Soy consumption and incidence of gestational diabetes mellitus: the Japan Environment and Children’s Study

Abstract

Background

Intervention studies have shown that isoflavone treatment improved glucose metabolism, indicating that soy intake may have a potential role in diabetes prevention.

Objectives

We aimed to investigate the prospective association of soy isoflavone and soy food intakes with incidence of gestational diabetes mellitus (GDM) in a birth cohort study.

Methods

We recruited 97,454 pregnant women (median gestational age 12 weeks) between January 2011 and March 2014. Dietary intakes during the 12 months preceding study enrollment were assessed by a semi-quantitative food frequency questionnaire. The relative risks of GDM associated with soy isoflavone and soy food intakes were obtained by Poisson regression. Demographic information, histories of diseases, socioeconomic status, lifestyles, and dietary habits, obtained by a self-administrated questionnaire, were used for covariate adjustments.

Results

We identified 1904 cases of GDM (2.2%) among 84,948 women. Compared with those in the lowest quintile of soy isoflavone intake, women in the highest quintile were found to have experienced a significantly lower risk of GDM (multivariate relative risk = 0.82; 95% confidence interval: 0.70, 0.95; P for trend = 0.05). Similar results were observed for genistein and daidzein. Regarding soy foods, intakes of miso soup and natto were inversely associated with GDM incidence (both P for trend ≤ 0.01), whereas the association for tofu intake appeared to be nonlinear (P for trend = 0.74).

Conclusions

Higher intakes of miso soup and natto before and during early pregnancy, compared with lower intakes, may be associated with a lower incidence of GDM.

This is a preview of subscription content, access via your institution.

Fig. 1

References

  1. 1.

    Setchell KD, Cassidy A (1999) Dietary isoflavones: biological effects and relevance to human health. J Nutr 129:758S–767S. https://doi.org/10.1093/jn/129.3.758S

    CAS  Article  PubMed  Google Scholar 

  2. 2.

    Dong JY, Qin LQ (2011) Soy isoflavones consumption and risk of breast cancer incidence or recurrence: a meta-analysis of prospective studies. Breast Cancer Res Treat 125:315–323

    CAS  Article  Google Scholar 

  3. 3.

    Applegate CC, Rowles JL, Ranard KM et al (2018) Soy consumption and the risk of prostate cancer: an updated systematic review and meta-analysis. Nutrients 10:40. https://doi.org/10.3390/nu10010040

    CAS  Article  PubMed Central  Google Scholar 

  4. 4.

    Nagata C, Wada K, Tamura T et al (2017) Dietary soy and natto intake and cardiovascular disease mortality in Japanese adults: the Takayama study. Am J Clin Nutr 105:426–431. https://doi.org/10.3945/ajcn.116.137281

    CAS  Article  PubMed  Google Scholar 

  5. 5.

    Tokede OA, Onabanjo TA, Yansane A et al (2015) Soya products and serum lipids: a meta-analysis of randomised controlled trials. Br J Nutr 114:831–843. https://doi.org/10.1017/S0007114515002603

    CAS  Article  PubMed  Google Scholar 

  6. 6.

    Dong J-Y, Tong X, Wu Z-W et al (2011) Effect of soya protein on blood pressure: a meta-analysis of randomised controlled trials. Br J Nutr 106:317–326. https://doi.org/10.1017/S0007114511000262

    CAS  Article  PubMed  Google Scholar 

  7. 7.

    Beavers DP, Beavers KM, Miller M et al (2012) Exposure to isoflavone-containing soy products and endothelial function: a Bayesian meta-analysis of randomized controlled trials. Nutr Metab Cardiovasc Dis 22:182–191. https://doi.org/10.1016/j.numecd.2010.05.007

    CAS  Article  PubMed  Google Scholar 

  8. 8.

    Fang K, Dong H, Wang D et al (2016) Soy isoflavones and glucose metabolism in menopausal women: a systematic review and meta-analysis of randomized controlled trials. Mol Nutr Food Res 60:1602–1614. https://doi.org/10.1002/mnfr.201501024

    CAS  Article  PubMed  Google Scholar 

  9. 9.

