Epidemiology and Health

Original Article

Sex-specific associations between dietary legume subtypes and type 2 diabetes in a prospective cohort study: Hye Won Woo, Sangmo Hong, Min-Ho Shin, Sang Baek Koh, Hyeon Chang Kim, Yu-Mi Kim, Mi Kyung Kim; Epidemiol Health. 2024;46:e2024083. Published online October 17, 2024; DOI: https://doi.org/10.4178/epih.e2024083

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
Dietary soy, known for its high phytoestrogen content, has been suggested to exhibit a sex-specific association with type 2 diabetes. However, evidence regarding the sex-specific associations of different legume subtypes with type 2 diabetes remains scarce. We aimed to evaluate whether habitual consumption of soy and non-soy legumes (beans and peanuts) was prospectively and sex-specifically associated with the risk of type 2 diabetes incidence, taking into considering significant sex-specific genetic factors beyond legume consumption.
METHODS
A total of 16,666 participants (96,945 person-years) were followed and 945 incident cases were observed. Cumulative intake of legume subtypes was calculated using a food frequency questionnaire administered at baseline and during the revisit surveys.
RESULTS
Non-soy legumes are inversely associated with type 2 diabetes in both men and women. Dietary soy intake, however, demonstrated a unilaterally interacting sex-specific association with type 2 diabetes risk (pinteraction for sex=0.017). Specifically, there was a significant inverse association with type 2 diabetes risk in women (incidence rate ratio, 0.66; 95% confidence interval, 0.48 to 0.80; ptrend=0.007), but no such association was observed in men. This sex-specific association persisted and even appeared antagonistic in minor allele carriers of 2 novel single nucleotide polymorphisms, rs10196939 (LRRTM4) and rs11750158 (near GFPT2) (pinteraction for sex=0.001 and 0.011, respectively).
CONCLUSIONS
Habitual consumption of legumes shows protective impacts against type 2 diabetes, although these benefits vary by sex. Non-soy legumes provide health advantages for both men and women, whereas soy consumption seems to be beneficial exclusively for women.; Summary

Korean summary
콩류 섭취는 제2형 당뇨병 예방에 도움이 되는데, 대두를 제외한 콩류와 땅콩은 남녀 모두에게 건강상의 이점이 있는 반면, 대두는 여성에게만 보호적 이점이 있는 것으로 관찰되었다. 대두 섭취는 남성과 여성에서 서로 다른 영향을 미치는 것으로 관찰되었으며, 이는 대두 섭취의 건강상의 영향이 성별에 따라 다르게 나타날 수 있음을 시사하였다.

Key Message
Our findings showed that while legume consumption was protective against type 2 diabetes, beans and peanuts demonstrated health benefits in both sexes, whereas soy's protective benefits were observed only in women. Soy consumption was observed to have different effects between men and women, suggesting that the health impact of soy intake may differ by sex.

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