Association between Soy Food and Dietary Soy Isoflavone Intake and the Risk of Cardiovascular Disease in Women: A Prospective Cohort Study in Korea

The association between soy food and soy isoflavone intake and cardiovascular disease (CVD) risk is uncertain, especially in women. We aimed to investigate this association in Korean women. We analyzed data from the Korean Genome and Epidemiology Study, including 4713 Korean women aged 40–69 years with no CVD or cancer at baseline. Dietary information was obtained using a validated semi-quantitative food frequency questionnaire, and the incidence of CVD was assessed using biennial self-reported questionnaires on medical history. The mean follow-up time was 7.4 years, during which 82 premenopausal and 200 postmenopausal women reported CVD incidence. The highest tofu, total soy foods, and dietary soy isoflavone intake groups were significantly associated with a decreased CVD risk in premenopausal women (tofu: hazard ratio (HR) 0.39; 95% confidence interval (CI), 0.19–0.80; total soy food: HR 0.36; 95% CI, 0.18–0.70; dietary soy isoflavones: HR 0.44; 95% CI, 0.22–0.89), whereas no association was observed in postmenopausal women. Other soy foods showed no association with CVD incidence. Dietary soy isoflavones and total soy foods are associated with a decreased CVD risk in premenopausal women. Among soy foods, only tofu showed significant health benefits.

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Abstract 16851: Lipid Profile Differences Among Premenopausal and Postmenopausal African American Women and Implications for Treatment Per Guideline

Circulation ◽

10.1161/circ.142.suppl_3.16851 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Courtney Bess ◽

Puja K Mehta ◽

Gina P Lundberg

Keyword(s):

Cardiovascular Disease ◽

Lipid Profile ◽

Postmenopausal Women ◽

Risk Score ◽

Density Lipoprotein ◽

Premenopausal Women ◽

Lipoprotein Cholesterol ◽

Atherosclerotic Cardiovascular Disease ◽

Cvd Risk ◽

Ascvd Risk

Introduction: Postmenopausal women have an increased cardiovascular disease (CVD) risk compared to premenopausal women. Though literature demonstrates a relationship between abnormal CVD risk factor patterns, namely lipids, and menopause, less is known about this association in minority racial and ethnic groups. Examining this association in African Americans (AA) is important because they experience disproportionate CVD outcomes. Moreover, recent studies have shown that AA eligible for statin therapy were less likely to receive treatment. Hypothesis: Postmenopausal women are more likely to have a more abnormal lipid profile compared to premenopausal women. Methods: A cohort of 962 women (mean age 50 ± 14 years) from the 10,000 Women Project were categorized into self-declared premenopausal (n = 475, mean age 40 ± 9.8 years) and postmenopausal (n= 487, mean age 61 ± 9.1 years) groups. Data was obtained at community health screening events through self-declared health history surveys. Lipid profiles were obtained through a non-fasting point-of-care cholesterol test. Several CVD risk factors were compared among these groups that include serum total cholesterol (TC), low density lipoprotein cholesterol (LDL), high density lipoprotein cholesterol (HDL), triglycerides (TG), pooled cohort Atherosclerotic Cardiovascular Disease (ASCVD) 10-year risk of heart disease or stroke score, BMI, waist circumference, and blood pressure. Student’s T test was utilized for statistical analysis. Results: Cholesterol testing revealed a significant increase in serum TC (p < 0.0001), LDL (p = 0.0001), and TG (p = 0.001) in the postmenopausal group compared to the premenopausal group. Interestingly, there was also a significant increase in serum HDL in the postmenopausal group (p = 0.0081). Additionally, the ASCVD risk score, which is heavily weighted on age, was significantly higher in the postmenopausal group compared to the premenopausal group (p < 0.0001). Conclusion: Menopause is associated with a more abnormal lipid profile and an elevated ASCVD risk score in AA women which places this group at a higher risk of CVD. Prioritizing lipid management, by adhering to cholesterol treatment guidelines, may assist with CVD risk reduction in this high-risk group.

