title: Consumption of soy foods and isoflavones and risk of type 2 diabetes: a pooled analysis of three US cohorts.
abstract: Evidence regarding the consumption of soy foods and isoflavones in relation to risk of type 2 diabetes (T2D) is scarce. Our study was to evaluate the association between soy food and isoflavone consumption and risk of T2D in US men and women.
  
  
  
  We followed 63 115 women in the Nurses' Health Study (1998-2012), 79 061 women in the Nurses' Health Study II (1999-2013) and 21 281 men in the Health Professionals Follow-Up Study (2002-2010). Diet was assessed by a validated food-frequency questionnaire and was updated every 4 years. Self-reports of incident T2D were confirmed by a validated supplementary questionnaire.
  
  
  
  During 1 966 321 person-years of follow-up, 9185 incident T2D cases were documented. After multivariate adjustment for covariates, consumption of soy foods (tofu and soy milk) was not associated with a lower T2D risk. Compared with non-consumers of soy foods, the hazard ratio (HR) was 1.00 (95% confidence interval (CI): 0.93, 1.07) for <1 serving/week and 0.93 (95% CI: 0.83, 1.03) for ⩾1 serving/week of soy foods (P for trend=0.14). In contrast, intake of total isoflavones was inversely associated with T2D risk. Comparing extreme quintiles of isoflavones, the HR was 0.89 (95% CI: 0.83, 0.96; P for trend=0.009). Inverse associations were also found for consumption of major individual isoflavones, including daidzein and genistein, with risk of T2D.
  
  
  
  Intake of isoflavones was associated with a modestly lower T2D risk in US men and women who typically consumed low-to-moderate amounts of soy foods. These findings warrant replications in other populations with similar soy intake levels.
authors.affiliation: Department of Nutrition, Harvard School of Public Health, Boston, MA, USA.
authors.forename: M
authors.initials: M
authors.lastname: Ding
authors.affiliation: Department of Epidemiology and Biostatistics, MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: A
authors.initials: A
authors.lastname: Pan
authors.affiliation: Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.|Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA.
authors.forename: J E
authors.initials: JE
authors.lastname: Manson
authors.affiliation: Department of Nutrition, Harvard School of Public Health, Boston, MA, USA.|Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA.|Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
authors.forename: W C
authors.initials: WC
authors.lastname: Willett
authors.affiliation: Department of Nutrition, Harvard School of Public Health, Boston, MA, USA.
authors.forename: V
authors.initials: V
authors.lastname: Malik
authors.affiliation: Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.|Department of Biostatistics, Harvard School of Public Health, Boston, MA, USA.
authors.forename: B
authors.initials: B
authors.lastname: Rosner
authors.affiliation: Department of Nutrition, Harvard School of Public Health, Boston, MA, USA.|Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA.|Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
authors.forename: E
authors.initials: E
authors.lastname: Giovannucci
authors.affiliation: Department of Nutrition, Harvard School of Public Health, Boston, MA, USA.|Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA.|Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
authors.forename: F B
authors.initials: FB
authors.lastname: Hu
authors.affiliation: Department of Nutrition, Harvard School of Public Health, Boston, MA, USA.|Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
authors.forename: Q
authors.initials: Q
authors.lastname: Sun
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000209:etiology*; D004032:Diet / Q000379:methods*; D004034:Diet Surveys / Q000379:methods; D004435:Eating; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007529:Isoflavones / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012307:Risk Factors; D045730:Soy Foods; D014481:United States
chemical_list: D007529:Isoflavones