title: Effect of legumes as part of a low glycemic index diet on glycemic control and cardiovascular risk factors in type 2 diabetes mellitus: a randomized controlled trial.
abstract: BACKGROUND
  Legumes, including beans, chickpeas, and lentils, are among the lowest glycemic index (GI) foods and have been recommended in national diabetes mellitus (DM) guidelines. Yet, to our knowledge, they have never been used specifically to lower the GI of the diet. We have therefore undertaken a study of low-GI foods in type 2 DM with a focus on legumes in the intervention.
  
  
  METHODS
  A total of 121 participants with type 2 DM were randomized to either a low-GI legume diet that encouraged participants to increase legume intake by at least 1 cup per day, or to increase insoluble fiber by consumption of whole wheat products, for 3 months. The primary outcome was change in hemoglobin A1c (HbA1c) values with calculated coronary heart disease (CHD) risk score as a secondary outcome.
  
  
  RESULTS
  The low-GI legume diet reduced HbA1c values by -0.5% (95% CI, -0.6% to -0.4%) and the high wheat fiber diet reduced HbA1c values by -0.3% (95% CI, -0.4% to -0.2%). The relative reduction in HbA1c values after the low-GI legume diet was greater than after the high wheat fiber diet by -0.2% (95% CI, -0.3% to -0.1%; P < .001). The respective CHD risk reduction on the low-GI legume diet was -0.8% (95% CI, -1.4% to -0.3%; P = .003), largely owing to a greater relative reduction in systolic blood pressure on the low-GI legume diet compared with the high wheat fiber diet (-4.5 mm Hg; 95% CI, -7.0 to -2.1 mm Hg; P < .001).
  
  
  CONCLUSIONS
  Incorporation of legumes as part of a low-GI diet improved both glycemic control and reduced calculated CHD risk score in type 2 DM.
authors.affiliation: Clinical Nutrition and Risk Factor Modification Center, St Michael’s Hospital, Toronto, Ontario, Canada. NutritionProject@smh.ca
authors.forename: David J A
authors.initials: DJ
authors.lastname: Jenkins
authors.forename: Cyril W C
authors.initials: CW
authors.lastname: Kendall
authors.forename: Livia S A
authors.initials: LS
authors.lastname: Augustin
authors.forename: Sandra
authors.initials: S
authors.lastname: Mitchell
authors.forename: Sandhya
authors.initials: S
authors.lastname: Sahye-Pudaruth
authors.forename: Sonia
authors.initials: S
authors.lastname: Blanco  Mejia
authors.forename: Laura
authors.initials: L
authors.lastname: Chiavaroli
authors.forename: Arash
authors.initials: A
authors.lastname: Mirrahimi
authors.forename: Christopher
authors.initials: C
authors.lastname: Ireland
authors.forename: Balachandran
authors.initials: B
authors.lastname: Bashyam
authors.forename: Edward
authors.initials: E
authors.lastname: Vidgen
authors.forename: Russell J
authors.initials: RJ
authors.lastname: de Souza
authors.forename: John L
authors.initials: JL
authors.lastname: Sievenpiper
authors.forename: Judy
authors.initials: J
authors.lastname: Coveney
authors.forename: Lawrence A
authors.initials: LA
authors.lastname: Leiter
authors.forename: Robert G
authors.initials: RG
authors.lastname: Josse
mesh_terms: D001786:Blood Glucose / Q000378:metabolism*; D002318:Cardiovascular Diseases / Q000209:etiology*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000178:diet therapy*; D003927:Diet, Diabetic / Q000379:methods*; D004043:Dietary Fiber; D007887:Fabaceae; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D038321:Glycemic Index; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D004043:Dietary Fiber; D006442:Glycated Hemoglobin