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.

中文翻译：

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大豆和发酵大豆制品摄入量与总死亡率和特定死亡率的关联：前瞻性队列研究。

目的调查几种类型的大豆制品与所有原因和特定死亡率之间的关系。设计基于人群的队列研究。地点基于日本公共卫生中心的前瞻性研究，其中包括日本的11个公共卫生中心区域。参与者92,915名参与者（42,750名男性和50,165名女性）年龄在45至74岁之间。暴露五年调查问卷中的大豆总产品，发酵大豆产品（纳豆和味mis），非发酵大豆产品和豆腐的摄入量。主要观察指标从住所登记处和死亡证明书中获得的所有原因引起的特定死亡率（癌症，总心血管疾病，心脏病，脑血管疾病，呼吸道疾病和伤害）。结果在14.8年的随访中，确定了13303例死亡。在多变量调整模型中，大豆总产品摄入量与总死亡率没有显着相关。与豆制品总摄入量中最低的五分之一相比，最高的五分之一的风险比率是男性为0.98（95％置信区间0.91至1.06，Ptrend = 0.43），女性为0.98（0.89至1.08，Ptrend = 0.46）。摄入发酵大豆产品与所有性别的死亡率成反比（最高与最低第五位：男性为0.90（0.83至0.97），男性Ptrend = 0.05，女性为0.89（0.80至0.98），Ptrend = 0.01）。纳豆显示与男女总心血管疾病相关死亡率显着且呈负相关。结论在这项研究中，发酵大豆摄入量的增加与死亡率的降低有关。然而，未观察到大豆总产品摄入量与所有原因死亡率之间的显着关联。对这些发现应谨慎解释，因为未经调整的残留混杂物可能会削弱发酵大豆产品的显着关联。