Legumes & pulses and cardiovascular disease.

CVD risk: Data about total CVD risk was provided by 6 cohorts. Nonsignificant protective effects were found in two cohorts of (very) small size (23, 42), but no associations were found in the remaining 4 cohorts which were all of moderate-large size (10, 26, 40).
CVD mortality: Data about total CVD mortality was provided by 3 cohorts. A significant protective effect was found in one cohort of small size examining diabetic subjects (Nöthlings U [26]), but no associations were found in both remaining cohorts which were of moderate size (36, 37).

CHD risk: Data about heart disease risk was provided by 7 cohorts. A significant protective effect was found in 2 cohorts of small size (1, 23), but no associations were found in the remaining 5 cohorts (3, 4, 10, 36).
CHD mortality: Data about heart disease mortality was provided by 3 cohorts. A nonsignificant protective effect was found in one cohort (17), but no associations were found in the remaining 2 cohorts (4, 37).

Stroke risk: Data about ischemic stroke risk was provided by 3 cohorts. A nonsignificant protective effect was found in one cohort among women only (36). No associations were found in the remaining 2 cohorts (10).
Stroke mortality: Data about total stroke mortality was provided by 2 cohorts examining Asian subjects only. A significant protective effect was found in one cohort among men only (Iso H [37]). A later publication about the same cohort showed that the effect size attenuated after further adjustment for possible confounders, but this analysis showed no results stratified by gender and included a smaller part of the cohort (Nagura J [37]). No association was found in the other cohort (16).

Conclusion: Some protective effects were found, but these were nonsignificant or restricted to cohorts of (very) small size. No evidence was found for an association between legumes and any CVD end point.

Total cardiovascular disease:

Author

Cohort name

Subjects

Years of follow-up

Cases

End point

Consumption of

Relative Risk (RR)

Adjustments

42) Panagiotakos D (2009)

The ATTICA Study

2,101 men and women aged 18-89 without CVD.
(Greece)

5
(2001-2002 to 2006)

170
(108 men and 62 women)

Cardiovascular disease incidence (fatal or non-fatal acute myocardial infarction, ustable angina, or any other type of CVD)

Legumes (beans, peas etc.)

Cases consumed fewer servings per week (5.2) than noncases (6.1; P = 0.06).

Age.

40) Yen AM (2008)

The KCIS Study

21,906 male subjects aged 20-79 from Keelung, and free of CVD.
(Taiwan)

2.81
(1999-2004 to 2004)

3,163

CVD incidence (hypertensive heart disease, IHD, cardiomyopathy, arrhytmia, congestive heart failure, cerebrovascular disease, coronary artery bypass grafting, percutaneous transluminal angioplasty, diseases of arteries, arterioles, and capillaries)

Beans (not defined)

HR = 1.00 (0.97-1.02; P = 0.1736)

Age and education level.

37) Nagura J (2009)

The JACC Study

25,206 men and 34,279 women aged 40-79, and without a history of CHD, stroke, or cancer.
(Japan)

12.7
(1989-2003)

2,243

Total CVD mortality

Beans (tofu, i.e. soyabean curd, and boiled beans)

HR = 0.89 (0.78-1.01; P = 0.106) for the highest vs lowest quartile of consumption.

Amount specific data (servings per week):
0.8: HR = 1.
1.8: HR = 0.93 (0.82-1.05).
3.0: HR = 1.03 (0.91-1.17).
4.5: HR = 0.89 (0.78-1.01).

The association did not vary by sex (no data shown).

Sex, age, BMI, smoking status, alcohol intake, hours of walking, hours of sleep, education years, perceived mental stress, cholesterol intake, SFA intake, n-3 fatty acids intake, sodium intake, fruit intake, vegetables intake and histories of hypertension and diabetes.

36) Kokubo Y (2007)

The JPHC Study Cohort I

40,462 subjects aged 40-59.
(Japan)

12.5
(1990-92 to 2002)

175 men, and 57 women.

Ischemic CVD mortality

Beans (not defined)


Men:	Women:
HR = 1.34 (0.82-2.17; P = 0.813) for the highest vs lowest tertile of consumption. Amount specific data (days per week): 0: HR = 1. 1-2: HR = 0.75 (0.51-1.10). ≥ 3: HR = 1.34 (0.82-2.17).	HR = 1.22 (0.57-2.61; P = 0.676) for the highest vs lowest tertile of consumption. Amount specific data (days per week): 0: HR = 1. 1-2: HR = 0.49 (0.24-0.99). ≥ 3: HR = 1.22 (0.57-2.61).

