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Cereal intake and mortality in older Chinese: a 15-year follow-up of a prospective cohort study

  • Original Contribution
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Abstract

Purpose

We examined the association between whole grain and refined grain intake with all-cause, cancer and cardiovascular disease (CVD) mortality using the data from the Guangzhou Biobank Cohort Study.

Methods

19,597 participants aged 50+ years were recruited from 2003 to 2006 and followed-up until April 2021. Multivariable Cox regression was used to calculate hazard radios (HRs) and 95% confidence intervals (CIs). Substitution analysis was used to replace a serving (50 g/day) of whole grain with a serving of refined grain.

Results

During 286,821 person-years of follow-up, 4385 deaths occurred, including 1450 from cancer, 1678 from CVD and 1257 from other causes. Compared with never whole grain intake, the highest intake category of whole grain (> 300 g/week) was associated with lower risk of all-cause (HR 0.90, 95% CI 0.82–0.98) and CVD mortality (HR 0.85, 0.74–0.98). Compared with the low-intake category of refined grain (< 500 g/day), the highest intake category (> 900 g/week) was associated with a lower risk of cancer mortality (HR 0.76, 0.62–0.95), but a higher risk of CVD mortality (HR 1.25, 1.03–1.51). No significant associations were found between whole grain intake and cancer mortality nor refined grain and all-cause mortality. The HRs of all-cause, cancer and CVD mortality substituting a serving of whole grain for refined grain were 0.96 (0.94–0.99), 1.01 (0.99–1.02) and 0.95 (0.90–0.99), respectively.

Conclusion

We have first shown that in older Chinese, whole grain intake was associated with lower risk of all-cause and CVD mortality. Our results suggest that intake of whole grain of at least 300 g/week and refined grain of ≤ 900 g/day might be suitable for older Asian. Substituting 50 g/day of whole grain for refined grain was associated with a 4–5% lower risk of all-cause and CVD mortality.

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Data availability

Due to ethical restrictions protecting patient privacy, data available on request from the Guangzhou Biobank Cohort Study Data Access Committee. Please contact us at gbcsdata@hku.hk for fielding data accession requests. The code book and analytic code will be made available upon request to the corresponding author.

References

  1. Swaminathan S, Dehghan M, Raj JM, Thomas T, Rangarajan S, Jenkins D, Mony P, Mohan V, Lear SA, Avezum A, Lopez-Jaramillo P, Rosengren A, Lanas F, AlHabib KF, Dans A, Keskinler MV, Puoane T, Soman B, Wei L, Zatonska K, Diaz R, Ismail N, Chifamba J, Kelishadi R, Yusufali A, Khatib R, Xiaoyun L, Bo H, Iqbal R, Yusuf R, Yeates K, Teo K, Yusuf S (2021) Associations of cereal grains intake with cardiovascular disease and mortality across 21 countries in Prospective Urban and Rural Epidemiology study: prospective cohort study. BMJ 372:m4948. https://doi.org/10.1136/bmj.m4948

    Article  PubMed  PubMed Central  Google Scholar 

  2. Dehghan M, Mente A, Zhang X, Swaminathan S, Li W, Mohan V, Iqbal R, Kumar R, Wentzel-Viljoen E, Rosengren A, Amma LI, Avezum A, Chifamba J, Diaz R, Khatib R, Lear S, Lopez-Jaramillo P, Liu X, Gupta R, Mohammadifard N, Gao N, Oguz A, Ramli AS, Seron P, Sun Y, Szuba A, Tsolekile L, Wielgosz A, Yusuf R, Hussein YA, Teo KK, Rangarajan S, Dagenais G, Bangdiwala SI, Islam S, Anand SS, Yusuf S (2017) Associations of fats and carbohydrate intake with cardiovascular disease and mortality in 18 countries from five continents (PURE): a prospective cohort study. Lancet 390:2050–2062. https://doi.org/10.1016/S0140-6736(17)32252-3

    Article  CAS  PubMed  Google Scholar 

  3. Ho FK, Gray SR, Welsh P, Petermann-Rocha F, Foster H, Waddell H, Anderson J, Lyall D, Sattar N, Gill J, Mathers JC, Pell JP, Celis-Morales C (2020) Associations of fat and carbohydrate intake with cardiovascular disease and mortality: prospective cohort study of UK Biobank participants. BMJ 368:m688. https://doi.org/10.1136/bmj.m688

