Legume consumption in adults and risk of cardiovascular disease and type 2 diabetes: a systematic review and meta-analysis

Birna Þórisdóttir*, Erik Kristoffer Arnesen, Linnea Bärebring, Jutta Dierkes, Christel Lamberg-Allardt, Alfons Ramel, Bright I. Nwaru, Fredrik Söderlund, Agneta Åkesson

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

Abstract

Objectives: This study aimed to systematically review the evidence for associations between consumption of legumes and cardiovascular disease (CVD), type 2 diabetes (T2D) and their risk factors among healthy adults. Methods: We searched MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and Scopus up to 16 May 2022 for ≥4 weeks long randomized (RCT) and non-randomized controlled trials and prospective cohort studies with follow-up ≥12 months, assessing legume intake (beans/lentils/peas/soybeans, excluding peanuts and legume-products/protein/powder/flour) as the intervention or exposure. Outcomes were CVD, coronary heart disease (CHD), stroke, T2D and in intervention trials only: changes in blood lipids, glycemic markers, and blood pressure. Risk of bias (RoB) was evaluated with Cochrane’s RoB2, ROBINS-I, and US Department of Agriculture (USDA)’s RoB-NObS. Effect sizes were pooled using random-effects meta-anal-yses and expressed as relative risk or weighed mean differences with 95% confidence intervals, heterogeneity quantified as I2. The evidence was appraised according to World Cancer Research Fund’s criteria. Results: Of the 181 full-text articles assessed for eligibility, 47 were included: 31 cohort studies (2,081,432 participants with generally low legume consumption), 14 crossover RCTs (448 participants), one parallel RCT and one non-randomized trial. Meta-analyses of cohort studies were suggestive of null associations for CVD, CHD, stroke and T2D. Meta-analyses of RCTs suggested a protective effect on total cholesterol (mean difference −0.22 mmol/L), low density lipoprotein (LDL)-cholesterol (−0.19 mmol/L), fasting glucose (−0.19 mmol/L), and HOMA-IR (−0.30). Heterogeneity was high (I2 = 52% for LDL-cholesterol, >75% for others). The overall evidence for associations between consumption of legumes and risk of CVD and T2D was con-sidered limited – no conclusion. Conclusion: Legume consumption was not found to influence risk of CVD and T2D in healthy adult pop-ulations with generally low legume consumption. However, protective effects on risk factors, seen in RCTs, lend some support for recommending legume consumption as part of diverse and healthy dietary patterns for prevention of CVD and T2D.

Original languageEnglish
Article number9541
JournalFood and Nutrition Research
Volume67
DOIs
Publication statusPublished - 30 May 2023

Bibliographical note

Funding Information:
This systematic review followed the guidelines developed for the 2022 revision of the NNR (12, 13) and preferred reporting for systematic reviews (14, 15). A study protocol was published prior to article selection in the PROSPERO database (https://www.crd.york.ac.uk, CRD42021250084). This systematic review is part of the NNR 2022 project, funded by the Nordic Council of Ministers and governmental food and health authorities of Norway, Finland, Sweden, Denmark, and Iceland (16).

Publisher Copyright:
© 2023 Birna Thorisdottir et al.

Other keywords

  • beans
  • cardiovascular diseases
  • diabetes mellitus type 2
  • fabaceae
  • human nutrition
  • lentils
  • non-communicable diseases
  • Peas
  • pulses

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