Soy food consumption is associated with lower risk of coronary heart disease in Chinese women

Effect of dietary vegetable and animal proteins on atherothrombosis in mice

OBJECTIVE

It is believed that vegetable and fish, but not animal, proteins prevent thrombosis. The present study compared the effect of long-term intake of purified vegetable and animal proteins (casein, pork, egg white, chicken, white and red fish, soybean, and potato) and powders from whole vegetable and animal meats (soybean, pork, chicken, and horse mackerel) on thrombotic tendency.

METHODS

Western-style high-fat diets with various proteins were given to mice deficient in apolipoprotein-E and low-density lipoprotein receptor for 8 or 12 wk. Thrombotic tendency was assessed by a laser-induced thrombosis test, severity of atherosclerosis was assessed by morphometric analysis of the aortic lesions, and reactivity of platelets was measured by a shear-induced platelet function test.

RESULTS

There was no difference in thrombotic tendency between the vegetable and animal protein diets with the exception of pork protein, which showed a prothrombotic effect. The latter was not observed in animals kept on a high-protein diet. Thrombotic tendency was not affected by preparation of dietary powders from whole pork, chicken, or horse mackerel meats and casein (control), all of which contained the same percentages of protein and lipid. In contrast, soybean powder showed an antithrombotic effect, which was mainly due to an inhibition of atherogenesis rather than to platelet inhibition.

CONCLUSION

Neither the purified animal nor the vegetable protein diet affected thrombotic tendency. Soybean powder inhibited atherothrombosis mainly by inhibiting the atherosclerotic process.

Cereal grains and legumes in the prevention of coronary heart disease and stroke: a review of the literature

A number of reviewers have examined studies investigating the relationship between coronary heart disease and stroke prior to 2000. Since then, several key studies have been published. Five studies have examined the relationship between wholegrain consumption, coronary heart disease (CHD) and cardiovascular (CVD) disease and found protection for either or both diseases. The researchers concluded that a relationship between wholegrain intake and CHD is seen with at least a 20% and perhaps a 40% reduction in risk for those who eat wholegrain food habitually vs those who eat them rarely. Notwithstanding the fact that fibre is an important component of wholegrains, many studies have not shown an independent effect of fibre alone on CHD events. Thus in terms of CHD prevention, fibre is best obtained from wholegrain sources. Wholegrain products have strong antioxidant activity and contain phytoestrogens, but there is insufficient evidence to determine whether this is beneficial in CHD prevention. Soluble fibre clearly lowers cholesterol to a small but significant degree and one would expect that this would reduce CHD events. There have been a small number of epidemiological studies showing soy consumption is associated with lower rates of heart disease. Countering the positive evidence for wholegrain and legume intake has been the Nurses Health Study in 2000 that showed women who were overweight or obese consuming a high glycaemic load (GL) diet doubled their relative risk of CHD compared with those consuming a low GL diet. Although the literature relating GL with CHD events is somewhat mixed, the relationship with risk factors such as HDL cholesterol, triglyceride and C reactive protein is relatively clear. Thus, carbohydrate-rich foods should be wholegrain and, if they are not, then the lowest glycaemic index (GI) product should be used. Promotion of carbohydrate foods should be focused on wholegrain cereals because these have proven to be associated with health benefits. There is insufficient evidence about whether the addition of other components of wholegrains such as polyphenolics or minerals (such as magnesium or zinc) would improve the health benefits of refined grain foods and this needs investigation. Whether adding bran to refined carbohydrate foods can improve the situation is also not clear, and it was found that added bran lowered heart disease risk in men by 30%. This persisted after full adjustment (including GL) suggesting, at least in men, that fibre may be more important than GI. Thus there are two messages: The intake of wholegrain foods clearly protects against heart disease and stroke but the exact mechanism is not clear. Fibre, magnesium, folate and vitamins B6 and vitamin E may be important. The intake of high GI carbohydrates (from both grain and non-grain sources) in large amounts is associated with an increased risk of heart disease in overweight and obese women even when fibre intake is high but this requires further confirmation in normal-weight women.

