Clinical and metabolic response to soy administration in older women with metabolic syndrome: a randomized controlled trial

The Inverse Association Between Isoflavone Intake and Prevalence of Metabolic Syndrome: A Cross-Sectional Study from National Health and Nutrition Examination Survey

Objective: Metabolic syndrome (MetS) is a global disease burden that has resulted in 10 million people being affected by it, yet no new drugs have been approved for clinical treatment. Isoflavone may be able to stop the development of MetS or enhance its treatment. Therefore, we investigated the relationship between dietary intake of isoflavone and prevalence of MetS to find potentially effective treatments. Methods: We conducted a cross-sectional study using data from 8512 National Health and Nutrition Examination Survey (NHANES) participants from 2007 to 2010 and 2017 to 2018 and their associated isoflavone intake from the flavonoid database in the USDA Food and Nutrient Database for Dietary Studies (FNDDS). We investigated the relationship between MetS status and isoflavone intake by adjusting for confounding variables using multivariable logistic regression models. Results: In a multivariable-adjusted model, there was a negative association between isoflavone intake and the incidence of MetS (odds ratio for Q4 vs. Q1 was 0.66, 95% confidence interval = 0.51-0.86, P = 0.003, p for trend was <0.001). This inverse association remained robust across most subgroups, while nonsignificant interactions were tested between isoflavone intake and age, sex, ethnicity, economic status, body mass index, smoking status, alcohol consumption, and physical activity level (P values for interaction >0.05). Conclusions: We found that MetS prevalence decreased with increased isoflavone intake, suggesting that dietary patterns of soy food or supplement consumption may be a valuable strategy to reduce the disease burden and the prevalence of MetS.

Plant-Based Dairy Alternatives Contribute to a Healthy and Sustainable Diet

Plant-based foods are increasing in popularity as more and more people are concerned about personal and planetary health. The consumption of plant-based dairy alternatives (PBDAs) has assumed a more significant dietary role in populations shifting to more sustainable eating habits. Plant-based drinks (PBDs) made from soya and other legumes have ample protein levels. PBDs that are appropriately fortified have adequate levels of important vitamins and minerals comparable to dairy milk. For the PBDs examined, the greenhouse gas emissions were diminished by 59-71% per 250 mL, and the land use and eutrophication impact was markedly less than the levels displayed by dairy milk. The water usage for the oat and soya drinks, but not rice drinks, was substantially lower compared to dairy milk. When one substitutes the 250 mL serving of dairy milk allowed within the EAT Lancet Planetary Health Diet for a fortified plant-based drink, we found that the nutritional status is not compromised but the environmental footprint is reduced. Combining a nutrient density score with an environmental index can easily lead to a misclassification of food when the full nutrition profile is not utilized or only a selection of environmental factors is used. Many PBDAs have been categorized as ultra-processed foods (UPFs). Such a classification, with the implied adverse nutritional and health associations, is inconsistent with current findings regarding the nutritional quality of such products and may discourage people from transitioning to a plant-based diet with its health and environmental advantages.

Legume consumption in adults and risk of cardiovascular disease and type 2 diabetes: a systematic review and meta-analysis

Objectives

This study aimed to systematically review the evidence for associations between consumption of legumes and cardiovascular disease (CVD), type 2 diabetes (T2D) and their risk factors among healthy adults.

Methods

We searched MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and Scopus up to 16 May 2022 for ≥4 weeks long randomized (RCT) and non-randomized controlled trials and prospective cohort studies with follow-up ≥12 months, assessing legume intake (beans/lentils/peas/soybeans, excluding peanuts and legume-products/protein/powder/flour) as the intervention or exposure. Outcomes were CVD, coronary heart disease (CHD), stroke, T2D and in intervention trials only: changes in blood lipids, glycemic markers, and blood pressure. Risk of bias (RoB) was evaluated with Cochrane's RoB2, ROBINS-I, and US Department of Agriculture (USDA)'s RoB-NObS. Effect sizes were pooled using random-effects meta-analyses and expressed as relative risk or weighed mean differences with 95% confidence intervals, heterogeneity quantified as I². The evidence was appraised according to World Cancer Research Fund's criteria.

Results

Of the 181 full-text articles assessed for eligibility, 47 were included: 31 cohort studies (2,081,432 participants with generally low legume consumption), 14 crossover RCTs (448 participants), one parallel RCT and one non-randomized trial. Meta-analyses of cohort studies were suggestive of null associations for CVD, CHD, stroke and T2D. Meta-analyses of RCTs suggested a protective effect on total cholesterol (mean difference -0.22 mmol/L), low density lipoprotein (LDL)-cholesterol (-0.19 mmol/L), fasting glucose (-0.19 mmol/L), and HOMA-IR (-0.30). Heterogeneity was high (I² = 52% for LDL-cholesterol, >75% for others). The overall evidence for associations between consumption of legumes and risk of CVD and T2D was considered limited - no conclusion.

