Research Progress on Cereal Consumption and Cardiovascular Health in Diabetic Patients
DOI:
https://doi.org/10.63313/hmt.9028Keywords:
Cereal, Diabetes, Cardiovascular diseaseAbstract
This review examines the impact of cereal consumption on cardiovascular health in patients with diabetes. Current evidence indicates that whole cereals and low-processed, high-fiber cereals can reduce cardiovascular risk by improving glycemic control, lipid metabolism, inflammation, endothelial function, and gut microbiota composition. In contrast, refined cereals and high-glycemic, highly processed cereal products may exacerbate postprandial hyperglycemia, insulin resistance, dyslipidemia, and metabolic stress, thereby increasing cardiovascular burden. Dietary recommendations for patients with diabetes should emphasize the substitution of low-processed whole cereals for refined cereals rather than simply increasing total cereal intake. Future research should further clarify the long-term cardiovascular outcomes associated with specific cereal subtypes and support more individualized dietary strategies.
References
[1] Saeedi P, Petersohn I, Salpea P, Malanda B, Karuranga S, Unwin N, et al. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas, 9(th) edition. Diabetes Res Clin Pract. 2019;157:107843.
[2] Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: a systematic analysis for the Global Burden of Disease Study 2021. Lancet. 2023;402(10397):203–34.
[3] Chong B, Jayabaskaran J, Jauhari SM, Chan SP, Goh R, Kueh MTW, et al. Global burden of cardiovascular diseases: projections from 2025 to 2050. Eur J Prev Cardiol. 2025;32(11):1001–15.
[4] Siam NH, Snigdha NN, Tabasumma N, Parvin I. Diabetes Mellitus and Cardiovascular Disease: Exploring Epidemiology, Pathophysiology, and Treatment Strategies. Rev Cardiovasc Med. 2024;25(12):436.
[5] Dal Canto E, Ceriello A, Rydén L, Ferrini M, Hansen TB, Schnell O, et al. Diabetes as a cardiovascular risk factor: An overview of global trends of macro and micro vascular complications. Eur J Prev Cardiol. 2019;26(2_suppl):25–32.
[6] Marx N, Federici M, Schütt K, Müller-Wieland D, Ajjan RA, Antunes MJ, et al. 2023 ESC Guidelines for the management of cardiovascular disease in patients with diabetes. Eur Heart J. 2023;44(39):4043–140.
[7] Evidence-based European recommendations for the dietary management of diabetes. Diabetologia. 2023;66(6):965–85.
[8] Reynolds A, Mann J, Cummings J, Winter N, Mete E, Te Morenga L. Carbohydrate quality and human health: a series of systematic reviews and meta-analyses. Lancet. 2019;393(10170):434–45.
[9] Hu Y, Ding M, Sampson L, Willett WC, Manson JE, Wang M, et al. Intake of whole grain foods and risk of type 2 diabetes: results from three prospective cohort studies. Bmj. 2020;370:m2206.
[10] Ghanbari-Gohari F, Mousavi SM, Esmaillzadeh A. Consumption of whole grains and risk of type 2 diabetes: A comprehensive systematic review and dose-response meta-analysis of prospective cohort studies. Food Sci Nutr. 2022;10(6):1950–60.
[11] Ying T, Zheng J, Kan J, Li W, Xue K, Du J, et al. Effects of whole grains on glycemic control: a systematic review and dose-response meta-analysis of prospective cohort studies and randomized controlled trials. Nutr J. 2024;23(1):47.
[12] Hu H, Zhao Y, Feng Y, Yang X, Li Y, Wu Y, et al. Consumption of whole grains and refined grains and associated risk of cardiovascular disease events and all-cause mortality: a systematic review and dose-response meta-analysis of prospective cohort studies. Am J Clin Nutr. 2023;117(1):149–59.
[13] Swaminathan S, Dehghan M, Raj JM, Thomas T, Rangarajan S, Jenkins D, et al. Associations of cereal grains intake with cardiovascular disease and mortality across 21 countries in Prospective Urban and Rural Epidemiology study: prospective cohort study. Bmj. 2021;372:m4948.
