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Association of soy food with cardiovascular outcomes and all-cause mortality in a Chinese population: a nationwide prospective cohort study

European Journal of Nutrition volume 61, pages 1609–1620 (2022)Cite this article

Abstract

Purpose

This study aimed to clarify the association of soy intake with cardiovascular disease (CVD) and all-cause mortality.

Methods

We conducted a prospective cohort study in a Chinese population composed of 97,930 participants aged ≥ 40 years old without CVD at baseline in 2011. Habitual soy intake over a period of 12 months was evaluated using a food frequency questionnaire. All participants were classified into four groups based on their soy food consumption levels: < 15, 15–29, 30–59, and ≥ 60 g/day, with the lowest category as the reference group. Follow-up was conducted between 2014 and 2016 to assess CVD incidence and all-cause mortality since baseline, which was collected from the local mortality and disease registers of the National Disease Surveillance Point System and National Health Insurance System. The Cox proportional hazards regression models were used to analyze the relationship of soy intake with later CVD events and all-cause mortality.

Results

During 350,604 person-years of follow-up (median [interquartile range]: 3.16 [2.98, 4.77] years), 2523 total CVD events and 1473 all-cause mortalities were documented. After controlling for covariates, the hazard ratios (95% confidence intervals) for total CVD events across increasing soy intake levels were 1.03 (0.93–1.14); 0.96 (0.86–1.07); and 0.86 (0.75–0.98; p for trend = 0.0434), while those for all-cause mortality were 0.88 (0.77–1.02); 0.86 (0.74–1.00); and 0.83 (0.69–0.99; p for trend = 0.0084).

Conclusion

High soy intake was associated with a reduced risk of total CVD events and all-cause mortality among a Chinese population.

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Availability of data and material

Data underlying this article were provided by Ruijin Hospital, Shanghai Jiaotong University. Data are available upon request from the corresponding author, with permission from Ruijin Hospital, Shanghai Jiaotong University.

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Acknowledgements

The authors thank all study participants.

Funding

This research was funded by the Ministry of Science and Technology of the People’s Republic of China (Grant Numbers: 2016YFC0901203, 2016YFC1305600, 2016YFC1305202, 2016YFC1304904, 2017YFC1310700, 2018YFC1311705, and 2018YFC1311800), the Chinese Medical Association Foundation and Chinese Endocrine Society (Grant Number: 12020240314), Chinese Academy of Medical Sciences (Grant No. 2018PT32017, 2019PT330006) Shanghai Medical and Health Development Foundation (Grant No. DMRFP_I_01), Clinical Research Plan of SHDC (Grant No. SHDC2020CR3064B), and Science and Technology Committee of Shanghai (Grant No. 19411964200 and 20Y11905100), the National Key New Drug Creation and Manufacturing Program of the Ministry of Science and Technology (Grant Number: 2012ZX09303006-001), and Startup Fund for Scientific Research of Fujian Medical University (Grant No. 2017XQ1138).

Author information

Author notes

  1. Ting Xue and Junping Wen contributed equally to this work.

Authors and Affiliations

  1. Center of Health Management, Fujian Provincial Hospital South Branch, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China

    Ting Xue

  2. Department of Endocrinology, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China

    Junping Wen & Gang Chen

  3. The Affiliated Hospital of Luzhou Medical College, Luzhou, China

    Qin Wan

  4. The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China

    Guijun Qin

  5. Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China

    Li Yan

  6. The First Hospital of Jilin University, Changchun, China

    Guixia Wang

  7. The First Affiliated Hospital of Guangxi Medical University, Nanning, China

    Yingfen Qin & Zuojie Luo

  8. The First Hospital of Lanzhou University, Lanzhou, China

    Xulei Tang

  9. Jiangxi Provincial People’s Hospital Affiliated to Nanchang University, Nanchang, China

    Yanan Huo

  10. Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China

    Ruying Hu & Zhen Ye

  11. Affiliated Hospital of Guiyang Medical College, Guiyang, China

    Lixin Shi

  12. Dalian Municipal Central Hospital, Dalian, China

    Zhengnan Gao

  13. Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China

    Qing Su

  14. Chinese People’s Liberation Army General Hospital, Beijing, China

    Yiming Mu

  15. Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China

    Jiajun Zhao

  16. Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

    Lulu Chen & Tianshu Zeng

  17. Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

    Xuefeng Yu

  18. The Second Affiliated Hospital of Harbin Medical University, Harbin, China

    Qiang Li

  19. The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China

    Feixia Shen

  20. Qilu Hospital of Shandong University, Jinan, China

    Li Chen

  21. Central Hospital of Shanghai Jiading District, Shanghai, China

    Yinfei Zhang

  22. The First Affiliated Hospital of Anhui Medical University, Hefei, China

    Youmin Wang

  23. The First Affiliated Hospital of Chongqing Medical University, Chongqing, China

    Huacong Deng

  24. Jiangsu Province Hospital on Integration of Chinese and Western Medicine, Nanjing, China

    Chao Liu

  25. Karamay Municipal People’s Hospital, Xinjiang, China

    Shengli Wu

  26. The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

    Tao Yang

  27. Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

    Mian Li, Yu Xu, Min Xu, Tiange Wang, Zhiyun Zhao, Jieli Lu, Yufang Bi, Weiqing Wang & Guang Ning

  28. Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

    Mian Li, Yu Xu, Min Xu, Tiange Wang, Zhiyun Zhao, Jieli Lu, Yufang Bi, Weiqing Wang & Guang Ning

Authors
  1. Ting Xue
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  2. Junping Wen
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  3. Qin Wan
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  4. Guijun Qin
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  5. Li Yan
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  10. Yanan Huo
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  11. Ruying Hu
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  31. Yu Xu
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  32. Min Xu
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  33. Tiange Wang
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  34. Zhiyun Zhao
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  35. Jieli Lu
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  36. Yufang Bi
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  37. Weiqing Wang
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  38. Gang Chen
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  39. Guang Ning
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Contributions

GN, WW, GC, and JL designed the study; JW, QW, GQ, LY, GW, YQ, ZL, XT, YH, RH, ZY, LS, ZG, QS, YM, JZ, LuC, TZ, XY, QL, FS, LiC, YZ, YW, HD, CL, SW, TY, ML, YX, MX, TW, ZZ, JL, and YB conducted the research; JL and TX analyzed the data; TX wrote the first draft of the manuscript; GC, JW, and JL revised the manuscript; GC assumed primary responsibility for the final content; GN, WW, and JL are the guarantors of this work and, as such, had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. All the authors have read and approved the final version.

Corresponding author

Correspondence to Gang Chen.

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Conflict of interest

The authors declare that they have no conflict of interest.

Consent for Publication

All the participants provided consent to publish their data.

Consent to participate

All the participants provided written informed consent.

Ethics approval

The present study was approved by the Medical Ethics Committee of Ruijin Hospital, Shanghai Jiaotong University (approval number: 2011-14).

Supplementary Information

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Xue, T., Wen, J., Wan, Q. et al. Association of soy food with cardiovascular outcomes and all-cause mortality in a Chinese population: a nationwide prospective cohort study. Eur J Nutr 61, 1609–1620 (2022). https://doi.org/10.1007/s00394-021-02724-8

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Keywords

  • Soy
  • Cardiovascular disease
  • Myocardial infarction
  • Cerebral infarction
  • Heart failure
  • All-cause mortality