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Multi-trajectories of lipid indices with incident cardiovascular disease, heart failure, and all-cause mortality: 23 years follow-up of two US cohort studies

Journal of Translational Medicine ◽

10.1186/s12967-021-02966-4 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Fatemeh Koohi ◽

Davood Khalili ◽

Mohammad Ali Mansournia ◽

Farzad Hadaegh ◽

Hamid Soori

Keyword(s):

Heart Failure ◽

Cardiovascular Disease ◽

Cohort Studies ◽

Significant Risk ◽

Density Lipoprotein ◽

Lipid Levels ◽

Cvd Risk ◽

All Cause Mortality ◽

Over Time

Abstract Background Understanding the distinct patterns (trajectories) of variation in blood lipid levels before diagnosing cardiovascular disease (CVD) might carry important implications for improving disease prevention or treatment. Methods We investigated 14,373 participants (45.5% men) aged 45–84 from two large US prospective cohort studies with a median of 23 years follow-up. First, we jointly estimated developmental trajectories of lipid indices, including low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglyceride (TG) concentrations using group-based multi-trajectory modeling. Then, the association of identified multi-trajectories with incident CVD, heart failure, and all-cause mortality were examined using Cox proportional hazard model. Results Seven distinct multi-trajectories were identified. The majority of participants (approximately 80%) exhibited decreasing LDL-C but rising TG levels and relatively stable HDL-C levels. Compared to the individuals with healthy and stable LDL-C, HDL-C, and TG levels, those in other groups were at significant risk of incident CVD after adjusting for other conventional risk factors. Individuals with the highest but decreasing LDL-C and borderline high and rising TG levels over time were at the highest risk than those in other groups with a 2.22-fold risk of CVD. Also, those with the highest and increased triglyceride levels over time, over optimal and decreasing LDL-C levels, and the lowest HDL-C profile had a nearly 1.84 times CVD risk. Even individuals in the multi-trajectory group with the highest HDL-C, optimal LDL-C, and optimal TG levels had a significant risk (HR, 1.45; 95% CI 1.02–2.08). Furthermore, only those with the highest HDL-C profile increased the risk of heart failure by 1.5-fold (95% CI 1.07–2.06). Conclusions The trajectories and risk of CVD identified in this study demonstrated that despite a decline in LDL-C over time, a significant amount of residual risk for CVD remains. These findings suggest the impact of the increasing trend of TG on CVD risk and emphasize the importance of assessing the lipid levels at each visit and undertaking potential interventions that lower triglyceride concentrations to reduce the residual risk of CVD, even among those with the optimal LDL-C level.

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Physical activity less than the recommended amount may prevent the onset of major biological risk factors for cardiovascular disease: a cohort study of 198 919 adults

British Journal of Sports Medicine ◽

10.1136/bjsports-2018-099740 ◽

2018 ◽

Vol 54 (4) ◽

pp. 238-244 ◽

Cited By ~ 1

Author(s):

David Martinez-Gomez ◽

Irene Esteban-Cornejo ◽

Esther Lopez-Garcia ◽

Esther García-Esquinas ◽

Kabir P Sadarangani ◽

...

Keyword(s):

Physical Activity ◽

Risk Factors ◽

Type 2 Diabetes ◽

Cardiovascular Disease ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Highly Active ◽

Atherogenic Dyslipidaemia

ObjectivesWe examined the dose–response relationship between physical activity (PA) and incidence of cardiovascular disease (CVD) risk factors in adults in Taiwan.MethodsThis study included 1 98 919 participants, aged 18–97 years, free of CVD, cancer and diabetes at baseline (1997–2013), who were followed until 2016. At baseline, participants were classified into five PA levels: inactive’ (0 metabolic equivalent of task (MET)-h/week), ‘lower insufficiently active’ (0.1–3.75 MET-h/week), ‘upper insufficiently active’ (3.75–7.49 MET-h/week), ‘active’ (7.5–14.99 MET-h/week) and ‘highly active’ (≥15 MET-h/week]. CVD risk factors were assessed at baseline and at follow-up by physical examination and laboratory tests. Analyses were performed with Cox regression and adjusted for the main confounders.ResultsDuring a mean follow-up of 6.0±4.5 years (range 0.5–19 years), 20 447 individuals developed obesity, 19 619 hypertension, 21 592 hypercholesterolaemia, 14 164 atherogenic dyslipidaemia, 24 275 metabolic syndrome and 8548 type 2 diabetes. Compared with inactive participants, those in the upper insufficiently active (but not active) category had a lower risk of obesity (HR 0.92; 95% CI 0.88 to 0.95), atherogenic dyslipidaemia (0.96; 0.90 to 0.99), metabolic syndrome (0.95; 0.92 to 0.99) and type 2 diabetes (0.91; 0.86 to 0.97). Only highly active individuals showed a lower incidence of CVD risk factors than their upper insufficiently active counterparts.ConclusionCompared with being inactive, doing half the recommended amount of PA is associated with a lower incidence of several common biological CVD risk factors. Given these benefits, half the recommended amount of PA is an evidence based target for inactive adults.

