Research Cite this as: BMJ 2021;372:m4948
Associations of cereal grains intake with cardiovascular disease and mortality across 21 countries in Prospective Urban and Rural Epidemiology study: prospective cohort study

Cite this as: BMJ 2021;372:m4948Conclusions and policy implications
Our study from 21 countries showed that higher intake of refined grains was associated with higher risk of total mortality and major cardiovascular events. We observed no significant association between intake of whole grains or white rice and clinical outcomes. Intakes of a combination of cereal grains with a lower intake of refined wheat products should be encouraged while promoting a higher intake of whole grains. Reduction in quantity and improvement in quality of carbohydrate is essential for better health outcomes.