Original articleLegume consumption is inversely associated with type 2 diabetes incidence in adults: A prospective assessment from the PREDIMED study
Section snippets
Background
Type 2 diabetes is recognised as a major public health issue worldwide. According to the International Diabetes Federation (IDF), type 2 diabetes affected 415 million adults in 2015 and it is estimated that this figure will increase to 642 million in 2040 [1]. Type 2 diabetes is associated with significant systemic consequences, including microvascular and macrovascular complications affecting the quality of life and decreasing the life expectancy [2]. Therefore, it is imperative to identify
Study population
The present data was analysed using an observational prospective design conducted within the frame of the PREDIMED (PREvención con DIeta MEDiterránea) trial (PREDIMED website: http://www.predimed.es) [24]. The PREDIMED study (registered at http://www.controlled-trials.com as ISRCTN35739639) was a randomized, multi center, parallel-group clinical trial conducted in Spain between October 2003 and December 2010. The main aim of the trial was to evaluate the effectiveness of the MedDiet on the
Results
During a median follow-up of 4.3 years, 266 incident cases of type 2 diabetes were documented. Baseline characteristics of the study population according to energy-adjusted quartiles of total legume intake are presented in Table 1. Participants in the highest quartile of total legume consumption were less likely to have higher education and had higher BMI and fasting plasma glucose levels than those in the bottom quartile. They also had a lower intake of total energy, dietary fat and alcohol
Discussion
To the best of our knowledge, this is the first prospective study conducted in senior Mediterranean individuals at high cardiovascular risk evaluating the association between consumption of total legumes and its different varieties, and type 2 diabetes. The present study revealed that a higher consumption of total legumes, especially lentils, was associated with a lower risk of type 2 diabetes development. The consumption of chickpeas was borderline significantly associated with a lower risk of
Conclusions
In summary, the current data suggests that a frequent consumption of legumes and particularly lentils could provide benefits on type 2 diabetes development in senior adults at high cardiovascular risk. The substitution of legumes for other protein- or carbohydrate-rich foods is also associated with a lower risk of type 2 diabetes. The present study supports an increased consumption of legumes for type 2 diabetes prevention. However, given the mixed results from previous researches, further
Authors' responsibilities
ER, DC, RE, MF, LS-M, FA, RML-R, M Fiol, JL and JS-S designed the research. NB-T, AD-L, NR-E, ER, PB-C, DC, RE, MF, LS-M, FA, RML-R, M Fiol, JMS-L, JD-E, OP and JS-S conducted the research. NB-T and JS-S analysed the data. NB-T, AD-Land JS-S wrote the paper. NB-T and JS-S had primary responsibility for final content. All authors read and approved the final manuscript.
Conflict of interest statement and Funding sources
The authors disclose no conflict of interest related with the article.
Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN) is an initiative of the Instituto de Salud Carlos III (ISCIII) of Spain which is supported by FEDER funds (CB06/03). Supported by the official funding agency for biomedical research of the Spanish government, ISCIII, through grants provided to research networks specifically developed for the trial (RTIC G03/140 and RD 06/0045)
Acknowledgements
The authors thank all the participants for their collaboration, all the PREDIMED personnel for their assistance and all the personnel of affiliated primary care centers for making the study possible. CIBEROBN is an initiative of ISCIII, Spain.
References (50)
- et al.
Pulse consumption, satiety, and weight management
Adv Nutr An Int Rev J
(2010) - et al.
Evidence-based nutritional approaches to the treatment and prevention of diabetes mellitus
Nutr Metab Cardiovasc Dis
(2004) - et al.
Effects of dietary pulse consumption on body weight: a systematic review and meta-analysis of randomized controlled trials
Am J Clin Nutr
(2016) - et al.
Carbohydrates, dietary fiber, and incident type 2 diabetes in older women
Am J Clin Nutr
(2000) - et al.
Legume and soy food intake and the incidence of type 2 diabetes in the Shanghai Women's Health Study
Am J Clin Nutr
(2008) - et al.
A short screener is valid for assessing Mediterranean diet adherence among older Spanish men and women
J Nutr
(2011) - et al.
Minor components of pulses and their potential impact on human health
Food Res Int
(2010) - et al.
Dietary flavonoids intake and risk of type 2 diabetes: a meta-analysis of prospective cohort studies
Clin Nutr
(2014) - et al.
Greater satiety response with resistant starch and corn bran in human subjects
Nutr Res
(2009) - et al.
Glycemic index, glycemic load, and risk of type 2 diabetes: results from 3 large US cohorts and an updated meta-analysis
Am J Clin Nutr
(2014)
Nutritional evaluation and bioactive microconstituents (phytosterols, tocopherols, polyphenols, triterpenic acids) in cooked dry legumes usually consumed in the Mediterranean countries
Food Chem
IDF diabetes
Standards of medical care in diabetes–2013
Diabetes Care
Contribution of the nurses' health studies to uncovering risk factors for type 2 diabetes: diet, lifestyle, biomarkers, and genetics
Am J Public Health
International tables of glycemic index and glycemic load values: 2008
Diabetes Care
A review of the nutritional value of legumes and their effects on obesity and its related co-morbidities
Obes Rev
Nutrition recommendations and interventions for diabetes: a position statement of the American Diabetes Association
Diabetes Care
Dietary patterns, meat intake, and the risk of type 2 diabetes in women
Arch Intern Med
Prevention of diabetes with Mediterranean diets: a subgroup analysis of a randomized trial
Ann Intern Med
Regular consumption of pulses for 8 weeks reduces metabolic syndrome risk factors in overweight and obese adults
Br J Nutr
A higher ratio of beans to white rice is associated with lower cardiometabolic risk factors in Costa Rican adults
Am J Clin Nutr
Bean consumption is associated with greater nutrient intake, reduced systolic blood pressure, lower body weight, and a smaller waist circumference in adults: results from the National Health and Nutrition Examination Survey 1999-2002
J Am Coll Nutr
Non-soya legume-based therapeutic lifestyle change diet reduces inflammatory status in diabetic patients: a randomised cross-over clinical trial
Br J Nutr
Substitution of red meat with legumes in the therapeutic lifestyle change diet based on dietary advice improves cardiometabolic risk factors in overweight type 2 diabetes patients: a cross-over randomized clinical trial
Eur J Clin Nutr
Association between legume intake and self-reported diabetes among adult men and women in India
BMC Public Health
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List of PREDIMED study investigators (Online Supplemental Material).