    Article  PubMed  PubMed Central  Google Scholar 

  4. Aune D, Keum N, Giovannucci E, Fadnes LT, Boffetta P, Greenwood DC, Tonstad S, Vatten LJ, Riboli E, Norat T (2016) Whole grain consumption and risk of cardiovascular disease, cancer, and all cause and cause specific mortality: systematic review and dose-response meta-analysis of prospective studies. BMJ 353:i2716. https://doi.org/10.1136/bmj.i2716

    Article  PubMed  PubMed Central  Google Scholar 

  5. Benisi-Kohansal S, Saneei P, Salehi-Marzijarani M, Larijani B, Esmaillzadeh A (2016) Whole-grain intake and mortality from all causes, cardiovascular disease, and cancer: a systematic review and dose-response meta-analysis of prospective cohort studies. Adv Nutr 7:1052–1065. https://doi.org/10.3945/an.115.011635

    Article  PubMed  PubMed Central  Google Scholar 

  6. Mantian C, Jinxiang L, Wei L, Xianghua S, Hong S (2017) Dietary refined grain intake could increase the coronary heart disease risk: evidence from a meta-analysis. Int J Clin Exp Med 10:12749–12755

    Google Scholar 

  7. Schwingshackl L, Schwedhelm C, Hoffmann G, Lampousi AM, Knüppel S, Iqbal K, Bechthold A, Schlesinger S, Boeing H (2017) Food groups and risk of all-cause mortality: a systematic review and meta-analysis of prospective studies. Am J Clin Nutr 105:1462–1473. https://doi.org/10.3945/ajcn.117.153148

    Article  CAS  PubMed  Google Scholar 

  8. Kyrø C, Skeie G, Dragsted LO, Christensen J, Overvad K, Hallmans G, Johansson I, Lund E, Slimani N, Johnsen NF, Halkjær J, Tjønneland A, Olsen A (2011) Intake of whole grains in Scandinavia is associated with healthy lifestyle, socio-economic and dietary factors. Public Health Nutr 14:1787–1795. https://doi.org/10.1017/S1368980011000206

    Article  PubMed  Google Scholar 

  9. Boggs DA, Ban Y, Palmer JR, Rosenberg L (2015) Higher diet quality is inversely associated with mortality in African-American women. J Nutr 145:547–554. https://doi.org/10.3945/jn.114.195735

    Article  CAS  PubMed  Google Scholar 

  10. Sharif MK, Butt MS, Anjum FM, Khan SH (2014) Rice bran: a novel functional ingredient. Crit Rev Food Sci Nutr 54:807–816. https://doi.org/10.1080/10408398.2011.608586

    Article  CAS  PubMed  Google Scholar 

  11. Shewry PR, Hassall KL, Grausgruber H, Andersson A, Lampi AM, Piironen V, Rakszegi M, Ward JL, Lovegrove A (2020) Do modern types of wheat have lower quality for human health? Nutr Bull 45:362–373. https://doi.org/10.1111/nbu.12461

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Research WCRF (2007) Food, nutrition physical activity and the prevention of cancer: a global perspective. AICR. https://doi.org/10.1017/S002966510800712X

    Article  Google Scholar 

  13. Mann KD, Pearce MS, McKevith B, Thielecke F, Seal CJ (2015) Low whole grain intake in the UK: results from the national diet and nutrition survey rolling programme 2008–11. Br J Nutr 113:1643–1651. https://doi.org/10.1017/S0007114515000422

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Oldways whole grain council. Whole grain guidelines worldwide. 2010. http://wholegrainscouncil.org/whole-grains-101/whole-grain-guidelines-worldwide. Accessed 5 Apr 2010

  15. Chinese Nutrition Society (2022) Chinese Dietary Guideline. http://dg.cnsoc.org/newslist_0501_1.htm. Accessed 26 Apr 2022