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Circulating Proangiogenic Cell Activity Is Associated with Cardiovascular Disease Risk

CrossRef Listing of Deleted DOIs ◽

10.1177/1087057112454919 ◽

2012 ◽

Vol 17 (9) ◽

pp. 1163-1170 ◽

Cited By ~ 8

Author(s):

Kreton Mavromatis ◽

Konstantinos Aznaouridis ◽

Ibhar Al Mheid ◽

Emir Veledar ◽

Saurabh Dhawan ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Bone Marrow ◽

Disease Risk ◽

Cardiovascular Disease Risk ◽

Cell Activity ◽

Atherosclerotic Cardiovascular Disease ◽

Cvd Risk ◽

The Relationship

Vascular injury mobilizes bone marrow–derived proangiogenic cells into the circulation, where these cells can facilitate vascular repair and new vessel formation. We sought to determine the relationship between a new biomarker of circulating bone marrow–derived proangiogenic cell activity, the presence of atherosclerotic cardiovascular disease (CVD) and its risk factors, and clinical outcomes. Circulating proangiogenic cell activity was estimated using a reproducible angiogenic colony-forming unit (CFU-A) assay in 532 clinically stable subjects aged 20 to 90 years and ranging in the CVD risk spectrum from those who are healthy without risk factors to those with active CVD. CFU-A counts increased with the burden of CVD risk factors ( p < 0.001). CFU-A counts were higher in subjects with symptomatic CVD than in those without ( p < 0.001). During follow-up of 232 subjects with CVD, CFU-A counts were higher in those with death, myocardial infarction, or stroke than in those without (110 [70–173] vs 84 [51–136], p = 0.01). Therefore, we conclude that circulating proangiogenic cell activity, as estimated by CFU-A counts, increases with CVD risk factor burden and in the presence of established CVD. Furthermore, higher circulating proangiogenic cell activity is associated with worse clinical outcome in those with CVD.

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Abstract 36: The Role of Sleep as a Cardiovascular Health Metric: Does It Improve Cardiovascular Disease Risk Prediction? Results From The Multi-Ethnic Study of Atherosclerosis

Circulation ◽

10.1161/circ.141.suppl_1.36 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Cited By ~ 1

Author(s):

Nour Makarem ◽

Cecilia Castro-Diehl ◽

Marie-Pierre St-Onge ◽

Susan Redline ◽

Steven Shea ◽

...

Keyword(s):

Cardiovascular Disease ◽

Sleep Duration ◽

Risk Prediction ◽

Cardiovascular Health ◽

Cvd Risk ◽

Sleep Study ◽

Lower Odds ◽

Wrist Actigraphy ◽

Incident Cases

Background: The AHA Life’s Simple 7 (LS7) is a measure of cardiovascular health (CVH). Sufficient and healthy sleep has been linked to higher LS7 scores and lower cardiovascular disease (CVD) risk, but sleep has not been included as a CVH metric. Hypothesis: A CVH score that includes the LS7 plus sleep metrics would be more strongly associated with CVD outcomes than the LS7 score. Methods: Participants were n=1920 diverse adults (mean age: 69.5 y) in the MESA Sleep Study who completed 7 days of wrist actigraphy, overnight in-home polysomnography, and sleep questionnaires. Logistic regression and Cox proportional hazards models were used to compare the LS7 score and 4 new CVH scores that incorporate aspects of sleep in relation to CVD prevalence and incidence (Table). There were 95 prevalent CVD events at the Sleep Exam and 93 incident cases during a mean follow up of 4.4y. Results: The mean LS7 score was 7.3, and the means of the alternate CVH scores ranged from 7.4 to 7.8. Overall, 63% of participants slept <7h, 10% had sleep efficiency <85%, 14% and 36% reported excess daytime sleepiness and insomnia, respectively, 47% had obstructive sleep apnea, and 39% and 25% had high night-to-night variability in sleep duration and sleep onset timing. The LS7 score was not significantly associated with CVD prevalence or incidence (Table). Those in the highest vs. lowest tertile of CVH score 1, that included sleep duration, and CVH score 2, that included sleep characteristics linked to CVD in the literature, had lower odds of prevalent CVD. Those in the highest vs. lowest tertile of CVH scores 3 and 4, which included sleep characteristics linked to cardiovascular risk in MESA, had lower odds of prevalent CVD and lower risk of developing CVD. Conclusions: CVH scores that include sleep were more strongly associated with CVD prevalence and incidence than the traditional LS7 score. The incorporation of sleep as a metric of CVH, akin to other health behaviors, may improve CVD risk prediction. Findings warrant confirmation in larger samples and over longer follow-up.

