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



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


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.


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).


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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The authors thank all study participants.


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).

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Authors and Affiliations



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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The authors declare that they have no conflict of interest.

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All the participants provided consent to publish their data.

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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).

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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).

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