Pulse consumption, satiety, and weight management. The acute effect of commercially available pulse powders on postprandial glycaemic response in healthy young men. Effect of legumes as part of a low glycemic index diet on glycemic control and cardiovascular risk factors in type 2 diabetes mellitus: a randomized controlled trial. Randomised controlled pilot study to assess the feasibility of a Mediterranean Portfolio dietary intervention for cardiovascular risk reduction in HIV dyslipidaemia: a study protocol Effect of an Indo-Mediterranean diet on progression of coronary artery disease in high risk patients (Indo-Mediterranean Diet Heart Study): a randomised single-blind trial A pulse-based diet is effective for reducing total and LDL-cholesterol in older adults. Pinto Bean Consumption Reduces Biomarkers for Heart Disease Risk Dietary counselling for dyslipidemia in primary care: results of a randomized trial. First and second meal effects of pulses on blood glucose, appetite, and food intake at a later meal. Rationale and design of the Dietary Approaches to Stop Hypertension trial (DASH). A multicenter controlled-feeding study of dietary patterns to lower blood pressure. Serum lipid response of hypercholesterolemic men to single and divided doses of canned beans. Ardeh (Sesamum indicum) could improve serum triglycerides and atherogenic lipid parameters in type 2 diabetic patients: a randomized clinical trial. The Effect of Increasing Consumption of Pulses and Wholegrains in Obese People: A Randomized Controlled Trial Legume consumption is inversely associated with type 2 diabetes incidence in adults: A prospective assessment from the PREDIMED study. Low-fat dietary pattern and risk of cardiovascular disease: the Women's Health Initiative Randomized Controlled Dietary Modification Trial. Effect of Current Dietary Recommendations on Weight Loss and Cardiovascular Risk Factors. Beneficial effects of short-term nutritional counselling at the primary health-care level among Brazilian adults.
The prevalence of obesity has reached epidemic proportions , making finding effective solutions to reduce obesity a public health priority . One part of the solution could be for individuals to increase consumption of nonoilseed pulses ( dry beans , peas , chickpeas , and lentils ) , because they have nutritional attributes thought to benefit weight control , including slowly digestible carbohydrates , high fiber and protein contents , and moderate energy density . Observational studies consistently show an inverse relationship between pulse consumption and BMI or risk for obesity , but many do not control for potentially confounding dietary and other lifestyle factors . Short-term ( ≤1 d ) experimental studies using meals controlled for energy , but not those controlled for available carbohydrate , show that pulse consumption increases satiety over 2 - 4 h , suggesting that at least part of the effect of pulses on satiety is mediated by available carbohydrate amount or composition . R and omized controlled trials generally support a beneficial effect  of pulses on weight loss when pulse consumption is coupled with energy restriction , but not without energy restriction . However , few r and omized trials have been conducted and most were short term ( 3 - 8 wk for whole pulses and 4 - 12 wk for pulse extracts ) . Overall , there is some indication of a beneficial effect of pulses on short-term satiety and weight loss during intentional energy restriction , but more studies are needed in this area , particularly those that are longer term ( ≥1 y ) , investigate the optimal amount of pulses to consume for weight control , and include behavioral elements to help overcome barriers to pulse consumption Whole pulses ( beans , peas , chickpeas and lentils ) elicit low postpr and ial blood glucose ( BG ) responses in adults ; however , their consumption in North America is low . One potential strategy to increase the dietary intake of pulses is the utilisation of commercial pulse powders in food products ; however , it is unclear whether they retain the biological benefits observed with whole pulses . Therefore , the present study examined the effects of commercially prepared pulse powders on BG response before and after a subsequent meal in healthy young men . Overall , three r and omised , within-subject experiments were conducted . In each experiment , participants received whole , puréed and powdered