***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: Background Few studies have investigated the association between whole-grain intake and colorectal cancer . Because whole-grain intake estimation might be prone to measurement errors , more objective measures ( eg , biomarkers ) could assist in investigating such associations . Methods The association between alkylresorcinols , biomarkers of whole-grain rye and wheat intake , and colorectal cancer incidence were investigated using prediagnostic plasma sample s from colorectal cancer case patients and matched control subjects nested within the European Prospect i ve Investigation into Cancer and Nutrition . We included 1372 incident colorectal cancer case patients and 1372 individual matched control subjects and calculated the incidence rate ratios ( IRRs ) for overall and anatomical subsites of colorectal cancer using conditional logistic regression adjusted for potential confounders . Regional differences ( Sc and inavia , the Mediterranean , Central Europe ) were also explored . Results High plasma total alkylresorcinol concentration was associated with lower incidence of distal colon cancer ; the adjusted incidence rate ratio of distal colon cancer for the highest vs lowest quartile of plasma total alkylresorcinols was 0.48 ( 95 % confidence interval [ CI ] = 0.28 to 0.83 ) . An inverse association between plasma total alkylresorcinol concentrations and colon cancer was found for Sc and inavian participants ( IRR per doubling = 0.83 ; 95 % CI = 0.70 to 0.98 ) . However , plasma total alkylresorcinol concentrations were not associated with overall colorectal cancer , proximal colon cancer , or rectal cancer . Plasma alkylresorcinols concentrations were associated with colon and distal colon cancer only in Central Europe and Sc and inavia ( ie , areas where alkylresorcinol levels were higher ) . Conclusions High concentrations of plasma alkylresorcinols were associated with a lower incidence of distal colon cancer but not with overall colorectal cancer , proximal colon cancer , and rectal cancer OBJECTIVE To identify the dietary , lifestyle and socio-economic factors associated with the intake of whole grains ( WG ) in Norway , Sweden and Denmark . DESIGN A cross-sectional study . SETTING Sub sample of the Sc and inavian cohort ' HELGA ' consisting of three prospect i ve cohorts : The Norwegian Women and Cancer Study ; The Northern Sweden Health and Disease Study ; and the Danish Diet , Cancer and Health Study . SUBJECTS A total of 8702 men and women aged 30 - 65 years . Dietary data are from one 24 h dietary recall and data on  socio-economic  status and lifestyle factors including anthropometric values are from the baseline collection of data . RESULTS Vegetables , fruits , dairy products , fish and shellfish , coffee , tea and margarine were directly associated with the intake of WG  , whereas red meat , white bread , alcohol and cakes and biscuits were inversely associated . Smoking and BMI were consistently inversely associated with the intake of WG . Furthermore , length of education was directly associated with the intake of WG among women . CONCLUSIONS The intake of WG was found to be directly associated with healthy diet , lifestyle and socio-economic factors and inversely associated with less healthy factors , suggesting that these factors are important for consideration as potential confounders when study ing WG intake and disease associations BACKGROUND Venous thromboembolism ( VTE ) and cardiovascular disease ( CVD ) share some risk factors , including obesity , but it is unclear how dietary patterns associated with reduced risk of CVD relate to risk of VTE . OBJECTIVE To compare the relationships of adherence to a Dietary Approaches to Stop Hypertension (DASH)-style diet with the risks of CVD and VTE . PATIENTS / METHODS We confirmed by medical record review 1094 incident cases of CVD and 675 incident VTEs during a mean follow-up of 14.6 years in 34 827 initially healthy participants in the Women 's Health Study who completed at baseline a 133-item food frequency question naire scored for adherence to a DASH diet .  