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

Abstract

Background: 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.

Methods: 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.

Results: 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.

Interpretation: 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.

Trial registration: ClinicalTrials.gov, no. NCT01594567.

Figures

Figure 1:

Selection of randomized controlled trials for the meta-analysis.

Figure 2:

Effect of isocaloric exchange of intervention diets with dietary pulses for control diets without dietary pulses on low-density lipoprotein (LDL) cholesterol. Data are expressed as mean differences in LDL with 95% confidence intervals (CIs). Values less than zero favour intake of dietary pulses. COM = multiple intervention arms combined for meta-analysis, H = healthy, IR = insulin resistance, IS = insulin sensitivity, pre-MS = pre-metabolic syndrome.

Figure 3:

Effect of isocaloric exchange of intervention diets with dietary pulses for control diets without dietary pulses on non–high-density lipoprotein (non-HDL) cholesterol. Data are expressed as mean differences in non-HDL with 95% confidence intervals (CIs). Values less than zero favour intake of dietary pulses. COM = multiple intervention arms combined for meta-analysis.