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Naghshi S, Tutunchi H, Yousefi M, Naeini F, Mobarak S, Asadi M, Sadeghi O. Soy isoflavone intake and risk of cardiovascular disease in adults: A systematic review and dose-response meta-analysis of prospective cohort studies. Crit Rev Food Sci Nutr 2024; 64:6087-6101. [PMID: 36705465 DOI: 10.1080/10408398.2022.2163372] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
We examined the association between soy isoflavone intake and risk of cardiovascular disease (CVD) outcomes in adults. We searched the online databases for relevant studies published up to September 2021. In total, 13 publications were included in the systematic review and 12 in the meta-analysis. We found that a high intake of soy isoflavones was significantly associated with a lower risk of coronary heart disease (CHD) among whole populations (Pooled RR: 0.92, 95% CI: 0.85-0.99, I2 = 41.0%, Pheterogeneity = 0.10) and a lower risk of overall CVD (Pooled RR: 0.91, 95% CI: 0.84-0.98, I2 = 30.7%, Pheterogeneity = 0.19) and CHD (Pooled RR: 0.89, 95% CI: 0.83-0.96, I2 = 14.4%, Pheterogeneity = 0.32) among Western population. In the linear dose-response analysis, a 3 mg/day increase in soy isoflavone intake was associated with 16% and 14% lower risks of overall CVD and CHD, respectively, among Western population. In conclusion, we found that soy isoflavone intake was associated with a lower risk of overall CVD and CHD in adults, particularly among Western population.
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Affiliation(s)
- Sina Naghshi
- Nutrition Research Center, Student Research Committee, School of Nutrition & Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Helda Tutunchi
- Endocrine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mojtaba Yousefi
- Department of Nutrition, School of Health and nutrition, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Fatemeh Naeini
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Sara Mobarak
- Abadan University of Medical Sciences, Abadan, Iran
| | - Masoomeh Asadi
- Department of Operating Room Nursing, Abadan University of Medical Sciences, Abadan, Iran
| | - Omid Sadeghi
- Nutrition and Food Security Research Center, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
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2
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Davis SJ, Arscott SA, Goltz S, Muir C, Binkley N, Tanumihardjo SA. Urinary 2- to 16α-hydroxyestrone ratio did not change with cruciferous vegetable intake in premenopausal women. INT J VITAM NUTR RES 2024; 94:177-186. [PMID: 37335576 DOI: 10.1024/0300-9831/a000785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
The mass ratio of urinary 2-hydroxyestrone to 16-α-hydroxyestrone (2:16) is hypothesized as a biomarker of breast cancer risk in premenopausal women, with higher ratios being theoretically protective. Cruciferous vegetable intake has been associated with higher urinary 2:16 in some studies. We investigated whether a whole-food supplement made from dried Brussels sprouts and kale would increase urinary 2:16 in comparison with placebo or cruciferous vegetables in women. This randomized, parallel arm, placebo-controlled, partly blinded study included 78 healthy premenopausal women (38-50 y) with screening urinary 2:16 ≤3.0. Subjects received either six capsules containing 550 mg dried Brussels sprouts and kale per capsule, 40 g daily alternating broccoli or Brussels sprouts, or placebo for eight weeks. Urinary 2:16 and creatinine were measured at baseline, four, and eight weeks. Intent-to-treat repeated measures-ANOVA with multiple imputation (n=100) for missing values identified no treatment effect (P=0.9) or treatment-by-time interaction (P=0.6); however, a significant time effect was noted (P=0.02). Per-protocol analyses including complete cases found no treatment effect (P=1) or treatment-by-time interaction (P=0.6); however, the significant time effect remained (P=0.03). Restricting analysis to subjects with >80% compliance maintained the time effect (P=0.02). Using Pearson correlations, android-pattern and android:gynoid fat were predictive of change (P≤0.05). In conclusion, neither cruciferous supplements nor an added vegetable serving altered urinary 2:16 in premenopausal women with eight weeks treatment. This ratio did vary with time, which is important for designing future trials.
