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BACKGROUND - Soy consumption has been shown to modulate bone turnover and increase bone mineral density in postmenopausal women. To our knowledge, no published studies have directly examined the association between soy consumption and risk of fracture.
METHODS - We examined the relationship between usual soy food consumption and fracture incidence in 24,403 postmenopausal women who had no history of fracture or cancer and were recruited between March 1, 1997, and May 23, 2000, in the Shanghai Women's Health Study, a cohort study of approximately 75,000 Chinese women aged 40 to 70 years. Usual soy food intake was assessed at baseline and reassessed during follow-up through in-person interviews using a validated food frequency questionnaire. Outcomes were ascertained by biennial in-person interview surveys.
RESULTS - During a mean follow-up of 4(1/2) years (110,243 person-years), 1770 incident fractures were identified. After adjustment for age, major risk factors of osteoporosis, socioeconomic status, and other dietary factors, the relative risks (95% confidence intervals) of fracture were 1.00, 0.72 (0.62-0.83), 0.69 (0.59-0.80), 0.64 (0.55-0.76), and 0.63 (0.53-0.76) across quintiles of soy protein intake (P<.001 for trend). The inverse association was more pronounced among women in early menopause. The multivariate relative risks (95% confidence intervals) of fracture comparing the extreme quintiles of soy protein intake were 0.52 (0.38-0.70) for women within 10 years of menopause vs 0.71 (0.56-0.89) for late postmenopausal women. Similar results were also found for intake of isoflavones.
CONCLUSION - Soy food consumption may reduce the risk of fracture in postmenopausal women, particularly among those in the early years following menopause.
Soy and its constituents have been shown in many in vivo and in vitro studies and in some epidemiological studies to have anti-cancer effects. Some soy constituents, however, also stimulate cell proliferation, which has raised concerns in promoting soy intake among breast cancer survivors. To investigate whether soy intake may be associated with breast cancer survival, we evaluated data from a cohort of 1459 breast cancer patients who participated in the Shanghai Breast Cancer Study between 1996 and 1998. Usual soy food intake was assessed using a validated food frequency questionnaire at baseline. The median follow-up time for this cohort of women was 5.2 years. We found that soy intake prior to cancer diagnosis was unrelated to disease-free breast cancer survival (adjusted hazard ratio [HR]=0.99, 95% confidence interval [CI], 0.73-1.33 for the highest tertile compared to the lowest tertile). The association between soy protein intake and breast cancer survival did not differ according to ER/PR status, tumor stage, age at diagnosis, body mass index (BMI), waist to hip ratio (WHR), or menopausal status. Additionally, the soy-survival association did not appear to vary according to XbaI or PvuII polymorphisms in ER-alpha, or C(14206)T, G(25652)A, or A(50766)G polymorphisms in ER-beta. These data suggest that soyfoods do not have an adverse effect on breast cancer survival.
OBJECTIVE - To assess the association between soyfood intake and risk of glycosuria.
DESIGN AND METHODS - A cross-sectional study was conducted among participants of the Shanghai Women's Health Study, a population-based cohort study of women aged 40-70 y. Information on usual intake of soyfoods was obtained at baseline survey through an in-person interview using a validated food-frequency questionnaire. Included in this study were 39,385 cohort members screened for diabetes at the baseline survey and free of previously diagnosed diabetes, cardiovascular diseases, kidney diseases, and cancer. There were 323 women who tested positive for urine glucose. Odds ratios (ORs) and 95% confidence intervals (CIs) were employed to measure the association between soyfood intake and glycosuria using unconditional logistic regression.
SETTING - Urban communities of Shanghai, China.
RESULTS - Overall, soyfood intake was not related to the risk of glycosuria. Among postmenopausal women, however, intake of tofu and other soy products was inversely associated with risk of glycosuria after adjustment for potential confounders. The ORs across quintiles of intake were 1.0, 0.75 (95% CI=0.47-1.20), 0.79 (95% CI=0.51-1.25), 0.53 (95% CI=0.32-0.88), and 0.51 (95% CI=0.26-0.98; P for trend=0.05). Further analyses showed that the inverse association was primarily confined to postmenopausal women with a body mass index (BMI) of <25 kg/m2. The adjusted OR comparing the extreme quintiles was 0.36 (95% CI=0.13-0.97; P for trend=0.004).
CONCLUSIONS - Soyfoods may play a role in the development of glycosuria, an important indicator of diabetes, among postmenopausal women with a low BMI.