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.

Background: The inability to assign a protein content claim (PCC) to plant foods may impede efforts from Canada’s Food Guide to increase consumption of plant protein. A systematic application of PCC frameworks from other regions to Canadian nutrition surveillance data would be useful to model potential effects of PCC regulations on the nutrient intake, protein quality, and corrected protein intake of diets. Methods: Plant food groups that qualified for a PCC within the Canadian Nutrient File according to regulations from Canada, the United States (US), Australia and New Zealand (ANZ), and the European Union (EU) were identified. Adults (≥19 years) (n = 11,817) from The Canadian Community Health Survey (2015) who consumed ≥1 plant food qualifying for a PCC in each region were allocated to the corresponding PCC group. The effects of Canadian PCC regulations on the protein quantity, quality (Digestible Indispensable Amino Acid Score, DIAAS), and nutrient intakes of Canadian diets in adults were compared to PCC groups from other regions. Results: Substantially more individuals were consumers of plant-based protein foods, using the ANZ and the EU PCC regulations, compared to the Canadian and US PCC groups. There were no differences in uncorrected protein intake across PCC groups. All DIAAS values were >0.94, and corrected protein intakes were >74–89 g/day or 16%E across PCC groups. Non-consumers of plant foods eligible for a PCC had corrected protein intakes that ranged between 68 and 78 g/d or 17%E. Generally, consumers of plant foods eligible for a PCC in the US, ANZ, and EU, or both Canada and the US/ANZ/EU, had higher intakes of positive nutrients, such as fibre, calcium, iron, magnesium, and zinc (p < 0.05) and lower saturated fat. Conclusions: Less restrictive regulatory frameworks for PCC used in ANZ and the EU did not substantially affect protein intake or the protein quality of Canadian diets in adults. These results suggest that more inclusive regulatory frameworks for protein PCCs could support increased intake of food sources of plant proteins in alignment with Canada’s Food Guide.

Background: Although dietary pulses are recognized by major clinical practice guidelines to reduce cholesterol and coronary heart disease risk, intake is low. There are no health claims for any pulse for cholesterol reduction, which could support uptake. We therefore conducted a systematic review and dose–response meta‐analysis of randomized trials of the effect of different types of whole dietary pulses on lipid targets. Methods: MEDLINE, Embase, and the Cochrane Library were searched through March 2025 for trials ≥3 weeks. The primary outcome was low‐density lipoprotein‐cholesterol. Secondary outcomes were other lipid targets. Independent reviewers extracted data and assessed risk of bias. Certainty of evidence was assessed using Grading of Recommendations Assessment, Development, and Evaluation. Results: Thirty‐eight trials (52 trial comparisons, n=2095) with a median of 6 weeks and dose of 130 g/d (0.5–0.67 cup/d) showed that whole dietary pulses decreased low‐density lipoprotein‐cholesterol (mean difference, −0.14 mmol/L [95% CI, −0.19 to −0.08]), non‐high‐density lipoprotein‐cholesterol (−0.22 mmol/L [95% CI, −0.30 to −0.14]), apoB (apolipoprotein B) (−0.08 g/L [95% CI, −0.13 to −0.03]) and high‐density lipoprotein‐cholesterol (−0.03 mmol/L [95% CI, −0.05 to −0.01]) with no effects on other lipids. Analyses by pulse type showed similar results. A linear inverse relationship was shown for beans up to 1 cup/d for low‐density lipoprotein‐cholesterol (coefficient, −0.25 mmol/L/0.5 cup [95% CI, −0.48 to −0.02]) and non‐high‐density lipoprotein‐cholesterol (−0.45 mmol/L/0.5 cup [95% CI, −0.71 to −0.18]). Grading of Recommendations Assessment, Development, and Evaluation was moderate‐to‐high for all outcomes, except apoB (very low). Conclusions: Whole dietary pulses likely result in small important‐to‐moderate reductions in lipid targets and trivial reductions in high‐density lipoprotein‐cholesterol. Similar effects were observed across pulse types with an inverse dose–response gradient for beans up to 1 cup/d. Future studies on chickpeas, dried peas, and lentils are warranted. Registration: URL: https://www.crd.york.ac.uk/PROSPERO/view/CRD42023432826 ; Unique identifier: CRD42023432826.