Conclusion

Legume consumption was not found to influence risk of CVD and T2D in healthy adult populations with generally low legume consumption. However, protective effects on risk factors, seen in RCTs, lend some support for recommending legume consumption as part of diverse and healthy dietary patterns for prevention of CVD and T2D.

Nuts as a Part of Dietary Strategy to Improve Metabolic Biomarkers: A Narrative Review

Background

Nuts are in the spotlight because of their association with improved health outcomes. We aimed to summarize the findings of previous studies to evaluate the impact of nuts consumption on glycaemic and lipid profile, inflammation, and oxidative stress.

Methods

Electronic searches for observational and intervention studies were undertaken in PubMed, Embase, Web of Science, and Science Direct until 2022 for searching the studies aiming the application of different types of nuts and the beneficial effects of nuts in improving glycemia, dyslipidemia, inflammation, and oxidative stress.

Results

Results from 56 interventional, 9 narrative and 3 systematic reviews, and 12 meta-analysis studies, aiming at the evaluating beneficial effects of different types of nuts on metabolic markers, showed that nut consumption could improve metabolic markers, including glycaemic factors, lipid profile, and inflammatory and oxidative stress parameters in both healthy and individuals with metabolic disorders in a type-, dose- and duration-dependent manner. According to their unique nutrient components, nuts can be known as a part of a healthy diet, resulting in improved metabolic biomarkers.

Conclusion

Considering the efficacy of nuts in improving metabolic markers, incorporation of, incorporating nuts the effectiveness of nuts in improving metabolic markers, incorporating nuts in the diet may prevent the incidence or aggravation of chronic metabolic diseases. Considering the health benefits of the nuts' components, including essential micronutrients, if consumed in the appropriate dose and duration to provide the necessary amount of effective micronutrients to improve health, we will see an improvement in metabolic factors. At the same time, more research is required to determine the optimal type, dose, and duration of nut intervention with regards to metabolic control and reducing the risk of developing metabolic disorders.

Potential Effects of Soy Isoflavones on the Prevention of Metabolic Syndrome

Isoflavones are polyphenols primarily contained in soybean. As phytoestrogens, isoflavones exert beneficial effects on various chronic diseases. Metabolic syndrome increases the risk of death due to arteriosclerosis in individuals with various pathological conditions, including obesity, hypertension, hyperglycemia, and dyslipidemia. Although the health benefits of soybean-derived isoflavones are widely known, their beneficial effects on the pathogenesis of metabolic syndrome are incompletely understood. This review aims to describe the association between soybean-derived isoflavone intake and the risk of metabolic syndrome development. We reviewed studies on soy isoflavones, particularly daidzein and genistein, and metabolic syndrome, using PubMed, ScienceDirect, and Web of Science. We describe the pathological characteristics of metabolic syndrome, including those contributing to multiple pathological conditions. Furthermore, we summarize the effects of soybean-derived daidzein and genistein on metabolic syndrome reported in human epidemiological studies and experiments using in vitro and in vivo models. In particular, we emphasize the role of soy isoflavones in metabolic syndrome-induced cardiovascular diseases. In conclusion, this review focuses on the potential of soy isoflavones to prevent metabolic syndrome by influencing the onset of hypertension, hyperglycemia, dyslipidemia, and arteriosclerosis and discusses the anti-inflammatory effects of isoflavones.

The efficacy of soy isoflavones combined with soy protein on serum concentration of interleukin-6 and tumour necrosis factor-α among post-menopausal women? A systematic review and meta-analysis of randomized controlled trials

The post-menopausal stage in women's life is associated with the enhancement of inflammation that may be reduced using soy isoflavones or soy protein. The present study aimed to summarize the effect of soy isoflavones plus soy protein on circulating interleukin-6 (IL-6) and tumour necrosis factor-α (TNF-α) in post-menopausal women. The English-language articles were identified from the databases such as Cochrane Library, clinicaltrials.gov, Web of Science, PubMed, and Scopus until December 2020. The mean change from baseline and its standard deviation (SD) for intervention and comparison groups were used to calculate the effect size. The statistical heterogeneity of the intervention effects was computing by Cochran's Q test and I² statistic. Nine and seven studies were selected for systematic review and meta-analysis, respectively. The results of our meta-analysis indicated a non-significant effect on the serum concentrations of IL-6 and TNF-α (weighted mean differences [WMD] = 0.07 pg/mL; 95% confidence interval [CI] = -0.03, 0.17 pg/mL; P = 0.190; WMD =0.05 pg/mL; 95% CI = -0.01, 0.12 pg/mL; P = 0.092; respectively). In subgroup analysis, soy isoflavones plus soy protein could increase the serum concentration of IL-6 in studies with soy isoflavones dose ≤87 mg/days, cross-over design, weak quality, and studies on participants who had health risk factors or diseases. The serum concentration of TNF-α increased in studies with cross-over design, intervention duration ≤56 days, and body mass index (BMI) >27, and in studies that were conducted on at-risk or sick participants. In conclusion, our meta-analysis did not confirm any significant effect on serum concentration of IL-6 and TNF-α among post-menopausal women.