  16. Jiang C, Thomas GN, Lam TH, Schooling CM, Zhang W, Lao X, Adab P, Liu B, Leung GM, Cheng KK (2006) Cohort profile: The Guangzhou Biobank Cohort Study, a Guangzhou-Hong Kong-Birmingham collaboration. Int J Epidemiol 35:844–852. https://doi.org/10.1093/ije/dyl131

    Article  PubMed  Google Scholar 

  17. Lam TH, Xu L, Jiang CQ, Zhang WS, Zhu F, Jin YL, Thomas GN, Cheng KK (2018) High relative risk of all-cause mortality attributed to smoking in China: Guangzhou Biobank Cohort Study. PLoS One 13:e196610. https://doi.org/10.1371/journal.pone.0196610

    Article  CAS  Google Scholar 

  18. Xu L, Lam TH, Jiang CQ, Zhang WS, Zhu F, Jin YL, Woo J, Cheng KK, Thomas GN (2019) Egg consumption and the risk of cardiovascular disease and all-cause mortality: Guangzhou Biobank Cohort Study and meta-analyses. Eur J Nutr 58:785–796. https://doi.org/10.1007/s00394-018-1692-3

    Article  PubMed  Google Scholar 

  19. Woo J, Leung SSF, Ho SC, Lam TH (1997) A food frequency questionnaire for use in the Chinese population in Hong Kong: description and examination of validity. Nutr Res 17:1633–1641

    Article  CAS  Google Scholar 

  20. Paul AA, Southgate D (1978) McCance and Widdowson’s the composition of foods. Elsevier

    Google Scholar 

  21. Yang Y (2002) China Food Composition. Peking University Medical Press, Beijing, China, Institute of Nutrition and Food Safety

    Google Scholar 

  22. Bhavadharini B, Mohan V, Dehghan M, Rangarajan S, Swaminathan S, Rosengren A, Wielgosz A, Avezum A, Lopez-Jaramillo P, Lanas F, Dans AL, Yeates K, Poirier P, Chifamba J, Alhabib KF, Mohammadifard N, Zatońska K, Khatib R, Vural KM, Wei L, Wang C, Liu X, Iqbal R, Yusuf R, Wentzel-Viljoen E, Yusufali A, Diaz R, Keat NK, Lakshmi P, Ismail N, Gupta R, Palileo-Villanueva LM, Sheridan P, Mente A, Yusuf S (2020) White rice intake and incident diabetes: a study of 132,373 participants in 21 countries. Diabetes Care 43:2643–2650. https://doi.org/10.2337/dc19-2335

    Article  PubMed  PubMed Central  Google Scholar 

  23. Vathesatogkit P, Batty GD, Woodward M (2014) Socioeconomic disadvantage and disease-specific mortality in Asia: systematic review with meta-analysis of population-based cohort studies. J Epidemiol Community Health 68:375–383. https://doi.org/10.1136/jech-2013-203053

    Article  PubMed  Google Scholar 

  24. Zhu N, Yu C, Guo Y, Bian Z, Han Y, Yang L, Chen Y, Du H, Li H, Liu F, Chen J, Chen Z, Lv J, Li L (2019) Adherence to a healthy lifestyle and all-cause and cause-specific mortality in Chinese adults: a 10-year prospective study of 0.5 million people. Int J Behav Nutr Phys Act 16:98. https://doi.org/10.1186/s12966-019-0860-z

    Article  PubMed  PubMed Central  Google Scholar 

  25. Ibsen DB, Laursen A, Würtz A, Dahm CC, Rimm EB, Parner ET, Overvad K, Jakobsen MU (2021) Food substitution models for nutritional epidemiology. Am J Clin Nutr 113:294–303. https://doi.org/10.1093/ajcn/nqaa315

    Article  PubMed  Google Scholar 

  26. Helnæs A, Kyrø C, Andersen I, Lacoppidan S, Overvad K, Christensen J, Tjønneland A, Olsen A (2016) Intake of whole grains is associated with lower risk of myocardial infarction: the Danish diet, cancer and health cohort. Am J Clin Nutr 103:999–1007. https://doi.org/10.3945/ajcn.115.124271

