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. 2020 Jan 29:368:m34.
doi: 10.1136/bmj.m34.

Association of soy and fermented soy product intake with total and cause specific mortality: prospective cohort study

Ryoko Katagiri  1 , Norie Sawada  2 , Atsushi Goto  1 , Taiki Yamaji  1 , Motoki Iwasaki  1 , Mitsuhiko Noda  3 , Hiroyasu Iso  4 , Shoichiro Tsugane  1 ; Japan Public Health Center-based Prospective Study Group
Affiliations

Association of soy and fermented soy product intake with total and cause specific mortality: prospective cohort study

Ryoko Katagiri et al. BMJ. .

Abstract

Objective: To investigate the association between several types of soy products and all cause and cause specific mortality.

Design: Population based cohort study.

Setting: Japan Public Health Centre-based Prospective Study, which includes 11 public health centre areas in Japan.

Participants: 92 915 participants (42 750 men and 50 165 women) aged 45 to 74 years.

Exposures: Intake of total soy products, fermented soy products (natto and miso), non-fermented soy products, and tofu from a five year survey questionnaire.

Main outcome measures: All cause and cause specific mortality (cancer, total cardiovascular disease, heart disease, cerebrovascular disease, respiratory disease, and injury) obtained from residential registries and death certificates.

Results: During 14.8 years of follow-up, 13 303 deaths were identified. In the multivariable adjusted models, intake of total soy products was not significantly associated with total mortality. Compared with the lowest fifth of total soy product intake, the hazard ratios in the highest fifth were 0.98 (95% confidence interval 0.91 to 1.06, Ptrend=0.43) in men and 0.98 (0.89 to 1.08, Ptrend=0.46) in women. Intake of fermented soy products was inversely associated with all cause mortality in both sexes (highest versus lowest fifth: 0.90 (0.83 to 0.97), Ptrend=0.05 in men, and 0.89 (0.80 to 0.98), Ptrend=0.01 in women). Natto showed significant and inverse associations with total cardiovascular disease related mortality in both sexes.

Conclusions: In this study a higher intake of fermented soy was associated with a lower risk of mortality. A significant association between intake of total soy products and all cause mortality was not, however, observed. The findings should be interpreted with caution because the significant association of fermented soy products might be attenuated by unadjusted residual confounding.

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Conflict of interest statement

Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and declare: no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; and no other relationships or activities that could appear to have influenced the submitted work.

Figures

Fig 1
Fig 1
Flow of participants through study
See this image and copyright information in PMC

Comment in

  • Soy intake and health.
    Kurotani K, Takimoto H. Kurotani K, et al. BMJ. 2020 Jan 29;368:m247. doi: 10.1136/bmj.m247. BMJ. 2020. PMID: 31996341 No abstract available.

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References

    1. GBD 2016 Causes of Death Collaborators Global, regional, and national age-sex specific mortality for 264 causes of death, 1980-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet 2017;390:1151-210. 10.1016/S0140-6736(17)32152-9 - DOI - PMC - PubMed
    1. World Health Organization, Food and Agriculture Organization. Diet, nutrition and the prevention of chronic diseases. Report No. WHO technical report series 916. 2003. https://apps.who.int/iris/bitstream/10665/42665/1/WHO_TRS_916.pdf. - PubMed
    1. Lukito W. Candidate foods in the asia-pacific region for cardiovascular protection: nuts, soy, lentils and tempe. Asia Pac J Clin Nutr 2001;10:128-33. 10.1046/j.1440-6047.2001.00240.x - DOI - PubMed
    1. Tucker KL, Qiao N, Maras JE. Simulation with soy replacement showed that increased soy intake could contribute to improved nutrient intake profiles in the U.S. population. J Nutr 2010;140:2296S-301S. 10.3945/jn.110.123901 - DOI - PubMed
    1. Reinwald S, Akabas SR, Weaver CM. Whole versus the piecemeal approach to evaluating soy. J Nutr 2010;140:2335S-43S. 10.3945/jn.110.124925 - DOI - PubMed

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