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Legume consumption is inversely associated with type 2 diabetes incidence in adults: A prospective assessment from the PREDIMED study.
Clin Nutr. 2018 06; 37(3):906-913.CN

Abstract

BACKGROUND & AIMS

Legumes, a low-energy, nutrient-dense and low glycemic index food, have shown beneficial effects on glycemic control and adiposity. As such, legumes are widely recommended in diabetic diets, even though there is little evidence that their consumption protects against type 2 diabetes. Therefore the aim of the present study was to examine the associations between consumption of total legumes and specific subtypes, and type 2 diabetes risk. We also investigated the effect of theoretically substituting legumes for other protein- or carbohydrate-rich foods.

METHODS

Prospective assessment of 3349 participants in the PREvención con DIeta MEDiterránea (PREDIMED) study without type 2 diabetes at baseline. Dietary information was assessed at baseline and yearly during follow-up. We used Cox regression models to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs) for type-2 diabetes incidence according to quartiles of cumulative average consumption of total legumes, lentils, chickpeas, dry beans and fresh peas.

RESULTS

During a median follow-up of 4.3 years, 266 new cases of type 2 diabetes occurred. Individuals in the highest quartile of total legume and lentil consumption had a lower risk of diabetes than those in the lowest quartile (HR: 0.65; 95% CI: 0.43, 0.96; P-trend = 0.04; and HR: 0.67; 95% CI: 0.46-0.98; P-trend = 0.05, respectively). A borderline significant association was also observed for chickpeas consumption (HR 0.68; 95% CI: 0.46, 1.00; P-trend = 0.06). Substitutions of half a serving/day of legumes for similar servings of eggs, bread, rice or baked potato was associated with lower risk of diabetes incidence.

CONCLUSIONS

A frequent consumption of legumes, particularly lentils, in the context of a Mediterranean diet, may provide benefits on type 2 diabetes prevention in older adults at high cardiovascular risk.

TRIAL REGISTRATION

The trial is registered at http://www.controlled-trials.com (ISRCTN35739639). Registration date: 5th October 2005.

Authors+Show Affiliations

Human Nutrition Unit, University Hospital of Sant Joan de Reus, Department of Biochemistry and Biotechnology, Faculty of Medicine and Health Sciences, Institut d'Investigació Sanitària Pere Virgili (IISPV), Rovira i Virgili University, Reus, Spain; Centro de Investigación Biomédica en Red Fisiopatologia de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.Human Nutrition Unit, University Hospital of Sant Joan de Reus, Department of Biochemistry and Biotechnology, Faculty of Medicine and Health Sciences, Institut d'Investigació Sanitària Pere Virgili (IISPV), Rovira i Virgili University, Reus, Spain; Centro de Investigación Biomédica en Red Fisiopatologia de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.Human Nutrition Unit, University Hospital of Sant Joan de Reus, Department of Biochemistry and Biotechnology, Faculty of Medicine and Health Sciences, Institut d'Investigació Sanitària Pere Virgili (IISPV), Rovira i Virgili University, Reus, Spain.Centro de Investigación Biomédica en Red Fisiopatologia de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Lipid Clinic, Endocrinology and Nutrition Service, IDIBAPS, Hospital Clinic, University of Barcelona, Barcelona, Spain.Centro de Investigación Biomédica en Red Fisiopatologia de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Atención Primaria, Servicio Navarro de Salud-Osasunbidea, 31010 Navarra, Spain; IdiSNA, Navarra Institute for Health Research, Spain.Centro de Investigación Biomédica en Red Fisiopatologia de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Department of Preventive Medicine, University of Valencia, Valencia, Spain.Centro de Investigación Biomédica en Red Fisiopatologia de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Department of Internal Medicine, August Pi i Sunyer Institute of Biomedical Research (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain.Centro de Investigación Biomédica en Red Fisiopatologia de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Cardiovascular Risk and Nutrition Research Group, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona Biomedical Research Park, Barcelona, Spain.Centro de Investigación Biomédica en Red Fisiopatologia de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Department of Clinical Sciences, University of Las Palmas de Gran Canaria, Las Palmas, Spain.Centro de Investigación Biomédica en Red Fisiopatologia de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Department of Cardiology, University Hospital Araba, Vitoria, Spain.Centro de Investigación Biomédica en Red Fisiopatologia de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Department of Nutrition, Food Science and Gastronomy, School of Pharmacy and Food Science, INSA-University of Barcelona, Barcelona, Spain.Centro de Investigación Biomédica en Red Fisiopatologia de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Institute of Health Sciences, University of Balearic Islands and Son Espases Hospital, Palma de Mallorca, Spain.Centro de Investigación Biomédica en Red Fisiopatologia de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Department of Family Medicine, Distrito Sanitario Atención Primaria Sevilla, Centro de Salud San Pablo, Sevilla, Spain.Centro de Investigación Biomédica en Red Fisiopatologia de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Atención Primaria, Servicio Navarro de Salud-Osasunbidea, 31010 Navarra, Spain; IdiSNA, Navarra Institute for Health Research, Spain.Centro de Investigación Biomédica en Red Fisiopatologia de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Department of Preventive Medicine, University of Valencia, Valencia, Spain.Human Nutrition Unit, University Hospital of Sant Joan de Reus, Department of Biochemistry and Biotechnology, Faculty of Medicine and Health Sciences, Institut d'Investigació Sanitària Pere Virgili (IISPV), Rovira i Virgili University, Reus, Spain; Centro de Investigación Biomédica en Red Fisiopatologia de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain. Electronic address: jordi.salas@urv.cat.No affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