    Article  CAS  PubMed  Google Scholar 

  27. Johnsen NF, Frederiksen K, Christensen J, Skeie G, Lund E, Landberg R, Johansson I, Nilsson LM, Halkjær J, Olsen A, Overvad K, Tjønneland A (2015) Whole-grain products and whole-grain types are associated with lower all-cause and cause-specific mortality in the Scandinavian HELGA cohort. Br J Nutr 114:608–623. https://doi.org/10.1017/S0007114515001701

    Article  CAS  PubMed  Google Scholar 

  28. Rebello SA, Koh H, Chen C, Naidoo N, Odegaard AO, Koh WP, Butler LM, Yuan JM, van Dam RM (2014) Amount, type, and sources of carbohydrates in relation to ischemic heart disease mortality in a Chinese population: a prospective cohort study. Am J Clin Nutr 100:53–64. https://doi.org/10.3945/ajcn.113.076273

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Wang JB, Fan JH, Dawsey SM, Sinha R, Freedman ND, Taylor PR, Qiao YL, Abnet CC (2016) Dietary components and risk of total, cancer and cardiovascular disease mortality in the Linxian Nutrition Intervention Trials cohort in China. Sci Rep 6:22619. https://doi.org/10.1038/srep22619

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Adom KK, Liu RH (2002) Antioxidant activity of grains. J Agric Food Chem 50:6182–6187. https://doi.org/10.1021/jf0205099

    Article  CAS  PubMed  Google Scholar 

  31. Belobrajdic DP, Bird AR (2013) The potential role of phytochemicals in wholegrain cereals for the prevention of type-2 diabetes. Nutr J 12:62. https://doi.org/10.1186/1475-2891-12-62

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. China Food Information Center, National Institute for Nutrition and Food Safety, Chinese Center for Disease Control and Prevention; Academy of National Food and Strategic Reserves Administration; Institute of Food and Nutrition Development, Ministry of Agriculture and Rural Affairs; Institute of Agricultural Products Processing, Chinese Academy of Agricultural Sciences; Branch of Food and Nutrition, China Association of Agricultural Science Society; Branch of Health Communication, Chinese Preventive Medicine Association; Branch of Food Hygiene, Chinese Preventive Medicine Association (2021) Scientific consensus on whole grains and health. Zhonghua Yu Fang Yi Xue Za Zhi 55:1383–1386. https://doi.org/10.3760/cma.j.cn112150-20210616-00587

    Article  Google Scholar 

  33. Jiang CQ, Xu L, Zhang WS, Jin YL, Zhu F, Cheng KK, Lam TH (2020) Adiposity and mortality in older Chinese: an 11-year follow-up of the Guangzhou Biobank Cohort Study. Sci Rep 10:1924. https://doi.org/10.1038/s41598-020-58633-z

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  34. Shao MY, Jiang CQ, Zhang WS, Zhu F, Jin YL, Woo J, Cheng KK, Lam TH, Xu L (2022) Association of fish consumption with risk of all-cause and cardiovascular disease mortality: an 11-year follow-up of the Guangzhou Biobank Cohort Study. Eur J Clin Nutr 76:389–396. https://doi.org/10.1038/s41430-021-00968-5

    Article  PubMed  Google Scholar 

  35. Huang Y, Jiang C, Xu L, Zhang W, Zhu F, Jin Y, Cheng KK, Lam TH (2021) Mortality in relation to changes in physical activity in middle-aged to older Chinese: an 8-year follow-up of the Guangzhou Biobank Cohort Study. J Sport Health Sci 10:430–438. https://doi.org/10.1016/j.jshs.2020.08.007

    Article  PubMed  Google Scholar 

  36. Bechthold A, Boeing H, Schwedhelm C, Hoffmann G, Knüppel S, Iqbal K, De Henauw S, Michels N, Devleesschauwer B, Schlesinger S, Schwingshackl L (2019) Food groups and risk of coronary heart disease, stroke and heart failure: a systematic review and dose-response meta-analysis of prospective studies. Crit Rev Food Sci Nutr 59:1071–1090. https://doi.org/10.1080/10408398.2017.1392288

    Article  CAS  PubMed  Google Scholar 

  37. Gaesser GA (2020) Whole grains, refined grains, and cancer risk: a systematic review of meta-analyses of observational studies. Nutrients 12:3756. https://doi.org/10.3390/nu12123756

