Effect of dietary pulse intake on established therapeutic lipid targets for cardiovascular risk reduction: a systematic review and meta-analysis of randomized controlled trials

• Published in: Canadian Medical Association journal (CMAJ) 2014-05, Vol.186 (8), p.E252-E262
• Main Authors: Ha, Vanessa, Sievenpiper, John L, de Souza, Russell J, Jayalath, Viranda H, Mirrahimi, Arash, Agarwal, Arnav, Chiavaroli, Laura, Mejia, Sonia Blanco, Sacks, Frank M, Di Buono, Marco, Bernstein, Adam M, Leiter, Lawrence A, Kris-Etherton, Penny M, Vuksan, Vladimir, Bazinet, Richard P, Josse, Robert G, Beyene, Joseph, Kendall, Cyril W C, Jenkins, David J A
• Format: Article
• Language: English
• Subjects: Beans; Blood cholesterol; Cardiovascular disease; Cardiovascular diseases; Cardiovascular Diseases - prevention & control; Cholesterol, HDL - blood; Cholesterol, LDL - blood; Clinical trials; Diet; Diet, Fat-Restricted - methods; Diet, High-Fat - methods; Diet, Reducing - methods; Effects; Feeding Behavior; Female; Health aspects; Humans; Lipids - blood; Low density lipoproteins; Male; Pharmaceutical industry; Randomized Controlled Trials as Topic; Risk factors; Risk Reduction Behavior; Soft drink industry; Studies; Systematic review; Trans fatty acids
• ISSN: 0820-3946; 1488-2329
• DOI: 10.1503/cmaj.131727

Evidence from controlled trials encourages the intake of dietary pulses (beans, chickpeas, lentils and peas) as a method of improving dyslipidemia, but heart health guidelines have stopped short of ascribing specific benefits to this type of intervention or have graded the beneficial evidence as low. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to assess the effect of dietary pulse intake on established therapeutic lipid targets for cardiovascular risk reduction. We searched electronic databases and bibliographies of selected trials for relevant articles published through Feb. 5, 2014. We included RCTs of at least 3 weeks' duration that compared a diet emphasizing dietary pulse intake with an isocaloric diet that did not include dietary pulses. The lipid targets investigated were low-density lipoprotein (LDL) cholesterol, apolipoprotein B and non-high-density lipoprotein (non-HDL) cholesterol. We pooled data using a random-effects model. We identified 26 RCTs (n = 1037) that satisfied the inclusion criteria. Diets emphasizing dietary pulse intake at a median dose of 130 g/d (about 1 serving daily) significantly lowered LDL cholesterol levels compared with the control diets (mean difference -0.17 mmol/L, 95% confidence interval -0.25 to -0.09 mmol/L). Treatment effects on apolipoprotein B and non-HDL cholesterol were not observed. Our findings suggest that dietary pulse intake significantly reduces LDL cholesterol levels. Trials of longer duration and higher quality are needed to verify these results. ClinicalTrials.gov, no. NCT01594567.