Effect of Dietary Pulses on Blood Pressure: A Systematic Review and Meta-analysis of Controlled Feeding Trials

Abstract

BACKGROUNDCurrent guidelines recommend diet and lifestyle modifications for primary prevention and treatment of hypertension, but do not encourage dietary pulses specifically for lowering blood pressure (BP). To quantify the effect of dietary pulse interventions on BP and provide evidence for their inclusion in dietary guidelines, a systematic review and meta-analysis of controlled feeding trials was conducted.METHODSMEDLINE, EMBASE, Cochrane Library, and CINAHL were each searched from inception through 5 May 2013. Human trials ≥3 weeks that reported data for systolic, diastolic, and/or mean arterial BPs were included. Two reviewers independently extracted data and assessed methodological quality and risk of bias of included studies. Effect estimates were pooled using random effects models, and reported as mean differences (MD) with 95% confidence intervals (CIs). Heterogeneity was assessed (χ2 test) and quantified (I2).RESULTSEight isocaloric trials (n = 554 participants with and without hypertension) were included in the analysis. Dietary pulses, exchanged isocalorically for other foods, significantly lowered systolic (MD = −2.25 mm Hg (95% CI, −4.22 to −0.28), P = 0.03) and mean arterial BP (MD = −0.75 mm Hg (95% CI, −1.44 to −0.06), P = 0.03), and diastolic BP non-significantly (MD = −0.71 mm Hg (95% CI, −1.74 to 0.31), P = 0.17). Heterogeneity was significant for all outcomes.CONCLUSIONSDietary pulses significantly lowered BP in people with and without hypertension. Higher-quality large-scale trials are needed to support these findings.CLINICAL TRIAL REGISTRATIONNCT01594567

Food Consumption and its Impact on Cardiovascular Disease: Importance of Solutions Focused on the Globalized Food System

“…In observational studies and RCTs consumption of legumes improves CVD risk factors, such as waist circumference, cholesterol, BP, C-reactive protein, glucose; and is protective against T2DM (224–231). A meta-analysis of 26 RCTs (1,037 participants) finds that 130 grams legumes/d (~1 serving) reduced LDL-C by 0.17 mmol/L (95% CI: −0.25, −0.09) (228).…”

“…A meta-analysis of 26 RCTs (1,037 participants) finds that 130 grams legumes/d (~1 serving) reduced LDL-C by 0.17 mmol/L (95% CI: −0.25, −0.09) (228). Legumes also reduce SBP (by 2 mmHg) and lowered mean arterial pressure(231) in a meta-analysis of eight RCTs. A legume-rich diet reduced HbA1c (−0.3%; 95% CI: −1.4, −0.1%) in an RCT in participants with diabetes (226).…”

Effects of dietary pulse consumption on body weight: a systematic review and meta-analysis of randomized controlled trials

“…The 2 investigators independently extracted data from selected studies with the use of a standardized extraction form that was developed and piloted for use in other meta-analyses (18)(19)(20)(21). The extraction form outlined information that needed to be recorded such as study design, blinding, sample size, participant characteristics, follow-up duration, types of dietary pulses used, dose of dietary pulse intake, comparator diet or food, adherence measures, macronutrient profile, funding source, and endpoint data.…”

“…Dietary pulses are satiating (5), affordable, and a sustainable source of protein and fiber that can be incorporated into weight-maintenance diets. Furthermore, there are additional health benefits of including dietary pulses in the diet that are related to cardiometabolic risk reduction because they improve markers of glycemic control (18), reduce LDL-cholesterol concentrations (19), and lower blood pressure (21), even without weight loss. Few randomized controlled trials have investigated the effects of dietary pulses on other measures of adiposity, such as waist circumference and body fat percentage.…”

Associations between Dietary Patterns and Blood Pressure in a Clinical Sample of Overweight Adults

“…In addition, the effect of individual foods on BP has been investigated in randomized controlled trials and observational studies but with conflicting results. Foods investigated include fruit and vegetables [9], dairy foods [10], eggs [11], nuts [12], pulses [13], meat [14], tea [15] and coffee [16].…”