Age, sex, smoking, alcohol use, BMI, history of hypertension or diabetes mellitus, medication use for hypercholesterolemia, education, sports, dietary intake of fruits, vegetables, fish, salt, and energy, menopausal status for women, and public health center.

26) Buckland G (2009)

The Spanish EPIC Cohort Study

40,757 subjects (15,335 men and 25,422 women) aged 29-69 and free of coronary events.

10.4
(1992-96 to 2004)

See variables

CHD incidence (fatal or nonfatal myocardial infarction or unstable angina requiring revascularization)

Legumes (not defined)


Total (606 cases)	Men (480 cases)	Women (126 cases)
HR = 1.01 (0.82-1.24; P = 0.99) for the highest vs lowest tertile of consumption. Amount specific data (g/1,000 kcal/day): 0-15.5: HR = 1. >15.5-27.1: HR = 1.10 (0.89-1.35). >27.1-192.6: HR = 1.01 (0.82-1.24).	HR = 1.01 (0.80-1.27; P = 0.97) for the highest vs lowest tertile of consumption. Amount specific data (g/1,000 kcal/day): 0-15.5: HR = 1. >15.5-27.1: HR = 1.07 (0.84-1.36). >27.1-192.6: HR = 1.01 (0.80-1.27).	HR = 0.94 (0.60-1.46; P = 0.81) for the highest vs lowest tertile of consumption. Amount specific data (g/1,000 kcal/day): 0-15.5: HR = 1. >15.5-27.1: HR = 1.16 (0.76-1.76). >27.1-192.6: HR = 0.94 (0.60-1.46).

Stratified by center and age.
Adjusted for education, physical activity, BMI, smoking status, diabetes, hypertension, and hyperlipidemia status, and total calorie intake.

26) Nöthlings U (2008)

The EPIC Study.

10,449 participants - aged 35 to 70- with self-reported diabetes mellitus.
(10 European Countries)

9
(1992-2000 to 2007)

517?

CVD mortality

Legumes (not defined. including soy products)

RR = 0.72 (0.60-0.88) for an increase of 20 g/d.

Stratified on age.
Adusted for sex, smoking status, self-reported heart attack at baseline, self-reported hypertension at baseline, self-reported cancer at baseline, waist-to-hip ratio, insulin treatment, age at diabetes diagnosis, energy intake, alcohol intake.

23) Bazzano LA (2001)

The NHEFS Study.
(= part of The NHANES I Epidemiologic Follow-up Study).

9,632 men and women aged 25-74.
(USA)

19
(1971-75 to 1992)

3,680.

Cardiovascular disease risk

Legumes (dry beans and peas like pinto beans, red beans, black-eye peas, peanuts and peanut butter)

RR = 0.91 (0.82-1.01; P = 0.06) for the highest vs lowest quartile of consumption.

Amount specific data (frequency per week):
< 1: RR = 1.
1: RR = 0.99 (0.90-1.08).
2-3: RR = 0.95 (0.88-1.03).
≥ 4: RR = 0.91 (0.82-1.01).

**Risk of Cardiovascular Disease stratified by 8 possible confounders:**
(RRs are for consumption ≥ 4 vs < 1 times/wk)
Age ≥ 60: RR = 0.73 (0.62-0.87; P = < 0.001).	Age < 60: RR = 1.04 (0.91-1.18).
Men: RR = 0.86 (0.76-0.97; P = < 0.05).	Women: RR = 0.92 (0.77-1.09).
Low physical activity: RR = 0.87 (0.76-1.00).	Medium/high physical activity: RR = 0.91 (0.80-1.04).
Current smoker: RR = 0.91 (0.74-1.12).	Nonsmoker: RR = 0.87 (0.77-0.98; P = < 0.05).
Vitamin supplement use: RR = 0.92 (0.76-1.11).	Non-vitamin supplement use: RR = 0.87 (0.76-0.99; P = < 0.05).
Hypertension: RR = 0.92 (0.79-1.08).	No hypertension: RR = 0.87 (0.76-0.99; P = 0.05).
Serum cholesterol ≥ 240 mmol/L: RR = 0.91 (0.77-1.08).	Serum cholesterol < 240 mmol/L: RR = 0.88 (0.76-1.01).
BMI ≥ 25: RR = 0.91 (0.78-1.07).	BMI < 25: RR = 0.89 (0.77-1.02).

Stratified by birth cohort. Adjusted for age, sex, race, history of diabetes, recreational physical activity, education, regular alcohol consumption, current cigarette smoking, and total energy intake.