[14] Åberg S, Mann J, Neumann S, Ross AB, Reynolds AN. Whole-Grain Processing and Glycemic Control in Type 2 Diabetes: A Randomized Crossover Trial. Diabetes Care. 2020;43(8):1717–23.
[15] Shen XL, Zhao T, Zhou Y, Shi X, Zou Y, Zhao G. Effect of Oat β-Glucan Intake on Glycaemic Control and Insulin Sensitivity of Diabetic Patients: A Meta-Analysis of Randomized Controlled Trials. Nutrients. 2016;8(1).
[16] Lillioja S, Neal AL, Tapsell L, Jacobs DR, Jr. Whole grains, type 2 diabetes, coronary heart disease, and hypertension: links to the aleurone preferred over indigestible fiber. Biofactors. 2013;39(3):242–58.
[17] Huang T, Xu M, Lee A, Cho S, Qi L. Consumption of whole grains and cereal fiber and total and cause-specific mortality: prospective analysis of 367,442 individuals. BMC Med. 2015;13:59.
[18] Zong G, Gao A, Hu FB, Sun Q. Whole Grain Intake and Mortality From All Causes, Cardiovascular Disease, and Cancer: A Meta-Analysis of Prospective Cohort Studies. Circulation. 2016;133(24):2370–80.
[19] Aune D, Keum N, Giovannucci E, Fadnes LT, Boffetta P, Greenwood DC, et al. 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. 2016;353:i2716.
[20] Ma X, Tang WG, Yang Y, Zhang QL, Zheng JL, Xiang YB. Association between whole grain intake and all-cause mortality: a meta-analysis of cohort studies. Oncotarget. 2016;7(38):61996–2005.
[21] Li B, Zhang G, Tan M, Zhao L, Jin L, Tang X, et al. Consumption of whole grains in relation to mortality from all causes, cardiovascular disease, and diabetes: Dose-response meta-analysis of prospective cohort studies. Medicine (Baltimore). 2016;95(33):e4229.
[22] Reynolds AN, Akerman AP, Mann J. Dietary fibre and whole grains in diabetes management: Systematic review and meta-analyses. PLoS Med. 2020;17(3):e1003053.
[23] Wang W, Li J, Chen X, Yu M, Pan Q, Guo L. Whole grain food diet slightly reduces cardiovascular risks in obese/overweight adults: a systematic review and meta-analysis. BMC Cardiovasc Disord. 2020;20(1):82.
[24] Marshall S, Petocz P, Duve E, Abbott K, Cassettari T, Blumfield M, et al. The Effect of Replacing Refined Grains with Whole Grains on Cardiovascular Risk Factors: A Systematic Review and Meta-Analysis of Randomized Controlled Trials with GRADE Clinical Recommendation. J Acad Nutr Diet. 2020;120(11):1859–83.e31.
[25] Barbaresko J, Lang A, Szczerba E, Baechle C, Beckhaus J, Schwingshackl L, et al. Dietary Factors and All-Cause Mortality in Individuals With Type 2 Diabetes: A Systematic Review and Meta-analysis of Prospective Observational Studies. Diabetes Care. 2023;46(2):469–77.
[26] Kanter M, Angadi S, Slavin J. Glycemic Index, Glycemic Load, and Cardiovascular Disease and Mortality. N Engl J Med. 2021;385(4):378–9.
[27] Yu J, Balaji B, Tinajero M, Jarvis S, Khan T, Vasudevan S, et al. White rice, brown rice and the risk of type 2 diabetes: a systematic review and meta-analysis. BMJ Open. 2022;12(9):e065426.
[28] Liu H, Zhu J, Gao R, Ding L, Yang Y, Zhao W, et al. Estimating effects of whole grain consumption on type 2 diabetes, colorectal cancer and cardiovascular disease: a burden of proof study. Nutr J. 2024;23(1):49.
Downloads
Published
Issue
Section
License
Copyright (c) 2026 by author(s) and Erytis Publishing Limited

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.