pulses ( navy beans in Expt 1 ; lentils in Expt 2 ; chickpeas in Expt 3 ) and whole-wheat flour as the control . All treatments were controlled for available carbohydrate content . A fixed-energy pizza meal ( 50·2 kJ/kg body weight ) was provided at 120 min . BG concentration was measured before ( 0 - 120 min ) and after ( 140 - 200 min ) the pizza meal . BG concentration peaked at 30 min in all experiments , and pulse forms did not predict their effect on BG response . Compared with the whole-wheat flour control , navy bean treatments lowered peak BG concentrations ( Expt 1 , P < 0.05 ) , but not the mean BG concentration over 120 min . The mean BG concentration was lower for all lentil ( Expt 2 , P= 0.008 ) and chickpea ( Expt 3 , P= 0.002 ) treatments over 120 min . Processing pulses to powdered form does not eliminate the benefits of whole pulses on BG response , lending support to the use of pulse powders as value-added food ingredients to moderate postpr and ial glycaemic response BACKGROUND Legumes , including beans , chickpeas , and lentils , are among the lowest glycemic index ( GI ) foods and have been recommended in national diabetes mellitus ( DM ) guidelines . Yet , to our knowledge , they have never been used specifically to lower the GI of the diet . We have therefore undertaken a study of low-GI foods in type 2 DM with a focus on legumes in the intervention . METHODS A total of 121 participants with type 2 DM were r and omized to either a low-GI legume diet that encouraged participants to increase legume intake by at least 1 cup per day , or to increase insoluble fiber by consumption of whole wheat products , for 3 months . The primary outcome was change in hemoglobin A1c ( HbA1c ) values with calculated coronary heart disease ( CHD ) risk score as a secondary outcome . RESULTS The low-GI legume diet reduced HbA1c values by -0.5 % ( 95 % CI , -0.6 % to -0.4 % ) and the high wheat fiber diet reduced HbA1c values by -0.3 % ( 95 % CI , -0.4 % to -0.2 % ) . The relative reduction in HbA1c values after the low-GI legume diet was greater than after the high wheat fiber diet by -0.2 % ( 95 % CI , -0.3 % to -0.1 % ; P < .001 ) . The respective CHD risk reduction on the low-GI legume diet was -0.8 % ( 95 % CI , -1.4 % to -0.3 % ; P = .003 ) , largely owing to a greater relative reduction in systolic blood pressure on the low-GI legume diet compared with the high wheat fiber diet ( -4.5 mm Hg ; 95 % CI , -7.0 to -2.1 mm Hg ; P < .001 ) . CONCLUSION Incorporation of legumes as part of a low-GI diet improved both glycemic control and reduced calculated CHD risk score in type 2 DM Introduction HIV drug treatment has greatly improved life expectancy , but increased risk of cardiovascular disease remains , potentially due to the additional burdens of infection , inflammation and antiretroviral treatment . The Mediterranean Diet has been shown to reduce cardiovascular risk and mortality in the general population , but no evidence exists for this effect in the HIV population . This study will explore the feasibility of a r and omised controlled trial ( RCT ) to examine whether a Mediterranean-style diet that incorporates a portfolio of cholesterol-lowering foods , reduces cardiovascular risk in people with HIV dyslipidaemia . Methods and analysis 60 adults with stable HIV infection on antiretroviral treatment and low-density lipoprotein cholesterol > 3 mmol/L will be recruited from 3 West Midl and s HIV services . Participants will be r and omised 1:1 to 1 of 2 dietary interventions , with stratification by gender and smoking status . Participants allocated to Diet1 will receive advice to reduce saturated fat intake , and those to Diet2 on how to adopt the Mediterranean Portfolio Diet with additional cholesterol-lowering foods ( nuts , stanols , soya , oats , pulses ) . Measurements of fasting blood lipids , body composition and arterial stiffness will be conducted at baseline , and month 6 and 12 of the intervention . Food intake will be assessed using the Mediterranean Diet Score , 3-day food diaries and metabolomic biomarkers . Question naires will be used to assess quality of life and process evaluation . Qualitative interviews will explore barriers and facilitators to making dietary changes , and participant views on the intervention . Qualitative data will be analysed using the Framework Method . Feasibility will be assessed in terms of trial recruitment , retention , compliance