28392166

Citation

Becerra-Tomás, Nerea, et al. "Legume Consumption Is Inversely Associated With Type 2 Diabetes Incidence in Adults: a Prospective Assessment From the PREDIMED Study." Clinical Nutrition (Edinburgh, Scotland), vol. 37, no. 3, 2018, pp. 906-913.
Becerra-Tomás N, Díaz-López A, Rosique-Esteban N, et al. Legume consumption is inversely associated with type 2 diabetes incidence in adults: A prospective assessment from the PREDIMED study. Clin Nutr. 2018;37(3):906-913.
Becerra-Tomás, N., Díaz-López, A., Rosique-Esteban, N., Ros, E., Buil-Cosiales, P., Corella, D., Estruch, R., Fitó, M., Serra-Majem, L., Arós, F., Lamuela-Raventós, R. M., Fiol, M., Santos-Lozano, J. M., Díez-Espino, J., Portoles, O., & Salas-Salvadó, J. (2018). Legume consumption is inversely associated with type 2 diabetes incidence in adults: A prospective assessment from the PREDIMED study. Clinical Nutrition (Edinburgh, Scotland), 37(3), 906-913. https://doi.org/10.1016/j.clnu.2017.03.015
Becerra-Tomás N, et al. Legume Consumption Is Inversely Associated With Type 2 Diabetes Incidence in Adults: a Prospective Assessment From the PREDIMED Study. Clin Nutr. 2018;37(3):906-913. PubMed PMID: 28392166.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Legume consumption is inversely associated with type 2 diabetes incidence in adults: A prospective assessment from the PREDIMED study. AU - Becerra-Tomás,Nerea, AU - Díaz-López,Andrés, AU - Rosique-Esteban,Núria, AU - Ros,Emilio, AU - Buil-Cosiales,Pilar, AU - Corella,Dolores, AU - Estruch,Ramon, AU - Fitó,Montserrat, AU - Serra-Majem,Lluís, AU - Arós,Fernando, AU - Lamuela-Raventós,Rosa Maria, AU - Fiol,Miquel, AU - Santos-Lozano,José Manuel, AU - Díez-Espino,Javier, AU - Portoles,Olga, AU - Salas-Salvadó,Jordi, AU - ,, Y1 - 2017/03/24/ PY - 2016/11/08/received PY - 2017/02/17/revised PY - 2017/03/14/accepted PY - 2017/4/11/pubmed PY - 2019/9/13/medline PY - 2017/4/11/entrez KW - Legumes KW - Lentils KW - PREDIMED-study KW - Type 2 diabetes SP - 906 EP - 913 JF - Clinical nutrition (Edinburgh, Scotland) JO - Clin Nutr VL - 37 IS - 3 N2 - BACKGROUND & AIMS: Legumes, a low-energy, nutrient-dense and low glycemic index food, have shown beneficial effects on glycemic control and adiposity. As such, legumes are widely recommended in diabetic diets, even though there is little evidence that their consumption protects against type 2 diabetes. Therefore the aim of the present study was to examine the associations between consumption of total legumes and specific subtypes, and type 2 diabetes risk. We also investigated the effect of theoretically substituting legumes for other protein- or carbohydrate-rich foods. METHODS: Prospective assessment of 3349 participants in the PREvención con DIeta MEDiterránea (PREDIMED) study without type 2 diabetes at baseline. Dietary information was assessed at baseline and yearly during follow-up. We used Cox regression models to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs) for type-2 diabetes incidence according to quartiles of cumulative average consumption of total legumes, lentils, chickpeas, dry beans and fresh peas. RESULTS: During a median follow-up of 4.3 years, 266 new cases of type 2 diabetes occurred. Individuals in the highest quartile of total legume and lentil consumption had a lower risk of diabetes than those in the lowest quartile (HR: 0.65; 95% CI: 0.43, 0.96; P-trend = 0.04; and HR: 0.67; 95% CI: 0.46-0.98; P-trend = 0.05, respectively). A borderline significant association was also observed for chickpeas consumption (HR 0.68; 95% CI: 0.46, 1.00; P-trend = 0.06). Substitutions of half a serving/day of legumes for similar servings of eggs, bread, rice or baked potato was associated with lower risk of diabetes incidence. CONCLUSIONS: A frequent consumption of legumes, particularly lentils, in the context of a Mediterranean diet, may provide benefits on type 2 diabetes prevention in older adults at high cardiovascular risk. TRIAL REGISTRATION: The trial is registered at http://www.controlled-trials.com (ISRCTN35739639). Registration date: 5th October 2005. SN - 1532-1983 UR - https://www.unboundmedicine.com/medline/citation/28392166/Legume_consumption_is_inversely_associated_with_type_2_diabetes_incidence_in_adults:_A_prospective_assessment_from_the_PREDIMED_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0261-5614(17)30106-1 DB - PRIME DP - Unbound Medicine ER -