Saw Swee Hock School of Public Health and.
Saw Swee Hock School of Public Health and Duke-NUS Graduate Medical School, Singapore.
J Nutr. 2014 Jun;144(6):921-8. doi: 10.3945/jn.114.190454. Epub 2014 Apr 3.
Although soy food has been recommended because of its presumed cardiovascular benefits, the long-term prospective association between habitual soy food intake and cardiovascular disease mortality remains unclear. This study aimed to evaluate the relation of soy protein and isoflavone intake with the risk of cardiovascular disease mortality in middle-aged and older Chinese adults residing in Singapore. The Singapore Chinese Health Study is a population-based study that recruited 63,257 Chinese adults aged 45-74 y from 1993 to 1998. Usual diet was measured at recruitment by using a validated semiquantitative food-frequency questionnaire, and mortality information was identified via registry linkage until 31 December 2011. Cox proportional hazards models were used to calculate HRs, with adjustment for potential confounders. The median intake was 5.2 g/d for soy protein, 15.8 mg/d for soy isoflavones, and 87.4 g/d for soy expressed as tofu equivalents. We documented 4780 cardiovascular deaths during 890,473 person-years of follow-up. After adjustment for sociodemographic, lifestyle, and other dietary factors, soy protein intake was not significantly associated with cardiovascular disease mortality: HRs (95% CIs) were 1.00 (reference), 1.02 (0.94, 1.11), 1.02 (0.93, 1.11), and 1.06 (0.97, 1.17) for increasing quartiles of soy protein (P-trend = 0.24). Similarly, no significant association was observed for soy isoflavones and total tofu equivalents and when deaths from coronary heart disease (n = 2697) and stroke (n = 1298) were considered separately. When stratified by sex, HRs for cardiovascular disease mortality across quartiles of soy protein were 1.00, 1.00, 1.05, and 1.16 (95% CI: 1.03, 1.31) in men (P-trend = 0.02) and 1.00, 1.01, 0.96, and 0.95 (95% CI: 0.81, 1.10) in women (P-trend = 0.31), although the interaction was not significant (P-interaction = 0.12). In conclusion, soy intake was not significantly associated with risk of cardiovascular disease mortality in the Chinese population. However, a slightly increased risk associated with high soy protein intake in men cannot be excluded and requires further investigation.
虽然大豆食品因其潜在的心血管益处而被推荐，但习惯性摄入大豆食品与心血管疾病死亡率之间的长期前瞻性关联仍不清楚。本研究旨在评估中年和老年居住在新加坡的中国人中，大豆蛋白和异黄酮的摄入量与心血管疾病死亡率风险之间的关系。新加坡华人健康研究是一项基于人群的研究，于 1993 年至 1998 年期间招募了 63257 名年龄在 45-74 岁的中国成年人。通过使用经过验证的半定量食物频率问卷在招募时测量通常的饮食，并且通过登记链接确定截至 2011 年 12 月 31 日的死亡率信息。使用 Cox 比例风险模型计算 HRs，并进行潜在混杂因素的调整。中位摄入量为大豆蛋白 5.2g/d，大豆异黄酮 15.8mg/d，豆腐当量表示的大豆 87.4g/d。在 890473 人年的随访期间，我们记录了 4780 例心血管死亡。在校正社会人口统计学、生活方式和其他饮食因素后，大豆蛋白摄入量与心血管疾病死亡率无显著相关性：HRs（95%CI）分别为 1.00（参考）、1.02（0.94，1.11）、1.02（0.93，1.11）和 1.06（0.97，1.17），递增四分位大豆蛋白（P 趋势=0.24）。同样，当分别考虑冠心病（n=2697）和中风（n=1298）死亡时，观察到大豆异黄酮和总豆腐当量之间也没有显著关联。按性别分层时，男性中按四分位大豆蛋白划分的心血管疾病死亡率 HRs 分别为 1.00、1.00、1.05 和 1.16（95%CI：1.03，1.31）（P 趋势=0.02），而女性分别为 1.00、1.01、0.96 和 0.95（95%CI：0.81，1.10）（P 趋势=0.31），尽管交互作用不显著（P 交互=0.12）。总之，大豆摄入量与中国人心血管疾病死亡率风险无显著相关性。然而，不能排除男性中与高大豆蛋白摄入量相关的风险略有增加，需要进一步研究。
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