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J Atheroscler Thromb. 2019 Feb 1;26(2):198-206. doi: 10.5551/jat.44172. Epub 2018 Aug 9.

Vegetable Protein Intake was Inversely Associated with Cardiovascular Mortality in a 15-Year Follow-Up Study of the General Japanese Population.

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Department of Preventive Medicine and Public Health, Keio University School of Medicine.
Department of Preventive Cardiology, National Cerebral and Cardiovascular Center.
Department of Health and Nutrition, University of Human Arts and Sciences.
Department of Public Health, Shiga University of Medical Science.
Center for Epidemiologic Research in Asia, Shiga University of Medical Science.
Department of Food and Nutrition, Osaka City University.
Department of Hygiene and Public Health, Teikyo University.
Research Institute of Strategy for Prevention.



To examine the relationship between the intake of dietary vegetable protein and CVD mortality in a 15-year follow-up study of a representative sample of the Japanese population.


A total of 7,744 participants aged 30 years or older (3,224 males and 4,520 females) who were free of CVD at baseline were included in this analysis. Vegetable protein intake (% energy) was assessed using a three-day semi-weighed dietary record at baseline. Multivariable-adjusted hazard ratios (HRs) were calculated using Cox's proportional hazards model after adjusting for confounding factors.


The total person-years studied were 107,988 with a mean follow-up period of 13.9 years. There were 1,213 deaths during the follow-up period, among which 354 (29.2%) were due to CVD. Vegetable protein intake was associated inversely with CVD and cerebral hemorrhage mortality, with the HRs for a 1% energy increment in vegetable protein intake being 0.86 (95% CI, 0.75-0.99) and 0.58 (95% CI, 0.35-0.95), respectively. In the subgroup analysis of participants with or without hypertension, the inverse association between vegetable protein intake and CVD mortality was more evident in the nonhypertensive group, with the HRs for CVD and stroke being 0.68 (95% CI, 0.50-0.94) and 0.50 (95% CI, 0.30-0.84), respectively.


Vegetable protein intake may prevent future CVD, particularly in nonhypertensive subjects in the Japanese population. However, further studies are necessary to examine the biological mechanisms of this effect.


Cardiovascular disease; Cohort studies; Hypertension; National nutrition survey; Stroke; Vegetable protein

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