We compared estimated associations of dietary patterns with CVD and VTE from proportional hazards models in a competing risk framework . RESULTS Initial analyses adjusted for age , energy intake and r and omized treatments showed 36 - 41 % reduced hazards of CVD among women in the top two quintiles of DASH score relative to those in the bottom quintile ( P(trend ) < 0.001 ) . In multivariate analysis , women in the top two quintiles had 12 - 23 % reduced hazards of CVD relative to women in the bottom quintile ( P(trend ) = 0.04 ) . Analyses restricted to coronary events showed more variable 10 - 33 % reduced hazards in the top two quintiles ( P(trend ) = 0.09 ) . In contrast , higher DASH scores were unrelated to risk of VTE , with a 1 % reduced hazard for the top vs. bottom quintile ( P(trend ) = 0.95 ) . CONCLUSION An apparently strong association of adherence to the DASH diet with incidence of CVD was attenuated upon control for confounding variables . Adherence to the DASH diet was not associated with risk of VTE in women Background : Intakes of ready-to-eat cereal ( RTEC ) have been inversely associated with risk factors of chronic diseases such as cardiovascular disease ( CVD ) , type 2 diabetes , and certain cancers ; however , their relations with total and cause-specific mortality remain unclear . Objective : To prospect ively assess the associations of RTEC intakes with all causes and disease-specific mortality risk . Design : The study included 367,442 participants from the prospect i ve National Institutes of Health (NIH)–AARP Diet and Health Study . Intakes of RTEC were assessed at baseline . Results : Over an average of 14 years of follow-up , 46,067 deaths were documented . Consumption of RTEC was significantly associated with reduced risk of mortality from all-cause mortality and death from CVD , diabetes , all cancer , and digestive cancer ( all p for trend < 0.05 ) . In multivariate models , compared to nonconsumers of RTEC , those in the highest intake of RTEC had a 15 % lower risk of all-cause mortality and 10%–30 % lower risk of disease-specific mortality . Within RTEC consumers , total fiber intakes were associated with reduced risk of mortality from all-cause mortality and deaths from CVD , all cancer , digestive cancer , and respiratory disease ( all p for trend < 0.005 ) . Conclusions : Consumption of RTEC was associated with reduced risk of all-cause mortality and mortality from specific diseases such as CVD , diabetes , and cancer . This association may be mediated via greater fiber intake CONTEXT Although increased intake of grain products has been recommended to prevent cardiovascular disease ( CVD ) , prospect i ve data examining the relation of whole grain intake to risk of ischemic stroke are sparse , especially among women . OBJECTIVE To examine the hypothesis that higher whole grain intake reduces the  risk of ischemic stroke in women . DESIGN , SETTING , AND PARTICIPANTS A prospect i ve cohort of 75,521 US women aged 38 to 63 years without previous diagnosis of diabetes mellitus , coronary heart disease , stroke , or other CVDs in 1984 , who completed detailed food frequency question naires ( FFQs ) in 1984 , 1986 , 1990 , and 1994 , and were followed up for 12 years as part of the Nurses ' Health Study . MAIN OUTCOME MEASURE Incidence of ischemic stroke , confirmed by medical records , by quintile of whole grain intake according to FFQ responses . RESULTS During 861,900 person-years of follow-up , 352 confirmed incident cases of ischemic stroke occurred . We observed an inverse association between whole grain intake and ischemic stroke risk . The age-adjusted relative risks ( RRs ) from the lowest to highest quintiles of whole grain intake were 1.00 ( referent ) , 0.68 ( 95 % confidence interval [ CI ] , 0.49 - 0.94 ) , 0.69 ( 95 % CI , 0.51 - 0.95 ) , 0.49 ( 95 % CI , 0.35 - 0.69 ) , and 0.57 ( 95 % CI , 0.42 - 0.78 ; P = .003 for trend ) . Adjustment for smoking modestly attenuated this association ( RR comparing extreme quintiles , 0.64 ; 95 % CI , 0.47 - 0.89 ) . This inverse association remained essentially unchanged with further adjustment for known CVD risk factors , including saturated fat and transfatty acid intake ( multivariate-adjusted RR comparing extreme quintiles , 0.69 ; 95 % CI , 0.50 - 0.98 ) . The inverse relation between whole grain intake and risk of ischemic stroke was also consistently observed among subgroups of women who never smoked , did not drink alcohol , did not exercise regularly , or who did not use postmenopausal hormones . No significant association was observed between total grain intake and risk of ischemic stroke . CONCLUSIONS In this cohort , higher intake of whole grain foods was associated with a  lower risk of ischemic stroke among women , independent of known CVD risk factors . These prospect i ve data support the notion that higher intake of whole