RECOMMENDATION

Carbohydrate-rich foods should be wholegrain and if they are not, then the lowest GI product available should be consumed. Glycemic index is largely irrelevant for foods that contain small amounts of carbohydrate per serve (such as most vegetables).

Soy protein with and without isoflavones fails to substantially increase postprandial antioxidant capacity

Five methods for the assessment of antioxidant capacity [whole plasma conjugated diene formation, low-density lipoprotein oxidation susceptibility, ferric-reducing ability of plasma, oxygen radical absorbance capacity and perchloric-acid-treated oxygen radical absorbance capacity (PCA-ORAC)] were used in a randomized, double blind, crossover study to determine the acute postprandial antioxidant protection imparted by the isoflavone component of soy. On separate days, 16 subjects consumed one of three isocaloric shakes containing 25 g of protein in the form of soy, with 107 mg of total aglycone units of isoflavones, soy with trace isoflavones (<4 mg) or total milk protein. Blood was collected at baseline, 4 h, 6 h and 8 h after consumption. Antioxidant capacity, serum isoflavone levels, fat-soluble antioxidants and plasma vitamin C levels were evaluated. Repeated measures analysis of variance showed no significant differences (P=.05) within treatments over time in four of five antioxidant capacity measurements. Significant differences over time between the soy with trace isoflavones and the total milk protein group were observed using the PCA-ORAC assay. It can be concluded that, on an acute basis, a significant increase in serum antioxidant capacity is not detectable following consumption of soy protein.

Effects of soy protein and soybean isoflavones on thyroid function in healthy adults and hypothyroid patients: a review of the relevant literature

Soy foods are a traditional staple of Asian diets but because of their purported health benefits they have become popular in recent years among non-Asians, especially postmenopausal women. There are many bioactive soybean components that may contribute to the hypothesized health benefits of soy but most attention has focused on the isoflavones, which have both hormonal and nonhormonal properties. However, despite the possible benefits concerns have been expressed that soy may be contraindicated for some subsets of the population. One concern is that soy may adversely affect thyroid function and interfere with the absorption of synthetic thyroid hormone. Thus, the purpose of this review is to evaluate the relevant literature and provide the clinician guidance for advising their patients about the effects of soy on thyroid function. In total, 14 trials (thyroid function was not the primary health outcome in any trial) were identified in which the effects of soy foods or isoflavones on at least one measure of thyroid function was assessed in presumably healthy subjects; eight involved women only, four involved men, and two both men and women. With only one exception, either no effects or only very modest changes were noted in these trials. Thus, collectively the findings provide little evidence that in euthyroid, iodine-replete individuals, soy foods, or isoflavones adversely affect thyroid function. In contrast, some evidence suggests that soy foods, by inhibiting absorption, may increase the dose of thyroid hormone required by hypothyroid patients. However, hypothyroid adults need not avoid soy foods. In addition, there remains a theoretical concern based on in vitro and animal data that in individuals with compromised thyroid function and/or whose iodine intake is marginal soy foods may increase risk of developing clinical hypothyroidism. Therefore, it is important for soy food consumers to make sure their intake of iodine is adequate.

