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June 24, 1992, Vol 267, No. 24 >
ARTICLE | June 24, 1992

Oat Products and Lipid Lowering: Title and subTitle BreakA Meta-analysis FREE

Cynthia M. Ripsin, MS, MPH; Joseph M. Keenan, MD; David R. Jacobs, Jr, PhD; Patricia J. Elmer, PhD; Robert R. Welch, PhD; Linda Van Horn, PhD, RD; Kiang Liu, PhD; Wilfred H. Turnbull, PhD; Forrest W. Thye, PhD; Mark Kestin, PhD, MPH; Maren Hegsted, PhD; Dennis M. Davidson, MD; Michael H. Davidson, MD; Lynn D. Dugan, MS, RD; Wendy Demark-Wahnefried, PhD, RD; Stephanie Beling, MD
[+] Author Affiliations

Reprint requests to Department of Family Practice, University of Minnesota, Box 25,825 University Ave SE, Minneapolis, MN 55414 (Ms Ripsin).


JAMA. 1992;267(24):3317-3325. doi:10.1001/jama.1992.03480240079039
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References

Objectives.  —To test the a priori hypothesis that consumption of oats will lower the blood total cholesterol level and to assess modifiers and confounders of this association.

Data Sources.  —A computerized literature (MEDLINE) search and the Quaker Oats Co identified published and unpublished trials as of March 1991. Raw data were requested for all trials.

Study Selection.  —Trials were included in summary effect size estimates if they were randomized and controlled, if a formal assessment of diet and body weight changes occurred, and, if raw data were not received, if there was enough information in the published report to perform calculations.

Data Synthesis.  —Twenty trials were identified. Using the methods of DerSimonian and Laird, a summary effect size for change in blood total cholesterol level of -0.13 mmol/L (-5.9 mg/dL) (95% confidence interval [Cl], -0.19 to -0.017 mmol/L [-8.4 to -3.3 mg/dL]) was calculated for the 10 trials meeting the inclusion criteria. The summary effect size for trials using wheat control groups was -0.11 mmol/L (-4.4 mg/dL) (95% Cl, -0.21 to -0.01 mmol/L [-8.3 to -0.38 mg/dL]). Calculation of Keys scores demonstrated that substituting carbohydrates for dietary fats and cholesterol did not account for the majority of blood cholesterol reduction. Larger reductions were seen in trials in which subjects had initially higher blood cholesterol levels (≥5.9 mmol/L [≥229 mg/dL]), particularly when a dose of 3 g or more of soluble fiber was employed.

Conclusion.  —This analysis supports the hypothesis that incorporating oat products into the diet causes a modest reduction in blood cholesterol level.(JAMA. 1992;267:3317-3325)