Non-stratified analysis of CHD and CVD are additionally adjusted for serum cholesterol, systolic blood pressure, BMI, saturated fat intake, frequency of meat and poultry intake, and frequency of fruit and vegetable intake.

23) Gartside PS (1998)

The NHANES I

5,811 men and women aged 40-74 with and without CHD and not using any special diets.

16
(1971-1987)

1,958

CHD risk (morbidity and mortality)

Legumes (peas, beans, peanuts, and peanut butter)

**Stratified by age:**
40-49	50-59	60-69	70-74
% of people with CHD for the highest vs lowest quartile of consumption. Amount specific data (Legume intake): None: 11% < 1/week: 14% 1-6/week: 14% ≥ 1/day: 17%	% of people with CHD for the highest vs lowest quartile of consumption. Amount specific data (Legume intake): None:31 % < 1/week: 26% 1-6/week: 24% ≥ 1/day: 26%; P = 0.053	% of people with CHD for the highest vs lowest quartile of consumption. Amount specific data (Legume intake): None: 48% < 1/week: 44% 1-6/week: 40% ≥ 1/day: 40%; P = 0.013	% of people with CHD for the highest vs lowest quartile of consumption. Amount specific data (Legume intake): None: 60% < 1/week: 53% 1-6/week: 60% ≥ 1/day: 62%

**Stratified by region:**
NE	South	West	MW
% of people with CHD for the highest vs lowest quartile of consumption. Amount specific data (Legume intake): None: 40% < 1/week: 33% 1-6/week: 32% ≥ 1/day: 31%	% of people with CHD for the highest vs lowest quartile of consumption. Amount specific data (Legume intake): None: 38% < 1/week: 32% 1-6/week: 29% ≥ 1/day: 36%	% of people with CHD for the highest vs lowest quartile of consumption. Amount specific data (Legume intake): None: 31% < 1/week: 32% 1-6/week: 29% ≥ 1/day: 34%	% of people with CHD for the highest vs lowest quartile of consumption. Amount specific data (Legume intake): None: 54% < 1/week: 41% 1-6/week: 36% ≥ 1/day: 29%

Effect modification:
No significant interactions were found with race, gender, serum cholesterol, physical exercise, physical activity, education, smoking, BMI, alcohol, fish, bread, cheese, and dessert intake.

Not defined. Possibly: Age, race, gender, geographic region, serum cholesterol, physical exercise, physical activity, education, smoking, BMI, alcohol, fish, bread, cheese, and dessert intake.

10) Joshipura KJ (2009)

The Nurses' Health Study

&

The Health Professional's Follow-up Study

70,870 women aged 38-63, and 38,918 men aged 40-75. Subjects were without cancer, diabetes or CVD.

Men: 14 (1986-2000).

Women: 16 (1984-2000)

2,040? men, and

1,852? women

Ischaemic CVD incidence (fatal and non-fatal MI and ischaemic stroke)

Legumes (not defined)

Highest vs lowest quintile of consumption.
Stratified by energy from carbohydrate intake:
< 40%	40-55%	> 55%
Men: RR = 1.07 Women: RR = 1.34 Men & women: RR = 1.19 (0.93-1.53)	Men: RR = 0.92 Women: RR = 1.06 Men & women: RR = 0.98 (0.86-1.12)	Men: RR = 0.90 Women: RR = 1.29 Men & women: RR = 1.01 (0.67-1.53)

Per increment of 1 serving/d.
Stratified by energy from carbohydrate intake:
< 40%	40-55%	> 55%
Men: RR = 1.08 Women: RR = 2.83 Men & women: RR = 1.69 (0.66-4.32)	Men: RR = 0.79 Women: RR = 1.21 Men & women: RR = 0.96 (0.63-1.44)	Men: RR = 0.90 Women: RR = 1.29 Men & women: RR = 1.01 (0.67-1.53)

Effect modification: All associations were generally attenuated among the multivitamin supplement users (data not shown).

Total energy, whole grains, age, smoking, alcohol, BMI, multivitamin and vitamin E supplement use, aspirin use, physical activity, family history of MI, history of hypertension, hypercholesterolaemia and incident diabetes, and menopausal status and hormone replacement therapy.

10) Hung HC. (2004)

The Nurses' Health Study
&
The Health Professionals' Follow-up Study.

71,910 women (aged 30-55) and
37,725 men (aged 40-75).
(USA)

14
(1984-1998)
(women), and
12
(1986-1998)
(men)

1964? women, and
1670? men.

