Intake of legumes and cardiovascular disease: A systematic review and dose-response meta-analysis

Exploring bioactive compounds in chickpea and bean aquafaba: Insights from glycomics and peptidomics analyses

The objective of this study was to identify bioactive oligosaccharides and peptides in the cooking water of chickpeas and common beans, known as aquafaba. The oligosaccharides stachyose, raffinose and verbascose were quantified by high-performance anion-exchange chromatography; 78 and 67 additional oligosaccharides were identified in chickpea and common bean aquafaba, respectively, by LC-MS/MS. Chickpea aquafaba uniquely harbored ciceritol and other methyl-inositol-containing oligosaccharides. In prebiotic growth assays, chickpea aquafaba oligosaccharides were differentially utilized, promoting growth of Limosilactobacillus reuteri DSM 20016 and Bifidobacterium longum subsp. infantis ATCC 15697, but not Lacticaseibacillus rhamnosus GG. Dimethyl labeling, along with LC-MS/MS, effectively differentiated α- and γ-glutamyl peptides, revealing the presence of several γ-glutamyl peptides known to possess kokumi and anti-inflammatory activities, including γ-Glu-Phe and γ-Glu-Tyr in chickpeas aquafaba and γ-Glu-S-methyl-Cys and γ-Glu-Leu in beans aquafaba. This work uncovered unique bioactive peptides and oligosaccharides in aquafaba, helping promote its valorization, food system sustainability, and future health-promoting claims.

Lifestyle Factors and Stroke Prevention: From the Individual to the Community

PURPOSE OF REVIEW

The overwhelming majority of stroke burden can be prevented through the pillars of lifestyle medicine: diet, exercise, sleep, substance abuse, stress management, and healthy relationships. Among these, diet confers the greatest attributable risk.

RECENT FINDINGS

Despite abundant data and integration of lifestyle medicine within major stroke prevention guidelines, several barriers to effective implementation remain. These include lack of emphasis in medical education, integration in hospital certification metrics, reimbursement from medical insurance, and health policy that inadequately addresses social determinants of health. However, both top-down and bottom-up solutions introduced within the last few years are helping to break down these barriers. This review highlights recent literature and interventions that are closing the gap between the theory and practice of stroke prevention through lifestyle risk factors from a US perspective. By strategically targeting the various institutional barriers, it is possible and essential to substantially reduce stroke burden.

Targeted hydrothermally induced cell biopolymer changes explain the in vitro digestion of starch and proteins in common bean (Phaseolus vulgaris) cotyledons

Digestion of macro-nutrients (protein and starch) in pulses is a consequence of the interplay of both extrinsic (process-related) and intrinsic (matrix-dependent) factors which influence their level of encapsulation and physical state, and therefore, their accessibility by the digestive enzymes. The current work aimed at understanding the consequences of hydrothermally induced changes in the physical state of cell biopolymers (cell wall, protein, and starch) in modulating the digestion kinetics of starch and proteins in common beans. The hydrothermal treatments were designed such that targeted microstructural/biopolymer changes occurred. Therefore, bean samples were processed at temperatures between 60 and 95 °C for 90 minutes. It was demonstrated that these treatments allowed the modulation of starch gelatinization, protein denaturation and cell separation. The specific role of hydrothermally induced starch gelatinization and protein denaturation, alongside enhanced cell wall permeability on the digestion kinetics of common bean starch and proteins is illustrated. For instance, bean samples processed at T > 70 °C were marked by higher levels of starch digestibility (Cf values above 47%) compared to the partially (un-)gelatinized samples (processed at T ≤ 70 °C) (Cf values below 35%). Similarly, samples processed at T > 85 °C exhibited significantly higher levels of protein digestibility (Cf values above 47%) resulting from complete protein denaturation. Moreover, increased permeability of the cell wall to digestive enzymes in these samples (T > 85 °C) increased levels of digestibility of both gelatinized starch and denatured proteins. This study provides an understanding of the potential use of hydrothermal processing to obtain pulse-based ingredients with pre-determined microstructural and nutritional characteristics.