REFERENCES

1 +
DeGroot AP, Luyken R, Pikaar NA.  Cholesterollowering effect of rolled oats. Lancet . 1963;;2:303-304.
2 +
Anderson JW, Gustafson NJ.  Hypocholesterolemic effects of oat and bean products. Am J Clin Nutr . 1988;;48:749-753.
3 +
Kirby RW, Anderson JW, Sieling B, et al.  Oatbran intake selectively lowers serum low-density lipoprotein cholesterol concentrations. Am J Clin Nutr . 1981;;34:824-829.
4 +
Anderson JW, Story L, Sieling B, Chen W-JL.  Hypocholesterolemic effects of high-fiber diets rich in water-soluble plant fibers: long-term studies with oat-bran and bean-supplemented diets for hypercholesterolemic men. J Can Diet Assoc . 1984;;45:140-149.
5 +
Anderson JW, Siesel AE.  Hypocholesterolemic effects of oat products.  In: Furda I, Brine CJ, eds. New Developments in Dietary Fiber . New York, NY: Plenum Press; 1990;:17-36.
6 +
Anderson JW, Gilinsky NH, Deakins DA, et al.  Lipid responses of hypercholesterolemic men to oatbran and wheat-bran intake. Am J Clin Nutr . 1991;; 54:678-683.
7 +
Van Horn LV, Liu K, Parker D, et al.  Serum lipid response to oat product intake with a fat modified diet. J Am Diet Assoc . 1986;;86:377-386.
8 +
Van Horn LV, Emidy LA, Liu K, et al.  Serum lipid response to a fat-modified, oatmeal-enhanced diet. Prev Med . 1988;;17:759-764.
9 +
Van Horn LV, Moag-Stahlberg A, Liu K, et al.  Effects on serum lipids of adding instant oats to usual American diets. Am J Public Health . 1991;;81:183-187.
10 +
Keenan JM, Wenz JB, Myers S, Ripsin CM, Huang Z.  Randomized controlled crossover trial of oat bran in hypercholesterolemic subjects. J Fam Pract . 1991;;33:600-608.
11 +
Davidson MH, Dugan LD, Burns JH, Bova J, Story K, Drennan KB.  The hypocholesterolemic effects of β-glucan in oatmeal and oat bran: a dosecontrolled study. JAMA . 1991;;265:1833-1839.
12 +
Swain JF, Rouse IL, Curley CB, Sacks FM.  Comparison of the effects of oat bran and low-fiber wheat on serum lipoprotein levels and blood pressure. N Engl J Med . 1990;;322:147-152.
13 +
O'Kell RT, Duston AA.  Lack of effect of dietary oats on serum cholesterol. Mo Med . 1988;;85:72-78.
14 +
Stewart LM, Welch RW.  The effects of dietary oatcakes on blood cholesterol and other factors in healthy free-living adults. J Hum Nutr Diet . 1990;;3: 436-437.
15 +
Demark-Wahnefried W, Bowering J, Cohen PS.  Reduced serum cholesterol with dietary change using fat-modified and oat bran supplemented diets. J Am Diet Assoc . 1990;;90:223-229.
16 +
O'Brien LT, Barnard J, Hall JA, Pritikin N.  Effects of a high-complex carbohydrate low cholesterol diet plus bran supplement on serum lipids. J Appl Nutr . 1985;;37:26-35.
17 +
Hegsted M, Windhauser MM, Lester SB, Morris SK.  Stabilized rice bran and oat bran lower cholesterol in humans. FASEB J . 1989;:A368.
18 +
Storch K, Anderson JW, Young VR.  Oat bran muffins lower serum cholesterol of healthy young people. Clin Res . 1984;;32:740A.
19 +
Welch RW, McVeigh AM, Murphy C.  Hypocholesterolemic and other responses to oat bran intake in human subjects. Proc Nutr Soc . 1990;;49:50A.
20 +
Reynolds HR, Lindake BS, Hunninghake DB.  Effect of oat bran on serum lipids. J Am Diet Assoc . 1989;;89:A112.
21 +
Gold KV, Davidson DM.  Oat bran as a cholesterol-reducing dietary adjunct in a young, healthy population. West J Med . 1988;;148:299-302.
22 +
Kestin M, Moss R, Clifton PM, Nestel PJ.  Comparative effects of three cereal brans on plasma lipids, blood pressure, and glucose metabolism in mildly hypercholesterolemic men. Am J Clin Nutr . 1990;;52: 661-666.
23 +
Turnbull WH, Leeds AR.  The effect of rolled oats and a reduced/modified fat diet on apolipoproteins Al and B. J Clin Nutr Gastroenterol . 1989;;1:15-19.
24 +
McMichael AJ, Potter JD.  Do intrinsic sex differences in lower alimentary tract physiology influence the sex-specific risks of bowel cancer and other biliary and intestinal diseases? Am J Epidemiol . 1983;; 118:620-627.
25 +
Turnbull WH, Leeds AR.  Reduction of total and LDL-C cholesterol in plasma by oats. J Clin Nutr Gastroenterol . 1987;;2:177-181.
26 +
Keys A, Anderson JT, Grande F.  Serum cholesterol response to changes in the diet, I-IV. Metabolism . 1965;;14:747-787.
27 +
Anderson JT, Jacobs DR Jr, Foster N, et al.  Scoring systems for evaluating dietary pattern effect on serum cholesterol. Prev Med . 1979;;8:525-537.
28 +
DerSimonian R, Laird N.  Meta-analysis in clinical trials. Controlled Clin Trials . 1986;;7:177-189.
29 +