    Villegas R, Gao Y-T, Yang G et al (2008) Legume and soy food intake and the incidence of type 2 diabetes in the Shanghai Women’s Health Study. Am J Clin Nutr 87:162–167. https://doi.org/10.1093/ajcn/87.1.162

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  10. 10.

    Nanri A, Mizoue T, Takahashi Y et al (2010) Soy product and isoflavone intakes are associated with a lower risk of type 2 diabetes in overweight Japanese women. J Nutr 140:580–586. https://doi.org/10.3945/jn.109.116020

    CAS  Article  PubMed  Google Scholar 

  11. 11.

    Mueller NT, Odegaard AO, Gross MD et al (2012) Soy intake and risk of type 2 diabetes in Chinese Singaporeans [corrected]. Eur J Nutr 51:1033–1040. https://doi.org/10.1007/s00394-011-0276-2

    CAS  Article  PubMed  Google Scholar 

  12. 12.

    Morimoto Y, Steinbrecher A, Kolonel LN, Maskarinec G (2011) Soy consumption is not protective against diabetes in Hawaii: the Multiethnic Cohort. Eur J Clin Nutr 65:279–282. https://doi.org/10.1038/ejcn.2010.228

    CAS  Article  PubMed  Google Scholar 

  13. 13.

    Ding M, Pan A, Manson JE et al (2016) Consumption of soy foods and isoflavones and risk of type 2 diabetes: a pooled analysis of three US cohorts. Eur J Clin Nutr 70:1381–1387. https://doi.org/10.1038/ejcn.2016.117

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  14. 14.

    Zhu Y, Zhang C (2016) Prevalence of gestational diabetes and risk of progression to type 2 diabetes: a global perspective. Curr Diab Rep 16:7. https://doi.org/10.1007/s11892-015-0699-x

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  15. 15.

    Reece EA, Leguizamon G, Wiznitzer A (2009) Gestational diabetes: the need for a common ground. Lancet (London, England) 373:1789–1797. https://doi.org/10.1016/S0140-6736(09)60515-8

    Article  Google Scholar 

  16. 16.

    Bellamy L, Casas J-P, Hingorani AD, Williams D (2009) Type 2 diabetes mellitus after gestational diabetes: a systematic review and meta-analysis. Lancet (London, England) 373:1773–1779. https://doi.org/10.1016/S0140-6736(09)60731-5

    CAS  Article  Google Scholar 

  17. 17.

    Boerschmann H, Pfluger M, Henneberger L et al (2010) Prevalence and predictors of overweight and insulin resistance in offspring of mothers with gestational diabetes mellitus. Diabetes Care 33:1845–1849. https://doi.org/10.2337/dc10-0139

    Article  PubMed  PubMed Central  Google Scholar 

  18. 18.

    Maftei O, Whitrow MJ, Davies MJ et al (2015) Maternal body size prior to pregnancy, gestational diabetes and weight gain: associations with insulin resistance in children at 9–10 years. Diabet Med 32:174–180. https://doi.org/10.1111/dme.12637

    CAS  Article  PubMed  Google Scholar 

  19. 19.

    Jamilian M, Asemi Z (2015) the effect of soy intake on metabolic profiles of women with gestational diabetes mellitus. J Clin Endocrinol Metab 100:4654–4661. https://doi.org/10.1210/jc.2015-3454

    CAS  Article  PubMed  Google Scholar 

  20. 20.

    Michikawa T, Nitta H, Nakayama SF et al (2018) Baseline profile of participants in the japan environment and children’s study (JECS). J Epidemiol 28:99–104. https://doi.org/10.2188/jea.JE20170018

    Article  PubMed  PubMed Central  Google Scholar 

  21. 21.

    Kawamoto T, Nitta H, Murata K et al (2014) Rationale and study design of the Japan environment and children’s study (JECS). BMC Public Health 14:25. https://doi.org/10.1186/1471-2458-14-25

    Article  PubMed  PubMed Central  Google Scholar 

  22. 22.

