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Associations of Total Legume, Pulse, and Soy Consumption with Incident Type 2 Diabetes: Federated Meta-Analysis of 27 Studies from Diverse World Regions.

Medical Research Council Epidemiology Unit, University of Cambridge School of Clinical Medicine, CB2 0QQ, Cambridge, United Kingdom. Department of Molecular Epidemiology, German Institute of Human Nutrition, Nuthetal, Germany. Inserm U 1198, Montpellier University, Montpellier, France. Departments of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain. Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition, Instituto de Salud Carlos III, Madrid, Spain. Navarra's Health Research Institute (IdiSNA), Pamplona, Spain. Department of Epidemiology & Biostatistics and the Amsterdam Public Health Institute, Amsterdam University Medical Center, HV, Amsterdam, The Netherlands. Department of Surgical Sciences, Uppsala University, Uppsala, Sweden. Faculty of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil. Postgraduate Program in Nutrition and Health, Federal University of Espírito Santo, Vitória, Brazil. Medical Research Council Population Health Research Unit, University of Oxford, Oxford, United Kingdom. Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, Oxford, United Kingdom. Center for Research on Population Health, National Institute of Public Health, Cuernavaca, Mexico. Department of Public Health Solutions, Finnish Institute for Health and Welfare, Helsinki, Finland. Digestive Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran. Biology Department, School of Arts and Sciences, Utica College, Utica, USA. Department of Preventive Medicine, Hanyang University, Seoul, South Korea. National Research Institute of Health, Centers for Disease Control and Prevention, Cheongju, South Korea. Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. Department of Epidemiology and Public Health, University College London, London, United Kingdom. Cardiovascular Risk and Nutrition Group, Hospital del Mar Research Institute (IMIM), Barcelona, Spain. Baker Heart and Diabetes Institute, Melbourne, Australia. Digestive Oncology Research Center, Tehran University of Medical Sciences, Tehran, Iran. Department of Medicine, Lausanne University Hospital, Lausanne, Switzerland. Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA. School of Public Health, Physiotherapy & Sports Science, University College Dublin, Dublin, Ireland. School of Health & Human Performance, Dublin City University, Dublin, Ireland. Center of Research on Psychological and Somatic Disorders (CoRPs), Tilburg University, Tilburg, The Netherlands. Institute for Food, Nutrition and Health, University of Reading, Reading, United Kingdom. National Council of Science and Technology (CONACyT)-Center for Research on Population Health, National Institute of Public Health, Cuernavaca, Mexico. Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.

The Journal of nutrition. 2021;(5):1231-1240
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Abstract

BACKGROUND The consumption of legumes is promoted as part of a healthy diet in many countries but associations of total and types of legume consumption with type 2 diabetes (T2D) are not well established. Analyses across diverse populations are lacking despite the availability of unpublished legume consumption data in prospective cohort studies. OBJECTIVE To examine the prospective associations of total and types of legume intake with the risk of incident T2D. METHODS Meta-analyses of associations between total legume, pulse, and soy consumption and T2D were conducted using a federated approach without physical data-pooling. Prospective cohorts were included if legume exposure and T2D outcome data were available and the cohort investigators agreed to participate. We estimated incidence rate ratios (IRRs) and CIs of associations using individual participant data including ≤42,473 incident cases among 807,785 adults without diabetes in 27 cohorts across the Americas, Eastern Mediterranean, Europe, and Western Pacific. Random-effects meta-analysis was used to combine effect estimates and estimate heterogeneity. RESULTS Median total legume intake ranged from 0-140 g/d across cohorts. We observed a weak positive association between total legume consumption and T2D (IRR = 1.02, 95% CI: 1.01 to 1.04) per 20 g/d higher intake, with moderately high heterogeneity (I2 = 74%). Analysis by region showed no evidence of associations in the Americas, Eastern Mediterranean, and Western Pacific. The positive association in Europe (IRR = 1.05, 95% CI: 1.01 to 1.10, I2 = 82%) was mainly driven by studies from Germany, UK, and Sweden. No evidence of associations was observed for the consumption of pulses or soy. CONCLUSIONS These findings suggest no evidence of an association of legume intakes with T2D in several world regions. The positive association observed in some European studies warrants further investigation relating to overall dietary contexts in which legumes are consumed, including accompanying foods which may be positively associated with T2D.

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Publication Type : Meta-Analysis

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