Whole dietary pulses decreased low-density lipoprotein-cholesterol (mean difference, -0.14 mmol/L; 95% CI, -0.19 to -0.08) and non-high-density lipoprotein-cholesterol.
Meta-Analysis (n=2,095)
Do whole dietary pulses reduce low-density lipoprotein-cholesterol?
Whole dietary pulses provide small but important reductions in LDL-C and non-HDL-C, supporting their role in cardiovascular risk reduction diets.
Effect estimate: mean difference -0.14 mmol/L (95% CI -0.19 to -0.08)
Background Although dietary pulses are recognized by major clinical practice guidelines to reduce cholesterol and coronary heart disease risk, intake is low. There are no health claims for any pulse for cholesterol reduction, which could support uptake. We therefore conducted a systematic review and dose–response meta‐analysis of randomized trials of the effect of different types of whole dietary pulses on lipid targets. Methods MEDLINE, Embase, and the Cochrane Library were searched through March 2025 for trials ≥3 weeks. The primary outcome was low‐density lipoprotein‐cholesterol. Secondary outcomes were other lipid targets. Independent reviewers extracted data and assessed risk of bias. Certainty of evidence was assessed using Grading of Recommendations Assessment, Development, and Evaluation. Results Thirty‐eight trials (52 trial comparisons, n=2095) with a median of 6 weeks and dose of 130 g/d (0.5–0.67 cup/d) showed that whole dietary pulses decreased low‐density lipoprotein‐cholesterol (mean difference, −0.14 mmol/L 95% CI, −0.19 to −0.08), non‐high‐density lipoprotein‐cholesterol (−0.22 mmol/L 95% CI, −0.30 to −0.14), apoB (apolipoprotein B) (−0.08 g/L 95% CI, −0.13 to −0.03) and high‐density lipoprotein‐cholesterol (−0.03 mmol/L 95% CI, −0.05 to −0.01) with no effects on other lipids. Analyses by pulse type showed similar results. A linear inverse relationship was shown for beans up to 1 cup/d for low‐density lipoprotein‐cholesterol (coefficient, −0.25 mmol/L/0.5 cup 95% CI, −0.48 to −0.02) and non‐high‐density lipoprotein‐cholesterol (−0.45 mmol/L/0.5 cup 95% CI, −0.71 to −0.18). Grading of Recommendations Assessment, Development, and Evaluation was moderate‐to‐high for all outcomes, except apoB (very low). Conclusions Whole dietary pulses likely result in small important‐to‐moderate reductions in lipid targets and trivial reductions in high‐density lipoprotein‐cholesterol. Similar effects were observed across pulse types with an inverse dose–response gradient for beans up to 1 cup/d. Future studies on chickpeas, dried peas, and lentils are warranted. Registration URL: https://www.crd.york.ac.uk/PROSPERO/view/CRD42023432826 ; Unique identifier: CRD42023432826.
Back et al. (Thu,) conducted a meta-analysis in Cardiovascular risk reduction (n=2,095). Whole dietary pulses was evaluated on low-density lipoprotein-cholesterol (mean difference -0.14 mmol/L, 95% CI -0.19 to -0.08). Whole dietary pulses decreased low-density lipoprotein-cholesterol (mean difference, -0.14 mmol/L; 95% CI, -0.19 to -0.08) and non-high-density lipoprotein-cholesterol.