    Yokoyama Y, Takachi R, Ishihara J et al (2016) Validity of short and long self-administered food frequency questionnaires in ranking dietary intake in middle-aged and elderly japanese in the japan public health center-based prospective study for the next generation (JPHC-NEXT) protocol area. J Epidemiol 26:420–432. https://doi.org/10.2188/jea.JE20150064

    Article  PubMed  Google Scholar 

  23. 23.

    Ogawa K, Jwa S-C, Kobayashi M et al (2017) Validation of a food frequency questionnaire for Japanese pregnant women with and without nausea and vomiting in early pregnancy. J Epidemiol 27:201–208. https://doi.org/10.1016/j.je.2016.06.004

    Article  PubMed  PubMed Central  Google Scholar 

  24. 24.

    https://www.fsc.go.jp/sonota/daizu_isoflavone.html. Accessed May 2020 (in Japanese)

  25. 25.

    Kuzuya T, Nakagawa S, Satoh J et al (2002) Report of the committee on the classification and diagnostic criteria of diabetes mellitus. Diabetes Res Clin Pract 55:65–85. https://doi.org/10.1016/s0168-8227(01)00365-5

    Article  PubMed  Google Scholar 

  26. 26.

    Willett WC, Howe GR, Kushi LH (1229S) Adjustment for total energy intake in epidemiologic studies. Am J Clin Nutr 65:1220S–1228S. https://doi.org/10.1093/ajcn/65.4.1220S(discussion 1229S-1231S)

    CAS  Article  PubMed  Google Scholar 

  27. 27.

    Spiegelman D, Hertzmark E (2005) Easy SAS calculations for risk or prevalence ratios and differences. Am J Epidemiol 162:199–200

    Article  Google Scholar 

  28. 28.

    Hoffmann K, Schulze MB, Schienkiewitz A et al (2004) Application of a new statistical method to derive dietary patterns in nutritional epidemiology. Am J Epidemiol 159:935–944. https://doi.org/10.1093/aje/kwh134

    Article  PubMed  Google Scholar 

  29. 29.

    Uusitupa M, Khan TA, Viguiliouk E et al (2019) Prevention of type 2 diabetes by lifestyle changes: a systematic review and meta-analysis. Nutrients 11:2611. https://doi.org/10.3390/nu11112611

    CAS  Article  PubMed Central  Google Scholar 

  30. 30.

    Kaaja R, Ronnemaa T (2008) Gestational diabetes: pathogenesis and consequences to mother and offspring. Rev Diabet Stud 5:194–202. https://doi.org/10.1900/RDS.2008.5.194

    Article  PubMed  Google Scholar 

  31. 31.

    Atteritano M, Marini H, Minutoli L et al (2007) Effects of the phytoestrogen genistein on some predictors of cardiovascular risk in osteopenic, postmenopausal women: a two-year randomized, double-blind, placebo-controlled study. J Clin Endocrinol Metab 92:3068–3075. https://doi.org/10.1210/jc.2006-2295

    CAS  Article  PubMed  Google Scholar 

  32. 32.

    Squadrito F, Marini H, Bitto A et al (2013) Genistein in the metabolic syndrome: results of a randomized clinical trial. J Clin Endocrinol Metab 98:3366–3374. https://doi.org/10.1210/jc.2013-1180

    CAS  Article  PubMed  Google Scholar 

  33. 33.

    Crisafulli A, Altavilla D, Marini H et al (2005) Effects of the phytoestrogen genistein on cardiovascular risk factors in postmenopausal women. Menopause 12:186–192

    Article  Google Scholar 

  34. 34.

    Marini H, Bitto A, Altavilla D et al (2010) Efficacy of genistein aglycone on some cardiovascular risk factors and homocysteine levels: A follow-up study. Nutr Metab Cardiovasc Dis 20:332–340. https://doi.org/10.1016/j.numecd.2009.04.012

    CAS  Article  PubMed  Google Scholar 

  35. 35.

