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Effect of non-oil-seed pulses on glycaemic control: a systematic review and meta-analysis of randomised controlled experimental trials in people with and without diabetes.
Diabetologia 2009; 52(8):1479-95D

Abstract

AIMS/HYPOTHESIS

Dietary non-oil-seed pulses (chickpeas, beans, peas, lentils, etc.) are a good source of slowly digestible carbohydrate, fibre and vegetable protein and a valuable means of lowering the glycaemic-index (GI) of the diet. To assess the evidence that dietary pulses may benefit glycaemic control, we conducted a systematic review and meta-analysis of randomised controlled experimental trials investigating the effect of pulses, alone or as part of low-GI or high-fibre diets, on markers of glycaemic control in people with and without diabetes.

METHODS

We searched MEDLINE, EMBASE, CINAHL, and the Cochrane Library for relevant controlled trials of >or=7 days. Two independent reviewers (A. Esfahani and J. M. W. Wong) extracted information on study design, participants, treatments and outcomes. Data were pooled using the generic inverse variance method and expressed as standardised mean differences (SMD) with 95% CIs. Heterogeneity was assessed by chi (2) and quantified by I (2). Meta-regression models identified independent predictors of effects.

RESULTS

A total of 41 trials (39 reports) were included. Pulses alone (11 trials) lowered fasting blood glucose (FBG) (-0.82, 95% CI -1.36 to -0.27) and insulin (-0.49, 95% CI -0.93 to -0.04). Pulses in low-GI diets (19 trials) lowered glycosylated blood proteins (GP), measured as HbA(1c) or fructosamine (-0.28, 95% CI -0.42 to -0.14). Finally, pulses in high-fibre diets (11 trials) lowered FBG (-0.32, 95% CI -0.49 to -0.15) and GP (-0.27, 95% CI -0.45 to -0.09). Inter-study heterogeneity was high and unexplained for most outcomes, with benefits modified or predicted by diabetes status, pulse type, dose, physical form, duration of follow-up, study quality, macronutrient profile of background diets, feeding control and design.

CONCLUSIONS/INTERPRETATION

Pooled analyses demonstrated that pulses, alone or in low-GI or high-fibre diets, improve markers of longer term glycaemic control in humans, with the extent of the improvements subject to significant inter-study heterogeneity. There is a need for further large, well-designed trials.

Authors+Show Affiliations

Risk Factor Modification Centre, St Michael's Hospital, Toronto, ON, Canada.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis
Multicenter Study
Research Support, Non-U.S. Gov't
Review
Systematic Review

Language

eng

PubMed ID

19526214

Citation

Sievenpiper, J L., et al. "Effect of Non-oil-seed Pulses On Glycaemic Control: a Systematic Review and Meta-analysis of Randomised Controlled Experimental Trials in People With and Without Diabetes." Diabetologia, vol. 52, no. 8, 2009, pp. 1479-95.
Sievenpiper JL, Kendall CW, Esfahani A, et al. Effect of non-oil-seed pulses on glycaemic control: a systematic review and meta-analysis of randomised controlled experimental trials in people with and without diabetes. Diabetologia. 2009;52(8):1479-95.
Sievenpiper, J. L., Kendall, C. W., Esfahani, A., Wong, J. M., Carleton, A. J., Jiang, H. Y., ... Jenkins, D. J. (2009). Effect of non-oil-seed pulses on glycaemic control: a systematic review and meta-analysis of randomised controlled experimental trials in people with and without diabetes. Diabetologia, 52(8), pp. 1479-95. doi:10.1007/s00125-009-1395-7.
Sievenpiper JL, et al. Effect of Non-oil-seed Pulses On Glycaemic Control: a Systematic Review and Meta-analysis of Randomised Controlled Experimental Trials in People With and Without Diabetes. Diabetologia. 2009;52(8):1479-95. PubMed PMID: 19526214.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of non-oil-seed pulses on glycaemic control: a systematic review and meta-analysis of randomised controlled experimental trials in people with and without diabetes. AU - Sievenpiper,J L, AU - Kendall,C W C, AU - Esfahani,A, AU - Wong,J M W, AU - Carleton,A J, AU - Jiang,H Y, AU - Bazinet,R P, AU - Vidgen,E, AU - Jenkins,D J A, Y1 - 2009/06/13/ PY - 2009/01/29/received PY - 2009/03/30/accepted PY - 2009/6/16/entrez PY - 2009/6/16/pubmed PY - 2009/10/24/medline SP - 1479 EP - 95 JF - Diabetologia JO - Diabetologia VL - 52 IS - 8 N2 - AIMS/HYPOTHESIS: Dietary non-oil-seed pulses (chickpeas, beans, peas, lentils, etc.) are a good source of slowly digestible carbohydrate, fibre and vegetable protein and a valuable means of lowering the glycaemic-index (GI) of the diet. To assess the evidence that dietary pulses may benefit glycaemic control, we conducted a systematic review and meta-analysis of randomised controlled experimental trials investigating the effect of pulses, alone or as part of low-GI or high-fibre diets, on markers of glycaemic control in people with and without diabetes. METHODS: We searched MEDLINE, EMBASE, CINAHL, and the Cochrane Library for relevant controlled trials of >or=7 days. Two independent reviewers (A. Esfahani and J. M. W. Wong) extracted information on study design, participants, treatments and outcomes. Data were pooled using the generic inverse variance method and expressed as standardised mean differences (SMD) with 95% CIs. Heterogeneity was assessed by chi (2) and quantified by I (2). Meta-regression models identified independent predictors of effects. RESULTS: A total of 41 trials (39 reports) were included. Pulses alone (11 trials) lowered fasting blood glucose (FBG) (-0.82, 95% CI -1.36 to -0.27) and insulin (-0.49, 95% CI -0.93 to -0.04). Pulses in low-GI diets (19 trials) lowered glycosylated blood proteins (GP), measured as HbA(1c) or fructosamine (-0.28, 95% CI -0.42 to -0.14). Finally, pulses in high-fibre diets (11 trials) lowered FBG (-0.32, 95% CI -0.49 to -0.15) and GP (-0.27, 95% CI -0.45 to -0.09). Inter-study heterogeneity was high and unexplained for most outcomes, with benefits modified or predicted by diabetes status, pulse type, dose, physical form, duration of follow-up, study quality, macronutrient profile of background diets, feeding control and design. CONCLUSIONS/INTERPRETATION: Pooled analyses demonstrated that pulses, alone or in low-GI or high-fibre diets, improve markers of longer term glycaemic control in humans, with the extent of the improvements subject to significant inter-study heterogeneity. There is a need for further large, well-designed trials. SN - 1432-0428 UR - https://www.unboundmedicine.com/medline/citation/19526214/Effect_of_non_oil_seed_pulses_on_glycaemic_control:_a_systematic_review_and_meta_analysis_of_randomised_controlled_experimental_trials_in_people_with_and_without_diabetes_ DB - PRIME DP - Unbound Medicine ER -