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Affiliation(s)
- Stephanie J Davis
- Interdepartmental Graduate Program in Nutritional Sciences, University of Wisconsin-Madison (UW), Madison, USA
| | - Sara A Arscott
- Standard Process Inc., Palmyra, Wisconsin, USA
- Department of Family Medicine and Community Health, University of Wisconsin-Madison (UW), Madison, USA
| | - Shellen Goltz
- Interdepartmental Graduate Program in Nutritional Sciences, University of Wisconsin-Madison (UW), Madison, USA
| | - Cassidy Muir
- Interdepartmental Graduate Program in Nutritional Sciences, University of Wisconsin-Madison (UW), Madison, USA
| | - Neil Binkley
- Osteoporosis Clinical Research Program, University of Wisconsin-Madison (UW), Madison, USA
| | - Sherry A Tanumihardjo
- Interdepartmental Graduate Program in Nutritional Sciences, University of Wisconsin-Madison (UW), Madison, USA
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Lu TY, Zhang WS, Jiang CQ, Jin YL, Au Yeung SL, Cheng KK, Lam TH, Xu L. Associations of soy product intake with all-cause, cardiovascular disease and cancer mortality: Guangzhou Biobank Cohort Study and updated meta-analyses. Eur J Nutr 2024:10.1007/s00394-024-03363-5. [PMID: 38520523 DOI: 10.1007/s00394-024-03363-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 03/10/2024] [Indexed: 03/25/2024]
Abstract
PURPOSE We examined the associations of soy product intake with all-cause, cardiovascular disease (CVD), and cancer mortality and mediations through CVD risk factors based on the Guangzhou Biobank Cohort Study (GBCS), and conducted updated meta-analyses. METHODS A total of 29,825 participants aged 50 + years were included. Causes of death were identified through record linkage. Soy product intake was assessed by food frequency questionnaire. Cox proportional hazards regression was used to analyze the associations between soy product intake and mortality, yielding hazard ratios (HRs) and 95% confidence intervals (CIs). Mediation analyses with CVD risk factors as mediators, and updated meta-analyses were conducted. RESULTS During 454,689 person-years of follow-up, 6899 deaths occurred, including 2694 CVD and 2236 cancer. Participants who consumed soy product of 1-6 portions/week, versus no consumption, had significantly lower risks of all-cause and CVD mortality (adjusted HR (95% CI) 0.91 (0.86, 0.97) and 0.87 (0.79, 0.96), respectively). In participants who consumed soy product of ≥ 7 portions/week, the association of higher intake with lower CVD mortality was modestly mediated by total cholesterol (4.2%, 95% CI 1.0-16.6%). Updated meta-analyses showed that the highest level of soy product intake, versus the lowest, was associated with lower risks of all-cause and CVD mortality (pooled HR (95% CI) 0.92 (0.88, 0.96) and 0.92 (0.87, 0.98), respectively). CONCLUSION Moderate and high soy product intake were associated with lower risks of all-cause and CVD mortality. Our findings provide support for current dietary guidelines recommending moderate soy product intake, and contribute additional evidence regarding the potential protective effects of high soy product intake.
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Affiliation(s)
- Ting Yu Lu
- School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
- Greater Bay Area Public Health Research Collaboration, Guangzhou, China
| | - Wei Sen Zhang
- Guangzhou Twelfth People's Hospital, Guangzhou, 510620, China.
- Greater Bay Area Public Health Research Collaboration, Guangzhou, China.
| | - Chao Qiang Jiang
- Guangzhou Twelfth People's Hospital, Guangzhou, 510620, China
- Greater Bay Area Public Health Research Collaboration, Guangzhou, China
| | - Ya Li Jin
- Guangzhou Twelfth People's Hospital, Guangzhou, 510620, China
| | - Shiu Lun Au Yeung
- School of Public Health, The University of Hong Kong, Pok Fu Lam, Hong Kong
- Greater Bay Area Public Health Research Collaboration, Guangzhou, China
| | - Kar Keung Cheng
- Institute of Applied Health Research, University of Birmingham, Birmingham, B15 2TT, UK
| | - Tai Hing Lam
- School of Public Health, The University of Hong Kong, Pok Fu Lam, Hong Kong
- Greater Bay Area Public Health Research Collaboration, Guangzhou, China
| | - Lin Xu
- School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.
- School of Public Health, The University of Hong Kong, Pok Fu Lam, Hong Kong.
