The longitudinal association between soybean and non-soybean legumes intakes and risk of cardiovascular disease: Isfahan cohort study

Abstract

PurposeThe associations between legume consumption and cardiovascular events (CVEs) have extensively been studied. However, there are few studies that considered longitudinal association between legume consumption (with repeated measurements across time) and CVEs in low-income countries where legume consumption is lower than the Western countries. The authors aimed to investigate the long-term longitudinal relationship between soybean, non-soybean and overall legume consumption and CVEs using repeated measures of legumes and time-varying confounders in a cohort study of the general population.Design/methodology/approachThe current study was performed within the framework of the Isfahan cohort study among 5,432 healthy participants. The participants were followed-up for fatal and non-fatal myocardial infarction, unstable angina, fatal and non-fatal stroke and sudden cardiac death for 13 years. Dietary intake was evaluated using a validated food frequency questionnaire in 2001, 2007 and 2013. The hazard ratios (HRs) and 95% confidence intervals (CI) for CVEs between categories of soybean, non-soybean and overall legumes intake were examined using marginal Cox's regression analysis.FindingsLong-term consumptions of overall legumes more than three times per week and non-soybean three times or more per week compared with those who had less than once a week were associated with 19.5% (HR = 0.805, 95% CI: 0.650,0.998; p < 0.048) and a 18.5% (HR = 0.815, 95% CI: 0.673, 0.988; p < 0.037) lower risk of CVEs in the general population, respectively. However, our findings revealed no significant reduction in CVEs following a higher intake of soybeans.Originality/valueIn the long run, even modest consumption of legumes, but not soybeans alone, can be effective to reduce CVEs risk in a low-income population. Further studies are warranted to confirm our results in other populations, examine the associations by the type of cardiovascular events and determine any possible threshold effects in this regard.

Legume consumption in adults and risk of cardiovascular disease and type 2 diabetes: a systematic review and meta-analysis

“…Five individual observational studies (four regarded with moderate and one with serious RoB) reported significant associations between legume intake and CVD outcomes in fully adjusted models (see Supplementary Table 3). Four reported inverse associations: two between total legume intake and CVD incidence ( 40 , 49 ), one between total legume intake and ischemic stroke (but not total stroke) ( 47 ) and one between soybean intake and CVD mortality ( 48 ). On the other hand, a prospective analysis from the PREDIMED trial reported an association between total legume intake and higher CVD mortality ( 50 ).…”

Soy Consumption and the Risk of Type 2 Diabetes and Cardiovascular Diseases: A Systematic Review and Meta-Analysis

“…This study included 45 articles by screening the titles and abstracts and sixteen articles were further excluded based on the inclusion and exclusion criteria ( Table S2 in online supplementary materials ). Finally, we identified 9 articles that were related to T2D [ 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 ] and 20 articles involving CVDs [ 12 , 13 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 ]. All the studies were published between 2001 and 2021.…”

“… The pooled risk association of CVDs with soy consumption. In the forest plot, the black point represents the point estimate of the effect size of each study, the gray square means the weight of each study, the line length represents the 95% CI of the effect size of each study, the diamond represents the meta-analysis synthesizes the summary results of each study, the diamond center represents the point estimate of the effect size of the summary results, and the diamond width represents the 95% CI of the effect size of the summary results [ 12 , 13 , 14 , 39 , 41 , 42 , 43 , 44 , 46 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 ]. …”

Long-Term Consumption of 10 Food Groups and Cardiovascular Mortality: A Systematic Review and Dose Response Meta-Analysis of Prospective Cohort Studies

“…After a full-text review, a total of 22 studies were included for data extraction based on the review eligibility criteria. Among the included studies, three studies reported consumption of grains [ [16] , [17] , [18] ] ( Supplemental Table 1 ), six studies for red/processed meat and eggs [ [19] , [20] , [21] , [22] , [23] , [24] ] (five red meat, one egg) ( Supplemental Table 2 ), four dairy product studies [ [25] , [26] , [27] , [28] ] ( Supplemental Table 3 ), three nut consumption studies [ [29] , [30] , [31] ] ( Supplemental Table 4 ), three legume studies [ [32] , [33] , [34] ] ( Supplemental Table 5 ), two fruit, [ 35 , 36 ], and one vegetable study [ 37 ] ( Supplemental Table 6 ). There were no studies for the food groups of fish/seafood and poultry based on our inclusion criteria of repeated measurements.…”

“…The characteristics of the included studies are shown in Supplemental Tables 1–6 . Ten studies were conducted in the United States [ 17 , 18 , [20] , [21] , [22] , 26 , [28] , [29] , [30] , [31] ], three in Australia [ 27 , 36 , 37 ], three in Japan [ 16 , 24 , 32 ], two in Sweden [ 19 , 25 ], one in United Kingdom [ 23 ], one in China [ 35 ], one in Spain [ 33 ], and one in Iran [ 34 ]. The length of follow-up ranged from 6 to 34 yr. Eighteen studies included both males and females (of these, only 38% reported sex-specific results), whereas three had only females and one had only male study participants.…”