Pharmaceutical prospects of phytoestrogens

Interest in the physiologic and pharmacologic role of bioactive compounds present in plants has increased dramatically over the last decade. Of particular interest in relation to human health are the classes of compounds known as the phytoestrogens, which embody several groups of non-steroidal estrogens, including isoflavones and lignans that are widely distributed within nature. The impact of dietary phytoestrogens on normal biologic processes was first recognized in sheep. Observations of sheep grazing on fields rich in clover and cheetahs fed high soy diets in zoos suggested that flavonoids and related phytochemicals can affect mammalian health. Endogenous estrogens have an important role not only in the hypothalamic-pituitary-gonadal axis, but also in various non-gonadal systems, such as cardiovascular systems, bone, and central nervous systems, and lipid metabolism. There have been several clinical studies of hormone replacement therapy (HRT) in post-menopausal women to examine whether HRT has beneficial effects on the cardiovascular system, bone fractures, lipid metabolism, and Alzheimer's disease. In addition, estrogen contributes to the development of some estrogen-dependent cancers, such as breast cancer and prostate cancer and the number of patients with these cancers is increasing in developed countries. Although recent mega-studies showed negative results for classical HRT in the prevention of some of these diseases, the molecules that interact with estrogen receptors are candidate drugs for various diseases, including hormone-dependent cancers. This review focuses on the molecular properties and pharmaceutical potential of phytoestrogens.

Cardiovascular consequences of life-long exposure to dietary isoflavones in the rat

Dietary soy intake in man is proposed to provide cardiovascular protection, but it is not established whether this property is attributable to the soy protein per se or to associated dietary isoflavones. This investigation aimed to establish whether the dietary isoflavones in soy protein affect cardiovascular function. Ten days prior to mating, male and female Wistar rats were habituated to either a soy based isoflavone rich diet (plasma concentration 1.87 micromol l(-1) isoflavones) or the same diet after isoflavone elution (plasma isoflavone not detectable). Offspring were weaned onto and maintained on the same diet as their dam and sire for 6 months. Blood pressure, and constrictor and dilator responses in the aorta and mesenteric resistance arteries were assessed at 3 and 6 months of age. There was no effect of isoflavone removal from the diet on blood pressure, heart rate, aortic function or mesenteric artery contractile function, at either 3 or 6 months of age. Resistance mesenteric arteries from 6-month-old female rats fed the isoflavone rich diet demonstrated a modest increase in arterial distensibility compared with those fed the depleted diet, and mesenteric arteries from male and female rats fed the isoflavone rich diet showed increased sensitivity to acetylcholine. In summary, the isoflavone content of soy protein has no influence on blood pressure in healthy rats fed a diet based on soy protein, but influences small artery function.

Vegetarian Diets

The quality of vegetarian diets to meet nutritional needs and support peak performance among athletes continues to be questioned. Appropriately planned vegetarian diets can provide sufficient energy and an appropriate range of carbohydrate, fat and protein intakes to support performance and health. The acceptable macronutrient distribution ranges for carbohydrate, fat and protein of 45-65%, 20-35% and 10-35%, respectively, are appropriate for vegetarian and non-vegetarian athletes alike, especially those who perform endurance events. Vegetarian athletes can meet their protein needs from predominantly or exclusively plant-based sources when a variety of these foods are consumed daily and energy intake is adequate. Muscle creatine stores are lower in vegetarians than non-vegetarians. Creatine supplementation provides ergogenic responses in both vegetarian and non-vegetarian athletes, with limited data supporting greater ergogenic effects on lean body mass accretion and work performance for vegetarians. The potential adverse effect of a vegetarian diet on iron status is based on the bioavailability of iron from plant foods rather than the amount of total iron present in the diet. Vegetarian and non-vegetarian athletes alike must consume sufficient iron to prevent deficiency, which will adversely affect performance. Other nutrients of concern for vegetarian athletes include zinc, vitamin B12 (cyanocobalamin), vitamin D (cholecalciferol) and calcium. The main sources of these nutrients are animal products; however, they can be found in many food sources suitable for vegetarians, including fortified soy milk and whole grain cereals. Vegetarians have higher antioxidant status for vitamin C (ascorbic acid), vitamin E (tocopherol), and beta-carotene than omnivores, which might help reduce exercise-induced oxidative stress. Research is needed comparing antioxidant defences in vegetarian and non-vegetarian athletes.