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Dietary Soy Intake Is Inversely Associated with Risk of Type 2 Diabetes in Japanese Women but Not in Men

Journal of Nutrition ◽

10.1093/jn/nxz047 ◽

2019 ◽

Vol 149 (7) ◽

pp. 1208-1214 ◽

Cited By ~ 8

Author(s):

Kie Konishi ◽

Keiko Wada ◽

Michiyo Yamakawa ◽

Yuko Goto ◽

Fumi Mizuta ◽

...

Keyword(s):

Soy Protein ◽

Smoking Status ◽

Menopausal Status ◽

Glycemic Load ◽

Japanese Women ◽

Cox Proportional Hazards ◽

Dietary Factors ◽

Soy Isoflavones ◽

Soy Foods

ABSTRACT Background Whole soy foods, as well as their components, including protein and isoflavones, have garnered attention because they may have beneficial effects against diabetes. Objectives We examined associations between the intake of soy foods, soy protein, and soy isoflavones and the risk of diabetes in the Japanese population. Methods This prospective cohort study included 13,521 residents (5883 men and 7638 women; 35–69 y old) of Takayama City, Japan. The subjects responded to a self-administered baseline questionnaire in 1992 and to a follow-up questionnaire seeking information about diabetes in 2002. Their mean ± SD body mass index was 22.6 ± 2.6 kg/m2 (men) and 22.1 ± 2.7 (women). The intakes of total soy foods, fried soy foods, nonfried soy foods, soy protein, and soy isoflavones were estimated through the use of a validated food-frequency questionnaire administered in 1992. Associations between soy intake and the risk of diabetes were evaluated through the use of Cox proportional hazards models incorporating age, education level, physical activity, smoking status, alcohol consumption, history of hypertension, use of vitamin supplements, menopausal status, and dietary factors including glycemic load, total energy, total fat, meat, fruit, vegetables, and coffee. Results During a 10-y follow-up, 438 participants reported physician-diagnosed diabetes. Women in the highest tertile of intakes of total soy foods, fried soy foods, nonfried soy foods, soy protein, and soy isoflavone had significantly lower HRs, after controlling for covariates, than those with the lowest intakes. For example, HRs were 0.45 (95% CI: 0.30, 0.68; P-trend <0.001) for total soy food intake. In men, there were no significant associations between soy intake and the risk of diabetes. Conclusions These results suggest that a high soy intake may be associated with a lower risk of diabetes in Japanese women.

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Screening and management of cardiovascular disease in Australian adults with HIV infection

Sexual Health ◽

10.1071/sh13009 ◽

2013 ◽

Vol 10 (6) ◽

pp. 495 ◽

Cited By ~ 7

Author(s):

Derek Chan ◽

David Gracey ◽

Michael Bailey ◽

Deborah Richards ◽

Brad Dalton

Keyword(s):

Cardiovascular Disease ◽

Primary Care ◽

Clinical Practice ◽

Hiv Infection ◽

Primary Care Physicians ◽

Management Practices ◽

Cvd Risk ◽

Online Forms ◽

Current Screening

Background Cardiovascular disease (CVD) is common in HIV infection. With no specific Australian guidelines for the screening and management of CVD in HIV-infected patients, best clinical practice is based on data from the general population. We evaluated adherence to these recommendations by primary care physicians who treat HIV-infected patients. Methods: Primary care physicians with a special interest in HIV infection were asked to complete details for at least 10 consecutive patient encounters using structured online forms. This included management practices pertaining to blood pressure (BP), blood glucose, electrocardiogram, lipid profile and CVD risk calculations. We assessed overall adherence to screening and follow-up recommendations as suggested by national and international guidelines. Results: Between May 2009 and March 2010, 43 physicians from 25 centres completed reporting for 530 HIV-infected patients, of whom 93% were male, 25% were aged 41–50 years and 83% were treated with antiretrovirals. Risk factors for CVD were common and included smoking (38%), hyperlipidaemia (16%) and hypertension (28%). In men aged >40 years and women aged >50 years without evidence of ischaemic heart disease, only 14% received a CVD risk assessment. Lipid and BP assessments were performed in 87% and 88% of patients, respectively. Conclusions: This Australian audit provides unique information on the characteristics and management of HIV and CVD in clinical practice. We have found a high burden of risk for CVD in HIV-infected Australians, but current screening and management practices in these patients fall short of contemporary guidelines.

