Background:Whether soy products confer health benefits related to coronary heart disease (CHD) remains controversial because of inconsistent evidence.Methods:A total of 74 241 women from the NHS (Nurses’ Health Study; 1984–2012), 94 233 women from the NHSII (Nurses’ Health Study II; 1991–2013), and 42 226 men from the Health Professionals Follow-Up Study (1986–2012), who were free of cardiovascular disease and cancer at baseline, were included in the present analysis. Dietary data were updated every 2 to 4 years using a validated food frequency questionnaire. Nonfatal myocardial infarction and CHD deaths were adjudicated through reviewing medical records, death certificates, and other medical documents.Results:In these cohorts, 8359 incident CHD cases were documented during 4 826 122 person-years of follow-up. In multivariable-adjusted analyses, isoflavone intake was inversely associated with CHD (pooled hazard ratio [HR] comparing the extreme quintiles: 0.87 [95% CI, 0.81–0.94]; P=0.008). Consumption of tofu, but not soy milk, was inversely associated with the risk of CHD, with pooled HRs (95% CIs) of 0.82 (0.70–0.95; P=0.005) and 0.87 (0.69–1.10; P=0.41), respectively, comparing ≥1 serving/week with <1 serving/month. Further analyses showed that, in women, the favorable association of tofu was primarily driven by stronger inverse association of tofu intake observed in younger women before menopause and postmenopausal women without hormone use (P_interaction=0.002).Conclusions:Higher intake of isoflavones and tofu was associated with a moderately lower risk of developing CHD, and in women the favorable association of tofu were more pronounced in young women or postmenopausal women without hormone use.

中文翻译：

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美国男性和女性的异黄酮摄入量和冠心病风险

背景：由于证据不一致，豆制品是否具有与冠心病 (CHD) 相关的健康益处仍存在争议。 NHSII（护士健康研究 II；1991-2013）和来自卫生专业人员随访研究（1986-2012）的 42226 名男性在基线时没有心血管疾病和癌症，被纳入本分析。使用经过验证的食物频率问卷每 2 到 4 年更新一次饮食数据。通过查阅病历、死亡证明和其他医疗文件来判定非致死性心肌梗死和冠心病死亡。结果：在这些队列中，在 4 826 122 人年的随访中记录了 8359 例冠心病病例。在多变量调整分析中，P = 0.008）。食用豆腐（而非豆奶）与冠心病风险呈负相关，汇总 HR（95% CI）分别为 0.82（0.70–0.95；P =0.005）和 0.87（0.69–1.10；P =0.41） ，比较≥1 份/周与 <1 份/月。进一步的分析表明，在女性中，豆腐的有利关联主要是由于在更年期前和未使用激素的绝经后女性中观察到的豆腐摄入量呈更强的负相关（P_交互作用=0.002）。结论：异黄酮和豆腐摄入量较高与中度较低的冠心病风险相关，在女性中，豆腐的有利关联在年轻女性或未使用激素的绝经后女性中更为明显。