grains may reduce the risk of ischemic stroke BACKGROUND Even though dietary fiber has been hypothesized to reduce the risk of coronary heart disease , few large epidemiological studies have examined this relation with good methodology . METHODS AND RESULTS The Alpha-Tocopherol , Beta-Carotene Cancer Prevention Study was a r and omized , double-blind , placebo-controlled trial with daily supplementation of alpha-tocopherol and /or beta-carotene . Of the participants , 21930 smoking men aged 50 to 69 years who were free of diagnosed cardiovascular disease and had completed a vali date d dietary question naire at baseline were followed for 6.1 years . We monitored the incidence of major coronary events ( a combination of first nonfatal myocardial infa rct ion and coronary heart disease death ; n = 1399 ) and mortality from coronary heart disease ( n = 635 ) . Both entities had a significant inverse association with  dietary fiber  , but the association was stronger for coronary death . For men in the highest quintile of total dietary fiber intake ( median , 34.8 g/d ) , the relative risk for coronary death was 0.69 ( 95 % confidence interval , 0.54 to 0.88 ; P < .001 for trend ) compared with men in the lowest quintile of intake ( median , 16.1 g/d ) . With an adjustment for known cardiovascular risk factors , intake of saturated fatty acids , beta-carotene , vitamin C , and vitamin E did not material ly change the result . Water-soluble fiber was slightly more strongly associated with reduced coronary death than water-insoluble fiber , and cereal fiber also had a stronger association than vegetable or fruit fiber . CONCLUSIONS These findings suggest that independent of other risk factors , greater intake of foods rich in fiber can substantially reduce the risk of coronary heart disease , and particularly coronary death , in middle-aged , smoking men Dietary factors are thought to be closely associated with the development of human cancers and hence numerous studies in this area have already been conducted in the United States and other Western countries . Comparatively few prospect i ve studies have been published in Japan , especially for Hokkaido people . The present investigation was therefore performed to assess links between four leading cancers and some of the Japanese  common dietary factors through a cohort study  ( 1984 - 2002 ) in Hokkaido by analyzing 1,524 men and 1,634 women separately aged 40 and over . Adjusted Cox proportional hazard regression was used to calculate the relative risk ( RR ) for each dietary factor . For men , two dietary factors , miso soup ( RR=0.2 , 95 % confidence interval (95%CI)=0.1 - 0.8 ) and pickled vegetables ( RR=0.2 , 95%CI=0.1 - 0.8 ) were associated with lower risk for stomach and colorectal cancer respectively . For women , three factors , namely salty confectionary ( RR=3.5 , 95%CI=1.1 - 10.9 ) , black tea ( RR=3.8 , 95%CI=1.1 - 13.6 ) , and carbonated drink/juice ( RR=3.9 , 95 % CI=1.4 - 11.1 ) appeared related to an elevated risk of stomach cancer . However , further analysis simultaneously with all other adjusted factors indicated only carbonated drink/juice ( RR=3.1 , 95%CI=1.1 - 8.9 ) to present a significant risk factor for stomach cancer . One factor , namely wild edible plants ( RR=3.3 , 95%CI=1.1 - 9.8 ) , increased the risk for colorectal cancer in women . None of the dietary components were significantly associated with lung or pancreatic cancers . This study also indicated a wide variation in the impact of dietary factors  by sex and cancer site , in line with earlier work , pointing to a necessity for careful interpretation . Further epidemiological investigations by sex with more study subjects and confounding factors will be useful for determining the contribution of individual dietary 
    Output:
    
Intakes of specific types of whole grains including whole grain bread , whole grain breakfast cereals , and added bran , as well as total bread and total breakfast cereals were also associated with reduced risks of cardiovascular disease and /or all cause mortality , but there was little evidence of an association with refined grains , white rice , total rice , or total grains .
CONCLUSIONS This meta- analysis provides further evidence that whole grain intake is associated with a reduced risk of coronary heart disease , cardiovascular disease , and total cancer , and mortality from all causes , respiratory diseases , infectious diseases , diabetes , and all non-cardiovascular , non-cancer causes .