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American Journal of Epidemiology Advance Access originally published online on August 31, 2009
American Journal of Epidemiology 2009 170(7):901-909; doi:10.1093/aje/kwp220
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American Journal of Epidemiology © The Author 2009. Published by the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

ORIGINAL CONTRIBUTIONS

Gender-specific Associations Between Soy and Risk of Hip Fracture in the Singapore Chinese Health Study

Woon-Puay Koh, Anna H. Wu, Renwei Wang, Li-Wei Ang, Derrick Heng, Jian-Min Yuan and Mimi C. Yu

Correspondence to Dr. Woon-Puay Koh, Department of Epidemiology and Public Health, Yong Loo Lin School of Medicine, National University of Singapore, MD3, 16 Medical Drive, Singapore 117597, Singapore (e-mail: ephkwp{at}nus.edu.sg).

Received for publication April 29, 2009. Accepted for publication June 23, 2009.

Although there is some epidemiologic evidence that soy may reduce risk of osteoporotic fracture in women, it is not known whether this risk reduction also occurs for men. The authors examined gender-specific associations between soy intake and hip fracture risk in the Singapore Chinese Health Study, a prospective cohort of 63,257 Chinese living in Singapore. At recruitment between 1993 and 1998, each subject was administered a food frequency questionnaire and questions on medical history and lifestyle factors. As of December 31, 2006, 276 incident cases of hip fracture in men and 692 cases in women were identified via linkage with hospital discharge databases. For both genders, hip fracture risk was positively associated with cigarette smoking and was inversely associated with body mass index. There was a statistically significant association of tofu equivalents, soy protein, and isoflavones with hip fracture risk among women but not among men. Compared with women in the lowest quartile of intakes for tofu equivalents (<49.4 g/day), soy protein (<2.7 g/day), and isoflavones (<5.8 mg/1,000 kcal/day), those in the second–fourth quartiles exhibited 21%–36% reductions in risk (all P < 0.036). Risk levels were comparable across the second, third, and fourth quartiles of soy intake categories.

Asian Continental Ancestry Group; hip fractures; isoflavones; osteoporosis; soy foods


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