1314 never smokers, 1513 past smokers, and 988 current smokers.

1625 non-vitamin supplement users, and 1444 vitamin supplement users.

Cardiovascular disease risk

Legumes (not defined)

**Stratified by sex:**
Men + women	Men	Women
RR = 1.04 (0.67-1.62; No P-value).	RR = 0.84 (No 95% CI; No P-value).	RR = 1.32 (No 95% CI; No P-value).

**Stratified by smoking status (men and women combined):**
Never	Past	Current
RR = 1.00 (0.53-1.91; No P-value).	RR = 1.29 (0.65-2.57; No P-value).	RR = 0.90 (0.59-1.39; No P-value).

**Stratified by multivitamin use (men and women combined):**
Non-vitamin use	Multivitamin use
RR = 1.03 (0.40-2.64; No P-value).	RR = 1.02 (0.75-1.39; No P-value).

All RRs are for an increment of 1 serving/day.

Total calorie intake, age, smoking status, alcohol use, body mass index, multivitamin and vitamin E supplement use, physical activity, family history of myocardial infarction, family history of colon cancer, personal history of hypertension, personal history of hypercholesterolemia, personal history of diabetes, and (for women only) family history of breast cancer, menopausal status, and use of hormone replacement therapy.

Coronary heart disease:

Author

Cohort name

Subjects

Years of follow-up

Cases

End point

Consumption of

Relative Risk (RR)

Adjustments

37) Nagura J (2009)

The JACC Study

25,206 men and 34,279 women aged 40-79, and without a history of CHD, stroke, or cancer.
(Japan)

12.7
(1989-2003)

452

CHD mortality

Beans (tofu, i.e. soyabean curd, and boiled beans)

HR = 0.88 (0.66-1.18; P = 0.407) for the highest vs lowest quartile of consumption.

Amount specific data (servings per week):
0.8: HR = 1.
1.8: HR = 0.93 (0.72-1.21).
3.0: HR = 0.92 (0.69-1.23).
4.5: HR = 0.88 (0.66-1.18).

The association did not vary by sex (no data shown).

Sex, age, BMI, smoking status, alcohol intake, hours of walking, hours of sleep, education years, perceived mental stress, cholesterol intake, SFA intake, n-3 fatty acids intake, sodium intake, fruit intake, vegetables intake and histories of hypertension and diabetes.

37) Iso H (2007)

The JACC Study.

41,816 men, and 57,985 women.
(Japan)

Not defined.

584 men, and
378 women.

Ischemic heart disease mortality

Boiled beans (not defined)


Men:	Women:
HR = 0.96 (0.76-1.21) for the highest vs lowest tertile of consumption. Amount specific data: < 1/w: HR = 1. 1-2/w: HR = 0.83 (0.67-1.04). ≥ 3/w: HR = 0.96 (0.76-1.21).	HR = 0.83 (0.62-1.12) for the highest vs lowest tertile of consumption. Amount specific data: < 1/w: HR = 1. 1-2/w: HR = 1.00 (0.76-1.31). ≥ 3/w: HR = 0.83 (0.62-1.12).

Age and study area.

36) Kokubo Y (2007)

The JPHC Study Cohort I

40,462 subjects aged 40-59.
(Japan)

12.5
(1990-92 to 2002)

242 men, and 66 women.

Myocardial infarction risk

Beans (not defined)


Men:	Women:
HR = 0.98 (0.60-1.62; P = 0.765) for the highest vs lowest tertile of consumption. Amount specific data (days per week): 0: HR = 1. 1-2: HR = 0.92 (0.67-1.26). ≥ 3: HR = 0.98 (0.60-1.62).	HR = 0.69 (0.26-1.84; P = 0.676) for the highest vs lowest tertile of consumption. Amount specific data (days per week): 0: HR = 1. 1-2: HR = 1.10 (0.62-1.97). ≥ 3: HR = 0.69 (0.26-1.84).

Age, sex, smoking, alcohol use, BMI, history of hypertension or diabetes mellitus, medication use for hypercholesterolemia, education, sports, dietary intake of fruits, vegetables, fish, salt, and energy, menopausal status for women, and public health center.

23) Bazzano LA (2001)

The NHEFS Study.
(= part of The NHANES I Epidemiologic Follow-up Study).

9,632 men and women aged 25-74.
(USA)

19
(1971-75 to 1992)

1,802

Coronary heart disease risk

Legumes (dry beans and peas like pinto beans, red beans, black-eye peas, peanuts and peanut butter)

RR = 0.79 (0.69-0.91; P = 0.003) for the highest vs lowest quartile of consumption.