    Article  PubMed  PubMed Central  Google Scholar 

  38. Jacobs DJ, Andersen LF, Blomhoff R (2007) Whole-grain consumption is associated with a reduced risk of noncardiovascular, noncancer death attributed to inflammatory diseases in the Iowa Women’s Health Study. Am J Clin Nutr 85:1606–1614. https://doi.org/10.1093/ajcn/85.6.1606

    Article  CAS  PubMed  Google Scholar 

  39. Steffen LM, Jacobs DJ, Stevens J, Shahar E, Carithers T, Folsom AR (2003) Associations of whole-grain, refined-grain, and fruit and vegetable consumption with risks of all-cause mortality and incident coronary artery disease and ischemic stroke: the Atherosclerosis Risk in Communities (ARIC) Study. Am J Clin Nutr 78:383–390. https://doi.org/10.1093/ajcn/78.3.383

    Article  CAS  PubMed  Google Scholar 

  40. Wu H, Flint AJ, Qi Q, van Dam RM, Sampson LA, Rimm EB, Holmes MD, Willett WC, Hu FB, Sun Q (2015) Association between dietary whole grain intake and risk of mortality: two large prospective studies in US men and women. JAMA Intern Med 175:373–384. https://doi.org/10.1001/jamainternmed.2014.6283

    Article  PubMed  PubMed Central  Google Scholar 

  41. Lai H, Sun M, Liu Y, Zhu H, Li M, Pan B, Wang Q, Yang Q, Cao X, Tian C, Lu Y, Song X, Ding G, Tian J, Yang K, Ge L (2022) White rice consumption and risk of cardiometabolic and cancer outcomes: a systematic review and dose-response meta-analysis of prospective cohort studies. Crit Rev Food Sci Nutr. https://doi.org/10.1080/10408398.2022.2101984

    Article  PubMed  Google Scholar 

  42. Lamster IB, Asadourian L, Del CT (2000) Friedman PK (2016) The aging mouth: differentiating normal aging from disease. Periodontol 72:96–107. https://doi.org/10.1111/prd.12131

    Article  Google Scholar 

  43. Kim Y, Je Y (2014) Dietary fiber intake and total mortality: a meta-analysis of prospective cohort studies. Am J Epidemiol 180:565–573. https://doi.org/10.1093/aje/kwu174

    Article  PubMed  Google Scholar 

  44. Threapleton DE, Greenwood DC, Evans CE, Cleghorn CL, Nykjaer C, Woodhead C, Cade JE, Gale CP, Burley VJ (2013) Dietary fibre intake and risk of cardiovascular disease: systematic review and meta-analysis. BMJ 347:f6879. https://doi.org/10.1136/bmj.f6879

    Article  PubMed  PubMed Central  Google Scholar 

  45. Truswell AS (2002) Cereal grains and coronary heart disease. Eur J Clin Nutr 56:1–14. https://doi.org/10.1038/sj.ejcn.1601283

    Article  CAS  PubMed  Google Scholar 

  46. Seal CJ, Courtin CM, Venema K, de Vries J (2021) Health benefits of whole grain: effects on dietary carbohydrate quality, the gut microbiome, and consequences of processing. Compr Rev Food Sci Food Saf 20:2742–2768. https://doi.org/10.1111/1541-4337.12728

    Article  CAS  PubMed  Google Scholar 

  47. Lafiandra D, Riccardi G, Shewry PR (2014) Improving cereal grain carbohydrates for diet and health. J Cereal Sci 59:312–326. https://doi.org/10.1016/j.jcs.2014.01.001

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  48. Musa-Veloso K, Poon T, Harkness LS, O’Shea M, Chu Y (2018) The effects of whole-grain compared with refined wheat, rice, and rye on the postprandial blood glucose response: a systematic review and meta-analysis of randomized controlled trials. Am J Clin Nutr 108:759–774. https://doi.org/10.1093/ajcn/nqy112