Plasma sitosterol elevations are associated with an increased incidence of coronary events in men: results of a nested case-control analysis of the Prospective Cardiovascular Münster (PROCAM) study

BACKGROUND AND AIM

Sitosterolemia, a rare genetic disorder characterized by profoundly elevated plasma sitosterol concentrations, is associated with premature atherosclerosis in some individuals. This study was conducted to evaluate if the modest sitosterol elevations seen in the general population are also associated with the occurrence of coronary events.

METHODS AND RESULTS

A nested case-control study using stored samples from male participants in the Prospective Cardiovascular Münster (PROCAM) study was performed. Each of 159 men who suffered a myocardial infarction or sudden coronary death (major coronary event) within 10 years of follow-up in PROCAM was matched with 2 controls (N = 318) by age, smoking status, and date of investigation. Analysis was performed using conditional logistic regression. Plasma sitosterol concentrations were elevated in cases compared with controls (4.94 +/- 3.44 micromol/L versus 4.27 +/- 2.38 micromol/L; P = 0.028). The upper quartile of sitosterol (>5.25 micromol/L) was associated with a 1.8-fold increase in risk (P < 0.05) compared with the lower three quartiles. Among men with an absolute coronary risk > or = 20% in 10 years as calculated using the PROCAM algorithm, high sitosterol concentrations were associated with an additional 3-fold increase in the incidence of coronary events (P = 0.032); a similar, significant relationship was observed between a high sitosterol/cholesterol ratio and coronary risk (P = 0.030).

CONCLUSIONS

Elevations in sitosterol concentrations and the sitosterol/cholesterol ratio appear to be associated with an increased occurrence of major coronary events in men at high global risk of coronary heart disease. Further evaluations are warranted to confirm these preliminary findings.

Soy extract has different effects compared with the isolated isoflavones on the proteome of homocysteine-stressed endothelial cells

Epidemiological studies suggest that soy consumption may provide a protection in the development and progression of atherosclerosis. It is under debate, however, whether the soy isoflavones or other compounds are the "active principle". As apoptosis is a driving force in the process of atherosclerosis, we tested whether a soy extract or a combination of the two predominant isoflavones genistein and daidzein, in concentrations as found in the extract, exert similar or different effects on apoptosis in EA.hy 926 endothelial cells after exposure to the endothelial stressor homocysteine. Plasma membrane disintegration and nuclear fragmentation served as relevant apoptosis markers. To assess whether the extract and the genistein/daidzein mixture differently affect cellular target proteins changed in amount by homocysteine treatment, proteome analysis was performed by two-dimensional gel-electrophoresis and peptide mass fingerprinting of regulated protein spots. Homocysteine induced apoptosis in the cells, and both extract and genistein/daidzein inhibited apoptosis to a comparable extent. Whereas the extract prevented for 10 proteins the changes in expression levels as caused by homocysteine, the genistein/daidzein mixture reversed the homocysteine effects on the proteome for 13 proteins. The cytoskeletal protein matrin 3 and a U5 snRNP-specific 40-kDa protein were the only protein entities where both extract and genistein/daidzein reversed the homocysteine-induced changes in a common way. In conclusion, our studies provide evidence that an isoflavone containing soy extract and isolated isoflavones, despite similar effects on inhibition of homocysteine-induced apoptosis in endothelial cells, affect a quite different spectrum of cellular target proteins.

Genistein blocks homocysteine-induced alterations in the proteome of human endothelial cells

