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Abstract

Background

The relationships between dietary intake of soy foods and risk of cardiovascular disease are uncertain. The aims of this study were to evaluate and summarize the evidence on the association between consumption of soy and risk of cardiovascular disease (including stroke and coronary heart disease).

Methods

We systematically searched the MEDLINE and EMBASE databases from their inception up to 22 February 2016. We included only observational studies, and used random-effects models to calculate summary relative risks (SRRs) and 95% confidence intervals (CIs).

Results

A total of 10 prospective cohort and seven case-control studies met the inclusion criteria. There were a total of 17,269 cardiovascular disease events, including 6265 stroke events, 10,806 coronary heart disease events, and 198 other cardiovascular disease events. A significant negative association was shown between soy intake and risk of cardiovascular disease (SRR = 0.84 95% CI: 0.75–0.94; p_{heterogeneity}<0.001, I²= 71.4%). Subgroup meta-analyses indicated that a statistically significant protective effect was primarily observed in case-control studies and in Asian populations. There was a borderline significant association between intake of tofu and the risk of cardiovascular disease (SRR = 0.80, 95% CI: 0.64–1.00). A significant negative association was shown for the association between soy intake and risk of stroke (SRR = 0.82, 95% CI: 0.68–0.99) and coronary heart disease (SRR = 0.83, 95% CI: 0.72–0.95). There were no associations between soy isoflavones consumption and risk of cardiovascular disease, stroke, and coronary heart disease.

Conclusion

Overall evidence indicated that consumption of soy was negatively associated with the risk of cardiovascular disease, stroke, and coronary heart disease risk.

Keywords

Cardiovascular disease coronary heart disease soy consumption stroke soy isoflavones

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References

Yusuf

Reddy

Ounpuu

. Global burden of cardiovascular diseases: Part I: general considerations, the epidemiologic transition, risk factors, and impact of urbanization. Circulation 2001; 104: 2746–2753.

Kwak

Kim

Lee

. Effects of black soy peptide supplementation on blood pressure and oxidative stress: A randomized controlled trial. Hypertens Res 2013; 36: 1060–1066.

Gao

Zhang

. Soy fiber improves weight loss and lipid profile in overweight and obese adults: A randomized controlled trial. Mol Nutr Food Res 2013; 57: 2147–2154.

Kwon

Daily

3rd Kim

. Antidiabetic effects of fermented soybean products on type 2 diabetes. Nutr Res 2010; 30: 1–13.

Pase

Grima

Sarris

. The effects of dietary and nutrient interventions on arterial stiffness: A systematic review. Am J Clin Nutr 2011; 93: 446–454.

Beavers

Miller

. Exposure to isoflavone-containing soy products and endothelial function: A Bayesian meta-analysis of randomized controlled trials. Nutr Metab Cardiovasc Dis 2012; 22: 182–191.

Afshin

Micha

Khatibzadeh

. Consumption of nuts and legumes and risk of incident ischemic heart disease, stroke, and diabetes: A systematic review and meta-analysis. Am J Clin Nutr 2014; 100: 278–288.

Zhang

Xiang

. Association of soy food intake with risk and biomarkers of coronary heart disease in Chinese men. Int J Cardiol 2014; 172: e285–e287.

Sasazuki

. Case-control study of nonfatal myocardial infarction in relation to selected foods in Japanese men and women. Jpn Circ J 2001; 65: 200–206.

10.

Fang

Foo

Fung

. Stroke risk among Chinese immigrants in New York City. J Immigr Minor Health 2006; 8: 387–393.

11.

Schooling

Hui

. Soy consumption and mortality in Hong Kong: Proxy-reported case-control study of all older adult deaths in 1998. Prev Med 2006; 43: 20–26.

12.

Okamoto

Horisawa

. Soy products and risk of an aneurysmal rupture subarachnoid hemorrhage in Japan. Eur J Cardiovasc Prev Rehabil 2006; 13: 284–287.

