Association of Dietary Intake of Soy, Beans, and Isoflavones With Risk of Cerebral and Myocardial Infarctions in Japanese Populations

Abstract

MD; for the JPHC Study GroupBackground-Soy and isoflavones have been proposed to reduce the risk of cardiovascular risk factors, but their potential as preventatives for cardiovascular disease remains uncertain. We investigated the association of soy and isoflavone intake with risk of cerebral and myocardial infarctions (CI and MI). Methods and Results-To examine the association of soy and isoflavone intake with the risk of CI and MI, we studied 40 462 Japanese (40 to 59 years old, without cardiovascular disease or cancer at baseline). They completed a food-frequency questionnaire (1990 -1992) and received follow-up to 2002. After 503 998 person-years of follow-up, we documented incidence of CI (nϭ587) and MI (nϭ308) and of mortality for CI and MI combined (nϭ232). For women, the multivariable hazard ratios and 95% confidence limits for soy intake Ն5 times per week versus 0 to 2 times per week were 0.64 (0.43 to 0.95) for risk of CI, 0.55 (0.26 to 1.09) for risk of MI, and 0.31 (0.13 to 0.74) for cardiovascular disease mortality. Similar but weaker inverse associations were observed between intake of miso soup and beans and risk of cardiovascular disease mortality. The multivariable hazard ratios for the highest versus the lowest quintiles of isoflavones in women were 0.35 (0.21 to 0.59) for CI, 0.37 (0.14 to 0.98) for MI, and 0.87 (0.29 to 2.52) for cardiovascular disease mortality. An inverse association between isoflavone intake and risk of CI and MI was observed primarily among postmenopausal women. No significant association of dietary intake of soy, miso soup, and beans and isoflavones with CI or MI was present in men. Conclusions-High isoflavone intake was associated with reduced risk of CI and MI in Japanese women. The risk reduction was pronounced for postmenopausal women.

Legume consumption and CVD risk: a systematic review and meta-analysis

“…One possible explanation for the lack of significant results in meta-analyses of studies conducted in Mediterranean countries could be the impact on cardiovascular health of all components of the diet typically consumed in these countries, or at least those included in the individual analyses. (17) Bernstein et al (2010) (23) , F Buckland et al (2009) (20) , M Kelemen et al (2005) (18) , F Kokubo et al (2007) (19) , M Buckland et al (2009) (20) , F Kokubo et al (2007) (19) , F Martinez-Gonzalez et al (2011) (24) Nagura et al (2009) (22) Dilis et al (2012) (25) , F Dilis et al (2012) (25) , M Haring et al (2014) (23) Total ( (19) , M Mizrahi et al (2009) (21) Misirili et al (2012) (27) Haring et al (2015) (29) Total ( (24) Bazzano et al (2001) (17) Kokubo et al (2007) (19) , F Kokubo et al (2007) (19) , M Nouri et al (2016) (30) Nagura et al (2009) (22) Total ( The study-specific RR and 95 % CI are represented by the black square and horizontal line, respectively; the area of the black square is proportional ...…”

“…Legume consumption and CHD risk The analysis relative to CHD risk related to consumption of legumes comprised twelve data sets derived from eight studies (17)(18)(19)(20)23,24,25,28) . Comparison of the highest v. the lowest legume consumption category showed a similar risk estimate to the previous analysis considering CVD as outcome (RR = 0·90; 95 % CI 0·84, 0·97; Fig.…”

“…Legume consumption and stroke risk Six studies (19,21,22,26,27,29) comprising eight data sets were considered for the analysis on the highest v. lowest level of dietary legume intake and stroke risk. The pooled analysis showed null results with no substantial risk increment or reduction for higher consumption of legumes (RR = 1·01; 95 % CI 0·89, 1·14).…”

“…However, the association was not significant when analyses included men only, when studies were conducted in non-Mediterranean countries and after controlling for dietary variables (Table 2). A second analysis was conducted including only studies that specifically considered CVD as the outcome (17,19,22,24,30) . Overall, a decreased risk of 10 % (RR = 0·90; 95 % CI 0·84, 0·97; Fig.…”

“…Exclusion of one study at the time did not change the strength of the association. Subgroup analyses demonstrated stability of results across strata considered, showing a significant decreased risk of CHD by high consumption of legumes in all subgroups with the exception of pooled analysis of studies conducted in the Mediterranean region.Legume consumption and stroke risk Six studies (19,21,22,26,27,29) comprising eight data sets were considered for the analysis on the highest v. lowest level of dietary legume intake and stroke risk. The pooled analysis showed null results with no substantial risk increment or reduction for higher consumption of legumes (RR = 1·01; 95 % CI 0·89, 1·14).…”