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Nutrition and Health (including climate and ecological aspects)

Fermented soy products intake and risk of cardiovascular disease and total cancer incidence: The Japan Public Health Center-based Prospective study

Abstract

Background/objectives

The association of fermented soy products, separately from total soy products, with cardiovascular disease (CVD) and total cancer has not been reported. We examined this association in a population-based prospective cohort study in Japan.

Subjects/methods

We studied 79,648 participants (42,788 women; 36,860 men) aged 45–74 years without a history of cancer, myocardial infarction, or stroke. Participants completed a food frequency questionnaire (1995–1998) and were followed to 2009–2012. Cox proportional hazards regression analysis was used to calculate the hazard ratios (HR) and 95% confidence intervals (CI) of incidence of CVD and total cancer according to quartiles of total soy products, nonfermented soy products, fermented soy products, miso soup, natto, total isoflavones from soy products, isoflavones from nonfermented soy products, and isoflavones from fermented soy products.

Results

In women, we observed a significant inverse association between fermented soy product intake and the risk of CVD (multivariate HR in the highest compared with the lowest quartile of fermented soy product intake: 0.80; 95% CI: 0.68, 0.95; P for trend = 0.010), and also found significant inverse associations for natto and isoflavones among fermented soy products. In site-specific analysis, we observed a similar, significant inverse association between fermented soy product intake and the risk of stroke in women. We found no significant association between any soy product and risk of CVD in men or total cancer in both sexes.

Conclusions

Intake of fermented soy products such as natto was inversely associated with the risk of CVD in women.

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Acknowledgements

JPHC members are listed at the following site (as of December 2019): https://epi.ncc.go.jp/en/jphc/781/8390.html

Funding

Supported by the National Cancer Research and Development Fund [23-A-31 (toku) and 26-A-2] (since 2010), a Grant-in-Aid for Cancer Research from the Ministry of Health, Labour and Welfare of Japan (from 1989 to 2010), a grant from commissioned project study, Ministry of Agriculture, Fishery and Forestry, Japan (JPJ005336).

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ST designed, initiated, and organized the study; MN analyzed the data; MN and TS wrote the paper; and TS had primary responsibility for final content. HC, NM, MM, NS, MIw, TY, MIn, YK, KY, and HI interpreted the data. All authors read and approved the final manuscript.

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Correspondence to Taichi Shimazu.

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The authors declare that they have no conflict of interest.

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Nozue, M., Shimazu, T., Charvat, H. et al. Fermented soy products intake and risk of cardiovascular disease and total cancer incidence: The Japan Public Health Center-based Prospective study. Eur J Clin Nutr 75, 954–968 (2021). https://doi.org/10.1038/s41430-020-00732-1

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