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Clin Nutr. 2018 Jun;37(3):906-913. doi: 10.1016/j.clnu.2017.03.015. Epub 2017 Mar 24.

Legume consumption is inversely associated with type 2 diabetes incidence in adults: A prospective assessment from the PREDIMED study.

Collaborators (227)

Serra-Mir M14, Pérez-Heras A14, Viñas C14, Casas R14, Medina-Renom A14, Baena JM14, García M14, Oller M14, Amat J14, Duaso I14, García Y14, Iglesias C14, Simón C14, Quinzavos L14, Parra L14, Liroz M14, Benavent J14, Clos J14, Pla I14, Amorós M14, Bonet MT14, Martín MT14, Sánchez MS14, Altirriba J14, Manzano E14, Altés A14, Cofán M14, Valls-Pedret C14, Sala-Vila A14, Doménech M14, Bulló M15, Babio N15, Basora J15, González R15, Molina C15, Márquez F15, Martínez P15, Ibarrola N15, Sorlí M15, García Roselló J15, Castro A15, Martin F15, Tort N15, Isach A15, Guasch-Ferre M15, Cabré JJ15, Mestres G15, Paris F15, Llauradó M15, Pedret R15, Basells J15, Vizcaino J15, Segarra R15, Frigola J15, Costa-Vizcaino J15, Salas-Huetos A15, Boj J15, Montañes D15, Papandreou C15, Fernández-Ballart J15, Carrasco P16, Ortega-Azorín C16, Asensio EM16, Osma R16, Barragán R16, Francés F16, Guillén M16, González JI16, Sáiz C16, Portolés O16, Giménez FJ16, Coltell O16, Fernández-Carrión R16, Guillem-Sáiz P16, González-Monje I16, Quiles L16, Pascual V16, Riera C16, Pages MA16, Godoy D16, Carratalá-Calvo A16, Sánchez-Navarro S16, Valero-Barceló C16, Tello S17, Vila J17, de la Torre R17, Muñoz-Aguayo D17, Elosua R17, Marrugat J17, Schröder H17, Molina N17, Maestre E17, Rovira A18, Castañer O17, Farré M17, Toledo E19, Ruiz-Canela M19, Sanjulián B19, Sánchez-Tainta A19, Eguaras S19, Martí A19, Buil-Cosiales P19, SerranoMartínez M19, Diez-Espino J19, García-Arellano A19, Martínez-Lapiscina EH19, Goñi E19, Vázquez Z19, Berrade N19, Extremera-Urabayen V19, Arroyo-Azpa C19, García-Pérez L19, Villanueva-Telleria J19, Cortés-Ugalde F19, Sagredo-Arce T19, Vigata-López MD19, Arceiz Campo MT19, Urtasun-Samper A19, Gueto Rubio MV19, Churio-Beraza B19, Arós F20, Salaverria I20, Del Hierro T20, Algorta J20, Francisco S20, Alonso-Gómez A20, Sanz E20, Rekondo J20, Belló MC20, Loma-Osorio A20, Gómez-Gracia E21, Wärnberg J21, Benítez Pont R21, Bianchi Alba M21, Gómez-Huelgas R21, Martínez-González J21, Velasco García V21, de Diego Salas J21, Baca Osorio A21, Gil Zarzosa J21, Sánchez Luque JJ21, Vargas López E21, Ruiz-Gutiérrez V22, Sánchez Perona J22, Montero Romero E22, García-García M22, Jurado-Ruiz E22, Fiol M23, Romaguera D23, García-Valdueza M23, Moñino M23, Munuera S23, Vivó M23, Bestard F23, Munar JA23, Coll L23, Proenza A23, Prieto R23, Frontera G23, Fiol F23, Ginard M23, Jover A23, García J23, Santos-Lozano JM24, Ortega-Calvo M24, Mellado L24, García-Corte FJ24, Román P24, Iglesias P24, Corchado Y24, Miró-Moriano L24, Domínguez-Espinaco C24, Lozano-Rodriguez JM24, Vaquero-Diaz S24, López-Sabater MC25, Castellote-Bargalló AI25, Quifer-Rada P25, Tresserra-Rimbau A25, Álvarez-Pérez J26, Díaz-Benítez EM26, Sánchez-Villegas A26, Casañas-Quintana LT26, Pérez-Cabrera J26, Ruano-Rodríguez C26, Bautista-Castaño I26, Sarmiento de la Fe F26, García Pastor JA26, Díaz-González BV26, Castillo Anzalas JM26, Sosa-Also RE26, Medina-Ponce J26, de la Cruz E27, Fanlo-Maresma M27, Galera A27, Trias F27, Sarasa I27, Corbella E27, Corbella X27, Cabezas C28, Vinyoles E28, Rovira MA28, García L28, Flores G28, Verdú JM28, Baby P28, Ramos A28, Mengual L28, Roura P28, Yuste MC28, Guarner A28, Santamaría MI28, Mata M28, de Juan C28, Brau A28, Tur JA29, Portillo MP30, Sáez G31, Arós F32, Aldamiz-Echevarría M32, Alonso-Gómez AM32, Berjón J32, Forga L32, Gállego J32, García-Layana A32, Larrauri A32, Portu-Zapirain J32, Timiraus-Fernández J32.

Author information

1
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.
2
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.
3
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.
4
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.
5
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.
6
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.
7
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.
8
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.
9
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.
10
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.
11
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.
12
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.
13
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.
14
Hospital Clinic, Institut d'Investigacions Biomediques August Pi i Sunyer, Barcelona, Spain.
15
Rovira i Virgili University, Reus, Spain.
16
University of Valencia, Valencia, Spain.
17
Hospital del Mar Research Institute, Barcelona, Spain.
18
Hospital del Mar Research Institute, Barcelona, Spain; Primary Care Division, Catalan Institute of Health, Barcelona, Spain.
19
University of Navarra and Osasunbidea (Servicio Navarro de Salud), Primary Care Centres, Pamplona, Spain.
20
University Hospital of Álava, Vitoria, Spain.
21
University of Málaga, Málaga, Spain.
22
Instituto de la Grasa, Consejo Superior de Investigaciones Científicas, Sevilla, Spain.
23
Instituto de Investigación Sanitaria de Palma (IdISPa), Palma de Mallorca, Spain.
24
Department of Family Medicine, Distrito Sanitario Atención Primaria Sevilla, Sevilla, Spain.
25
School of Pharmacy, University of Barcelona, Barcelona, Spain.
26
Instituto Universitario de Investigaciones Biomédicas y Sanitarias (I.U.I.B.S.) de la Universidad de Las Palmas de Gran Canaria, Las Palmas, Spain.
27
Hospital Universitari de Bellvitge-IDIBELL, Hospitalet de Llobregat, Barcelona, Spain.
28
Primary Care Division, Catalan Institute of Health, Barcelona, Spain.
29
University of Balearic Islands, Spain.
30
University of Basque Country, Spain.
31
University of Valencia, Spain.
32
University Hospital Araba, Spain.

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.

KEYWORDS:

Legumes; Lentils; PREDIMED-study; Type 2 diabetes

PMID:
28392166
DOI:
10.1016/j.clnu.2017.03.015

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