Effects of Extracted Pulse Proteins on Lipid Targets for Cardiovascular Risk Reduction: Systematic Review and Meta-Analysis of Randomized Controlled Trials

Shuting Yang; Songhee Back; Shannan M Grant; Sabrina Ayoub-Charette; Victoria Chen; Erika J Lin; Lukas Haintz; Yue-Tong Chen; Elmirah Ahmad; Jacqueline Gahagan; Christopher P F Marinangeli; Vanessa Ha; Tauseef Ahmad Khan; Sonia Blanco Mejia; Andreea Zurbau; Russell J de Souza; Joseph Beyene; Marcia M English; Vladimir Vuksan; Robert G Josse; Lawrence A Leiter; Cyril W C Kendall; David J A Jenkins; John L Sievenpiper; Laura Chiavaroli

doi:10.3390/nu16213765

Effects of Extracted Pulse Proteins on Lipid Targets for Cardiovascular Risk Reduction: Systematic Review and Meta-Analysis of Randomized Controlled Trials

Nutrients. 2024 Nov 1;16(21):3765. doi: 10.3390/nu16213765.

Authors

Shuting Yang^{1

2}, Songhee Back^{1

2}, Shannan M Grant^{3

4

5}, Sabrina Ayoub-Charette^{1

2}, Victoria Chen^{1

2}, Erika J Lin¹, Lukas Haintz⁶, Yue-Tong Chen¹, Elmirah Ahmad¹, Jacqueline Gahagan⁷, Christopher P F Marinangeli⁸, Vanessa Ha⁹, Tauseef Ahmad Khan^{1

2}, Sonia Blanco Mejia^{1

2}, Andreea Zurbau^{1

2

10}, Russell J de Souza^{1

2

11

12}, Joseph Beyene¹¹, Marcia M English¹³, Vladimir Vuksan¹, Robert G Josse^{1

2

14

15

16}, Lawrence A Leiter^{1

2

14

15

16}, Cyril W C Kendall^{1

2

17}, David J A Jenkins^{1

2

14

15

16}, John L Sievenpiper^{1

2

14

15

16}, Laura Chiavaroli^{1

2

16}

Affiliations

¹ Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada.
² Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, ON M5B 1W8, Canada.
³ Department of Applied Human Nutrition, Faculty of Professional Studies, Mount Saint Vincent University, Halifax, NS B3M 2J6, Canada.
⁴ Department of Obstetrics and Gynaecology, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 4R2, Canada.
⁵ Department of Obstetrics and Gynecology, IWK Health Centre, Halifax, NS B3K 6R8, Canada.
⁶ Department of Medicine, Medical University of Graz, 8010 Graz, Austria.
⁷ Research Office, Mount Saint Vincent University, Halifax, NS B3M 2J6, Canada.
⁸ Protein Industries Canada, Regina, SK S4P 1Y1, Canada.
⁹ Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada.
¹⁰ INQUIS Clinical Research Ltd. (Formerly GI Labs), Toronto, ON M5C 2N8, Canada.
¹¹ Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON L8S 4L8, Canada.
¹² Population Health Research Institute, Hamilton Health Sciences Corporation, Hamilton, ON L8N 1B2, Canada.
¹³ Department of Human Nutrition, Saint Francis Xavier University, Halifax, NS B2G 2W5, Canada.
¹⁴ Division of Endocrinology and Metabolism, Department of Medicine, St. Michael's Hospital, Toronto, ON M5B 1W8, Canada.
¹⁵ Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A1, Canada.
¹⁶ Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON M5B 1W8, Canada.
¹⁷ College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada.

Abstract

Background: Many clinical practice guidelines recommend dietary pulses for the prevention and management of cardiovascular disease and diabetes. The impact of extracted pulse proteins remains unclear. We therefore conducted a systematic review and meta-analysis of randomized controlled trials of the effect of extracted pulse proteins on therapeutic lipid targets.

Methods and findings: MEDLINE, Embase, and the Cochrane Library were searched through April 2024 for trials of ≥3-weeks. The primary outcome was low-density lipoprotein-cholesterol (LDL-C). The secondary outcomes were other lipid targets. Independent reviewers extracted data and assessed the risk of bias. Subgroup analyses included by pulse type and the certainty of evidence was assessed using GRADE.

Results: Seven included trials (14 trial comparisons, n = 453) with a median of 4-weeks duration and dose of 35 g/day showed that extracted pulse proteins decreased LDL-C by -0.23 mmol/L (95% confidence interval: -0.36 to -0.10 mmol/L, p < 0.001). Similar effects were observed for non-high-density lipoprotein-cholesterol and apolipoprotein B. No interactions were found by pulse type. Subgroup analyses revealed effect modification by sex, with greater proportions of females seeing greater reductions. GRADE was generally moderate.

Conclusions: Extracted pulse proteins likely result in moderate reductions in LDL-C and other lipid targets. Future studies on various types of extracted pulse proteins including assessments by sex are warranted.

Keywords: blood lipids; cardiovascular; dietary pulses; extracted proteins; meta-analysis; sex; systematic review.

Publication types

Meta-Analysis
Systematic Review

MeSH terms

Cardiovascular Diseases* / prevention & control
Cholesterol, LDL* / blood
Female
Heart Disease Risk Factors
Humans
Lipids / blood
Male
Randomized Controlled Trials as Topic
Risk Reduction Behavior

Substances

Cholesterol, LDL
Lipids

Grants and funding

S.Y. received research support from a Banting and Best Diabetes Centre Charles Hollenberg Summer Studentship. S.B. received research support from an internal sabbatical research grant awarded to SMG through Mount Saint Vincent University 2022–23, an Undergraduate Research Opportunity Program Award from the Department of Nutritional Sciences, University of Toronto, and a Toronto 3D Knowledge Synthesis Summer Student Top-Up Award. S.A.-C. received research support from a CIHR Canadian Graduate Scholarship Doctoral Award (funding reference number 476251). S.M.G. received support through an internal sabbatical research grant, awarded to SMG through Mount Saint Vincent University, 2022–23, and an internal travel grant, awarded to SMG through Mount Saint Vincent University, 2022. V.C. was funded by a Toronto 3D Research Fellowship Award, CIHR Canada Graduate Scholarship—Masters (CGS-M) Research Award, and a University of Toronto Department of Nutritional Sciences Fellowship. A.Z. was funded by the Toronto 3D Postdoctoral Fellowship Award. Y.-T.C. received research support from the Toronto 3D Knowledge Synthesis Summer Student Scholarship. E.J.L. received research support from an Undergraduate Research Opportunity Program Award from the Department of Nutritional Sciences, University of Toronto. D.J.A.J. was funded by the Government of Canada through the Canada Research Chair Endowment. L.C. was funded by a Toronto 3D New Investigator Award.