Table 4.

Associations of main food sources of phytoestrogens and total and cause-specific mortality

Tofu
	<1 serving/month	<1 serving/week	≥1 serving/week			Ptrend
Total mortality	1	0.93 (0.90, 0.95)	0.85 (0.80, 0.89)			<0.0001
CVD mortality	1	0.92 (0.87, 0.96)	0.86 (0.77, 0.96)			0.001
Cancer mortality	1	0.92 (0.88, 0.97)	0.98 (0.89, 1.07)			0.42
Other mortality	1	0.93 (0.90, 0.97)	0.78 (0.73, 0.84)			<0.0001
Soy milk
	<1 serving/month	<1 serving/week	≥1 serving/week			Ptrend
Total mortality	1	0.73 (0.67, 0.80)	0.84 (0.79, 0.89)			<0.0001
CVD mortality	1	0.97 (0.81, 1.15)	0.89 (0.78, 1.01)			0.06
Cancer mortality	1	0.75 (0.62, 0.90)	0.91 (0.80, 1.26)			0.09
Other mortality	1	0.89 (0.79, 1.00)	0.89 (0.82, 0.97)			0.005
Whole grains
	Q1 (Low)	Q2	Q3	Q4	Q5 (High)	Ptrend
Total mortality	1	0.93 (0.91, 0.96)	0.90 (0.87, 0.92)	0.86 (0.83, 0.88)	0.81 (0.78, 0.83)	<0.0001
CVD mortality	1	0.86 (0.81, 0.91)	0.85 (0.80, 0.89)	0.79 (0.75, 0.83)	0.76 (0.72, 0.81)	<0.0001
Cancer mortality	1	0.93 (0.88, 0.98)	0.88 (0.84, 0.93)	0.84 (0.80, 0.89)	0.79 (0.75, 0.84)	<0.0001
Other mortality	1	0.97 (0.93, 1.01)	0.94 (0.90, 0.98)	0.91 (0.87, 0.95)	0.85 (0.81, 0.89)	<0.0001
Tea
	<1 cup/week	<1 cup/d	>1 cup/d			Ptrend
Total mortality	1	0.95 (0.93, 0.97)	0.94 (0.91, 0.96)			<0.0001
CVD mortality	1	0.97 (0.94, 1.01)	0.93 (0.88, 0.98)			0.01
Cancer mortality	1	0.93 (0.90, 0.97)	0.94 (0.89, 0.98)			0.01
Other mortality	1	0.96 (0.93, 0.99)	0.95 (0.91, 0.98)			0.005
Flaxseed1
	No consumption		Consumption
Total mortality	1		0.89 (0.83, 0.96)
CVD mortality	1		1.05 (0.90, 1.23)
Cancer mortality	1		0.85 (0.73, 1.00)
Other mortality	1		0.94 (0.86, 1.04)
Flaxseed oil1
	No consumption		Consumption
Total mortality	1		0.91 (0.84, 0.99)
CVD mortality	1		0.99 (0.83, 1.18)
Cancer mortality	1		1.03 (0.86, 1.23)
Other mortality	1		0.92 (0.83, 1.02)

Data were combined from Nurses’ Health Study and Health Professionals Follow-Up Study. Estimates were calculated in Cox proportional-hazards models and adjusted for age, ethnicity (Caucasians/other races), smoking status (never, former, current [1–14, 15–24, or ≥25 cigarettes/d], or missing), alcohol intake (0, 0.1–4.9, 5.0–14.9, and ≥15.0 g/d for females; 0, 0.1–4.9, 5.0–29.9, and ≥30.0 g/d for males; or missing), physical activity (metabolic equivalents of task-hour/week), multivitamin use (yes/no), aspirin use (yes/no), history of hypertension (yes/no) and hypercholesterolemia (yes/no), family history of myocardial infarction (yes/no), family history of cancer (yes/no), family history of diabetes (yes/no), menopausal status and postmenopausal hormone use (premenopause, postmenopause [never, former, or current hormone use], or missing; for females), body mass index (<23, 23–24.9, 25–29.9, 30–34.9, >35 kg/m², or missing), and total energy intake (kcal/d), and modified alternative health eating index score. P_trend < 0.05 was considered statistically significant.

¹The analysis involving flaxseed products only included data after 2006 when they were specifically assessed.