    Article  PubMed  Google Scholar 

  49. Vanegas SM, Meydani M, Barnett JB, Goldin B, Kane A, Rasmussen H, Brown C, Vangay P, Knights D, Jonnalagadda S, Koecher K, Karl JP, Thomas M, Dolnikowski G, Li L, Saltzman E, Wu D, Meydani SN (2017) Substituting whole grains for refined grains in a 6-wk randomized trial has a modest effect on gut microbiota and immune and inflammatory markers of healthy adults. Am J Clin Nutr 105:635–650. https://doi.org/10.3945/ajcn.116.146928

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  50. Welsh JA, Sharma A, Abramson JL, Vaccarino V, Gillespie C, Vos MB (2010) Caloric sweetener consumption and dyslipidemia among US adults. JAMA 303:1490–1497. https://doi.org/10.1001/jama.2010.449

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  51. Qiang Y, Li Q, Xin Y, Fang X, Tian Y, Ma J, Wang J, Wang Q, Zhang R, Wang J, Wang F (2018) Intake of Dietary One-Carbon metabolism-related B vitamins and the risk of esophageal cancer: a dose-response meta-analysis. Nutrients 10:835. https://doi.org/10.3390/nu10070835

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  52. Ma JL, Zhao Y, Guo CY, Hu HT, Zheng L, Zhao EJ, Li HL (2018) Dietary vitamin B intake and the risk of esophageal cancer: a meta-analysis. Cancer Manag Res 10:5395–5410. https://doi.org/10.2147/CMAR.S168413

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  53. Shan Z, Rehm CD, Rogers G, Ruan M, Wang DD, Hu FB, Mozaffarian D, Zhang FF, Bhupathiraju SN (2019) Trends in dietary carbohydrate, protein, and fat intake and diet quality among US adults, 1999–2016. JAMA 322:1178–1187. https://doi.org/10.1001/jama.2019.13771

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  54. Yu D, Zhao L, Zhao W (2020) Status and trends in consumption of grains and dietary fiber among Chinese adults (1982–2015). Nutr Rev 78:43–53. https://doi.org/10.1093/nutrit/nuz075

    Article  PubMed  Google Scholar 

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Funding

This work was supported by the Natural Science Foundation of China (81941019). The Guangzhou Biobank Cohort Study was funded by The University of Hong Kong Foundation for Educational Development and Research (SN/1f/HKUF-DC; C20400.28505200), the Health Medical Research Fund (Grant number: HMRF/13143241) in Hong Kong; Guangzhou Public Health Bureau (201102A211004011) Natural Science Foundation of Guangdong (2018A030313140), and the University of Birmingham, UK.

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Authors and Affiliations

  1. School of Public Health, Sun Yat-Sen University, 74 Zhongshan 2nd Road, Guangzhou, Guangdong Province, China

    Ce Sun, Xue Qing Deng & Lin Xu

  2. Guangzhou Twelfth People’s Hospital, Guangzhou, 510620, China

    Wei Sen Zhang, Chao Qiang Jiang, Ya Li Jin & Tai Hing Lam

  3. Institute of Applied Health Research, University of Birmingham, Birmingham, UK

    G. Neil Thomas, Kar Keung Cheng & Lin Xu

  4. Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China

    Jean Woo

  5. School of Public Health, The University of Hong Kong, Hong Kong, China

    Tai Hing Lam & Lin Xu

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Contributions

CS, LX, THL, CQJ, WSZ, XQD, YLJ, GNT, JW and KKC: have substantial contributions to conception and design, acquisition of funding, data and interpretation of data; CS and LX: analyzed the data, CS, LX, THL and CQJ: drafted the article, THL, LX and CQJ: revised it critically for important intellectual content, and all authors contributed to final approval of the paper.

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Correspondence to Wei Sen Zhang or Lin Xu.

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The authors have no conflicts of interest relevant to this article to disclose.

Institutional review board statement

The study was conducted in accordance with the Declaration of Helsinki, and approved by the Guangzhou Medical Ethics Committee of the Chinese Medical Association, Guangzhou, China (IRB No. GWYL-2019-125).

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Sun, C., Zhang, W.S., Jiang, C.Q. et al. Cereal intake and mortality in older Chinese: a 15-year follow-up of a prospective cohort study. Eur J Nutr 62, 1239–1251 (2023). https://doi.org/10.1007/s00394-022-03067-8

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