Impact of dietary risk on global ischemic heart disease: findings from 1990-2019

Ischemic heart disease (IHD) is a condition in which the heart is starved of oxygen. Knowing the dietary risk factors implementing appropriate nutritional interventions in this regard seems essential. Therefore, the present study was carried out to determine the epidemiological features of IHD affected by dietary risks. This study used data from the Global Burden of Disease (GBD) study. In this study, we collected information on death, years lived with disability (YLD), and disability-adjusted life years (DALYs) of IHD affected by dietary risks in one hundred thousand people with 95% confidence based on the direct Age Standard Rate (ASR). We applied these data based on the Socio-demographic Index (SDI). In 2019, the number of IHD deaths, YLDs, and DALYs attributable to dietary risks was 62.43 million (95% UI [50.97-73.63] per 100,000 population), 36.88 (95% UI [23.87-53.32] per 100,000 population), and 1271.32 (95% UI [1061.29-1473.75] per 100,000 population), respectively. We found that the lowest DALYs of IHD affected by dietary risks by ASR are for high SDI countries. Most dietary risk factors related to IHD in countries with high and high middle SDI were related to a diet high in red and processed meat, sodium, and low in legumes, but in countries with low and low middle SDI, it was related to a diet low in fiber, fruit, nuts and seeds, PUFA, seafood W3 fatty acids, vegetables and whole grain. Considering that the dietary risk factors related to IHD are different based on SDI, it is necessary to consider nutritional interventions according to SDI.

Animal vs Plant-Based Meat: A Hearty Debate

Plant-based meat alternatives (PBMAs) are highly processed food products that typically replace meat in the diet. In Canada, the growing demand for PBMAs coincides with public health recommendations to reduce ultra-processed food consumption, which prompts the need to investigate the long-term health implications of PBMAs. This review assesses the available literature on PBMAs and cardiovascular disease (CVD), including an evaluation of their nutritional profile and impact on CVD risk factors. Overall, the nutritional profiles of PBMAs vary considerably but generally align with recommendations for improving cardiovascular health; compared with meat, PBMAs are usually lower in saturated fat and higher in polyunsaturated fat and dietary fibre. Some dietary trials that have replaced meat with PBMAs have reported improvements in CVD risk factors, including total cholesterol, low-density lipoprotein cholesterol, apolipoprotein B-100, and body weight. No currently available evidence suggests that the concerning aspects of PMBAs (eg, food processing and high sodium content) negate the potential cardiovascular benefits. We conclude that replacing meat with PBMAs may be cardioprotective; however, long-term randomised controlled trials and prospective cohort studies that evaluate CVD events (eg, myocardial infarction, stroke) are essential to draw more definitive conclusions.

Guidance on risk-benefit assessment of foods

The EFSA Scientific Committee has updated its 2010 Guidance on risk-benefit assessment (RBA) of foods. The update addresses methodological developments and regulatory needs. While it retains the stepwise RBA approach, it provides additional methods for complex assessments, such as multiple chemical hazards and all relevant health effects impacting different population subgroups. The updated guidance includes approaches for systematic identification, prioritisation and selection of hazardous and beneficial food components. It also offers updates relevant to characterising adverse and beneficial effects, such as measures of effect size and dose-response modelling. The guidance expands options for characterising risks and benefits, incorporating variability, uncertainty, severity categorisation and ranking of different (beneficial or adverse) effects. The impact of different types of health effects is assessed qualitatively or quantitatively, depending on the problem formulation, scope of the RBA question and data availability. The integration of risks and benefits often involves value-based judgements and should ideally be performed with the risk-benefit manager. Metrics such as Disability-Adjusted Life Years (DALYs) and Quality-Adjusted Life Years (QALYs) can be used. Additional approaches are presented, such as probability of all relevant effects and/or effects of given severities and their integration using severity weight functions. The update includes practical guidance on reporting results, interpreting outcomes and communicating the outcome of an RBA, considering consumer perspectives and responses to advice.