to study visits and the intervention . SD of outcomes will inform the power calculation of the definitive RCT . Ethics The West Midl and s Ethics Committee has approved this study and informed consent forms . This trial is the first to test cholesterol-lowering foods in adults with HIV . Trial registration number IS RCT N32090191 ; Pre- results BACKGROUND The rapid emergence of coronary artery disease ( CAD ) in south Asian people is not explained by conventional risk factors . In view of cardioprotective effects of a Mediterranean style diet rich in alpha-linolenic acid , we assessed the benefits of this diet for patients at high risk of CAD . METHODS We did a r and omised , single-blind trial in 1000 patients with angina pectoris , myocardial infa rct ion , or surrogate risk factors for CAD . 499 patients were allocated to a diet rich in whole grains , fruits , vegetables , walnuts , and almonds . 501 controls consumed a local diet similar to the step I National Cholesterol Education Program ( NCEP ) prudent diet . FINDINGS The intervention group consumed more  fruits , vegetables , legumes , walnuts , and almonds  than did controls ( 573 g [ SD 127 ] vs 231 g [ 19 ] per day p<0.001 ) . The intervention group had an increased intake of whole grains and mustard or soy bean oil . The mean intake of alpha-linolenic acid was two-fold greater in the intervention group ( 1.8 g [ SD 0.4 ] vs 0.8 g [ 0.2 ] per day , p<0.001 ) . Total cardiac end points were significantly fewer in the intervention group than the controls ( 39 vs 76 events , p<0.001 ) . Sudden cardiac deaths were also reduced ( 6 vs 16 , p=0.015 ) , as were non-fatal myocardial infa rct ions ( 21 vs 43 , p<0.001 ) . We noted a significant reduction in serum cholesterol concentration and other risk factors in both groups , but especially in the intervention diet group . In the treatment group , patients with pre-existing CAD had significantly greater benefits compared with such patients in the control group . INTERPRETATION An Indo-Mediterranean diet that is rich in alpha-linolenic acid might be more effective in primary and secondary prevention of CAD than the conventional step I NCEP prudent diet Our purpose was to determine the effects of a pulse-based diet in individuals 50 years or older for reducing CVD risk factors . A total of 108 participants were  r and omised to receive pulse-based foods ( two servings daily of beans , chickpeas , peas or lentils ; about 150 g/d dry weight ) or their regular diet for 2 months , followed by a washout of 1 month and a cross-over to the other diet for 2 months . Anthropometric measures , body composition and biochemical markers ( i.e. serum LDL-cholesterol ( LDL-C ) , as the primary outcome , and other lipids , glucose , insulin and C-reactive protein ) were assessed before and after each diet phase . A total of eighty-seven participants ( thirty males and fifty-seven females ; 59·7 ( sd 6·3 ) years , body mass 76 ( sd 16 ) kg ) completed the study . Compared with the regular diet , the pulse-based diet  decreased total cholesterol by 8·3 % ( pulse , 4·57 ( sd 0·93 ) to 4·11 ( sd 0·91 ) mmol/l ; regular , 4·47 ( sd 0·94 ) to 4·39 ( sd 0·97 ) mmol/l ; P < 0·001 ) and LDL-C by 7·9 % ( pulse , 2·93 ( sd 0·84 ) to 2·55 ( sd 0·75 ) mmol/l ; regular , 2·96 ( sd 0·86 ) to 2·81 ( sd 0·83 ) mmol/l ; P = 0·01 ) . In a sub- analysis of individuals with high lipid levels at baseline ( twenty individuals with high cholesterol ) , the pulse-based diet  reduced cholesterol by 6 % compared with the regular diet ( pulse , 5·62 ( sd 0·78 ) to 5·26 ( sd 0·68 ) mmol/l ; regular , 5·60 ( sd 0·91 ) to 5·57 ( sd 0·85 ) mmol/l ; P = 0·05 ) . A pulse-based diet is effective for reducing total cholesterol and LDL-C in older adults and therefore reduces the risk of CVD Objective : To determine effects of daily intake of 1/2 cup pinto beans , black-eyed peas or carrots ( placebo ) on risk factors for  coronary heart disease ( CHD ) and diabetes mellitus ( DM ) in free-living , mildly insulin resistant adults over an 8 week period . Methods : R and omized , crossover 3 × 3 block design . Sixteen participants ( 7 men , 9 women ) received each treatment for eight-weeks with two-week washouts .  