    Kwon DY, Daily JW 3rd, Kim HJ, Park S (2010) Antidiabetic effects of fermented soybean products on type 2 diabetes. Nutr Res 30:1–13. https://doi.org/10.1016/j.nutres.2009.11.004

    CAS  Article  PubMed  Google Scholar 

  36. 36.

    Huang H, Krishnan HB, Pham Q et al (2016) Soy and gut microbiota: interaction and implication for human health. J Agric Food Chem 64:8695–8709. https://doi.org/10.1021/acs.jafc.6b03725

    CAS  Article  PubMed  Google Scholar 

  37. 37.

    Hartstra AV, Bouter KEC, Backhed F, Nieuwdorp M (2015) Insights into the role of the microbiome in obesity and type 2 diabetes. Diabetes Care 38:159–165. https://doi.org/10.2337/dc14-0769

    CAS  Article  PubMed  Google Scholar 

  38. 38.

    Chatterjee C, Gleddie S, Xiao C-W (2018) Soybean bioactive peptides and their functional properties. Nutrients 10:1211. https://doi.org/10.3390/nu10091211

    CAS  Article  PubMed Central  Google Scholar 

  39. 39.

    Morales FJ, Somoza V, Fogliano V (2012) Physiological relevance of dietary melanoidins. Amino Acids 42:1097–1109. https://doi.org/10.1007/s00726-010-0774-1

    CAS  Article  PubMed  Google Scholar 

  40. 40.

    Hiramatsu Y, Haneda M, Yasuhi I et al (2015) The joint committee with the Japan Society of Diabetes and Pregnancy and the Japan Diabetes Society “an abnormal glucose metabolism during pregnancy and the standardization of its diagnostic criteria”. J Japan Diabetes Soc 58:801–803. https://doi.org/10.11213/tonyobyo.58.801 (in Japanese)

    Article  Google Scholar 

Download references

Acknowledgements

The present analysis was based on the dataset of jecs-ag-20160424 released in June 2016 and revised in October 2016. Members of the Japan Environment and Children's Study (JECS) as of 2019 (principal investigator, Michihiro Kamijima): Shin Yamazaki (National Institute for Environmental Studies, Tsukuba, Japan), Yukihiro Ohya (National Centre for Child Health and Development, Tokyo, Japan), Reiko Kishi (Hokkaido University, Sapporo, Japan), Nobuo Yaegashi (Tohoku University, Sendai, Japan), Koichi Hashimoto (Fukushima Medical University, Fukushima, Japan), Chisato Mori (Chiba University, Chiba, Japan), Shuichi Ito (Yokohama City University, Yokohama, Japan), Zentaro Yamagata (University of Yamanashi, Chuo, Japan), Hidekuni Inadera (University of Toyama, Toyama, Japan), Michihiro Kamijima (Nagoya City University, Nagoya, Japan), Takeo Nakayama (Kyoto University, Kyoto, Japan), Hiroyasu Iso (Osaka University, Suita, Japan), Masayuki Shima (Hyogo College of Medicine, Nishinomiya, Japan), Youichi Kurosawa (Tottori University, Yonago, Japan), Narufumi Suganuma (Kochi University, Nankoku, Japan), Koichi Kusuhara (University of Occupational and Environmental Health, Kitakyushu, Japan), and Takahiko Katoh (Kumamoto University, Kumamoto, Japan).

Funding

The Japan Environment and Children’s Study was funded by the Ministry of the Environment, Japan. The findings and conclusions of this article are solely the responsibility of the authors and do not represent the official views of the above government.

Author information

Affiliations

Authors

Consortia

Corresponding author

Correspondence to Hiroyasu Iso.

Ethics declarations

Conflict of interest

None declared.

Additional information

The Japan Environment and Children’s Study Group members are listed in “Acknowledgement” section.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 187 kb)

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Dong, JY., Kimura, T., Ikehara, S. et al. Soy consumption and incidence of gestational diabetes mellitus: the Japan Environment and Children’s Study. Eur J Nutr 60, 897–904 (2021). https://doi.org/10.1007/s00394-020-02294-1

Download citation

Keywords

  • Soy
  • Isoflavone
  • Gestational diabetes mellitus
  • Cohort study
  • Prevention