Unlocking the Nutraceutical Potential of Legumes and Their By-Products: Paving the Way for the Circular Economy in the Agri-Food Industry

Legumes, including beans, peas, chickpeas, and lentils, are cultivated worldwide and serve as important components of a balanced and nutritious diet. Each legume variety contains unique levels of protein, starch, fiber, lipids, minerals, and vitamins, with potential applications in various industries. By-products such as hulls, rich in bioactive compounds, offer promise for value-added utilization and health-focused product development. Various extraction methods are employed to enhance protein extraction rates from legume by-products, finding applications in various foods such as meat analogs, breads, and desserts. Moreover, essential fatty acids, carotenoids, tocols, and polyphenols are abundant in several residual fractions from legumes. These bioactive classes are linked to reduced incidence of cardiovascular diseases, chronic inflammation, some cancers, obesity, and type 2 diabetes, among other relevant health conditions. The present contribution provides a comprehensive review of the nutritional and bioactive composition of major legumes and their by-products. Additionally, the bioaccessibility and bioavailability aspects of legume consumption, as well as in vitro and in vivo evidence of their health effects are addressed.

Mediterranean diet for cardiovascular disease: an evidence mapping study

OBJECTIVE

This study aimed to evaluate the methodological quality of existing meta-analyses (MA) and the quality of evidence for outcome indicators to provide an updated overview of the evidence concerning the therapeutic efficacy of the Mediterranean diet (MD) for various types of CVD.

DESIGN

We conducted comprehensive searches of PubMed, Cochrane Library, and Embase databases. The quality of the MA was assessed using the A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2) checklist, while the Grading of Recommendations Assessment, Development and Evaluation (GRADE) evidence evaluation system was employed to evaluate the quality of evidence for significant outcomes.

SETTING

The CVD remains a significant contributor to global mortality. Multiple MA have consistently demonstrated the efficacy of medical interventions in managing CVD. However, due to variations in the scope, quality and outcomes of these reviews, definitive conclusions are yet to be established.

PARTICIPANTS

This study included five randomized trials and twelve non-randomized studies, with a combined participant population of 716 318.

RESULTS

The AMSTAR 2 checklist revealed that 54·55 % of the studies demonstrated high quality, while 9·09 % exhibited low quality, and 36·36 % were deemed critically low quality. Additionally, there was moderate evidence supporting a positive correlation between MD and CHD/acute myocardial infarction, stroke, heart failure, cardiovascular events, coronary events and major adverse cardiovascular events.

CONCLUSIONS

This study indicates that although recognizing the potential efficacy of MD in managing CVD, the quality of the methodology and the evidence for the outcome indicators remain unsatisfactory.

Three approaches to assessing dietary quality in Mexican adolescents from 2006 to 2018 with data from national health and nutrition surveys

OBJECTIVE

To assess trends in the dietary quality of Mexican adolescents from 2006 to 2018, both overall and by sociodemographic indicators, using adaptations of the EAT-Lancet Planetary Health (PH) recommendations, optimal intake estimated by the Global Burden of Disease (GBD) and 2015 Mexican Dietary Guidelines (MDG) in nationally representative samples.

DESIGN

Using dietary data from a semi-quantitative FFQ, dietary quality indexes were constructed as adaptations of three dietary intake recommendations. Trends in adherence to recommendations were evaluated with multivariate quantile regression models with survey year as the main independent variable and adjusted for age, sex, energy intake, dwelling area, geographical region, household assets condition, and student/non-student status. P values and CI were Bonferroni-corrected.

SETTING

Mexico.

PARTICIPANTS

Non-pregnant or lactating adolescents aged 12-19 years (n 16 520).

RESULTS

Adherence to the PH index was about 40 %, GBD was nearly 35 % and MDG was about 37 %. The lowest adherences were for added sugars, sugar-sweetened beverages, nuts and seeds, red meats, processed meats, and legumes (<28 %). No 2006-2018 trends in total adherence were found in any index. Nevertheless, negative adherence trends were identified for poultry (β = -2·4), and saturated fats (β = -0·93), and positive for unsaturated oils (β = 1·23), in the PH. In MDG, relevant trends were found for plain water (β = 1·63) and foods rich in fats (β = -1·24).