Fasting blood sample s collected at beginning and end of periods were analyzed for total cholesterol ( TC ) , low density lipoprotein cholesterol ( LDL-C ) , high density lipoprotein cholesterol , triacylglycerols , high-sensitivity C-reactive protein , insulin , glucose , and hemoglobin A1c . Results : A significant treatment-by-time effect impacted serum TC ( p = 0.026 ) and LDL ( p = 0.033 ) after eight weeks . Paired t-tests indicated that pinto beans were responsible for this effect ( p = 0.003 ; p = 0.008 ) . Mean change of serum TC for pinto bean , black-eyed pea and placebo were −19 ± 5 , 2.5 ± 6 , and 1 ± 5 mg/dL , respectively ( p = 0.011 ) . Mean change of serum LDL-C  for pinto bean , black-eyed pea and placebo were −14 ± 4 , 4 ± 5 , and 1 ± 4 mg/dL , in that order ( p = 0.013 ) . Pinto beans differed significantly from placebo ( p = 0.021 ) . No significant differences were seen with other blood concentrations across the 3 treatment periods . Conclusions : Pinto bean intake should be encouraged to lower serum TC and LDL-C , thereby reducing risk for CHD This study compared the effectiveness of physician advice versus dietitian advice for a fat-reduced diet , and of dietitian advice for a fat-reduced diet versus a soluble fibre-enhanced diet in patients with moderate dyslipidemia . A total of 111 men and women took part in this 26-week , three-group , r and omized , clinical trial . The physician advice fat-reduced diet group ( n = 38 ) and the dietitian advice fat-reduced diet group ( n = 35 ) received dietary advice based on the American Heart Association ( AHA ) Step II guidelines . The dietitian advice soluble fibre-enhanced diet group ( n = 38 ) consumed one-third cup per day of psyllium-containing cereal and was advised to increase soluble fibre intake to over 10 grams a day . LDL-C , TC/HDL-C ratio and body weight reductions over six months were -5.3 % , -4.6 % , and -1.9 % , respectively , regardless of whether a physician or a dietitian provided advice , or whether advice was focused on a fat-reduced diet or a soluble fibre-enhanced diet . Both dietitians and physicians can help moderately dyslipidemic patients make clinical ly meaningful changes in blood lipid levels .  Soluble fibre enhancement of the usual diet leads to similar reductions in LDL-C and TC/HDL-C ratio compared to interventions focused on fat reduction Pulses are low-glycemic appetite-suppressing foods , but it is not known whether these properties persist after being consumed as part of a meal and after a second meal . The objective of this study was to determine the effects of a fixed-size pulse meal on appetite and blood glucose ( BG ) before and after an ad libitum test meal ( pizza ) and on food intake ( FI ) at the test meal . Males ( n = 25 ; 21.3 ± 0.5 years ; 21.6 ± 0.3 kg·m(-2 ) ) r and omly consumed 4 isocaloric meals : chickpea ; lentil ; yellow split pea ; and macaroni and cheese ( control ) . Commercially available canned pulses provided 250 kcal , and were consumed with macaroni and tomato sauce . FI was measured at a pizza meal 260 min after consumption of the isocaloric meal . BG and appetite were measured from 0 to 340 min . The lentil and yellow pea , but not chickpea , treatments led to lower appetite ratings during the 260 min prepizza meal period , and less FI at the pizza meal , compared with macaroni and cheese ( p < 0.05 ) . All pulse treatments lowered BG immediately following consumption ( at 20 min ) ( p < 0.05 ) , but there was no effect of treatment on prepizza meal BG AUC ( p = 0.07 ) . Immediately after the pizza meal , BG was lower following the chickpea and lentil treatments , but not the yellow pea treatment ( p < 0.05 ) . Postpizza meal BG AUC was lower following the chickpea and lentil treatments than in the yellow pea treatment ( p < 0.05 ) . The beneficial effects of consuming a pulse meal on appetite , FI at a later meal , and the BG response to a later meal are dependent on pulse type Epidemiologic studies have found that dietary patterns characterized by high intakes of certain minerals and fiber are associated with low blood pressure .  