Beneficiary and Adverse Effects of Phytoestrogens: A Potential Constituent of Plant-based Diet

BACKGROUND

Phytoestrogens are non-endocrine, non-steroidal secondary derivatives of plants and consumed through a plant-based diet also named as "dietary estrogens". The major sources of phytoestrogens are soy and soy-based foods, flaxseed, chickpeas, green beans, dairy products, etc. The dietary inclusion of phytoestrogen based foods plays a crucial role in the maintenance of metabolic syndrome cluster, including obesity, diabetes, blood pressure, cancer, inflammation, cardiovascular diseases, postmenopausal ailments and their complications. In recent days, phytoestrogens are the preferred molecules for hormone replacement therapy. On the other hand, they act as endocrine disruptors via estrogen receptor-mediated pathways. These effects are not restricted to adult males or females and identified even in development.

OBJECTIVE

Since phytoestrogenic occurrence is high at daily meals for most people worldwide, they focused to study for its beneficiary effects towards developing pharmaceutical drugs for treating various metabolic disorders by observing endocrine disruption.

CONCLUSION

The present review emphasizes the pros and cons of phytoestrogens on human health, which may help to direct the pharmaceutical industry to produce various phytoestrongen based drugs against various metabolic disorders.

Beneficial effect of soy isoflavones and soy isoflavones plus soy protein on serum concentration of C-reactive protein among postmenopausal women: An updated systematic review and meta-analysis of randomized controlled trials

BACKGROUND

Scientists suggest that soy isoflavones or the combination of soy isoflavones and soy protein may have beneficial effects on inflammation. Thus, the present study aims at conducting a systematic review and meta-analysis on randomized controlled trials (RCTs) in which the effect of soy isoflavones and the combination of soy isoflavones and soy protein on serum concentration of C-reactive protein (CRP) among postmenopausal women is assessed.

METHODS AND MATERIALS

A literature searching was done to identify a breadth of related references in PubMed, Scopus, ISI Web of Science, Cochrane Library, and Clinicaltrials.gov up to December 2020. The mean change from baseline in the CRP concentrations and its standard deviation (SD) for both intervention and comparison groups were used to calculate the effect size. The summary of the overall effects and heterogeneity was estimated by using the DerSimonian and Laird random effects model. The protocol was registered in PROSPERO (No. CRD42020166053).

RESULTS

This study considered 23 articles for systematic review and 19 articles for meta-analysis. The overall effect presented a non-significant effect of soy isoflavones on serum CRP concentrations (WMD = 0.08 mg/L, 95 % CI: -0.08, 0.24; p = 0.302) and the overall effect of the combination of soy isoflavones and soy protein indicated non-significant effect in serum levels of CRP (WMD= -0.02 mg/L 95 % CI: -0.12, 0.08; p = 0.715).

CONCLUSION

Published RCTs did not provide strong evidence regarding beneficial effect of soy isoflavones or the combination of soy isoflavones and soy protein on serum CRP concentration among postmenopausal women.

Effects of soy consumption on metabolic parameters in patients with metabolic syndrome: A systematic review and meta-analysis

Functional foods like soy have unique effects on health status. Although various dietary modifications have been recommended to ameliorate features of metabolic syndrome (MetS), no meta-analysis has summarized the effect of soy consumption in patients with MetS. PubMed, ISI Web of Science, and Scopus were searched for relevant articles until Jun 2020, resulting in six relevant publications that were included in our meta-analysis. Combining a total of 9 comparisons suggested a significant decrease in serum levels of triglyceride (WMD: -0.29; 95 % CI: -0.49, -0.09 mg/dL), total cholesterol (WMD: -1.46; 95 % CI: -1.70, -1.22 mg/dL), LDL-C (WMD: -0.73; 95 % CI: -0.93, -0.52 mg/dL) and no change in serum HDL-c levels. Combining a total of 7 effect sizes examining soy effects on glycemic parameters indicated that subjects who consumed soy products had lower levels of fasting blood sugar (WMD: -0.90; 95 % CI: -1.12, -0.68 mg/dL), insulin (WMD: -1.06; 95 % CI: -1.29, -0.84 pmol/ L) and HOMA-IR (WMD: -1.08; 95 % CI: -1.31, -0.85) compared with those in the control group. Soy consumption could not significantly change anthropometric measures and blood pressure. Consuming soy products in patients with MetS effectively improved lipid profile and glycemic parameters independent of affecting anthropometric measures.

