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Refined grains

From the YapSpan Longevity Wiki · Updated 2026-10-01

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Refined grains are cereal grains that have been milled to remove the bran and the germ, leaving mainly the starchy endosperm. White bread, white pasta, many breakfast cereals and baked goods made with white flour are common examples. Milling removes most of the fiber along with some vitamins and minerals, which is why refined grains are often contrasted with whole grains.

In the Prospective Urban and Rural Epidemiology (PURE) study, a single cohort study (a study that follows a group of people over time) in 21 countries with a median follow-up of 9.5 years, eating 350 grams or more of refined grains a day was associated with 27% higher all-cause mortality (death from any cause) than eating under 50 grams a day [1]. Pooled reviews of many studies have not found a clear link [2].

In the PURE study, the highest refined grain intake was associated with 27% higher all-cause mortality and 33% higher risk of major cardiovascular events than the lowest [1].
Higher refined grain intake in PURE was associated with higher systolic blood pressure (the upper number in a blood pressure reading) [1].
A 2023 meta-analysis (a study that pools the results of earlier studies) found a link with all-cause mortality only in one flexible statistical model and rated all refined-grain evidence low quality [3].
A 2025 umbrella review (a review of earlier meta-analyses) found no clear association between refined grains and mortality [2].

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PURE compared people eating 350 grams or more of refined grains a day with those eating under 50 grams [1]. The hazard ratio (the rate of death in one group relative to another) for all-cause mortality was 1.27, with a 95% confidence interval (the range the true value probably lies in) of 1.11 to 1.46 [1]. The same comparison gave a hazard ratio of 1.33 for major cardiovascular disease events [1].

Reviews that pool many studies point the other way. The 2023 meta-analysis found no significant influence of refined grain intake on stroke, coronary heart disease, heart failure or cardiovascular disease [3]. The 2025 umbrella review listed refined grains among the food groups without clear associations with mortality [2]. No pooled all-cause mortality figure for refined grains was found in these reviews.

The figure above comes from a single observational study (one that tracks people's existing diets rather than assigning them), and meta-analyses have not found a clear link, so it should be read with caution. Observational studies show associations, and people who eat large amounts of refined grains may differ from others in income, overall diet and other habits. The 2023 meta-analysis rated all of the refined-grain evidence low quality [3]. Grains with the bran and germ left in are covered under whole grains, and their fiber under dietary fiber.

Categories: Foods|Nutrition|Cardiovascular health|Metabolic health|Longevity Wiki

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YapSpan estimates are for reflection and entertainment only. They are not medical advice, a diagnosis, or a prediction of any individual outcome. Check with a doctor before making any medical decision.

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