- Institute of Applied Health Research, University of Birmingham, Birmingham, B15 2TT, UK.
- Greater Bay Area Public Health Research Collaboration, Guangzhou, China.
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Yu S, Yang H, Wang B, Guo X, Li G, Sun Y. Gender-specific effects of soybean consumption on cardiovascular events in elderly individuals from rural Northeast China - a prospective cohort study. BMC Geriatr 2023; 23:510. [PMID: 37612640 PMCID: PMC10464065 DOI: 10.1186/s12877-023-04209-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 07/31/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND The impact of consuming soybean and its products on cardiovascular events (CVEs), cardiovascular mortality, and all-cause mortality remains unclear. This study aimed to examine the prospective association of soybean consumption with CVEs, cardiovascular mortality, and all-cause mortality among the elderly population in rural China. METHODS The Northeast China Rural Cardiovascular Health Study included 2477 elderly individuals (mean age 67 ± 6 years, 49.97% men) in the initial phase of the study from 2012 to 2013, with a follow-up period between 2015 and 2017. Soybean consumption was categorized as follows: low-frequency consumption: rare consumption; moderate-frequency consumption: two to three times/week; high-frequency consumption: ≥ four times/week. Cox proportional hazard analysis assessed the potential relationship of soybean consumption with CVEs, cardiovascular mortality, and all-cause mortality. RESULTS The prevalence of soybean and its product consumption was as follows: 38.3% for low-frequency consumption (43.8% for women; 32.8% for men), 49.7% for moderate-frequency consumption (45.8% for women; 53.7% for men), and 11.9% for high-frequency consumption (10.4% for women; 13.5% for men). After adjusting for possible confounders, Cox proportional hazard analysis revealed that the frequency of soybean consumption was an effective predictor of CVEs [Hazard ratio (HR) high (95% CI): 0.555 (0.348, 0.883)], stroke [HR moderate (95% CI): 0.672 (0.494, 0.913); HR high (95% CI): 0.483 (0.276, 0.842)], and all-cause mortality [HR high (95% CI): 0.540 (0.310, 0.942)] in the overall older population. High-frequency consumption of soybean [HR (95% CI): 0.467 (0.225, 0.968)] and moderate-frequency consumption [HR (95% CI): 0.458 (0.270, 0.779)] were associated with stroke events in older men and women, respectively. In addition, high-frequency consumption of soybean [HR (95% CI): 0.437 (0.197, 0.968)] decreased the risk of CVEs in older women. CONCLUSION Soybean consumption is closely associated with CVEs and all-cause mortality in older individuals residing in rural areas, with a significant gender discrepancy in this relationship. These findings provide new insights into the impact of soybean consumption on cardiovascular well-being in the elderly rural population, thus enhancing our understanding of this field of interest.
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Affiliation(s)
- Shasha Yu
- Department of Cardiology, First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, China
| | - Hongmei Yang
- Department of Cardiology, First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, China
| | - Bo Wang
- Department of Cardiology, First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, China
| | - Xiaofan Guo
- Department of Cardiology, First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, China
| | - GuangXiao Li
- Department of Clinical Epidemiology, Institute of Cardiovascular Diseases, First Hospital of China Medical University, Shenyang, 110001, China
| | - Yingxian Sun
- Department of Cardiology, First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, China.
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Soy Consumption and the Risk of Type 2 Diabetes and Cardiovascular Diseases: A Systematic Review and Meta-Analysis. Nutrients 2023; 15:nu15061358. [PMID: 36986086 PMCID: PMC10058927 DOI: 10.3390/nu15061358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/03/2023] [Accepted: 03/08/2023] [Indexed: 03/14/2023] Open
Abstract
Soy is rich in plant protein, isoflavones, and polyunsaturated fatty acids. To clarify the associations between soy intake and type 2 diabetes (T2D) and cardiovascular diseases (CVDs) events, we performed a meta-analysis and review. A total of 1963 studies met the inclusion criteria, and 29 articles with 16,521 T2D and 54,213 CVDs events were identified by the eligibility criteria. During a follow-up of 2.5–24 years, the risk of T2D, CVDs, coronary heart disease, and stroke in participants with the highest soy consumption decreased by 17% (total relative risk (TRR) = 0.83, 95% CI: 0.74–0.93), 13% (TRR = 0.87, 95% CI: 0.81–0.94), 21% (TRR = 0.79, 95% CI: 0.71–0.88), and 12% (TRR = 0.88, 95% CI: 0.79–0.99), respectively, compared to the lowest sot consumption. A daily intake of 26.7 g of tofu reduced CVDs risk by 18% (TRR = 0.82, 95% CI: 0.74–0.92) and 11.1 g of natto lowered the risk of CVDs by 17% (TRR = 0.83, 95% CI: 0.78–0.89), especially stroke. This meta-analysis demonstrated that soy consumption was negatively associated with the risks of T2D and CVDs and a specific quantity of soy products was the most beneficial for the prevention of T2D and CVDs. This study has been registered on PROSPERO (registration number: CRD42022360504).
