Legumes (pulses) and all-cause mortality/survival.

Use of data from The EPIC Study: 6 publications were found about The EPIC Study (21). Publications included data about the same population with different length of follow-up (Trichopoulou A. 2003 vs Trichopoulou A. 2009). Obviously, the publication including longer length of follow-up was included.
The EPIC-Elderly study provided data about 74,607 elderly (aged ≥ 60) subjects - with or whithout diabetes - from 9 countries (including Greece & Spain), and including 4,047 deaths (Trichopoulou A. 2005b). But 3 other publications provided information about subgroups of this cohort from which the data partly overlapped with data from The EPIC-Elderly Study:

  • Agudo A (2007) 41.358 subjects aged 30-69 from EPIC-Spain, including 562 deaths.
  • Nöthlings U (2008) 10.449 subjects aged 35-70 with diabetes from 10 countries, and including 1,346 deaths.
  • Trichopoulou A (2009) 23,349 subjects aged 20-86 from EPIC-Greece, including 1,075 deaths.

The latter 3 publications were included in the systematic review, excluding data from The EPIC-Elderly Study. These 3 subcohorts included less deaths than the former subcohort (2,983 vs 4,047). But they all provided RR's as a categorized variable, allowing for analysis about effects at different levels of consumption, and for more precise analysis of the effect size. Whereas The EPIC-Elderly Study provided RR's as a continuous variable.
Also, a 4th publication about this cohort was included: Trichopoulou A (2005a) provided data about subjects from EPIC-Greece with CHD only, whereas he provided data about subjects from EPIC-Greece without CHD only in a later publication (Trichopoulou A. 2009).

Results: Data about legumes was provided by 11 cohorts. Significant protective effects were found in 3 cohorts (Nöthlings U [21], Darmadi-Blackberry I [27], Iso H [32]), though in the last cohort the effect was significant among women only. On the contrary, A nonsignificantly increased risk of mortality was found in one cohort (30).
Conclusion: Few and inconsistent associations were found. Inconclusive evidence was found for an association between legumes and mortality.