Legume Consumption and Risk of All-Cause and Cause-Specific Mortality: A Systematic Review and Dose-Response Meta-Analysis of Prospective Studies.
Level 3 - non-randomized controlled study
Systematic review and meta-analysis of prospective observational cohort studies
PubMed 36811595 · doi:10.1016/j.advnut.2022.10.009
What was done
Authors conducted a systematic review and dose-response meta-analysis across PubMed/Medline, Scopus, Web of Science, and Embase up to September 2022. They evaluated prospective cohort studies reporting risk estimates for legume consumption and all-cause or cause-specific mortality. Random-effects models calculated summary hazard ratios (HRs) for highest versus lowest intake categories and per 50 g/day increments, along with 1-stage linear mixed-effects modeling for curvilinear associations. The review included 32 cohorts (31 publications) covering 1,141,793 participants and 93,373 all-cause deaths.
What was found
Highest compared with lowest legume consumption showed: - All-cause mortality: HR 0.94 (95% CI: 0.91 to 0.98; n = 27 cohorts) - Stroke mortality: HR 0.91 (95% CI: 0.84 to 0.99; n = 5 cohorts) - CVD mortality: HR 0.99 (95% CI: 0.91 to 1.09; n = 11 cohorts) - CHD mortality: HR 0.93 (95% CI: 0.78 to 1.09; n = 5 cohorts) - Cancer mortality: HR 0.85 (95% CI: 0.72 to 1.01; n = 5 cohorts) In linear dose-response modeling, each 50 g/day increase in legume intake was associated with a 6% lower risk of all-cause mortality (HR: 0.94; 95% CI: 0.89 to 0.99; n = 19 cohorts), with no statistically significant linear dose-response relationship for the specific causes of death.
Why it matters
This meta-analysis provides quantified dose-response data showing a modest association between legume intake and reduced all-cause and stroke mortality, providing observational support for dietary guidelines encouraging legume consumption.
Limits
The findings derive exclusively from observational cohorts, leaving susceptibility to residual confounding (such as broader healthy diet and lifestyle patterns) and self-reported dietary measurement error. Cause-specific mortality outcomes were based on a small number of cohorts (only 5 cohorts each for stroke, CHD, and cancer mortality), and the authors rated the overall certainty of evidence as low to moderate.
Cited by
- supports Consumption of legumes such as lentils, chickpeas, and beans has been consistently linked in large studies to reduced cardiovascular risk and reduced all-cause mortality.