OST DIETARY MANIPULAtions result in modest cholesterol reductions of 4% to 13%, 1-10 and diet has been considered by some as a relatively ineffective therapy. 11 In contrast, 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) repeatedly have been shown to reduce mean serum low-density lipoprotein cholesterol (LDL-C) concentrations by 28% to 35% in long-term trials, [12][13][14] with corresponding reductions in cardiovascular death of 23% to 32% in both primary and secondary prevention trials. 13,14 Recently, to boost effectiveness of diet for primary prevention of cardiovascular disease, the Adult Treatment Panel (ATP III) of the National Cholesterol Education Program has recommended addition of plant sterols (2 g/d) and viscous fibers (10-25 g/d) to the diet. 15 The American Heart Association has also drawn atten-Author Affiliations and Financial Disclosures are listed at the end of this article.
In patients with type 2 diabetes, 6-month treatment with a low-glycemic index diet resulted in moderately lower HbA(1c) levels compared with a high-cereal fiber diet. Trial Registration clinicaltrials.gov identifier: NCT00438698.
Aims/hypothesis Dietary non-oil-seed pulses (chickpeas, beans, peas, lentils, etc.) are a good source of slowly digestible carbohydrate, fibre and vegetable protein and a valuable means of lowering the glycaemic-index (GI) of the diet. To assess the evidence that dietary pulses may benefit glycaemic control, we conducted a systematic review and meta-analysis of randomised controlled experimental trials investigating the effect of pulses, alone or as part of low-GI or high-fibre diets, on markers of glycaemic control in people with and without diabetes. Methods We searched MEDLINE, EMBASE, CINAHL, and the Cochrane Library for relevant controlled trials of ≥7 days. Two independent reviewers (A. Esfahani and J. M. W. Wong) extracted information on study design, participants, treatments and outcomes. Data were pooled using the generic inverse variance method and expressed as standardised mean differences (SMD) with 95% CIs. Heterogeneity was assessed by χ 2 and quantified by I 2 . Meta-regression models identified independent predictors of effects. Results A total of 41 trials (39 reports) were included. Pulses alone (11 trials) lowered fasting blood glucose (FBG) (−0.82, 95% CI −1.36 to −0.27) and insulin (−0.49, 95%
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