Soy food consumption is associated with lower risk of coronary heart disease in Chinese women.

Soy food intake has been shown to have beneficial effects on cardiovascular disease risk factors. Data directly linking soy food intake to clinical outcomes of cardiovascular disease, however, are sparse. We examined the relationship between soy food intake and incidence of coronary heart disease (CHD) among participants in the Shanghai Women's Health Study, a population-based prospective cohort study of approximately 75000 Chinese women aged 40-70 y at the baseline survey that was conducted from 1997 to 2000. Included in this study were 64915 women without previously diagnosed CHD, stroke, cancer and diabetes at baseline. Information on usual intake of soy foods was obtained at baseline through an in-person interview using a validated food-frequency questionnaire. Cohort members were followed biennially through in-person interviews. After a mean of 2.5 y (162277 person-years) of follow-up, 62 incident cases of CHD (43 nonfatal myocardial infarctions and 19 CHD deaths) were documented. There was a clear monotonic dose-response relationship between soy food intake and risk of total CHD (P for trend = 0.003) with an adjusted relative risk (RR) of 0.25 (95% CI, 0.10-0.63) observed for women in the highest vs. the lowest quartile of total soy protein intake. The inverse association was more pronounced for nonfatal myocardial infarction (RR = 0.14; 95% CI, 0.04-0.48 for the highest vs. the lowest quartile of intake; P for trend = 0.001). This study provides, for the first time, direct evidence that soy food consumption may reduce the risk of CHD in women.

[1]  C. Nagata,et al.  Soy and fish oil intake and mortality in a Japanese community. , 2002, American journal of epidemiology.

[2]  D. Grobbee,et al.  Higher Usual Dietary Intake of Phytoestrogens Is Associated With Lower Aortic Stiffness in Postmenopausal Women , 2002, Arteriosclerosis, thrombosis, and vascular biology.

[3]  R. Garay,et al.  Soy milk lowers blood pressure in men and women with mild to moderate essential hypertension. , 2002, The Journal of nutrition.

[4]  T. Clarkson Soy, soy phytoestrogens and cardiovascular disease. , 2002, The Journal of nutrition.

[5]  P. Wilson,et al.  Dietary intake of phytoestrogens is associated with a favorable metabolic cardiovascular risk profile in postmenopausal U.S.women: the Framingham study. , 2002, The Journal of nutrition.

[6]  K. Setchell,et al.  Dietary inclusion of whole soy foods results in significant reductions in clinical risk factors for osteoporosis and cardiovascular disease in normal postmenopausal women , 2001, Menopause.

[7]  G. Burke,et al.  Soy protein isoflavones, lipids and arterial disease , 2001, Current opinion in lipidology.

[8]  H. Teede,et al.  Dietary soy has both beneficial and potentially adverse cardiovascular effects: a placebo-controlled study in men and postmenopausal women. , 2001, The Journal of clinical endocrinology and metabolism.

[9]  D. Kritz-Silverstein,et al.  Usual dietary isoflavone intake is associated with cardiovascular disease risk factors in postmenopausal women. , 2001, The Journal of nutrition.

[10]  A. Duncan,et al.  Soy isoflavones improve plasma lipids in normocholesterolemic and mildly hypercholesterolemic postmenopausal women. , 2001, The American journal of clinical nutrition.

[11]  T. Sanders,et al.  The Phytoestrogen Genistein Produces Acute Nitric Oxide–Dependent Dilation of Human Forearm Vasculature With Similar Potency to 17&bgr;-Estradiol , 2001, Circulation.

[12]  J. Erdman AHA Science Advisory: Soy protein and cardiovascular disease: A statement for healthcare professionals from the Nutrition Committee of the AHA. , 2000, Circulation.

[13]  V. Fulgoni,et al.  Effect of soy-based breakfast cereal on blood lipids and oxidized low-density lipoprotein. , 2000, Metabolism: clinical and experimental.