Dietary isoflavones from soy are suggested to protect endothelial cells from damaging effects of endothelial stressors and thereby to prevent atherosclerosis. In search of the molecular targets of isoflavone action, we analyzed the effects of the major soy isoflavone, genistein, on changes in protein expression levels induced by the endothelial stressor homocysteine (Hcy) in EA.hy 926 endothelial cells. Proteins from cells exposed for 24 h to 25 microM Hcy alone or in combination with 2.5 microM genistein were separated by two-dimensional gel electrophoresis and those with altered spot intensities were identified by peptide mass fingerprinting. Genistein reversed Hcy-induced changes of proteins involved in metabolism, detoxification, and gene regulation; and some of those effects can be linked functionally to the antiatherosclerotic properties of the soy isoflavone. Alterations of steady-state levels of cytoskeletal proteins by genistein suggested an effect on apoptosis. As a matter of fact genistein caused inhibition of Hcy-mediated apoptotic cell death as indicated by inhibition of DNA fragmentation and chromatin condensation. In conclusion, proteome analysis allows the rapid identification of cellular target proteins of genistein action in endothelial cells exposed to the endothelial stressor Hcy and therefore enables the identification of molecular pathways of its antiatherosclerotic action.

Soy protein containing isoflavones reduces the size of atherosclerotic plaques without affecting coronary artery reactivity in adult male monkeys

The cardiovascular effects of dietary soy on men or adult male experimental animals have received little attention. We determined the effects of long-term (31 mo) consumption of a commercially available soy protein concentrate containing experimentally varied concentrations of isoflavones on the development of atherosclerosis and vascular reactivity in adult male monkeys. The monkeys were fed atherogenic diets that differed only in the source of protein: Control (n = 30), casein and lactalbumin; low-isoflavone soy (n = 30), a mixture of unmodified soy protein isolate and isoflavone-depleted soy protein isolate containing 0.94 mg of isoflavones/g protein; and high-isoflavone soy (n = 31), unmodified soy protein isolate containing 1.88 mg of isoflavone/g protein. Plasma LDL cholesterol was reduced, whereas HDL cholesterol and apolipoprotein A-1 (P < 0.05) were increased in both groups that consumed soy protein. Atherosclerosis (mean plaque size in the coronary arteries) was reduced by approximately 34% (P < 0.05) in both groups fed soy protein. There were no effects of dietary soy on endothelium-dependent or -independent reactivity of coronary arteries. The results indicate that long-term consumption of soy protein containing a modest amount of isoflavones inhibits the early progression of coronary artery atherosclerosis without affecting endothelium-dependent or -independent arterial function.

The Shanghai Women's Health Study: rationale, study design, and baseline characteristics

Although cancer is a major cause of morbidity and mortality in most nations, the spectrum of cancer occurrence varies substantially worldwide. Most previous epidemiologic studies investigating cancer etiology were conducted in North American and western European countries that are relatively homogenous in terms of cancer spectrums and many lifestyle exposures. These limitations may have hindered these studies from evaluating some important etiologic hypotheses. From 1996 to 2000, the Shanghai Women's Health Study recruited 74,942 adult Chinese women from selected urban communities, with a 92% response rate. All participants completed a detailed baseline survey and anthropometrics. Approximately 88% of cohort members donated a urine sample (n = 65,755) and a blood (n = 56,832) or exfoliated buccal cell (n = 8,934) sample. Noteworthy characteristics of this cohort include low consumption of alcohol (1.9%) and use of tobacco (2.4%); high intake of fish (mean, 50.8 g/day), soy foods (mean, 142.3 g/day), and certain vegetables; low prevalence of obesity (5.1%); and nearly 100% employment outside the home. Currently, this cohort of women is being followed via biennial in-person recontact and periodic linkage to cancer and vital statistics registries. The resources from the cohort will be valuable in future studies of environmental exposures and biomarkers for the risk of cancer and other chronic diseases.

Soybean Foods and Their Benefits: Potential Mechanisms of Action

Isoflavones have been proposed to be the active component responsible for the beneficial effects of soybean foods, and appear to work in conjunction with the proteins to protect against cancer, cardiovascular disease, and osteoporosis. Most of the research activities on the benefits of soybean foods have focused on the role these isoflavones play in disease prevention or treatment; however, there is also some evidence that the benefits are attributable to certain peptides or protein fractions from soybeans. This review will focus on some of the potential mechanisms whereby soybeans exert their protective effects against heart disease, cancer, and osteoporosis.