CONCLUSIONS

Mexican adolescents have demonstrated poor dietary quality by these three approaches. Therefore, this population has a high-risk profile for diet-associated chronic diseases. Further research and appropriate public policies are needed.

Adherence to an energy-restricted Mediterranean diet is associated with the presence and burden of carotid atherosclerosis in people with type 1 diabetes

AIMS

People with type 1 diabetes (T1D) have an increased risk of cardiovascular disease (CVD). The Mediterranean diet is associated with reduced CVD; however, the evidence in T1D is scarce. We aimed to analyse the relationships between adherence to the energy-restricted Mediterranean diet (erMEDd) and carotid atherosclerosis.

MATERIALS AND METHODS

We included children with T1D without CVD, with ≥1 of the following: age ≥40 years, diabetic kidney disease, or ≥10 years of disease duration with another risk factor. Plaque presence (intima-media thickness ≥1.5 mm) was determined by ultrasonography. The PREDIMED-Plus 17-item questionnaire (PP-17) was used to assess adherence to the erMEDd.

RESULTS

Four hundred one individuals were included (48% males, age 48.3 ± 11 years, diabetes duration 26.8 ± 11.4 years). Those harbouring plaques (42%) showed lower adherence to the erMEDd (PP-17: 8.9 ± 2.3 of a maximum of 17 vs. 9.8 ± 2.5, p < 0.001). Greater adherence to the erMEDd was correlated with an overall better metabolic profile. After adjusting for multiple confounders, adherence to the erMEDd was independently associated with carotid atherosclerosis (OR 0.86 [0.77-0.95] for plaque presence and OR 0.85 [0.75-0.97] for ≥2 plaques). The consumption of fruit and nuts and preference of white over red meat was higher in individuals without atherosclerosis (p < 0.05). Fruit and nut consumption was associated with lower plaque prevalence in the fully adjusted models (OR 0.38 [0.19-0.73] and 0.51 [0.29-0.93]).

CONCLUSIONS

Greater adherence to the erMEDd is associated with less carotid atherosclerosis in children with T1D at high risk of CVD. Strategies to improve and implement healthy dietary patterns in this population should be encouraged.

Associations between Cardiometabolic Risk Factors and Increased Consumption of Diverse Legumes: A South African Food and Nutrition Security Programme Case Study

The programme aimed to improve selected cardiometabolic risk (CMR) variables using a nutritional intervention among farmers who reported hypertensive disorders as hindrances during agricultural activities. The intervention had two case controls (n = 103) [experimental group-EG (n = 53) and control group-CG (n = 50)] which were tracked and whose blood pressure measurements, dietary intake, blood indices for cholesterol concentration and glucose levels from pre- and post-intervention surveys after the baseline survey (n = 112) were analysed. The interval for data collection was 12 weeks (±120 days) after five legume varieties were consumed between 3 and 5 times a day, and servings were not <125 g per at least three times per week. Sixty-five per cent of farmers were above 60 years old, with mean age ranges of 63.3 (SD ± 6.3) years for women and 67.2 (SD ± 6.7) for men. The post-intervention survey revealed that EG blood results indicated nutrient improvement with p <= 0.05 for blood glucose (p = 0.003) and cholesterol (p = 0.001) as opposed to the CG. A trend analysis revealed that cholesterol (p = 0.033) and systolic blood pressure (SBP); (p = 0.013) were statistically significant when comparing genders for all study phases. Interventions focusing on legumes can improve hypertension and cardiovascular disease and fast-track the achievement of SGDs 3 and 12 through community-based programmes.

Plasma metabolite profile of legume consumption and future risk of type 2 diabetes and cardiovascular disease

BACKGROUND

Legume consumption has been linked to a reduced risk of type 2 diabetes (T2D) and cardiovascular disease (CVD), while the potential association between plasma metabolites associated with legume consumption and the risk of cardiometabolic diseases has never been explored. Therefore, we aimed to identify a metabolite signature of legume consumption, and subsequently investigate its potential association with the incidence of T2D and CVD.