13.

Liang

Lee

Binns

. Soy consumption reduces risk of ischemic stroke: A case-control study in southern china. Neuroepidemiology 2009; 33: 111–116.

14.

Guo

Wang

. Influence of dietary patterns on the risk of acute myocardial infarction in China population: The INTERHEART China study. Chin Med J (Engl) 2013; 126: 464–470.

15.

Tavani

Spertini

Bosetti

. Intake of specific flavonoids and risk of acute myocardial infarction in Italy. Public Health Nutr 2006; 9: 369–374.

16.

Zhang

Shu

Gao

. Soy food consumption is associated with lower risk of coronary heart disease in Chinese women. J Nutr 2003; 133: 2874–2878.

17.

Van der Schouw

Kreijkamp-Kaspers

Peeters

. Prospective study on usual dietary phytoestrogen intake and cardiovascular disease risk in Western women. Circulation 2005; 111: 465–471.

18.

Kokubo

Iso

Ishihara

. Association of dietary intake of soy, beans, and isoflavones with risk of cerebral and myocardial infarctions in Japanese populations: The Japan Public Health Center-based (JPHC) study cohort I. Circulation 2007; 116: 2553–2562.

19.

Talaei

Koh

van Dam

. Dietary soy intake is not associated with risk of cardiovascular disease mortality in Singapore Chinese adults. J Nutr 2014; 144: 921–928.

20.

Nagata

Takatsuka

Shimizu

. Soy and fish oil intake and mortality in a Japanese community. Am J Epidemiol 2002; 156: 824–831.

21.

McCullough

Peterson

Patel

. Flavonoid intake and cardiovascular disease mortality in a prospective cohort of US adults. Am J Clin Nutr 2012; 95: 454–464.

22.

Shu

. Dietary isoflavones, urinary isoflavonoids, and risk of ischemic stroke in women. Am J Clin Nutr 2015; 102: 680–686.

23.

Mink

Scrafford

Barraj

. Flavonoid intake and cardiovascular disease mortality: A prospective study in postmenopausal women. Am J Clin Nutr 2007; 85: 895–909.

24.

Yamasaki

Kayaba

Ishikawa

. Soy and soy products intake, all-cause mortality, and cause-specific mortality in Japan: The Jichi Medical School Cohort Study. Asia Pac J Public Health 2015; 27: 531–541.

25.

Kurzer

. Dietary phytoestrogens. Annu Rev Nutr 1997; 17: 353–381.

26.

Wells GA, O'Connell D, Peterson J, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses, http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp (accessed 15 June 2012).

27.

Higgins

Thompson

Deeks

. Measuring inconsistency in meta-analyses. Br Med J 2003; 327: 557–560.

28.

Begg

Mazumdar

. Operating characteristics of a rank correlation test for publication bias. Biometrics 1994; 50: 1088–1101.

29.

Egger

Davey Smith

Schneider

. Bias in meta-analysis detected by a simple, graphical test. Br Med J 1997; 315: 629–634.

30.

Duval

Tweedie

. Trim and fill: A simple funnel-plot-based method of testing and adjusting for publication bias in meta-analysis. Biometrics 2000; 56: 455–463.

31.

Montgomery

. Soy protein. J Perinat Educ 2003; 12: 42–45.

32.

Matori

Umar

Nadadur

. Genistein, a soy phytoestrogen, reverses severe pulmonary hypertension and prevents right heart failure in rats. Hypertension 2012; 60: 425–430.

33.

Kim

Lim

Shin

. Inhibitory effects of black soybean on platelet activation mediated through its active component of adenosine. Thromb Res 2013; 131: 254–261.

34.

Yoon

Park

. Antioxidant action of soy isoflavones on oxidative stress and antioxidant enzyme activities in exercised rats. Nutr Res Pract 2014; 8: 618–624.

35.