Amount specific data (frequency per week):
< 1: RR = 1.
1: RR = 0.93 (0.81-1.07).
2-3: RR = 0.90 (0.81-1.01).
≥ 4: RR = 0.79 (0.69-0.91).

**Risk of Coronary Heart Disease stratified by 8 possible confounders:**
(RRs are for consumption ≥ 4 vs < 1 times/wk)
Age ≥ 60: RR = 0.62 (0.50-0.77; P = < 0.001).	Age < 60: RR = 1.05 (0.83-1.32).
Men: RR = 0.82 (0.6-0.97; P = < 0.05).	Women: RR = 0.75 (0.60-0.94; P = < 0.05).
Low physical activity: RR = 0.75 (0.61-0.92; P = < 0.05).	Medium/high physical activity: RR = 0.81 (0.68-0.97; P = < 0.05).
Current smoker: RR = 0.98 (0.78-1.25).	Nonsmoker: RR = 0.68 (0.66-0.82; P = < 0.01).
Vitamin supplement use: RR = 0.77 (0.59-0.99; P = < 0.05).	Non-vitamin supplement use: RR = 0.79 (0.66-0.94; P = < 0.01).
Hypertension: RR = 0.75 (0.62-0.91; P = < 0.01).	No hypertension: RR = 0.81 (0.66-1.01).
Serum cholesterol ≥ 240 mmol/L: RR = 0.78 (0.64-0.96; P = < 0.05).	Serum cholesterol < 240 mmol/L: RR = 0.79 (0.64-0.98; P = < 0.05).
BMI ≥ 25: RR = 0.78 (0.65-0.94; P = < 0.05).	BMI < 25: RR = 0.81 (0.66-0.99; P = < 0.05).

Stratified by birth cohort. Adjusted for age, sex, race, history of diabetes, recreational physical activity, education, regular alcohol consumption, current cigarette smoking, and total energy intake.

Non-stratified analysis of CHD and CVD are additionally adjusted for serum cholesterol, systolic blood pressure, BMI, saturated fat intake, frequency of meat and poultry intake, and frequency of fruit and vegetable intake.

17) Kelemen LE. (2005)

The Iowa Women's Health study.

29,017 postmenopausal women aged 55-69.
(USA)

15 (1986-2000)

739?

Coronary heart disease mortality

Legumes (tofu, dried beans, nuts, and peanut butter)

RR = 0.83 (0.65-1.07; P = 0.08) for the highest vs lowest quintile (median servings per 1,000 kcal between extreme quintiles = 0.08 and 0.56) of substitution for an isoenergetic amount of all carbohydrate-rich foods*

Amount specific data (quintiles. No amounts specified):
Q1: RR = 1.
Q2: RR = 0.89.
Q3: RR = 0.91.
Q4: RR = 0.81.
Q5: RR = 0.83.

*Carbohydrate rich foods [defined as: A composite of refined carbohydrates (rice, pasta, potatoes, refined cold breakfast cereal, muffins, snack foods, sweetened sodas, pizza, chocolate, candy, cakes, cookies, donuts, pastries, pies) and whole-grain carbohydrates (dark bread, brown rice, oatmeal, whole-grain breakfast cereal, bran, wheat germ, and other grains such as bulgar, kasha, and couscous)].

Age, total energy, saturated fat, polyunsaturated fat, monounsaturated fat, trans-fat, total fiber, dietary cholesterol, dietary methionine, alcohol, smoking, activity level, BMI, history of hypertension, postmenopausal hormone use, multivitamin use, vitamin E supplement use, education, family history of cancer, servings of fruits and vegetables excluding potatoes, legumes, dairy, eggs, red meats, poultry, and fish.

10) Joshipura KJ (2001)

The Nurses' Health Study &

The Health Professionals' Follow-Up Study.

84,251 women aged 34-59, and 42,148 men aged 40-75.
(USA)

Women: 14 (1980-1994).

Men: 8 (1986-1994).

1,127? women and
1,063? men.

1.193? non-multivitamin supplement users and
729? multivitamin supplement users.

1.446? never or past smokers and
708? current smokers.

