British Journal of Nutrition

Full Papers

Human and Clinical Nutrition

Changes in bread consumption and 4-year changes in adiposity in Spanish subjects at high cardiovascular risk

I. Bautista-Castañoa1a2 , A. Sánchez-Villegasa1a2 , R. Estrucha2a3a4, M. A. Martínez-Gonzáleza2a5, D. Corellaa4a6, J. Salas-Salvadóa2a4a7, M. I. Covasa4a8, H. Schrodera4a8, J. Alvarez-Péreza1a2, J. Quileza4a7, R. M. Lamuela-Raventósa2a4a9, E. Rosa4a10, F. Arósa2a11, M. Fiola4a12, J. Lapetraa4a13, M. A. Muñoza4a14, E. Gómez-Graciaa2a15, J. Tura2a16, X. Pintóa2a17, V. Ruiz-Gutierreza18, M. P. Portillo-Baquedanoa19 and L. Serra-Majema1a2 c1 on behalf of the PREDIMED Study Investigators

a1 Department of Clinical Sciences, University of Las Palmas de Gran Canaria, PO Box 550, 35080 Las Palmas de Gran Canaria, Spain

a2 RETIC Alimentación saludable en la prevención primaria de enfermedades crónicas: la Red Predimed (RD06/0045), Spain

a3 Department of Internal Medicine, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Barcelona, Spain

a4 Ciber Fisiopatologia de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain

a5 Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain

a6 Department of Preventive Medicine and Public Health, University of Valencia, Valencia, Spain

a7 Human Nutrition Department, School of Medicine, University Rovira i Virgili, Reus, Spain

a8 Cardiovascular Risk and Nutrition Research Group, IMIM – Institut de Recerca del Hospital del Mar, Barcelona, Spain

a9 Department of Nutrition and Bromatology, University of Barcelona, Barcelona, Spain

a10 Lipid Clinic, Endocrinology and Nutrition Service, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clinic, Barcelona, Spain

a11 Department of Cardiology, Hospital Txagorritxu, Vitoria, Spain

a12 University Institute for Health Sciences Investigation, Palma de Mallorca, Spain

a13 Department of Family Medicine, Primary Care Division of Sevilla, San Pablo Health Center, Sevilla, Spain

a14 Primary Health Care Division and Research, IDIAP-Jordi Gol, Barcelona, Spain

a15 Department of Preventive Medicine, University of Málaga, Málaga, Spain

a16 Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands, Palma de Mallorca, Spain

a17 Internal Medicine Service, Hospital of Bellvitge, Hospitalet de Llobregat, Barcelona, Spain

a18 Instituto de la Grasa, CSIC, Sevilla, Spain

a19 Department of Pharmacy and Food Sciences, University of the Basc Country, Bilbao, Spain


The effects of bread consumption change over time on anthropometric measures have been scarcely studied. We analysed 2213 participants at high risk for CVD from the PREvención con DIeta MEDiterránea (PREDIMED) trial to assess the association between changes in the consumption of bread and weight and waist circumference gain over time. Dietary habits were assessed with validated FFQ at baseline and repeatedly every year during 4 years of follow-up. Using multivariate models to adjust for covariates, long-term weight and waist circumference changes according to quartiles of change in energy-adjusted white and whole-grain bread consumption were calculated. The present results showed that over 4 years, participants in the highest quartile of change in white bread intake gained 0·76 kg more than those in the lowest quartile (P for trend = 0·003) and 1·28 cm more than those in the lowest quartile (P for trend < 0·001). No significant dose–response relationships were observed for change in whole-bread consumption and anthropometric measures. Gaining weight (>2 kg) and gaining waist circumference (>2 cm) during follow-up was not associated with increase in bread consumption, but participants in the highest quartile of changes in white bread intake had a reduction of 33 % in the odds of losing weight (>2 kg) and a reduction of 36 % in the odds of losing waist circumference (>2 cm). The present results suggest that reducing white bread, but not whole-grain bread consumption, within a Mediterranean-style food pattern setting is associated with lower gains in weight and abdominal fat.

(Received February 03 2012)

(Revised September 20 2012)

(Accepted September 20 2012)

(Online publication December 03 2012)

Key Words:

  • White bread;
  • Whole-grain bread;
  • Cereals;
  • Body weight;
  • Abdominal fat


c1 Corresponding author: L. Serra-Majem, email


  I. B.-C. and A. S.-V. contributed equally to the present study.

  Abbreviations: DM, diabetes mellitus; GI, glycaemic index; PREDIMED, PREvención con DIeta MEDiterránea