TY - JOUR

T1 - Legume consumption is inversely associated with type 2 diabetes incidence in adults

T2 - 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 - Serra-Mir, M.

AU - Pérez-Heras, A.

AU - Viñas, C.

AU - Casas, R.

AU - Medina-Renom, A.

AU - Baena, J. M.

AU - García, M.

AU - Oller, M.

AU - Amat, J.

AU - Duaso, I.

AU - García, Y.

AU - Iglesias, C.

AU - Simón, C.

AU - Quinzavos, L.

AU - Parra, L.

AU - Liroz, M.

AU - Benavent, J.

AU - Clos, J.

AU - Pla, I.

AU - Amorós, M.

AU - Bonet, M. T.

AU - Martín, M. T.

AU - Sánchez, M. S.

AU - Altirriba, J.

AU - Manzano, E.

AU - Altés, A.

AU - Cofán, M.

AU - Valls-Pedret, C.

AU - Sala-Vila, A.

AU - Martin, F.

AU - Guasch-Ferre, M.

AU - Schröder, H.

AU - García-García, M.

AU - García, L.

AU - PREDIMED Study Investigators

N1 - Publisher Copyright: © 2017 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism

PY - 2018

Y1 - 2018

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.

AB - 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.

KW - Legumes

KW - Lentils

KW - PREDIMED-study

KW - Type 2 diabetes

U2 - 10.1016/j.clnu.2017.03.015

DO - 10.1016/j.clnu.2017.03.015

M3 - Journal article

C2 - 28392166

AN - SCOPUS:85017176641

VL - 37

SP - 906

EP - 913

JO - Clinical Nutrition

JF - Clinical Nutrition

SN - 0261-5614

IS - 3

ER -