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Ohishi T, Miyoshi N, Mori M, Sagara M, Yamori Y. Health Effects of Soy Isoflavones and Green Tea Catechins on Cancer and Cardiovascular Diseases Based on Urinary Biomarker Levels. MOLECULES (BASEL, SWITZERLAND) 2022; 27:molecules27248899. [PMID: 36558031 PMCID: PMC9781513 DOI: 10.3390/molecules27248899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 12/07/2022] [Accepted: 12/09/2022] [Indexed: 12/23/2022]
Abstract
Plant polyphenols have various health effects. Genistein, which is abundant in soybeans, and epigallocatechin-3-gallate, which is abundant in green tea, are major flavonoids, a subclass group of polyphenols. Several epidemiological studies have shown that these flavonoids have beneficial effects against cancer and cardiovascular diseases. However, other studies did not show such effects. Several confounding factors, including recall bias, are related to these inconsistent findings, and the determination of metabolites in the urine may be useful in reducing the number of confounding factors. Equipment, which can be used by research participants to collect samples from a portion of voided urine within 24 h without the help of medical workers, has been developed for epidemiological investigations. Previous studies, in which flavonoid metabolites in these urine samples were measured, revealed that soy intake was correlated with a reduced risk of certain types of cancer and cardiovascular diseases worldwide. Although soybeans and green tea consumption may have protective effects against cancer and cardiovascular diseases, further clinical studies that consider different confounding factors are required to provide evidence for the actual impact of dietary flavonoids on human diseases, including cancer and cardiovascular diseases. One possible mechanism involved is discussed in relation to the downregulation of reactive oxygen species and the upregulation of 5'-adenosine monophosphate-activated protein kinase elicited by these flavonoids.
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Affiliation(s)
- Tomokazu Ohishi
- Institute of Microbial Chemistry (BIKAKEN), Numazu, Microbial Chemistry Research Foundation, Shizuoka 410-0301, Japan
- Laboratory of Oncology, Institute of Microbial Chemistry (BIKAKEN), Microbial Chemistry Research Foundation, Tokyo 141-0021, Japan
- Correspondence: (T.O.); (Y.Y.)
| | - Noriyuki Miyoshi
- Graduate School of Integrated Pharmaceutical and Nutritional Sciences, University of Shizuoka, Shizuoka 422-8526, Japan
| | - Mari Mori
- Department of Health Management, School of Health Studies, Tokai University, Kanagawa 259-1292, Japan
- NPO World Health Frontier Institute, Nishinomiya 663-8143, Japan
- Institute for World Health Development, Mukogawa Women’s University, Nishinomiya 663-8143, Japan
| | - Miki Sagara
- Institute for World Health Development, Mukogawa Women’s University, Nishinomiya 663-8143, Japan
- Disease Model Cooperative Research Association, Kyoto 606-0805, Japan
| | - Yukio Yamori
- Institute for World Health Development, Mukogawa Women’s University, Nishinomiya 663-8143, Japan
- Correspondence: (T.O.); (Y.Y.)