METHODS

The current cross-sectional and longitudinal analysis was conducted in 1833 PREDIMED study participants (mean age 67 years, 57.6% women) with available baseline metabolomic data. A subset of these participants with 1-year follow-up metabolomics data (n = 1522) was used for internal validation. Plasma metabolites were assessed through liquid chromatography-tandem mass spectrometry. Cross-sectional associations between 382 different known metabolites and legume consumption were performed using elastic net regression. Associations between the identified metabolite profile and incident T2D and CVD were estimated using multivariable Cox regression models.

RESULTS

Specific metabolic signatures of legume consumption were identified, these included amino acids, cortisol, and various classes of lipid metabolites including diacylglycerols, triacylglycerols, plasmalogens, sphingomyelins and other metabolites. Among these identified metabolites, 22 were negatively and 18 were positively associated with legume consumption. After adjustment for recognized risk factors and legume consumption, the identified legume metabolite profile was inversely associated with T2D incidence (hazard ratio (HR) per 1 SD: 0.75, 95% CI 0.61-0.94; p = 0.017), but not with CVD incidence risk (1.01, 95% CI 0.86-1.19; p = 0.817) over the follow-up period.

CONCLUSIONS

This study identified a set of 40 metabolites associated with legume consumption and with a reduced risk of T2D development in a Mediterranean population at high risk of cardiovascular disease.

TRIAL REGISTRATION

ISRCTN35739639.

UK Chickpea Consumption Doubled from 2008/09-2018/19

Background: Only 9% of individuals in the United Kingdom (UK) meet the recommendation for dietary fibre intake. Little is known about chickpea consumption in the UK. Methods: Chickpea intake trends and sociodemographic patterns were analysed using the National Diet and Nutrition Survey Rolling Programme data collected from 2008/09 to 2018/19 among 15,655 individuals ≥1.5 years completing a four-day food diary. Chickpea consumers were identified based on a list of chickpea-containing foods, with the most consumed foods being hummus, boiled chickpeas, chickpea flour, and low/reduced-fat hummus. Micronutrient and food group intakes were compared between chickpea consumers and non-consumers; the Modified Healthy Dietary Score was also assessed, which measures adherence to UK dietary recommendations. Results: Chickpea consumption increased from 6.1% (2008-2012) to 12.3% (2016-2019). Among 1.5-3 years, consumption increased from 5.7% to 13.4%, and among 19-64 years, consumption increased from 7.1% to 14.4%. The percentage of individuals eating chickpeas was higher among individuals with higher incomes and more education. Healthy-weight adults were more likely to consume chickpeas compared to those who were overweight or obese. Compared to both bean and non-bean consumers, chickpea consumers ate significantly more dietary fibre, fruits and vegetables, pulses, nuts, and less red meat and processed meat products. Chickpea consumers also had a higher Modified Healthy Dietary Score. Conclusions: In the UK, chickpea consumption more than doubled from 2008/09 to 2018/19. Chickpea consumers had a higher diet quality than non-consumers.

Comparison of Consumption of Pulses in Two Seasons of the Year in Chile

BACKGROUND

In Chile, the consumption of legumes at least two times per week is promoted. However, there is a low consumption of legumes. Therefore, our objective is to describe legume consumption in two different seasonal periods.

METHODS

Serial cross-sectional study: surveys were distributed during summer and winter using different digital platforms. Frequency of consumption, purchase access, and preparation type were investigated.

RESULTS

In total, 3280 adults were surveyed in summer and 3339 in winter. The mean age was 33 years. Totals of 97.7% and 97.5% of the population reported consuming legumes in both periods; consumption increased to 3 times per week during winter. In both periods, the main reason for their preference is that they are delicious and nutritious, followed by their use as a meat substitute; the main barriers to their consumption in both periods are that they are expensive (29% in summer and 27.8% in winter) and difficult to prepare.

CONCLUSION

A good consumption of legumes was observed, but with a higher frequency of consumption during winter, with an intake of ≥1 per day; additionally, differences were found in purchases according to season, although no differences were found in the method of preparation.