain kernels, coarsely ground kernels or flour that is made from whole grains (whole-meal flour). In this review the effect of whole grain foods and cereal fibre (as a marker of whole-grain food intake) on the prevention of type 2 diabetes mellitus (T2DM) was assessed using all available prospective cohort studies and randomised controlled trials. Only one randomised controlled trial was found which was of low methodological quality. This study investigated in 12 overweight persons during six weeks the effect of the consumption of refined grain foods versus that of whole grain foods on insulin sensitivity (risk factor for the development of T2DM). Intake of whole grain foods resulted in a slight improvement of insulin sensitivity, increased bowel movements and no adverse effects. No information was given about patient satisfaction, health related quality of life, total mortality and morbidity. In addition eleven prospective cohort studies were found. One study was conducted in Finland and the rest in the United States of America of which seven were done in health care workers. Some of the studies were of limited quality. They consistently showed that a high intake of whole grain foods or cereal fibre is associated with a lower risk of the development of T2DM. However, evidence for a protective effect coming from prospective cohort studies only has to be considered as weak as with this design no cause and effect relationship can be established. Well-designed randomised controlled trials are needed to be able to draw definite conclusions about the preventive effects of whole grain consumption on development of T2DM.



  1. Top of page
  2. Abstract
  3. Plain language summary
  4. アブストラクト
  5. 摘要
  6. Laički sažetak

















監  訳: 江川 賢一,2008.4.1

実施組織: 厚生労働省委託事業によりMindsが実施した。

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  1. Top of page
  2. Abstract
  3. Plain language summary
  4. アブストラクト
  5. 摘要
  6. Laički sažetak









我們選擇了分析攝取全穀類食物或穀類纖維與第2型糖尿病發生率之間的關係且持續至少5年的世代研究(cohort studies)。此外,我們也選擇了比較富含全穀類食物的飲食及富含精製穀類食物的飲食對於第2型糖尿病及其主要危險因子的影響且持續至少6週以上的隨機對照試驗(randomised controlled trials; RCTs)。









此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。




Laički sažetak

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. アブストラクト
  5. 摘要
  6. Laički sažetak

Hrana s cjelovitim žitaricama za sprječavanje dijabetesa tipa 2

Prehrambeni proizvodi koji se dobivaju iz cjelovitih žitarica, kao što su pšenica, riža, kukuruz, raž, zob i ječam čine glavni udio u prehrani ljudi iz brojnih zemalja. U proizvodima od rafiniranih žitarica uklanjaju se mekinje i klice žitarice, koje sadrže glavninu hranjivih tvari i prehrambenih vlakana te se ostavlja samo škrobni unutarnji dio žitarice (oko 80% čitavoga zrna). Hrana s cjelovitim žitaricama sadrži netaknute žitarice, ili žitarice koje su u dijelovima, grubo usitnjene ili se radi o brašnu napravljenom od cjelovitih žitarica. U ovom Cochrane sustavnom pregledu ispitan je učinak cjelovitih žitarica i vlakana iz žitarica (kao mjera unosa cjelovitih žitarica) na sprječavanje dijabetesa tipa 2. U sustavni pregled uključene su sve kohortne studije koje su pratile ispitanike određeno vrijeme, kao i klinička ispitivanja sa slučajnim uzorkom ispitanika. Pronađeno je samo jedno kliničko ispitivanje sa slučajnim uzorkom ispitanika, a i to jedno je bilo loše metodološke kvalitete. U toj je studiji na 12 pretilih osoba tijekom šest tjedana uspoređen utjecaj konzumiranja hrane s rafiniranim žitaricama i hrane s cjelovitim žitaricama na osjetljivost na inzulin (čimbenik rizika za razvoj dijabetesa tipa 2). Unos cjelovitih žitarica donekle je poboljšao osjetljivost na inzulin, povećao aktivnost crijeva i nisu uočene nuspojave. Nisu navedene nikakve informacije o zadovoljstvu pacijenata, kvaliteti života povezanoj sa zdravljem, ukupnoj smrtnosti i pobolu. Osim ove studije, pronađeno je i 11 prospektivnih kohortnih studija. Jedna je provedena u Finskoj, a ostale u SAD-u, od kojih je sedam provedeno među zdravstvenim djelatnicima. Neke od ovih studija bile su ograničene kvalitete. Studije su konzistentno pokazale da je veći unos cjelovitih žitarica ili vlakana iz žitarica povezan s manjim rizikom od razvoja dijabetesa tipa 2. Međutim, dokazi za zaštitni učinak koji se dobiju prospektivnim kohortnim studijama trebaju se smatrati slabim dokazima jer u ovakvoj vrsti istraživanja nije moguće povezati uzrok i posljedicu. Nužna su nam dobro osmišljena kontrolirana ispitivanja na slučajnom uzorku ispitanika kako bi se mogli donijeti definitivni zaključci o preventivnom učinku konzumiranja cjelovitih žitarica na razvoj dijabetesa tipa 2.

Bilješke prijevoda

Prevoditelj:: Croatian Branch of the Italian Cochrane Centre
Prijevod financira:: Ministry of Education, Science and Sports