Protein, body weight, and cardiovascular health

Widespread popularity of high-protein diets has drawn controversy as well as scientific interest. By reducing intake of carbohydrates and increasing consumption of fats and proteins, such diets are thought to increase satiety, facilitate weight loss, and improve cardiovascular risk factors. In recent years, many randomized controlled studies have compared the effects of higher-protein diets on weight loss and cardiovascular risk factors with those of lower-protein diets. The aim of this review was to provide an overview of experimental and epidemiologic evidence regarding the role of protein in weight loss and cardiovascular risk. Emerging evidence from clinical trials indicates that higher-protein diets increase short-term weight loss and improve blood lipids, but long-term data are lacking. Findings from epidemiologic studies show a significant relationship between increased protein intake and lower risk of hypertension and coronary heart disease. However, different sources of protein appear to have different effects on cardiovascular disease. Although optimal amounts and sources of protein cannot be determined at this time, evidence suggests a potential benefit of partially replace refined carbohydrates with protein sources low in saturated fats.

Dietary protein type and cardiovascular disease risk factors

Observational studies suggested a negative association between vegetable protein and cardiovascular disease risk, whereas intervention studies have been less consistent. The majority of interventional studies that have evaluated the effects of soy protein compared to animal protein have used casein. Relative to casein, the effect of soy protein on lipids and lipoprotein appears to be variable and less dramatic than originally reported. When compared to animal proteins other than casein, relatively large intakes of soy protein (>/=25 g/d) appear to have a consistent, albeit small ( asymptotically equal to 5%), hypocholesterolemic effect. When assessed, no consistent additional benefit of soy protein on other cardiovascular disease risk factors; Lp(a), inflammatory markers, biomarkers of oxidative stress and endothelial function, has been reported. The data available on the effect of dietary protein on plasma lipids, lipoprotein levels, and cardiovascular disease risk factors is difficult to interpret and insufficient to account for the discrepancy between the observational and interventional studies.

Comparison of regulative functions between dietary soy isoflavones aglycone and glucoside on lipid metabolism in rats fed cholesterol

The effects of dietary soy isoflavones aglycone and glucoside on lipid metabolism were compared in male Sprague-Dawley rats (4 weeks old) given purified diets containing 0.3% cholesterol. The rats were fed a diet supplemented with either isoflavone aglycone-rich powder (IF-A group) or isoflavone glucoside-rich powder (IF-G group) or isoflavone-free diet (control group) for 40 days. The additional level of isoflavone aglycone moiety in the diet was prepared to the same level (approximately 0.096 g/100 g: approximately 0.1% in diet). The activity of hepatic cholesterol 7alpha-hydroxylase tended to be slightly higher in the rats fed isoflavones than in those fed the isoflavone-free diet. On the other hand, the activity of hepatic Delta6 desaturase in the IF-A group was lower than that of the control group. Reflecting this effect, the Delta6 desaturation indices [(20:3n-6+20:4n-6)/18:2n-6] in liver phospholipids of the IF-A group were lower than those in the control group. Liver and serum total cholesterol levels and liver TG level were also reduced by consumption of isoflavone aglycone. Moreover, serum TG level was lowered by consumption of both isoflavones aglycone and glucoside. The level of serum total isoflavones in the IF-A group was significantly higher than that in the IF-G group. Therefore, we speculate that the absorption speed of isoflavone aglycones might be faster than that of isoflavone glucosides in rats. This study suggests that dietary soy isoflavones, particularly their aglycone form, may exert a beneficial effect on lipid metabolism in rats fed cholesterol.