Mormodica charantia L. fruit and Genistein ameliorates type 2 diabetes in rats by preventing lipid accumulation, insulin resistance and enhancing beta cell function

PURPOSE

The present study was aimed at evaluating the role of Momordica charantia L. fruit and Genistein on beta cell, insulin resistance/sensitivity and lipid profile in type 2 diabetic rats.

METHODS

Thirty-five (35) albino rats were divided into seven (7) groups of 5 rats each comprising of five (5) non-diabetic and thirty (30) diabetic rats. Groups 1 and 2 served as the normal control and diabetic control groups respectively and received distill water, groups 3 and 4 received Mormodica charantia L. at 250 mg/kg and 500 mg/kg respectively. Groups 5 and 6 received Genistein at 10 mg/kg and 20 mg/kg respectively while group 7 received Metformin at 500 mg/kg the experiment lasted for four weeks. All the rats were euthanized at the end of the fourth week.

RESULTS

Lipid profile, glucose and insulin levels were determined from the analysis of serum parameters and the histology of the pancreas. A significant reduction (p < 0.05) in blood glucose levels was noticed in rats that received Momordica charantia L. (MC) and genistein when compared with diabetic control rats. A significant decrease (p < 0.05) in cholesterol, triglyceride, low density lipoprotein (LDL) and very low density lipoprotein (VLDL) levels were also noted in rats that received MC and Genistein when compared with the diabetic control rats. MC and Genistein significantly increased (P < 0.05) serum insulin level compared to the diabetic control rats. MC and Genistein significantly decreased (p < 0.05) homeostatic model assessment-insulin resistance (HOMA-IR) level compared with the diabetic control group. Pancreas of rats that received MC and Genistein showed regenerating beta-cells.

CONCLUSION

Momordica charantia L. fruit and Genistein were able to enhance beta cell function and prevent lipid accumulation and insulin resistance in type 2 diabetic rats.

Effect of soy products and isoflavones on oxidative stress parameters: A systematic review and meta-analysis of randomized controlled trials

Soy products and isoflavones intake have been shown to exert antioxidant effects. There are several randomized control trials (RCTs) that evaluated the effect of soy products intake on oxidative stress (OS) parameters. The aim of the present systematic review and meta-analysis was to summarize the results of RCTs evaluating the effect of soy products and isoflavones intake on OS parameters. Randomized trials that assessed the effect of soy products and isoflavones intake on OS parameters in adults were identified through searching in electronic databases: Cochrane clinical trial center, Embase, PubMed, Scopus, and Web of Sciences up to April 2020. Random effects model was used to calculate the effects sizes of soy intake on OS parameters. Twenty-four trials with 1,852 participants were eligible and were included in the meta-analysis which measured OS parameters. Soy intake compared to control group significantly reduced MDA levels (SMD: -0.53; 95% CI: -0.86, -0.19; I2 = 88.3%), increased GSH levels (SMD: 0.51; 95% CI: 0.13, 0.88; I2 = 72.4%), SOD activity (SMD: 0.53; 95% CI: 0.08, 0.99; I2 = 84.1%), TAC (SMD: 0.54; 95% CI: 0.27, 0.82; I2 = 49.3%) and TRAP (SMD: 1.74; 95% CI: 0.82, 2.65; I2 = 81.3%) significantly compared to control group. Soy products and isoflavones intake are effective in improving OS parameters in adults compared with controls; thus, it could be a valuable advise to control OS progress in chronic diseases.

The Antioxidant Role of Soy and Soy Foods in Human Health

Oxidative stress seems to play a role in many chronic diseases, such as cardiovascular diseases, diabetes, and some cancers. Research is always looking for effective approaches in the prevention and treatment of these pathologies with safe strategies. Given the central role of nutrition, the identification of beneficial healthy foods can be the best key to having a safe and at the same time effective approach. Soy has always aroused great scientific interest but often this attention is galvanized by the interaction with estrogen receptors and related consequences on health. However, soy, soy foods, and soy bioactive substances seem to have antioxidant properties, suggesting their role in quenching reactive oxygen species, although it was frequently mentioned but not studied in depth. The purpose of this review is to summarize the scientific evidence of the antioxidant properties of soy by identifying the human clinical trials available in the literature. A total of 58 manuscripts were individuated through the literature search for the final synthesis. Soy bioactive substances involved in redox processes appear to be multiple and their use seems promising. Other larger clinical trials with adequate standardization and adequate choice of biomarkers will fill the gap currently existing on the suggestive role of soy in antioxidant mechanisms.