Acharjee

Zhou

Elajami

. Effect of soy nuts and equol status on blood pressure, lipids and inflammation in postmenopausal women stratified by metabolic syndrome status. Metabolism 2015; 64: 236–243.

36.

Liu

Chen

. Effect of soy protein and isoflavones on blood pressure and endothelial cytokines: A 6-month randomized controlled trial among postmenopausal women. J Hypertens 2013; 31: 384–392.

37.

Zhang

Chen

Guo

. Soy isoflavone supplementation could reduce body weight and improve glucose metabolism in non-Asian postmenopausal women–a meta-analysis. Nutrition 2013; 29: 8–14.

38.

Qian

Pan

. Association between dietary fiber intake and risk of coronary heart disease: A meta-analysis. Clin Nutr 2015; 34: 603–611.

39.

Tanaka

Yoshimura

Kamada

. Intakes of dietary fiber, vegetables, and fruits and incidence of cardiovascular disease in Japanese patients with type 2 diabetes. Diabetes Care 2013; 36: 3916–3922.

40.

Threapleton

Burley

Greenwood

. Dietary fibre intake and risk of ischaemic and haemorrhagic stroke in the UK Women's Cohort Study. Eur J Clin Nutr 2013; 69: 467–474.

41.

Larsson

Wolk

. Dietary fiber intake is inversely associated with stroke incidence in healthy Swedish adults. J Nutr 2014; 144: 1952–1955.

42.

Galisteo

Duarte

Zarzuelo

. Effects of dietary fibers on disturbances clustered in the metabolic syndrome. J Nutr Biochem 2008; 19: 71–84.

43.

Shimazu

Inoue

Sasazuki

. Isoflavone intake and risk of lung cancer: A prospective cohort study in Japan. Am J Clin Nutr 2010; 91: 722–728.

44.

Seow

Koh

Wang

. Reproductive variables, soy intake, and lung cancer risk among nonsmoking women in the Singapore Chinese Health Study. Cancer Epidemiol Biomarkers Prev 2009; 18: 821–827.

45.

Schabath

Hernandez

. Dietary phytoestrogens and lung cancer risk. JAMA 2005; 294: 1493–1504.

46.

Keogh

White

Rodwell

. Using surrogate biomarkers to improve measurement error models in nutritional epidemiology. Stat Med 2013; 32: 3838–3861.

47.

Boeing

. Nutritional epidemiology: New perspectives for understanding the diet-disease relationship? Eur J Clin Nutr 2013; 67: 424–429.

48.

Archer

Hand

Blair

. Validity of U.S. nutritional surveillance: National Health and Nutrition Examination Survey caloric energy intake data, 1971–2010. PLoS One 2013; 8: e76632–e76632.

49.

Peng

Jiang

. Long-term alcohol consumption is an independent risk factor of hypertension development in northern China: Evidence from Kailuan study. J Hypertens 2013; 31: 2342–2347.

50.

Goldstein

. Physical activity and the risk of stroke. Expert Rev Neurother 2010; 10: 1263–1265.

51.

Stefler

Pikhart

Kubinova

. Fruit and vegetable consumption and mortality in Eastern Europe: Longitudinal results from the Health, Alcohol and Psychosocial Factors in Eastern Europe study. Eur J Prev Cardiol 2016; 23: 493–501.

52.

Thuesen

Toft

Buhelt

. Estimated daily salt intake in relation to blood pressure and blood lipids: The role of obesity. Eur J Prev Cardiol 2015; 22: 1567–1574.

53.

Aburto

Ziolkovska

Hooper

. Effect of lower sodium intake on health: Systematic review and meta-analyses. Br Med J 2013; 346: f1326–f1326.

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Association between consumption of soy and risk of cardiovascular disease: A meta-analysis of observational studies

Abstract

Background

Methods

Results

Conclusion

Keywords

Get full access to this article

References

Supplementary Material