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Zhang X, Fujiyoshi A, Ahuja V, Vishnu A, Barinas-Mitchell E, Kadota A, Miura K, Edmundowicz D, Ueshima H, Sekikawa A. Association of equol producing status with aortic calcification in middle-aged Japanese men: The ERA JUMP study. Int J Cardiol 2022; 352:158-164. [PMID: 35122909 PMCID: PMC8915951 DOI: 10.1016/j.ijcard.2022.01.065] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 01/15/2022] [Accepted: 01/28/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Equol, an isoflavone (ISF)-derived metabolite by the gut microbiome in certain individuals termed as equol-producers, might be the key anti-atherogenic component of ISFs. Our objective was to determine the association between equol-producing status and aortic atherosclerosis assessed as aortic calcification (AC). METHODS This population-based study of 302 Japanese men aged 40-49, free of cardiovascular disease, examined serum levels of equol and ISFs, AC in the entire aorta by electron-beam computed tomography with Agatston method, and cardiovascular risk factors. We defined equol-producers as individuals with serum levels of equol ≥20 nM and prevalent AC as an AC score ≥ 10. We analyzed the association between equol-producing status and AC using Tobit and logistic regressions. We performed age-stratified analyses since age was a significant effect-modifier. RESULTS The 60th to 90th percentile AC scores were 4 to 243 in equol-producers and 15 to 444 in non-producers, respectively. Overall, equol-producers (41% of the sample) had lower AC scores (-209, [95% confidence interval (CI): -455, 36]) and odds of AC (odds ratio (OR): 0.7 [95% CI: 0.4, 1.3]), although not statistically significant, compared to non-producers after controlling for cardiovascular risk factors. Among men aged 46-49, equol-producers had significantly lower AC scores (-428 [95% CI: -827, -29]). Furthermore, there were null associations between serum levels of ISFs and both AC score and the odds of AC. CONCLUSION In middle-aged Japanese men, equol-producers had a non-significantly lower burden of aortic atherosclerosis than non-producers whereas ISFs had a null association. Studies with larger sample sizes in both sexes are warranted.
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Affiliation(s)
- Xiao Zhang
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Akira Fujiyoshi
- Department of Public Health, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Vasudha Ahuja
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Abhishek Vishnu
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Emma Barinas-Mitchell
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Aya Kadota
- Department of Public Health, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Katsuyuki Miura
- Department of Public Health, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Daniel Edmundowicz
- Department of Medicine, Lewis Katz School of Medicine, Temple University, USA
| | - Hirotsugu Ueshima
- Department of Public Health, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Akira Sekikawa
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA.
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Xue T, Wen J, Wan Q, Qin G, Yan L, Wang G, Qin Y, Luo Z, Tang X, Huo Y, Hu R, Ye Z, Shi L, Gao Z, Su Q, Mu Y, Zhao J, Chen L, Zeng T, Yu X, Li Q, Shen F, Chen L, Zhang Y, Wang Y, Deng H, Liu C, Wu S, Yang T, Li M, Xu Y, Xu M, Wang T, Zhao Z, Lu J, Bi Y, Wang W, Chen G, Ning G. Association of soy food with cardiovascular outcomes and all-cause mortality in a Chinese population: a nationwide prospective cohort study. Eur J Nutr 2022; 61:1609-1620. [PMID: 35001219 DOI: 10.1007/s00394-021-02724-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Accepted: 10/22/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE This study aimed to clarify the association of soy intake with cardiovascular disease (CVD) and all-cause mortality. METHODS We conducted a prospective cohort study in a Chinese population composed of 97,930 participants aged ≥ 40 years old without CVD at baseline in 2011. Habitual soy intake over a period of 12 months was evaluated using a food frequency questionnaire. All participants were classified into four groups based on their soy food consumption levels: < 15, 15-29, 30-59, and ≥ 60 g/day, with the lowest category as the reference group. Follow-up was conducted between 2014 and 2016 to assess CVD incidence and all-cause mortality since baseline, which was collected from the local mortality and disease registers of the National Disease Surveillance Point System and National Health Insurance System. The Cox proportional hazards regression models were used to analyze the relationship of soy intake with later CVD events and all-cause mortality. RESULTS During 350,604 person-years of follow-up (median [interquartile range]: 3.16 [2.98, 4.77] years), 2523 total CVD events and 1473 all-cause mortalities were documented. After controlling for covariates, the hazard ratios (95% confidence intervals) for total CVD events across increasing soy intake levels were 1.03 (0.93-1.14); 0.96 (0.86-1.07); and 0.86 (0.75-0.98; p for trend = 0.0434), while those for all-cause mortality were 0.88 (0.77-1.02); 0.86 (0.74-1.00); and 0.83 (0.69-0.99; p for trend = 0.0084). CONCLUSION High soy intake was associated with a reduced risk of total CVD events and all-cause mortality among a Chinese population.
