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Consumption of soy products and cardiovascular mortality in people with and without cardiovascular disease: a prospective cohort study of 0.5 million individuals

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Abstract

Purpose

We sought to examine the association of soy product consumption with risk of cardiovascular death in Chinese individuals with and without a history of cardiovascular disease (CVD).

Methods

The current analysis included 487,034 individuals free of CVD and 22,923 individuals with a history of CVD at study baseline. Data on consumption of soy products were collected by a food frequency questionnaire. The Cox regression was used to obtain the hazard ratios (HRs) of cardiovascular mortality associated with soy product consumption among people with and without a history of CVD at baseline.

Results

During the period of follow-up, 12,582 and 2860 cardiovascular deaths were recorded among people without and with a history of CVD. Compared with those who never or rarely ate soy products, the multivariable HRs (95% CIs) were 1.02 (0.96, 1.08) for those who ate soy products monthly, 1.01 (0.95, 1.07) for those who ate soy products 1–3 days per week, 0.95 (0.88, 1.04) for those who ate soy products ≥ 4 days per week. For cause-specific mortality, soy product consumption was inversely associated with mortality from acute myocardial infarction (HR [95% CI] = 0.75 [0.61, 0.92]). Among people with a history of CVD, higher soy product consumption was not associated with cardiovascular mortality.

Conclusions

Soy consumption ≥ 4 days per week was associated with a significantly lower risk of mortality from acute myocardial infarction in comparison with never or rarely consumption among people without a history of CVD. Among people with a history of CVD, higher soy product consumption was not associated with cardiovascular mortality.

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Abbreviations

AMI:

Acute myocardial infarction

CHD:

Coronary heart disease

CI:

Confidence interval

CKB:

China Kadoorie Biobank

CVD:

Cardiovascular disease

HR:

Hazard ratio

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Acknowledgements

Data were obtained from CKB Data Access System (www.ckbiobank.org, DAR-2019-00016). We thank all the participants in the study, the members of the survey teams in the ten regional centers of China, as well as to the project development and management teams based at Beijing, Oxford, and the ten regional centers. The members of the China Kadoorie Biobank are as follows: International Steering Committee: Junshi Chen, Zhengming Chen (principal investigator), Rory Collins, Liming Li (principal investigator), Richard Peto. Inter- national Co-ordinating Centre, Oxford: Daniel Avery, Derrick Bennett, Yumei Chang, Yip- ing Chen, Zhengming Chen, Robert Clarke, Huaidong Du, Xuejuan Fan, Haiyan Gao, Simon Gilbert, Michael Holmes, Andri Iona, Rene Kerosi, Ling Kong, Om Kurmi, Garry Lancaster, Sarah Lewington, John McDonnell, Winnie Mei, Iona Millwood, Qunhua Nie, Jayakrishnan Radhakrishnan, Paul Ryder, Sam Sansome, Dan Schmidt, Paul Sherliker, Rajani Sohoni, Robin Walters, Jenny Wang, Lin Wang, Alex Williams, Ling Yang, Xiaoming Yang. National Co-ordinating Centre, Beijing: Zheng Bian, Ge Chen, Lei Guo, Yu Guo, Bingyang Han, Can Hou, Peng Liu, Jun Lv, Pei Pei, Shuzhen Qu, Yunlong Tan, Canqing Yu, Huiyan Zhou. Regional Co-ordinating Centres (in bold) and local Centers for Disease Control and Pre- vention (CDCs): Qingdao CDC: Zengchang Pang, Shutao Pang, Shaojie Wang, Yongmei Liu, Ranran Du, Yajing Zang, Liang Cheng. Licang CDC: Silu Lv, Junzheng Wang, Wei Hou. Hei- longjiang CDC: Jiyuan Yin, Shumei Liu, Zhigang Pang, Xue Zhou, Huijun Wang. Nangang CDC: Liqiu Yang, Bo Yu, Yanjie Li, Jing Qi, Huaiyi Mu, Qin’ai Xu, Meiling Dou. Hainan CDC: Jianwei Du, Shanqing Wang, Ximin Hu, Hongmei Wang, Jinyan Chen, Yan Fu, Zhenwang Fu, Xiaohuan Wang, Hua Dong. Meilan CDC: Min Weng, Xiangyang Zheng, Yijun Li, Huimei Li. Jiangsu CDC: Ming Wu, Jinyi Zhou, Ran Tao, Jie Yang. Suzhou CDC: Jie Shen, Yihe Hu, Yan Lu, Yan Gao, Liangcai Ma, Aiyu Tang, Shuo Zhang, Jianrong Jin. Guangxi CDC: Zhenzhu Tang, Naying Chen, Ying Huang. Liuzhou CDC: Mingqiang Li, Jinhuai Meng, Rong Pan, Qilian Jiang, Jingxin Qin, Weiyuan Zhang, Yun Liu, Liuping Wei, Liyuan Zhou, Ningyu Chen, Jun Yang, Hairong Guan. Sichuan CDC: Xianping Wu, Ningmei Zhang, Xiao- fang Chen, Xuefeng Tang. Pengzhou CDC: Guojin Luo, Jianguo Li, Xiaofang Chen, Jian Wang, Jiaqiu Liu, Qiang Sun. Gansu CDC: Pengfei Ge, Xiaolan Ren, Caixia Dong. Maiji CDC: Hui Zhang, Enke Mao, Xiaoping Wang, Tao Wang. Henan CDC: Guohua Liu, Baoyu Zhu, Gang Zhou, Shixian Feng, Liang Chang, Lei Fan. Huixian CDC: Yulian Gao, Tianyou He, Li Jiang, Huarong Sun, Pan He, Chen Hu, Qiannan Lv, Xukui Zhang. Zhejiang CDC: Min Yu, Ruying Hu, Le Fang, Hao Wang. Tongxiang CDC: Yijian Qian, Chunmei Wang, Kaixue Xie, Lingli Chen, Yaxing Pan, Dongxia Pan. Hunan CDC: Yuelong Huang, Biyun Chen, Donghui Jin, Huilin Liu, Zhongxi Fu, Qiaohua Xu. Liuyang CDC: Xin Xu, Youping Xiong, Weifang Jia, Xianzhi Li, Libo Zhang, Zhe Qiu.

Funding

The Chinese Kadoorie Biobank study has received funding from the British Heart Foundation, Cancer Research UK, Chinese Ministry of Science and Technology, Chinese National Natural Science Foundation, the Kadoorie Charitable Foundation in Hong Kong, Medical Research Council UK and the Wellcome Trust. This work was funded by the Fuji Foundation for Protein Research to J.-Y. D.

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Authors and Affiliations

  1. Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, 100191, China

    Xiaowen Wang, Canqing Yu, Jun Lv, Liming Li & Yonghua Hu

  2. Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, 5650871, Japan

    Xiaowen Wang, Keyang Liu, Kokoro Shirai, Hiroyasu Iso & Jia-Yi Dong

Authors
  1. Xiaowen Wang
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  2. Canqing Yu
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  3. Jun Lv
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  4. Liming Li
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  5. Yonghua Hu
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  9. Jia-Yi Dong
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Contributions

X.W. and J-Y. D. designed the study, analyzed the data, and wrote the manuscript. All authors conducted the technique review and reviewed and edited the manuscript. J-Y. D. is the guarantor of this work and, as such, had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

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Correspondence to Jia-Yi Dong.

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Wang, X., Yu, C., Lv, J. et al. Consumption of soy products and cardiovascular mortality in people with and without cardiovascular disease: a prospective cohort study of 0.5 million individuals. Eur J Nutr 60, 4429–4438 (2021). https://doi.org/10.1007/s00394-021-02602-3

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