Intake of legumes and the risk of cardiovascular disease: frailty modeling of a prospective cohort study in the Iranian middle-aged and older population

BACKGROUND/OBJECTIVES: The purpose of this study was to explore the association of legume intake (beans, chickpeas, lentils and so on), as part of a low-glycemic index diet, with the risk of cardiovascular events in the Iranian middle-and old-aged people. SUBJECTS/METHODS: A total of 6504 subjects living in the three counties of Iran participated in the Isfahan Cohort Study. Totally, 6323 were free of cardiovascular disease (CVD) at their baseline examination. Of the 6323 individuals, 5398 participants remained in the study for 7 years of follow-up. They have been contacted every 2 years for possible occurrence of CVD events including fatal and non-fatal myocardial infarction, unstable angina, fatal and non-fatal stroke, and sudden cardiac death. The frequency of legume intake was estimated using a food frequency questionnaire. Cox proportional hazards models with shared gamma frailty terms were used to model time to event outcomes. RESULTS: After a median follow-up of 6.8 years, 427 cardiovascular events occurred. The intake of legumes in different tertiles of consuming measure was associated with 34% lower risk of CVD in old-aged people, after controlling for the other probable confounders (hazard ratio and 95% CI: 0.66 (0.45, 0.98), P-value = 0.039). However, there was no significant association between the frequency of consuming legumes and CVD events in the middle-aged people. CONCLUSIONS: The present study indicated a strong inverse relationship between legume intake and the risk of cardiovascular events in old-aged Iranian people.