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Affiliation(s)
- Ting Xue
- Center of Health Management, Fujian Provincial Hospital South Branch, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Junping Wen
- Department of Endocrinology, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Qin Wan
- The Affiliated Hospital of Luzhou Medical College, Luzhou, China
| | - Guijun Qin
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Li Yan
- Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Guixia Wang
- The First Hospital of Jilin University, Changchun, China
| | - Yingfen Qin
- The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Zuojie Luo
- The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Xulei Tang
- The First Hospital of Lanzhou University, Lanzhou, China
| | - Yanan Huo
- Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, China
| | - Ruying Hu
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Zhen Ye
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Lixin Shi
- Affiliated Hospital of Guiyang Medical College, Guiyang, China
| | - Zhengnan Gao
- Dalian Municipal Central Hospital, Dalian, China
| | - Qing Su
- Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yiming Mu
- Chinese People's Liberation Army General Hospital, Beijing, China
| | - Jiajun Zhao
- Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China
| | - Lulu Chen
- Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tianshu Zeng
- Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xuefeng Yu
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qiang Li
- The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Feixia Shen
- The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Li Chen
- Qilu Hospital of Shandong University, Jinan, China
| | - Yinfei Zhang
- Central Hospital of Shanghai Jiading District, Shanghai, China
| | - Youmin Wang
- The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Huacong Deng
- The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Chao Liu
- Jiangsu Province Hospital on Integration of Chinese and Western Medicine, Nanjing, China
| | - Shengli Wu
- Karamay Municipal People's Hospital, Xinjiang, China
| | - Tao Yang
- The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Mian Li
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yu Xu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Min Xu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Tiange Wang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhiyun Zhao
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jieli Lu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yufang Bi
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Weiqing Wang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Gang Chen
- Department of Endocrinology, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China.
| | - Guang Ning
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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9
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Wang X, Yu C, Lv J, Li L, Hu Y, Liu K, Shirai K, Iso H, Dong JY. Consumption of soy products and cardiovascular mortality in people with and without cardiovascular disease: a prospective cohort study of 0.5 million individuals. Eur J Nutr 2021; 60:4429-4438. [PMID: 34076716 DOI: 10.1007/s00394-021-02602-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 05/26/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE We sought to examine the association of soy product consumption with risk of cardiovascular death in Chinese individuals with and without a history of cardiovascular disease (CVD). METHODS The current analysis included 487,034 individuals free of CVD and 22,923 individuals with a history of CVD at study baseline. Data on consumption of soy products were collected by a food frequency questionnaire. The Cox regression was used to obtain the hazard ratios (HRs) of cardiovascular mortality associated with soy product consumption among people with and without a history of CVD at baseline. RESULTS During the period of follow-up, 12,582 and 2860 cardiovascular deaths were recorded among people without and with a history of CVD. Compared with those who never or rarely ate soy products, the multivariable HRs (95% CIs) were 1.02 (0.96, 1.08) for those who ate soy products monthly, 1.01 (0.95, 1.07) for those who ate soy products 1-3 days per week, 0.95 (0.88, 1.04) for those who ate soy products ≥ 4 days per week. For cause-specific mortality, soy product consumption was inversely associated with mortality from acute myocardial infarction (HR [95% CI] = 0.75 [0.61, 0.92]). Among people with a history of CVD, higher soy product consumption was not associated with cardiovascular mortality. CONCLUSIONS Soy consumption ≥ 4 days per week was associated with a significantly lower risk of mortality from acute myocardial infarction in comparison with never or rarely consumption among people without a history of CVD. Among people with a history of CVD, higher soy product consumption was not associated with cardiovascular mortality.