Berlin JA, Laird NM, Sacks HS, Chalmers TC.  A comparison of statistical methods for combining event rates in clinical trials. Stat Med . 1989;;8:141-151.
30 +
SAS/STAT User's Guide . Release 6.03 edition. Cary, NC: SAS Institute Inc; 1988;.
31 +
Sacks HS, Berrier J, Reitman D, Ancona-Berk VA, Chalmers TC.  Meta-analyses of randomized controlled trials. N Engl J Med . 1987;;316:450-455.
32 +
Yach D.  Meta-analysis in epidemiology. S Afr J Med . 1990;;78:94-97.
33 +
Oakes M. Statistical Inference . Chestnut Hill, Mass: Epidemiology Resources Inc; 1986;:157-159.
34 +
Thacker SB.  Meta-analysis: a quantitative approach to research integration. JAMA . 1988;;259: 1685-1689.
35 +
Irwig L, Glasziou P, Wilson A, Macaskill P.  Estimating an individual's true cholesterol level and response to intervention. JAMA . 1991;;266:1678-1685.
36 +
Clifton PM, Kestin M, Abbey M, Drysdale M, Nestel PJ.  Relationship between sensitivity to dietary fat and dietary cholesterol. Arterioscler Thromb . 1990;;10:394-401.
37 +
Physiological Effects and Health Consequences of Dietary Fiber . Bethesda, Md: Life Science Research Office, Federation of American Societies for Experimental Biology; 1987;. Contract 223-84-2059.
38 +
Topping DL, Illman RJ, Dowling K, Trimble RP.  Mechanisms whereby fibre could lower plasma cholesterol.  In: Southgate DAT, Waldron K, Johnson IT, Fenwick GR. Dietary Fibre: Chemical and Biological Aspects . Cambridge, England: Royal Society of Chemistry; 1990;:300-304.
39 +
Slavin JL.  Dietary fiber: classification, chemical analyses, and food sources. J Am Diet Assoc . 1987;;87: 1164-1171.
40 +
Welch RW, Leggett JM, Lloyd JD.  Variation in the kernel (1—>3)(1—>4)-β-D-glucan content of oat cultivars and wild Avena species and its relationship to other characteristics. J Cereal Sci . 1991;;13:173-178.
41 +
Lipid Research Clinics Program.  The lipid research clinics coronary primary prevention trial results, I: reduction in incidence of coronary heart disease. JAMA . 1984;;251:351-364.
42 +
Lipid Research Clinics Program.  The lipid research clinics coronary primary prevention trial results, II: the relationship of reduction in incidence of coronary heart disease to cholesterol lowering. JAMA . 1984;;251:365-374.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
DeGroot AP, Luyken R, Pikaar NA.  Cholesterollowering effect of rolled oats. Lancet . 1963;;2:303-304.
2 +
Anderson JW, Gustafson NJ.  Hypocholesterolemic effects of oat and bean products. Am J Clin Nutr . 1988;;48:749-753.
3 +
Kirby RW, Anderson JW, Sieling B, et al.  Oatbran intake selectively lowers serum low-density lipoprotein cholesterol concentrations. Am J Clin Nutr . 1981;;34:824-829.
4 +
Anderson JW, Story L, Sieling B, Chen W-JL.  Hypocholesterolemic effects of high-fiber diets rich in water-soluble plant fibers: long-term studies with oat-bran and bean-supplemented diets for hypercholesterolemic men. J Can Diet Assoc . 1984;;45:140-149.
5 +
Anderson JW, Siesel AE.  Hypocholesterolemic effects of oat products.  In: Furda I, Brine CJ, eds. New Developments in Dietary Fiber . New York, NY: Plenum Press; 1990;:17-36.
6 +
Anderson JW, Gilinsky NH, Deakins DA, et al.  Lipid responses of hypercholesterolemic men to oatbran and wheat-bran intake. Am J Clin Nutr . 1991;; 54:678-683.
7 +
Van Horn LV, Liu K, Parker D, et al.  Serum lipid response to oat product intake with a fat modified diet. J Am Diet Assoc . 1986;;86:377-386.
8 +
Van Horn LV, Emidy LA, Liu K, et al.  Serum lipid response to a fat-modified, oatmeal-enhanced diet. Prev Med . 1988;;17:759-764.
9 +
Van Horn LV, Moag-Stahlberg A, Liu K, et al.  Effects on serum lipids of adding instant oats to usual American diets. Am J Public Health . 1991;;81:183-187.
10 +
Keenan JM, Wenz JB, Myers S, Ripsin CM, Huang Z.  Randomized controlled crossover trial of oat bran in hypercholesterolemic subjects. J Fam Pract . 1991;;33:600-608.
11 +
Davidson MH, Dugan LD, Burns JH, Bova J, Story K, Drennan KB.  The hypocholesterolemic effects of β-glucan in oatmeal and oat bran: a dosecontrolled study. JAMA . 1991;;265:1833-1839.
12 +
Swain JF, Rouse IL, Curley CB, Sacks FM.  Comparison of the effects of oat bran and low-fiber wheat on serum lipoprotein levels and blood pressure. N Engl J Med . 1990;;322:147-152.
13 +
O'Kell RT, Duston AA.  Lack of effect of dietary oats on serum cholesterol. Mo Med . 1988;;85:72-78.
14 +
Stewart LM, Welch RW.  The effects of dietary oatcakes on blood cholesterol and other factors in healthy free-living adults. J Hum Nutr Diet . 1990;;3: 436-437.