Coronary heart disease risk (nonfatal myocardial infarction or fatal coronary disease)

Legumes


Pooled	Women	Men
RR = 1.06 (0.91-1.24; No P-value) for the highest vs lowest quintile of consumption. Amount specific data (quintiles. not defined): Q1: RR = 1. Q2: RR = 1.04 (0.91-1.18). Q3: RR = 0.98 (0.85-1.13). Q4: RR = 1.03 (0.90-1.17). Q5: RR = 1.06 (0.91-1.24). RR for a 1-serving/d increase in intake: 1.14 (0.82-1.59).	RR = 1.15 (No 95% CI; No P-value) for the highest vs lowest quintile of consumption. Amount specific data (median servings/d): 0.00: RR = 1. Not defined: RR = 1.07. Not defined: RR = 1.00. Not defined: RR = 1.05. 0.43: RR = 1.15. RR for a 1-serving/d increase in intake: 1.39.	RR = 0.98 (No 95% CI; No P-value) for the highest vs lowest quintile of consumption. Amount specific data (median servings/d): 0.00: RR = 1. Not defined: RR = 1.01. Not defined: RR = 0.96. Not defined: RR = 1.01. 0.57: RR = 0.98. RR for a 1-serving/d increase in intake: 0.99.

**Stratified by multivitamin supplement use:**
Participants not using multivitamin supplements	Participants using multivitamin supplements
RR = 1.10 (0.52-2.32).	RR = 1.17 (0.76-1.81).

**Stratified by smoking status:**
Never or past smokers	Current smokers
RR = 1.04 (0.76-1.43).	RR = 1.28 (0.66-2.46).

Age, smoking status, alcohol intake, family history of myocardial infarction, BMI, vitamin supplement use, vitamin E use, physical activity, aspirin use, 2-year follow-up period, presence of hypertension, presence of hypercholesterolemia, total daily caloric intake, and postmenopausal hormone use (women).

4) Fraser GE (1997)

The Adventist Health Study

Non-Hispanic white Seventh Seventh Day Adventists aged ≥ 84.
At study baseline there were 603 subjects older than 84 years, and during a 12-year follow-up, these and intitially younger subjects contributed 11,828 person-years of observation in the oldest-old age range.
(USA)

12
(1976-88)

364?
(110 men, and 254 women)

CHD death

Beans (not defined)


Total:	Men:	Women:
HR = 0.85 (0.64-1.14) for the highest vs lowest tertile of consumption. Amount specific data (per week): < 1: RR = 1. 1-2: RR = 1.10 (0.86-1.42). ≥ 3: RR = 0.85 (0.64-1.14).	HR = 0.63 (0.37-1.08) for the highest vs lowest tertile of consumption. Amount specific data (per week): < 1: RR = 1. 1-2: RR = 0.95 (0.61-1.50). ≥ 3: RR = 0.63 (0.37-1.08).	HR = 0.98 (0.69-1.37) for the highest vs lowest tertile of consumption. Amount specific data (per week): < 1: RR = 1. 1-2: RR = 1.16 (0.85-1.58). ≥ 3: RR = 0.98 (0.69-1.37).

Age and sex.

4) Fraser GE. (1994)

The Adventist Health Study.

26,473 nondiabetic California Seventh-day Adventists.

No data shown.

No data shown.

Coronary events incidence (nonfatal myocardial infarction or definite fatal coronary heart disease)

Beans (not defined)

< 1/wk: Relative Hazard = 1.00.
1-2/wk: Relative Hazard = 1.09.
> or = 3/wk: Relative Hazard = 1.46 (No 95% CI; P = < 0.02).

Proportional hazards analysis.

4) Fraser GE. (1992)

The Adventist Health Study.

31,208 non-Hispanic white California Seventh-Day Adventists.
(USA)

6
(1977-1982)

Definite nonfatal myocardial infarction: 134?

Definite fatal CHD: 260?

Incident coronary death (by death certificate): 463?

CHD

Legumes (beans and peas)


Definite nonfatal myocardial infarction:	Definite fatal CHD:	Fatal CHD determined by death certificate:
RR = 1.16 (0.72-1.85) for the highest vs lowest tertile of consumption. Amount specific data (times/wk): < 1: RR = 1. 1-2: RR = 0.90 (0.58-1.40). ≥ 3: RR = 1.16 (0.72-1.85).	RR = 1.26 (0.90-1.78) for the highest vs lowest tertile of consumption. Amount specific data (times/wk): < 1: RR = 1. 1-2: RR = 1.07 (0.78-1.47). ≥ 3: RR = 1.26 (0.90-1.78).	RR = 1.06 (0.81-1.37) for the highest vs lowest tertile of consumption. Amount specific data (times/wk): < 1: RR = 1. 1-2: RR = 0.98 (0.77-1.24). ≥ 3: RR = 1.06 (0.81-1.37).

Age, sex, smoking, exercise, relative weight, and high blood pressure.

3) Tanaka H (1987)

The Shibata Study.

963 men + 1,338 women aged ≥ 40.
(Japan)

7.5
(1977-1984)

Not defined.

Ischemic heart disease risk
(MI + angina pectoris + sudden death)

Pulses (not defined, but excluding miso)

No significant association was observed: RR = 1.16 (No 95% CI; No P-value) for intake ≥ 2.75 g/kg body weight per day.

Sex and age.

1) Gordon T (1981)

The Puerto Rico Heart Health Program

8,218 men aged 45-64 and free of CHD.

6
(1965-68 to ?)

See variables

CHD incidence

Starch from peas or beans (not defined)


Total CHD (MI, CHD death and angina pectoris) (286? cases)	MI or CHD death (163? cases)	Other CHD (angina pectoris) (123? cases)
Cases consumed the same amount of starch as noncases.	Cases consumed less starch than noncases (P = < 0.01).	Cases consumed the same amount of starch as noncases.

Age, relative weignt, systolic blood pressure, serum cholesterol, cigarettes smoked, alcohol, area of residence, and blood glucose.

1) Garcia-Palmieri MR (1980)

The Puerto Rico Heart Health Program

8,218 men aged 45-64 who were free of CHD at entry.

6
(1965-?)

161?

CHD incidence (MI and CHD death)

starch from beans and peas

A significant inverse relationship was found (no data shown).

Cigarettes, alcohol, systolic blood pressure, serum cholesterol, hematocrit, area of residence, age, and relative weight.

Stroke:

Author

Cohort name

Subjects

Years of follow-up

Cases

End point

Consumption of

Relative Risk (RR)

Adjustments

37) Nagura J (2009)

The JACC Study

25,206 men and 34,279 women aged 40-79, and without a history of CHD, stroke, or cancer.
(Japan)

12.7
(1989-2003)

1,053

Total stroke mortality

Beans (tofu, i.e. soyabean curd, and boiled beans)

HR = 0.95 (0.79-1.16; P = 0.496) for the highest vs lowest quartile of consumption.

Amount specific data (servings per week):
0.8: HR = 1.
1.8: HR = 1.02 (0.85-1.22).
3.0: HR = 1.14 (0.95-1.38).
4.5: HR = 0.95 (0.79-1.16).

The association did not vary by sex (no data shown).


Haemorrhagic stroke: (393 cases)	Ischaemic stroke: (362 cases)
HR = 1.11 (0.80-1.52; P = 0.620) for the highest vs lowest quartile of consumption. Amount specific data (servings per week): 0.8: HR = 1. 1.8: HR = 1.10 (0.82-1.47). 3.0: HR = 1.34 (0.98-1.82). 4.5: HR = 1.11 (0.80-1.52).	HR = 0.92 (0.66-1.26; P = 0.554) for the highest vs lowest quartile of consumption. Amount specific data (servings per week): 0.8: HR = 1. 1.8: HR = 0.95 (0.70-1.29). 3.0: HR = 0.98 (0.71-1.35). 4.5: HR = 0.92 (0.66-1.26).

Sex, age, BMI, smoking status, alcohol intake, hours of walking, hours of sleep, education years, perceived mental stress, cholesterol intake, SFA intake, n-3 fatty acids intake, sodium intake, fruit intake, vegetables intake and histories of hypertension and diabetes.

37) Iso H (2007)

The JACC Study.

41,816 men, and 57,985 women.
(Japan)

Not defined.

1,145 men, and
974 women.

Cerebrovascular mortality

Boiled beans (not defined)


Men:	Women:
HR = 0.84 (0.70-1.00; P = < 0.05) for the highest vs lowest tertile of consumption. Amount specific data: < 1/w: HR = 1. 1-2/w: HR = 1.03 (0.88-1.19). ≥ 3/w: HR = 0.84 (0.70-1.00).	HR = 0.88 (0.74-1.04) for the highest vs lowest tertile of consumption. Amount specific data: < 1/w: HR = 1. 1-2/w: HR = 0.91 (0.77-1.08). ≥ 3/w: HR = 0.88 (0.74-1.04).

Age and study area.

36) Kokubo Y (2007)

The JPHC Study Cohort I

40,462 subjects aged 40-59.
(Japan)

12.5
(1990-92 to 2002)

387 men, and 200 women.

Cerebral infarction risk

Beans (not defined)

**Stratified by sex:**
Men	Women
HR = 1.25 (0.91-1.71; P = 0.856) for the highest vs lowest tertile of consumption. Amount specific data (days per week): 0: HR = 1. 1-2: HR = 0.89 (0.71-1.12). ≥ 3: HR = 1.25 (0.91-1.71).	HR = 0.68 (0.42-1.09; P = 0.055) for the highest vs lowest tertile of consumption. Amount specific data (days per week): 0: HR = 1. 1-2: HR = 0.78 (0.57-1.06). ≥ 3: HR = 0.68 (0.42-1.09).

Age, sex, smoking, alcohol use, BMI, history of hypertension or diabetes mellitus, medication use for hypercholesterolemia, education, sports, dietary intake of fruits, vegetables, fish, salt, and energy, menopausal status for women, and public health center.

16) Ross RK (1997)

No cohort name defined

18,244 men aged 45-64 from Shanghai.
(China)

1986-89 to 1994

245?

Stroke/cerebrovascular accident death

dried beans or peas (broad beans, mung beans, red beans, peas, etc.)

No significant association was found when evaluated either as median levels of daily intake or as tertiles of intake frequencies (No data shown).

Education, marital status, BMI, lifetime cigarette smoking, lifetime ethanol intake, and history of hypertension.

16) Ross RK (1997)

No cohort name defined

18,244 men aged 45-64 from Shanghai.
(China)

1986-89 to 1994

245?

Stroke/cerebrovascular accident death

fresh bean curd (tofu, partially dried tofu, tofu sheet, sugee, etc.)

No significant association was found when evaluated either as median levels of daily intake or as tertiles of intake frequencies (No data shown).

Education, marital status, BMI, lifetime cigarette smoking, lifetime ethanol intake, and history of hypertension.

16) Ross RK (1997)

No cohort name defined

18,244 men aged 45-64 from Shanghai.
(China)

1986-89 to 1994

245?

Stroke/cerebrovascular accident death

fresh green beans or peas (broad beans, peas, etc.)

No significant association was found when evaluated either as median levels of daily intake or as tertiles of intake frequencies (No data shown).

Education, marital status, BMI, lifetime cigarette smoking, lifetime ethanol intake, and history of hypertension.

10) Joshipura KJ (1999)

The Nurses' Health Study
&
The Health Professionals' Follow-Up Study

75,596 women aged 34-59, and 38,683 men aged 40-75.
(USA)

Women: 14
(1980-1994).

Men: 8
(1986-1994).

570?

295 non-users of vitamin supplements, and 216 users of multivitamin supplements.
388 never & past smokers, and 172 current smokers.

Ischemic stroke risk

Legumes (not defined)


Pooled	Women (366? cases)	Men (204? cases)
RR = 1.03 (0.77-1.39) for the highest vs lowest quintile of consumption. Amount specific data (not defined): Q1: RR = 1. Q2: RR = 1.00 (0.73-1.38). Q3: RR = 1.00 (0.75-1.32). Q4: RR = 1.26 (0.98-1.62). Q5: RR = 1.03 (0.77-1.39). RR for an increment of 1 serving/day: 1.09 (0.47-2.51).	RR = 1.16 (0.83-1.63) for the highest vs lowest quintile of consumption. Amount specific data (servings/day): 0.00: RR = 1. Not defined: RR = 1.15 (0.83-1.60). Not defined: RR = 1.01 (0.71-1.44). Not defined: RR = 1.38 (1.02-1.88). 0.43: RR = 1.16 (0.83-1.63). RR for an increment of 1 serving/day: 1.65 (0.81-3.40).	RR = 0.85 (0.54-1.34) for the highest vs lowest quintile of consumption. Amount specific data (servings/day): 0.00: RR = 1. Not defined: RR = 0.83 (0.55-1.25). Not defined: RR = 0.98 (0.62-1.54). Not defined: RR = 1.07 (0.71-1.62). 0.57: RR = 0.85 (0.54-1.34). RR for an increment of 1 serving/day: 0.71 (0.33-1.52).

**Stratified by vitamin supplement use:**
No vitamin supplement	Multivitamin supplement
RR for an increment of 1 serving/day: 1.40 (0.48-4.09).	RR for an increment of 1 serving/day: 0.85 (0.36-1.98).

**Stratified by smoking status:**
Never and past smokers	Current smokers
RR for an increment of 1 serving/day: 1.05 (0.56-1.98).	RR for an increment of 1 serving/day: 1.58 (0.58-4.29).

Age, smoking, alcohol, family history of MI, BMI, vitamin supplement use, vitamin E use, physical activity, aspirin use, time period, hypertension and hypercholesterolemia, total energy intake, and amon women, postmenopausal hormone use.