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Affiliation(s)
- Xiaowen Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, 100191, China
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, 5650871, Japan
| | - Canqing Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, 100191, China
| | - Jun Lv
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, 100191, China
| | - Liming Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, 100191, China
| | - Yonghua Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, 100191, China
| | - Keyang Liu
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, 5650871, Japan
| | - Kokoro Shirai
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, 5650871, Japan
| | - Hiroyasu Iso
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, 5650871, Japan
| | - Jia-Yi Dong
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, 5650871, Japan.
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10
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Akhavan Zanjani M, Rahmani S, Mehranfar S, Zarrin M, Bazyar H, Moradi Poodeh B, Zare Javid A, Hosseini SA, Sadeghian M. Soy Foods and the Risk of Fracture: A Systematic Review of Prospective Cohort Studies. Complement Med Res 2021; 29:172-181. [PMID: 34547749 DOI: 10.1159/000519036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Accepted: 08/16/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVES The primary objective of our study was to systematically review all available prospective cohort studies which investigated the association of soy food intake and incident fracture risk. METHODS We searched PubMed, Scopus, and Embase databases for relevant studies up to June 2021. SYNTHESIS Of 695 records, a total of 5 cohort studies were included in the current systematic review. Two studies that were performed in China evaluated hip fracture while 2 studies that were done in Singapore evaluated any kind of fractures. The other study was conducted in Japan and evaluated osteoporosis fractures. All studies used a face-to-face interview to assess the dietary intake of soy foods. All 5 cohort studies were determined to be of high quality. One study considered soy food as a part of a vegetables-fruit-soy food dietary pattern. Others reported the association of dietary intake of soy foods with the risk of fractures. CONCLUSION The evidence from prospective cohort studies was suggestive for a protective role of soy foods, alone or within a dietary pattern, in the risk of incident fracture among Asian women, particularly for those in early menopause and those who used fermented soy products. But for men, the association was not significant. However, more cohort studies, including non-Asian populations, are required to confirm this association fully.
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Affiliation(s)
- Mohsen Akhavan Zanjani
- Division of Kinesiology, School of Health and Human Performance, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Sepideh Rahmani
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sanaz Mehranfar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, University of Medical Sciences, Tehran, Iran
| | - Milad Zarrin
- Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Hadi Bazyar
- Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.,Department of Nutrition, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.,Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Bahman Moradi Poodeh
- Department of Laboratory, Lahijan Branch, Islamic Azad University, Lahijan, Iran
| | - Ahmad Zare Javid
- Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.,Department of Nutrition, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Seyed Ahmad Hosseini
- Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.,Department of Nutrition, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mehdi Sadeghian
- Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.,Department of Nutrition, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.,Shefa Neuroscience Research Center, Khatam Alanbia Hospital, Tehran, Iran
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11
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Alshehri MM, Sharifi-Rad J, Herrera-Bravo J, Jara EL, Salazar LA, Kregiel D, Uprety Y, Akram M, Iqbal M, Martorell M, Torrens-Mas M, Pons DG, Daştan SD, Cruz-Martins N, Ozdemir FA, Kumar M, Cho WC. Therapeutic Potential of Isoflavones with an Emphasis on Daidzein. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2021; 2021:6331630. [PMID: 34539970 PMCID: PMC8448605 DOI: 10.1155/2021/6331630] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 08/26/2021] [Indexed: 12/20/2022]
Abstract
Daidzein is a phytoestrogen isoflavone found in soybeans and other legumes. The chemical composition of daidzein is analogous to mammalian estrogens, and it could be useful with a dual-directional purpose by substituting/hindering with estrogen and estrogen receptor (ER) complex. Hence, daidzein puts forth shielding effects against a great number of diseases, especially those associated with the control of estrogen, such as breast cancer, diabetes, osteoporosis, and cardiovascular disease. However, daidzein also has other ER-independent biological activities, such as oxidative damage reduction acting as an antioxidant, immune regulator as an anti-inflammatory agent, and apoptosis regulation, directly linked to its potential anticancer effects. In this sense, the present review is aimed at providing a deepen analysis of daidzein pharmacodynamics and its implications in human health, from its best-known effects alleviating postmenopausal symptoms to its potential anticancer and antiaging properties.
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Affiliation(s)
- Mohammed M. Alshehri
- Pharmaceutical Care Department, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia
| | - Javad Sharifi-Rad
- Phytochemistry Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Jesús Herrera-Bravo
- Departamento de Ciencias Básicas, