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The Effect of Oats on Cardiovascular Health:

A Review of Oats Benefits of Oats

Kate Grabusky
October 18, 2016
Food Science NTR 402
Dr. FitzPatrick

Introduction

Heart disease is a major cause of morbidity and mortality. It is

evidenced that lowering LDL cholesterol reduced the risk of developing heart
disease. In addition to achieving and maintaining a normal body weight,
maintaining regular physical activity, and restricting dietary intake of
saturated fats, trans fats, and cholesterol, incorporation of dietary adjuncts
that favorably affect LDL cholesterol level, such as viscous fibers and plant
sterols and stanols, are recommended (Momenizadeh, 2014). Oat B-Glucan
is the main soluble fiber in oats. There are many health claims about oats
lowering cholesterol. Oat b-glucan is the non-starch polysaccharide in oats
that reduces cholesterol. It is also the fiber in barley oat, yeast, rye, and
mushrooms (Momenizadeh, 2014). The Food and Drug Administration
recommends the consumption of 3 g of oats per day to reduce serum total
cholesterol. -glucan is a highly viscous soluble fiber localized mainly in cell
walls of endosperm oat. It is an important component in food in modulating
of metabolic deregulations associated with the metabolic syndrome
(Schuster, 2015). Mello et al. produced evidence that support whole grains
and sources of insoluble fiber in the preventing diabetes (Schuster, 2015). It
has been proposed that a meal containing such fiber increases the viscosity
of stomach and intestinal contents, which may reduce
absorption/reabsorption of cholesterol and bile acids, thus lowering blood
cholesterol concentration (Maki, 2010). Consuming 3g of high MW oats daily as
part of an appropriate calorie diet can benefit total, HDL, and LDL cholesterol levels,
and aid in weight loss, thus reducing cardiovascular disease.

Amount needed for benefits

Health claims regarding cholesterol lowering effects of oat B-glucan
have been approved by food standards agencies worldwide in the United
States, Canada, Europe, Australia and New Zealand, and Malaysia
(Whitehead, 2014). With the exception of Malaysia, all of these claims are
based on a diet containing 3 g/d of oat B-glucan. The US Food and Drug
Administration claims that food that contain oats and have3 g B-glucan/d can
reduce risk of heart disease. The European Food Safety Authority established
that the consumption of oat B-glucan causes a reduction in blood cholesterol.
Adding 3 g OBG/d to the diet reduces LDL and total cholesterol by 0.25
mmol/L and 0.30 mmol/L, respectively, without changing HDL cholesterol or
triglycerides (Whitehead, 2014). Diets that contain 3 g OBG/d have been
proven to reduce serum total by 0.30 mmol/L and LDL cholesterol 0.25
mmol/L relative to control. There was no significant effect of dose or duration
of treatment of the range of OBG doses (3.012.4 g/d), meaning consuming
>3 g/d did not have more benefits than 3.0g/d.
Molecular Weight
Not all studies have shown oats to lower cholesterol. This study that
examines the relationship between viscosity and LDL cholesterol suggests
that oat B-glucans ability to lower LDL cholesterol is affected by its ability to
increase viscosity of the intestine contents (Wolever, 2010). Viscosity is
affected by the molecular weight (MW) and the amount of oat B-glucan

solubilized in the intestine. In this double blind clinical trial, participants

were randomly assigned to receive cereal containing wheat fiber, 3 g highMW (2,210,000 g/mol, 4 g medium-MW (850,000 g/mol), 3 g medium-MW
(530,000 g/mol), or 4 g low-MW (210,000 g/mol) oat -glucan/d (Wolever,
2010). Participants were given a serving of oats twice daily, for 4 weeks. The
results showed that the participants who consumed 3 g high-MW lowered
their LDL cholesterol by .21mmol/L, or 5.5% more than the wheat cereal
with. 4 g medium-MW reduced LDL cholesterol by 0.26 mmol/L, 6.5%. Those
who consumed 3 g medium-MW oat -glucan cereals decreased by 0.19
mmol/L, or 4.7%. Each of these differences are significant, with p-values
=.002, .0007, and .01, respectively (Wolever, 2010). However, the group
that received 4 g low-MW oat -glucan/d only reduced their LDL cholesterol
by 0.10 mmol/L, or 2.3%. This shows that the low MW oat B-glucan was only
50% as effective at lowering LDL cholesterol as the high MW oat B-glucans.
Comparison to wheat
Oats may be better for your health than most whole grains. Wheat is
one of the best sources of soluble fiber, yet oats showed better results in this
study. Thirty-eight men followed a calorically equal diet for one week, and
were then sorted into two groups. Group A was fed the American Heart
Association Step II diet, with whole wheat bread. Group B also consumed the
AHA Step II diet, but with more monounsaturated fatty acids and bread with
6 g of beta-glucan. The diets were maintained for 8 weeks and both groups

walked 60 minutes a day. Group B raised their HDL cholesterol by 27.8%

(39.4 +/- 2.0 to 49.5 +/- 2.1 mg/dL (P < 0.001), while Group A had no
change. The total cholesterol was reduced approximately the same in both
groups group A, from 232.8 +/- 2.7 mg/dL to 202.7 +/- 6.7 mg/dL; P <
0.001; and group B, from 231.8 +/- 4.3 mg/dL to 194.2 +/- 4.3 mg dL; P <
0.001 (Reyna-Villasmil, 2007.) The B-glucan group lowered their LDL
cholesterol 27.3%, more than the whole wheat group, which decreased
16.8%. Group A decreased from 160.3 +/- 2.8 mg/dL to 133.2 +/- 5.4 mg/dL,
with P < 0.001. Group B dropped reduced from 167.9 +/- 4.3 mg/dL to 120.9
+/- 4.3 mg/dL, with P < 0.001. Non-HDL cholesterol levels were decreased in
both groups. Those who consumed the diet containing B-glucan diet dropped
24.5%, and Group A dropped 16.1%. The significance was <0.04. Group B
reduced total cholesterol/HDL cholesterol ratio of 33.3% more than Group As
8.4% decrease. The significance was < .003. The group consuming more Bglucan also had decreased fasting glucose levels, unlike Group A. Lastly,
both Groups lowered their weight and BMI. Group B again had a greater
effect. Overall, the B-glucan group experienced benefits to a higher extent
than the group without b-glucans. All of these improvements have been
shown to lower risk of heart disease. Potentially, consuming oat B-glucan
instead of whole wheat can reduce risk of cardiovascular disease.
Hypercholesterolemia is a risk factor for the development of various
cardiovascular diseases including diabetes, several cancers, and endothelial
dysfunction (Momenizadeh, 2014.) The endothelium is essential to vascular

tone and regulation of blood flow (Momenizadeh, 2014). In order to

determine the effects of oat bran on serum lipids and endothelial
dysfunction, 60 isolated hypercholesterolemic patients were randomly
assigned to the control or experimental group. The experimental group
consumed at least five servings a day of oat bread with 6 g beta-glucan. The
control group consumed at least five servings of wheat bread each day.
Anthropometric indicators, fasting blood sugar and lipid profiles were
measured at the start and after the 6 week study. Endothelial function was
assessed using flow-mediated dilation (FMD). None of the measurements
changed significantly in the control group. In the oat bran group, only
brachial artery diameter after ischemia and baseline brachial artery diameter
changed significantly (Momenizadeh, 2014). The study showed that oat
bread consumption significantly reduced total cholesterol (P=.029). The oat
bread resulted in increased artery diameter. But, with P=.825, it did not
significantly affect flow-mediated dilation. While there were not many
significant changes in this study, the group consuming oat bread reduced
their cholesterol. This suggests that oat bread can lower cholesterol in
hypercholesterolemic patients. In past studies, consumption of oat bread has
improved endothelial function. This study may have produced different
results because the participants were hypercholesterolemic prior to the
study, meaning they may have been hypercholesterolemic for years, making
it harder to reverse.
Lipids and Insulin

Studies suggest that the soluble, rather than insoluble, fiber can
positively impact glucose metabolism and insulin. A Brazilian study in
Nutricion Hospitalaria examined the effect of oats on blood glucose levels,
HOMA-IR index, lipid profile, weight and Body Mass Index. This case control
study used a control and experimental group (Schuster, 2015). The control
group consumed their usual diet. The experimental group ate 40g of oats in
addition to their usual diet. Researchers measured height and weight, BMI,
fasting glucose, insulin, total cholesterol, triglycerides and HDL cholesterol
for eight weeks. They also calculated LDL cholesterol and HOMA-IR index.
The Control group did not reduce any of the variables listed, and increased
blood glucose and HOMA- IR with a significance of p < 0.05. The
experimental group significantly (p < 0.001) reduced all of their variables.
This suggests that those who consume oats are more likely to maintain lower
BMI, fasting glucose, insulin, total cholesterol, triglyceride, and LDL
cholesterol levels. A major confounder in this study is that the usual diet of
the participants is not defined. In addition, a participant who knows they are
consuming oats and hence, in the experimental group, may alter their diet or
lifestyle to influence the study.
Weight loss
Meta-analyses show that 3 g/d b-glucan can lower LDL cholesterol by
5.0 mg/dL or 4%. Weight loss has also been shown to decrease LDL levels
0.8 mg/dL or 0.6%, for each kilogram decrease in body weight (Maki,

2010). In a randomized control trial, 144 free-living, overweight and obese

adults with baseline LDL cholesterol levels 130 to 200 mg/dL were
randomized (Maki, 2010). In this study, both groups were put on a reduced
calorie diet with a 500 kcal/day deficit that limited high energy and fat foods,
and implemented portion control. Participants were also encouraged to do
30-60 minutes of physical activity per day. The experimental group
consumed two portions per day of whole-grain ready to eat oat cereal
containing 3 g/day oat b-glucan. The control group consumed or energymatched low-fiber foods instead of oats. Fasting lipoprotein levels, waist
circumference, triceps skinfold thickness, and body weight were measured at
baseline and weeks 4, 8, 10, and 12 (Maki, 2010). Compared to the control,
the oat consuming group reduced several values significantly more. LDL
cholesterol decreased (-8.7+/-1.0 vs -4.3+/-1.1%, P=0.005), total cholesterol
decreased (-5.4+/-0.8 vs -2.9+/-0.9%, P=0.038), and non-high-density
lipoprotein-cholesterol decreased (-6.3+/-1.0 vs -3.3+/-1.1%, P=0.046).
(Maki, 2010). There was no difference between the two groups for highdensity lipoprotein and triglyceride responses. Weight loss was not
significantly different between the two groups (-2.2+/-0.3 vs -1.7+/-0.3 kg,
P=0.325). However, the oat group reduced waist circumference more than
the control (-3.3+/-0.4 vs -1.9+/-0.4 cm, P=0.012) (Maki, 2010).
Figure 1

From: (Maki, 2010).

Figure 1 shows the mean change from baseline in waist circumference

for subjects in the whole-grain ready-to-eat oat cereal compared to the
control group. To determine if a dietary program for weight loss that includes
a whole grain, ready to eat oat cereal containing viscous fiber improves
cardiovascular disease risk markers more than a reduced calorie diet alone.
Values to the right of week 12 data are means (95% confidence interval).
(Maki, 2010).
This study suggests that while on a calorie-reduced diet, oats can help
promote weight loss. The viscous fiber in oats increases the viscosity of the
stomach contents, which produces more satiety than the low fiber, calorically
equal food in the control group.
Conclusion
Oats provide several cardiovascular benefits. These include lowering
LDL cholesterol, raising HDL cholesterol, lowering total cholesterol and
reducing waist circumfrence. These benefits can aid in weights loss. In order

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to achieve these benefits, studies recommend consuming 3g of high MW

oats as part of a healthy diet. Most studies that involve the consumption of
oats also include a calorie reduced diet, which can promote weight loss.
These calorie-reduced diets are a major confounder in these studies about
oats. The major component in oats is B-glucan, a soluble fiber in oats that
increases viscosity of stomach contents. Overall, healthy diets that include
oats have more benefits than those without oats.

References
Maki, K.C., Beiseigel, J.M., Jonnalagadda, S.S., Gugger, C.K., Reeves, M.S.,
Farmer, M.V., Kaden, V.N., & Rains, T.M. (2010). Whole-grain ready-to-

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eat oat cereal, as part of a dietary program for weight loss, reduces
low-density lipoprotein cholesterol in adults with overweight and
obesity more than a dietary program including low-fiber control foods.
Journal of the Academy of Nutrition and Dietetics, 110(2), 205-214.
Momenizadeh , A., Heidari, R., Sadeghi ,M., Tabesh ,F., Ekramzadeh, M.,
Haghighatian, Z., Golshahi, J., & Baseri, M. (2014). Effects of oat and
wheat bread consumption on lipid profile, blood sugar, and endothelial
function in hypercholesterolemic patients: A randomized controlled
clinical trial. Arya Atherosclerosis, 10(5), 259-265.
Reyna-Villasmil, N., Bermdez-Pirela, V., Mengual-Moreno, E., Arias, N.,
Cano-Ponce, C., Leal-Gonzalez, E., Souki, A., Inglett, G.E., Israili, Z.H.,
Hernndez-Hernndez, R., Valasco, M., & Arraiz, N. (2007). Oat-derived
beta-glucan significantly improves HDLC and diminishes LDLC and nonHDL cholesterol in overweight individuals with mild
hypercholesterolemia. American Journal of Therapeutics, 14(2), 203212.
Schuster, J., Beninc, G., Vitorazzi, R.,& Morelo Dal Bosco, S. (2015). Effects
of oats on lipid profile, insulin resistance and weight loss. Nutricion
Hospitalaria, 32(5), 2111-2116.
Whitehead, A., Beck, E.J., Tosh, S., & Wolever, T.M. (2014). Cholesterollowering effects of oat -glucan: a meta-analysis of randomized
controlled trials. The American Journal of Clinical Nutriton, 100(6),
1413-1421.
Wolever, T.M., Tosh, S.M., Gibbs, A.L., Brand-Miller, J., Duncan, A.M., Hart,
V., Lamarche, B., Thomson, B.A., Duss, R., & Wood, P.J. (2010).
Physicochemical properties of oat -glucan influence its ability to
reduce serum LDL cholesterol in humans: a randomized clinical trial.
American Journal of Clinical Nutrition, 92(4), 723-732.