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Associations of recreational and non-recreational physical activity with coronary artery calcium density vs. volume and cardiovascular disease events: the Multi-Ethnic Study of Atherosclerosis

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jez271 ◽

2019 ◽

Cited By ~ 1

Author(s):

Isac C Thomas ◽

Michelle L Takemoto ◽

Nketi I Forbang ◽

Britta A Larsen ◽

Erin D Michos ◽

...

Keyword(s):

Physical Activity ◽

Cardiovascular Disease ◽

Coronary Artery ◽

Standard Deviation ◽

Coronary Artery Calcium ◽

Recreational Physical Activity ◽

Cvd Risk ◽

Ethnic Study ◽

Subclinical Marker

Abstract Aims The benefits of physical activity (PA) on cardiovascular disease (CVD) are well known. However, studies suggest PA is associated with coronary artery calcium (CAC), a subclinical marker of CVD. In this study, we evaluated the associations of self-reported recreational and non-recreational PA with CAC composition and incident CVD events. Prior studies suggest high CAC density may be protective for CVD events. Methods and results We evaluated 3393 participants of the Multi-Ethnic Study of Atherosclerosis with prevalent CAC. After adjusting for demographics, the highest quintile of recreational PA was associated with 0.07 (95% confidence interval 0.01–0.13) units greater CAC density but was not associated with CAC volume. In contrast, the highest quintile of non-recreational PA was associated with 0.08 (0.02–0.14) units lower CAC density and a trend toward 0.13 (−0.01 to 0.27) log-units higher CAC volume. There were 520 CVD events over a 13.7-year median follow-up. Recreational PA was associated with lower CVD risk (hazard ratio 0.88, 0.79–0.98, per standard deviation), with an effect size that was not changed with adjustment for CAC composition or across levels of prevalent CAC. Conclusion Recreational PA may be associated with a higher density but not a higher volume of CAC. Non-recreational PA may be associated with lower CAC density, suggesting these forms of PA may not have equivalent associations with this subclinical marker of CVD. While PA may affect the composition of CAC, the associations of PA with CVD risk appear to be independent of CAC.

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Western dietary pattern increases risk of cardiovascular disease in Iranian adults: a prospective population-based study

Applied Physiology Nutrition and Metabolism ◽

10.1139/apnm-2016-0508 ◽

2017 ◽

Vol 42 (3) ◽

pp. 326-332 ◽

Cited By ~ 9

Author(s):

Parvin Mirmiran ◽

Zahra Bahadoran ◽

Azita Zadeh Vakili ◽

Fereidoun Azizi

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Dietary Patterns ◽

Dietary Pattern ◽

Regression Models ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Western Dietary Pattern ◽

Increased Risk

Limited data are available regarding the association of major dietary patterns and risk of cardiovascular disease (CVD) in Middle Eastern countries. We aimed to evaluate the association of major dietary patterns, using factor analysis, with the risk of CVD. Participants without CVD (n = 2284) were recruited from the Tehran Lipid and Glucose Study and were followed for a mean of 4.7 years. Dietary intake of participants was assessed at baseline (2006–2008); biochemical variables were evaluated at baseline and follow-up examination. Multivariate Cox proportional hazard regression models, adjusted for potential confounders, were used to estimate risk of CVD across tertiles of dietary pattern scores. Linear regression models were used to indicate association of dietary pattern scores with changes of CVD risk factors over the study period. Two major dietary patterns, Western and traditional, were identified. During a mean 4.7 ± 1.4 years of follow-up, 57 participants experienced CVD-related events. In the fully adjusted model, we observed an increased risk of CVD-related events in the highest compared to the lowest tertile category of Western dietary pattern score (HR = 2.07, 95% CI = 1.03–4.18, P for trend = 0.01). Traditional dietary pattern was not associated with incidence of CVD or CVD risk factors. A significant association was observed between the Western dietary pattern and changes in serum insulin (β = 5.88, 95% CI = 0.34–11.4). Our findings confirm that the Western dietary pattern, characterized by higher loads of processed meats, salty snacks, sweets, and soft drinks, is a dietary risk factor for CVD in the Iranian population.

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