Dietary Approaches to Stop Hypertension ( DASH ) is a multicenter , r and omized , controlled-feeding trial design ed to test the effects on blood pressure of two such dietary patterns consumed for 8 weeks . The two experimental diets will be compared with each other and with a control dietary pattern that is relatively low in potassium , magnesium , calcium , and fiber , and has a fat and protein profile mirroring current consumption . The first experimental diet , arguably termed " ideal , " is high in fruits , vegetables , whole cereal products , low-fat dairy products , fish , chicken , and lean meats design ed to be low in saturated fat and cholesterol ; moderately high in protein ; and high in minerals and fiber . The second experimental diet tests the effect of fruits and vegetables alone . Its potassium , magnesium , and dietary fiber content will be at the same high levels as the ideal dietary pattern , while its fat , protein , and calcium content will resemble that of the control dietary pattern . The study population will consist of 456 healthy men and women , aged 22 years or older , with systolic blood pressure less than 160 mm Hg and diastolic blood pressure 80 to 95 mm Hg . African-American and other minority groups will comprise 67 % of the population . Participants will eat one of the three dietary patterns . The DASH trial has unique features . First , dietary patterns rather than single nutrients are being tested . Second , all food for the experimental diets is provided to the participants using a st and ardized multicenter protocol . Because the dietary patterns are constructed with commonly consumed food items , the results , if positive , may be conveniently implemented in dietary recommendations to the general public Dried beans lower serum lipid concentrations in healthy and hyperlipidemic subjects . To determine the effects of canned beans on serum lipid concentrations , 24 hyperlipidemic men ate one of three bean diets for 21 d in a metabolic ward . Diets A and B included 227 g canned beans ( 120 g beans with 107 g tomato sauce ) daily , in a single dose for diet A and in a divided dose for diet B. Diet C included 182 g canned beans ( 162 g beans with 20 g tomato sauce ) daily in a divided dose . All bean diets combined lowered serum cholesterol and triglyceride concentrations 10.4 % ( p less than 0.001 ) and 10.8 % ( p less than 0.025 ) , respectively . Diet B was as effective as diet C , and the groups on those diets had greater cholesterol reductions than did the group on diet A. Serum cholesterol reduction was positively correlated ( p less than 0.01 ) with intake of total dietary fiber and soluble fiber . The ratios of low- to high-density-lipoprotein cholesterol remained constant for all groups . Body weight decreased 1.0 - 1.5 kg for all groups despite constant energy intakes . Canned beans may make an important contribution to hyperlipidemia management BACKGROUND Data suggest that sesame seeds have properties beneficial to modulating lipid disorders and decreasing cardiovascular disease ( CVD ) risk factors . The aim of this study was to investigate the effects of Ardeh , paste of ground unhulled sesame seeds , on lipid profiles and atherogenic lipid parameters . METHODS This r and omized clinical trial included 41 patients with type 2 diabetes , who were r and omly assigned to one of the two groups : group A ( Ardeh 28 g/d , n = 21 ) and group B ( control , n = 20 ) . After an initial two-week washout period , the patients in group A , replaced a part of their usual breakfast with two tablespoon ( tbsp ) ( ~ 28 g ) Ardeh , while group B patients continued the usual breakfast meal for six weeks ; energy content of both breakfast meals was maintained in the same range . Anthropometric measures , blood pressure , serum levels of total cholesterol ( TC ) , triglycerides ( TG ) , LDL-C , HDL-C , and atherogenic index of plasma ( AIP ; log TG/HDL-C ) , TC/HDL-C ratio , and LDL/HDL-C ratio were determined at baseline and six weeks later . RESULTS After six weeks , there were significant decreases in serum TG ( 15.3 mg/dL ) and AIP ( 39 % ) in group A. Moreover , slight decreases in serum TC , LDL-C , and other atherogenic lipid parameters and a mild increase in HDL-C also were observed during Ardeh supplementation . Anthropometric measures and blood pressure were unchanged during the study period in both groups . CONCLUSION Ardeh could have favorable effects in decreasing CVD risk factors in type 2 diabetics Background : Wholegrain intake is inversely related to weight gain over time , but little information is available on the role of pulses in weight control . Objective : To compare weight loss , metabolic outcomes , and nutrient intakes in obese people assigned to a  diet rich in pulses and wholegrains or a control diet . Methods : R and omized controlled study of 18 months with 113 volunteers ( body mass index [ BMI ] ≥ 28 kg/m2 ) . Diets were based on guidelines published by the National