Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Am J Clin Nutr. 2023 Jan;117(1):130-140. doi: 10.1016/j.ajcnut.2022.10.019. Epub 2022 Dec 20.
Evidence regarding dietary phytoestrogens in relation to mortality remains limited.
The objective of the study is to examine the associations of intake of isoflavones, lignans, and coumarins with total and cause-specific mortality in US males and females.
We followed 75,981 females in the Nurses' Health Study (1984-2018) and 44,001 males in the Health Professionals Follow-up Study (1986-2018), who were free of cardiovascular disease (CVD), diabetes, or cancer at baseline. Their diet was repeatedly assessed using validated food frequency questionnaires every 2-4 y. Associations with mortality were assessed using time-dependent Cox models with adjustments for demographics, dietary and lifestyle factors, and medical history.
During 3,427,156 person-years of follow-up, we documented 50,734 deaths, including 12,492 CVD deaths, 13,726 cancer deaths, and 24,516 other non-CVD and noncancer deaths. After multivariable adjustment, the higher total phytoestrogen intake was associated with lower risk of total CVD and other non-CVD and noncancer mortality: comparing extreme quintiles, the pooled HRs (95% CIs) were 0.89 (0.87, 0.92), 0.90 (0.85, 0.96), and 0.86 (0.82, 0.90), respectively. We did not find a significant association with cancer mortality [0.97 (0.92, 1.03)]. For individual phytoestrogens in relation to total mortality, the pooled HRs (95% CIs) comparing extreme quintiles were 0.90 (0.87, 0.92) for isoflavones, 0.93 (0.90, 0.96) for lignans, and 0.93 (0.90, 0.95) for coumarins. Individual phytoestrogens were also significantly associated with lower risk of CVD mortality and other types of mortality. Primary food sources of phytoestrogens, including tofu, soy milk, whole grains, tea, and flaxseed, were also inversely associated with total mortality.
A higher intake of total phytoestrogens, including isoflavones, lignans, and coumarins, and foods rich in these compounds was associated with lower risk of total and certain cause-specific mortality in generally healthy US adults. These data suggest that these phytochemicals and their dietary sources may be integrated into an overall healthy diet to achieve a longer life span.
有关饮食植物雌激素与死亡率的证据仍然有限。
本研究旨在探讨大豆异黄酮、木脂素和香豆素的摄入量与美国男性和女性总死亡率和死因特异性死亡率的关系。
我们随访了 75981 名参加护士健康研究（1984-2018 年）的女性和 44001 名参加健康专业人员随访研究（1986-2018 年）的男性，他们在基线时没有心血管疾病（CVD）、糖尿病或癌症。他们的饮食使用经过验证的食物频率问卷每隔 2-4 年进行重复评估。使用时间依赖性 Cox 模型评估死亡率与死亡率的相关性，模型调整了人口统计学、饮食和生活方式因素以及病史。
在 3427156 人年的随访期间，我们记录了 50734 例死亡，包括 12492 例 CVD 死亡、13726 例癌症死亡和 24516 例其他非 CVD 和非癌症死亡。经过多变量调整后，较高的总植物雌激素摄入量与总 CVD 和其他非 CVD 和非癌症死亡率降低相关：比较极端五分位数，汇总 HR（95%CI）分别为 0.89（0.87，0.92）、0.90（0.85，0.96）和 0.86（0.82，0.90）。我们没有发现与癌症死亡率的显著关联[0.97（0.92，1.03）]。对于与总死亡率相关的个别植物雌激素，比较极端五分位数的汇总 HR（95%CI）分别为 0.90（0.87，0.92）的大豆异黄酮、0.93（0.90，0.96）的木脂素和 0.93（0.90，0.95）的香豆素。个别植物雌激素也与 CVD 死亡率和其他类型死亡率降低显著相关。植物雌激素的主要食物来源，包括豆腐、豆浆、全谷物、茶和亚麻籽，也与总死亡率呈负相关。
在一般健康的美国成年人中，较高的总植物雌激素摄入量，包括大豆异黄酮、木脂素和香豆素，以及富含这些化合物的食物与总死亡率和某些特定原因死亡率的降低相关。这些数据表明，这些植物化学物质及其饮食来源可以纳入整体健康饮食中，以延长寿命。