Soy, isoflavones and atherosclerosis

Consumption of soy protein is associated with a lower risk of cardiovascular disease in man, and reduced atherosclerosis in a variety of experimental animals. Although a portion of the cardiovascular protective effects appears to be due to reductions in plasma lipoprotein concentration, in most people the magnitude of this effect is relatively small. In many, but not all studies using animal models, the reduction in atherosclerosis is in part independent of changes in plasma lipids and lipoproteins. This implies that there may be a direct effect on the arterial wall of one or more of the components in soyprotein that reduces susceptibility to atherosclerosis. The most actively studied components of soy protein that may be responsible for these anti-atherogenic effects are the isoflavones and various protein factions. Extraction of isoflavones and other alcohol-soluble components from soy protein lowers, but does not eliminate its ability to reduce atherosclerosis. Surprisingly, in most studies, adding back the isoflavone-rich alcohol extract to the previously extracted soy protein, or to another protein, does not restore its lipoprotein lowering or anti-atherogenic properties. This implies that alcohol extraction either destroys an active component of soy, alters the structural integrity of the soy proteins, or disassociates a required isoflavone-soy protein complex. Understanding the mechanism of this effect is an important goal for future research. Likewise, the sites of action on the arterial wall, and the mechanisms by which various soy components act to reduce atherosclerosis are just now being studied. The recent demonstration that expression of estrogen receptor alpha is required for atheroprotection by soy protein provides important new mechanistic insight. Other properties of soy, including antioxidant, anti-inflammatory and potentially antithrombogenic properties need to be explored more mechanistically before the full potential of dietary soy protein for the protection from cardiovascular disease will be known.

Plasma antioxidant capacity in response to diets high in soy or animal protein with or without isoflavones

BACKGROUND

Several clinical trials have suggested that soy intake decreases oxidative stress. Soy isoflavones have antioxidant properties in vitro, but results of supplementation in clinical trials are inconclusive.

OBJECTIVE

The objective was to evaluate the independent effects of soy protein and soy-derived isoflavones on plasma antioxidant capacity and biomarkers of oxidative stress.

DESIGN

Forty-two hypercholesterolemic (LDL cholesterol > 3.36 mmol/L) subjects aged >50 y were provided with each of 4 diets in random order in a crossover design. Diets varied in protein source (10% of energy, soy or animal) and isoflavone content (trace or 50 mg/1000 kcal) and were consumed for 42 d each. Plasma antioxidants, protein carbonyls, malondialdehyde, total antioxidant performance, LDL oxidizability, and urinary F(2)-isoprostanes were measured at the end of each dietary phase.

RESULTS

Plasma antioxidant concentrations were not significantly different, regardless of dietary treatment, except for isoflavones, which were higher after isoflavone supplementation (P = 0.0001). Although plasma total antioxidant performance was 10% higher with soy protein intake, regardless of dietary isoflavones (P = 0.0003), soy protein did not significantly affect most individual markers of oxidative stress (LDL oxidizability, urinary F(2)-isoprostanes, malondialdehyde, or protein carbonyls in native plasma). However, soy protein was associated with modestly lower concentrations of protein carbonyls in oxidized plasma. There was no significant effect of isoflavones on LDL oxidation, urinary F(2)-isoprostanes, or protein carbonyl groups, although, paradoxically, the plasma malondialdehyde concentration was significantly higher after the isoflavone-rich diets (P = 0.04).

CONCLUSIONS

Diets relatively high in soy protein or soy-derived isoflavones have little effect on plasma antioxidant capacity and biomarkers of oxidative stress.

Soy intake and blood cholesterol concentrations: a cross-sectional study of 1033 pre- and postmenopausal women in the Oxford arm of the European Prospective Investigation into Cancer and Nutrition

BACKGROUND

Clinical trials have suggested that the intake of soy protein reduces blood cholesterol. Few studies have explored this relation in subjects who consume soy as part of their regular diet.

OBJECTIVE

In this study, we investigated whether blood cholesterol concentrations are related to the intake of soyfoods in a cohort comprising subjects with a wide variation in soy intake.