[14]  T. Sanders,et al.  Isoflavone phytoestrogens consumed in soy decrease F(2)-isoprostane concentrations and increase resistance of low-density lipoprotein to oxidation in humans. , 2000, The American journal of clinical nutrition.

[15]  A. Oto,et al.  Soy protein diet significantly improves endothelial function and lipid parameters , 2000, Clinical cardiology.

[16]  H. Adlercreutz,et al.  Dietary soy-derived isoflavone phytoestrogens. Could they have a role in coronary heart disease prevention? , 2000, Biochemical pharmacology.

[17]  A. Duncan,et al.  Soy isoflavones improve plasma lipids in normocholesterolemic, premenopausal women. , 2000, The American journal of clinical nutrition.

[18]  J. Cooke,et al.  Phytoestrogens and cardiovascular health. , 2000, Journal of the American College of Cardiology.

[19]  M. Anthony Soy and cardiovascular disease: cholesterol lowering and beyond. , 2000, The Journal of nutrition.

[20]  M. Anthony,et al.  Effects of soy isoflavones on atherosclerosis: potential mechanisms. , 1998, The American journal of clinical nutrition.

[21]  W. Wong,et al.  Cholesterol-lowering effect of soy protein in normocholesterolemic and hypercholesterolemic men. , 1998, The American journal of clinical nutrition.

[22]  A. Lichtenstein Soy protein, isoflavones and cardiovascular disease risk. , 1998, The Journal of nutrition.

[23]  S. Ojala,et al.  Effect of soybean phytoestrogen intake on low density lipoprotein oxidation resistance. , 1998, Proceedings of the National Academy of Sciences of the United States of America.

[24]  A. Dart,et al.  Soy isoflavones improve systemic arterial compliance but not plasma lipids in menopausal and perimenopausal women. , 1997, Arteriosclerosis, thrombosis, and vascular biology.

[25]  J. D. Wagner,et al.  Soy protein versus soy phytoestrogens in the prevention of diet-induced coronary artery atherosclerosis of male cynomolgus monkeys. , 1997, Arteriosclerosis, thrombosis, and vascular biology.

[26]  W. Mazur,et al.  Phyto-oestrogens and Western diseases. , 1997, Annals of medicine.

[27]  James W. Anderson,et al.  Meta-analysis of the effects of soy protein intake on serum lipids. , 1995, The New England journal of medicine.

[28]  J. Wilcox,et al.  Thrombotic mechanisms in atherosclerosis: potential impact of soy proteins. , 1995, The Journal of nutrition.

[29]  R. Ross,et al.  Biology of atherosclerotic plaque formation: possible role of growth factors in lesion development and the potential impact of soy. , 1995, The Journal of nutrition.

[30]  A. Ershow,et al.  Chinese Food Composition Tables: An annotated translation of the 1981 edition published by the Institute of Nutrition and Food Hygiene, Chinese Academy of Preventive Medicine, Beijing , 1990 .

[31]  Kent K. Stewart,et al.  The Chinese food composition tables , 1990 .

[32]  H. Blackburn,et al.  Cardiovascular survey methods. , 1969, Monograph series. World Health Organization.

[33]  X. Shu,et al.  Validity and reproducibility of the food frequency questionnaire used in the Shanghai Women's Health Study , 2004, European Journal of Clinical Nutrition.

[34]  C. Sirtori,et al.  Soy proteins and cardiovascular disease , 2001, Current atherosclerosis reports.

[35]  M. Anthony,et al.  Inhibition of postmenopausal atherosclerosis progression: a comparison of the effects of conjugated equine estrogens and soy phytoestrogens. , 2001, The Journal of clinical endocrinology and metabolism.

[36]  G. Burke,et al.  Effect of soy protein supplementation on serum lipoproteins, blood pressure, and menopausal symptoms in perimenopausal women. , 1999, Menopause.