15 +
Demark-Wahnefried W, Bowering J, Cohen PS.  Reduced serum cholesterol with dietary change using fat-modified and oat bran supplemented diets. J Am Diet Assoc . 1990;;90:223-229.
16 +
O'Brien LT, Barnard J, Hall JA, Pritikin N.  Effects of a high-complex carbohydrate low cholesterol diet plus bran supplement on serum lipids. J Appl Nutr . 1985;;37:26-35.
17 +
Hegsted M, Windhauser MM, Lester SB, Morris SK.  Stabilized rice bran and oat bran lower cholesterol in humans. FASEB J . 1989;:A368.
18 +
Storch K, Anderson JW, Young VR.  Oat bran muffins lower serum cholesterol of healthy young people. Clin Res . 1984;;32:740A.
19 +
Welch RW, McVeigh AM, Murphy C.  Hypocholesterolemic and other responses to oat bran intake in human subjects. Proc Nutr Soc . 1990;;49:50A.
20 +
Reynolds HR, Lindake BS, Hunninghake DB.  Effect of oat bran on serum lipids. J Am Diet Assoc . 1989;;89:A112.
21 +
Gold KV, Davidson DM.  Oat bran as a cholesterol-reducing dietary adjunct in a young, healthy population. West J Med . 1988;;148:299-302.
22 +
Kestin M, Moss R, Clifton PM, Nestel PJ.  Comparative effects of three cereal brans on plasma lipids, blood pressure, and glucose metabolism in mildly hypercholesterolemic men. Am J Clin Nutr . 1990;;52: 661-666.
23 +
Turnbull WH, Leeds AR.  The effect of rolled oats and a reduced/modified fat diet on apolipoproteins Al and B. J Clin Nutr Gastroenterol . 1989;;1:15-19.
24 +
McMichael AJ, Potter JD.  Do intrinsic sex differences in lower alimentary tract physiology influence the sex-specific risks of bowel cancer and other biliary and intestinal diseases? Am J Epidemiol . 1983;; 118:620-627.
25 +
Turnbull WH, Leeds AR.  Reduction of total and LDL-C cholesterol in plasma by oats. J Clin Nutr Gastroenterol . 1987;;2:177-181.
26 +
Keys A, Anderson JT, Grande F.  Serum cholesterol response to changes in the diet, I-IV. Metabolism . 1965;;14:747-787.
27 +
Anderson JT, Jacobs DR Jr, Foster N, et al.  Scoring systems for evaluating dietary pattern effect on serum cholesterol. Prev Med . 1979;;8:525-537.
28 +
DerSimonian R, Laird N.  Meta-analysis in clinical trials. Controlled Clin Trials . 1986;;7:177-189.
29 +
Berlin JA, Laird NM, Sacks HS, Chalmers TC.  A comparison of statistical methods for combining event rates in clinical trials. Stat Med . 1989;;8:141-151.
30 +
SAS/STAT User's Guide . Release 6.03 edition. Cary, NC: SAS Institute Inc; 1988;.
31 +
Sacks HS, Berrier J, Reitman D, Ancona-Berk VA, Chalmers TC.  Meta-analyses of randomized controlled trials. N Engl J Med . 1987;;316:450-455.
32 +
Yach D.  Meta-analysis in epidemiology. S Afr J Med . 1990;;78:94-97.
33 +
Oakes M. Statistical Inference . Chestnut Hill, Mass: Epidemiology Resources Inc; 1986;:157-159.
34 +
Thacker SB.  Meta-analysis: a quantitative approach to research integration. JAMA . 1988;;259: 1685-1689.
35 +
Irwig L, Glasziou P, Wilson A, Macaskill P.  Estimating an individual's true cholesterol level and response to intervention. JAMA . 1991;;266:1678-1685.
36 +
Clifton PM, Kestin M, Abbey M, Drysdale M, Nestel PJ.  Relationship between sensitivity to dietary fat and dietary cholesterol. Arterioscler Thromb . 1990;;10:394-401.
37 +
Physiological Effects and Health Consequences of Dietary Fiber . Bethesda, Md: Life Science Research Office, Federation of American Societies for Experimental Biology; 1987;. Contract 223-84-2059.
38 +
Topping DL, Illman RJ, Dowling K, Trimble RP.  Mechanisms whereby fibre could lower plasma cholesterol.  In: Southgate DAT, Waldron K, Johnson IT, Fenwick GR. Dietary Fibre: Chemical and Biological Aspects . Cambridge, England: Royal Society of Chemistry; 1990;:300-304.
39 +
Slavin JL.  Dietary fiber: classification, chemical analyses, and food sources. J Am Diet Assoc . 1987;;87: 1164-1171.
40 +
Welch RW, Leggett JM, Lloyd JD.  Variation in the kernel (1—>3)(1—>4)-β-D-glucan content of oat cultivars and wild Avena species and its relationship to other characteristics. J Cereal Sci . 1991;;13:173-178.
41 +
Lipid Research Clinics Program.  The lipid research clinics coronary primary prevention trial results, I: reduction in incidence of coronary heart disease. JAMA . 1984;;251:351-364.
42 +
Lipid Research Clinics Program.  The lipid research clinics coronary primary prevention trial results, II: the relationship of reduction in incidence of coronary heart disease to cholesterol lowering. JAMA . 1984;;251:365-374.

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