DESIGN

This cross-sectional study included 1033 pre- and postmenopausal women selected from the Oxford arm of the European Prospective Investigation into Cancer and Nutrition. The sample included 361 nonvegetarians, 570 vegetarians, and 102 vegans. Their dietary intake was assessed by using a food-frequency questionnaire. Anthropometric data, medical history, and lifestyle information were obtained with the use of a questionnaire, blood samples were obtained, and plasma total, LDL-, and HDL-cholesterol concentrations were measured.

RESULTS

Soy-protein intake was inversely associated with total and LDL-cholesterol concentrations and with the ratio of total to HDL cholesterol but not with HDL-cholesterol concentrations. Mean plasma LDL-cholesterol concentrations in women with a soy-protein intake >/=6 g/d was 12.4% lower than that in women who consumed <0.5 g/d (P < 0.001).

CONCLUSION

Moderate intakes of soyfoods as part of a regular diet are associated with favorable blood cholesterol concentrations.

Not all soy products are created equal: caution needed in interpretation of research results

Interest in the health benefits of soy foods has been intense among the research community, health professionals, and the public. At the same time, potential concerns associated with soy consumption, especially as related to soy isoflavones, have tempered the enthusiasm for making public health recommendations. On both accounts, the primary soybean isoflavone, genistein, has received the most attention. Because consumers are becoming increasingly confused by the often conflicting dietary messages, a balanced and accurate view of the risks and benefits of soy foods and soy food components is essential. Even among health professionals, confusion exists about proper nomenclature and about the precise composition of the agents under investigation. Levels of isoflavones are frequently assumed to be constant within categories of soy foods, and intakes are estimated rather than being directly analyzed. Furthermore, all too often research dealing singularly with genistein is interpreted by both health professionals and the media as equating directly with soy. Researchers often fail to fully understand the implications of their research outcomes and the context in which those outcomes should be placed. With the hundreds of publications yearly on soy and isoflavones, it is especially important to consider the literature in its entirety when making pronouncements about health effects. Efforts are needed by all to reduce the public confusion by adapting standardized approaches to the reporting of data. This paper provides a framework for both standardization of nomenclature and appropriate interpretation of data.

Anthropometric predictors of coronary heart disease in Chinese women

OBJECTIVE

To evaluate the associations of body size and fat distribution with incidence of coronary heart disease (CHD) in Chinese women.

DESIGN

Population-based, prospective cohort study.

SUBJECTS

A total of 67 334 women aged 40-70 y, who had no prior history of CHD, stroke, and cancer at study recruitment.

MEASUREMENTS

Weight, standing and sitting heights, circumferences of waist and hip, and ratios of the anthropometric measurements.

OUTCOME

incidence of CHD (non-fatal myocardial infarction (MI) or fatal CHD).

RESULTS

After a mean follow-up of 2.5 y (168 164 person-years), there were 70 incident cases of CHD (49 non-fatal MIs and 21 CHD deaths). Body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), waist-to-standing height ratio (WHtR), waist-to-sitting height ratio (WsHtR), and conicity index were all positively associated with the risk of CHD. With the exception of WHR, all other anthropometric indexes only predicted the risk of CHD among women </=55 y of age at enrollment. The relative risks (RRs) between extreme tertiles of BMI were 9.0 (95% CI, 2.0-41.5; P for trend=0.002) for younger women vs 1.3 (0.6-3.0; P for trend=0.83) for older women. Similarly, the RRs for WC, WHtR, WsHtR, and conicity index were 6.1 (1.8-21.4) vs 1.9 (0.6-5.4), 9.4 (2.6-33.8) vs 1.2 (0.5-3.1), 15.2 (3.3-69.1) vs 1.0 (0.4-2.5), and 7.8 (2.2-28.0) vs 0.9 (0.4-2.3) for the young and elderly, respectively. In contrast, the RR for WHR was 3.2 (1.1-9.1) for the young and 2.9 (1.0-8.4) for the elderly.

CONCLUSIONS

WHR was positively associated with the risk of CHD in both younger and older women, while other anthropometrics, including BMI, were related to CHD risk primarily among younger women.