Heart Foundation of New Zeal and . The intervention group was advised to consume 2 serves of pulses and 4 serves of wholegrain foods per day as substitutions for more refined carbohydrates . Results : Fiber intakes were higher , intakes of several vitamins and minerals were better maintained , and dietary glycemic index was lower in the intervention compared with the control group . Mean ( st and ard error [ SE ] ) weight loss at 6 months was 6.0 ( 0.7 ) kg and 6.3 ( 0.6 ) kg in the control and intervention groups , respectively , and was not different between groups ( p > 0.05 ) . Blood pressure , triglycerides , and glycemic load were lowered in both groups compared with baseline . Waist circumference was decreased at 18 months in the intervention compared with the control group ( −2.8 cm ; 95 % confidence interval [ CI ] : −0.4 , −5.1 ) . Conclusions : Incorporation of pulses and wholegrain foods into a weight loss program result ed in a greater reduction in waist circumference compared with the group consuming a control diet , although no difference in weight loss was noted between groups . Retention of several nutrients was better with the pulse and wholegrain diet 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 Prospect i ve 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 ( IS RCT N35739639 ) . Registration date : 5th October 2005 CONTEXT Multiple epidemiologic studies and some trials have linked diet with cardiovascular disease ( CVD ) prevention , but long-term intervention data are needed . OBJECTIVE To test the hypothesis that a dietary intervention , intended to be low in fat and high in vegetables , fruits , and grains to reduce cancer , would reduce CVD risk . DESIGN , SETTING , AND PARTICIPANTS R and omized controlled trial of 48,835 postmenopausal women aged 50 to 79 years , of diverse background s and ethnicities , who participated in the Women 's Health Initiative Dietary Modification Trial . Women were r and omly assigned to an intervention ( 19,541 [ 40 % ] ) or comparison group ( 29,294 [ 60 % ] ) in a free-living setting . Study enrollment occurred between 1993 and 1998 in 40 US clinical centers ; mean follow-up in this analysis was 8.1 years . INTERVENTION Intensive behavior modification in group and individual sessions design ed to reduce total fat intake to 20 % of calories and increase intakes of vegetables/fruits to 5 servings/d and grains to at least 6 servings/d . The comparison group received diet-related education material s. MAIN OUTCOME MEASURES Fatal and nonfatal coronary heart disease ( CHD ) , fatal and nonfatal stroke , and CVD ( composite of CHD and stroke ) . RESULTS By year 6 , mean fat intake decreased by 8.2 % of energy intake in the intervention vs the comparison group , with small decreases in saturated ( 2.9 % ) , monounsaturated ( 3.3 % ) , and polyunsaturated ( 1.5 % ) fat ; increases occurred in intakes of vegetables/fruits ( 1.1 servings/d ) and grains ( 0.5 serving/d ) . Low-density lipoprotein cholesterol levels , diastolic blood pressure , and factor VIIc levels were significantly reduced by 3.55 mg/dL , 0.31 mm Hg , and 4.29 % , respectively ; levels of high-density lipoprotein cholesterol , triglycerides , glucose , and insulin did not significantly differ in the intervention vs comparison groups . The numbers who developed CHD , stroke , and CVD ( annualized incidence rates ) were 1000 ( 0.63 % ) , 434 ( 0.28 % ) , and 1357 ( 0.86 % ) in the intervention and 1549 ( 0.65 % ) , 642 ( 0.27 % ) , and 2088 ( 0.88 % ) in the comparison group . The diet had no significant effects on incidence of CHD ( hazard ratio [ HR ] , 0.97 ; 95 % confidence interval [ CI ] , 0.90 - 1.06 ) , stroke ( HR , 1.02 ; 95 % CI , 0.90 - 1.15 ) , or CVD ( HR , 0.98 ; 95 % CI , 0.92 - 1.05 ) . Excluding participants with baseline CVD ( 3.4 % ) , the HRs ( 95 % CIs ) for CHD and stroke were 0.94 ( 0.86 - 1.02 ) and 1.02 ( 0.90 - 1.17 ) , respectively . Trends toward greater reductions in CHD risk were observed in those with lower intakes of saturated fat or trans fat or higher intakes of vegetables/fruits . CONCLUSIONS Over a mean of 8.1 years , a dietary intervention that reduced total fat intake and increased intakes of vegetables , fruits , and grains did not significantly reduce the risk of CHD , stroke , or CVD  in postmenopausal women and achieved only modest effects on CVD risk factors , suggesting that more focused diet and lifestyle