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Higher intake of carbohydrates has been associated with higher risks for cardiovascular disease and death in various studies, but most did not differentiate between refined and unrefined grains. To understand associations by carbohydrate type, investigators used data from the Prospective Urban and Rural Epidemiology (PURE) study, an epidemiological study conducted across five continents.
At baseline, the 137,130 participants were free of cardiovascular disease and had completed validated culture-specific food-frequency questionnaires, which were used to assess intakes of refined grains, whole grains, and white rice. At a median follow-up of 9.5 years, 9.2% experienced a primary outcome, which was a composite of death and major cardiovascular…