interventions may be needed to improve risk factors and reduce CVD risk . CLINICAL TRIALS REGISTRATION Clinical Trials.gov Identifier : NCT00000611 BACKGROUND Dietary recommendations emphasize increased consumption of fruit , vegetables , and whole grain cereals for prevention of chronic disease . OBJECTIVES This study assessed the effect of dietary advice and /or food provision on body weight and cardiovascular disease risk factors . METHODS Healthy overweight men ( n = 209 ) and women ( n = 710 ) , mean age 44.7 years , body mass index [ BMI ] 32.4 kg/m2 , were r and omized between November 2005 and August 2009 to receive Health Canada 's food guide ( control , n = 486 ) or 1 of 3 interventions : dietary advice consistent with both Dietary Approaches to Stop Hypertension ( DASH ) and dietary portfolio principles ( n = 145 ) ; weekly food provision reflecting this advice ( n = 148 ) ; or food delivery plus advice ( n = 140 ) . Interventions lasted 6 months with 12-month follow-up . Semiquantitative food frequency question naires and fasting blood , anthropometric and blood pressure measurements were obtained at baseline , 6 months , and 18 months . RESULTS Participant retention at 6 and 18 months was 91 % and 81 % , respectively , after food provision compared to 67 % and 57 % when no food was provided ( p < 0.0001 ) . Test and control treatments showed small reductions in body weight ( -0.8 to -1.2 kg ) , waist circumference ( -1.1 to -1.9 cm ) , and mean arterial pressure ( 0.0 to -1.1 mm Hg ) at 6 months and Framingham coronary heart disease risk score at 18 months ( -0.19 to -0.42 % ) , which were significant overall . Outcomes did not differ among test and control groups . CONCLUSIONS Provision of foods increased retention but only modestly increased intake of recommended foods . Current dietary recommendations showed small overall benefits in coronary heart disease risk factors . Additional dietary strategies to maximize these benefits are required . ( Fruits , Vegetables , and Whole Grains : A Community-based Intervention ; NCT00516620 ) OBJECTIVE To evaluate the impact of a low-cost nutritional intervention in changing the lifestyle of adults . DESIGN R and omised clinical trial . SETTING Primary health-care centre in São José do Rio Preto , São Paulo State , Brazil . SUBJECTS We r and omly assigned 104 adults ( 83 women and 21 men aged 30 - 65 years , body mass index 24 - 35 kg m(-2 ) , non-diabetic ) into two groups : nutrition counselling and control . Each subject in the intervention group received three individualised nutritional counselling sessions during the first 6 months aim ed at increasing intakes of fruits , vegetables and olive oil , reducing saturated fat and improving physical activity .  Body composition , biochemical indicators and lifestyle were assessed at baseline and at 6 months and 1 year in both groups . RESULTS After 6 months of follow-up , body weight , waist circumference , diastolic blood pressure , fasting blood glucose , total and low-density lipoprotein cholesterol , total and saturated fat , and dietary energy and cholesterol levels showed a more significant decrease among subjects in the intervention group than in the control group ( P < 0.05 ) . Moreover , the intervention group showed significantly greater improvement in each intervention goal , such as reduced intake of saturated fat and increased intakes of fruits , vegetables , fibre and olive oil ( P < 0.05 ) . After 12 months of follow-up , most of the outcomes were maintained . CONCLUSIONS The low-cost nutritional intervention programme improved serum lipids profile and weight control , and appeared to be feasible for use at a primary health-care centre in a developing country
Treatment effects on apolipoprotein B and non-HDL cholesterol were not observed .
INTERPRETATION Our findings suggest that dietary pulse intake significantly reduces LDL cholesterol levels .
BACKGROUND Evidence from controlled trials encourages the intake of dietary pulses ( beans , chickpeas , lentils and peas ) as a method of improving dyslipidemia , but heart health guidelines have stopped short of ascribing specific benefits to this type of intervention or have grade d the beneficial evidence as low .
We conducted a systematic review and meta- analysis of r and omized controlled trials ( RCTs ) to assess the effect of dietary pulse intake on established therapeutic lipid targets for cardiovascular risk reduction .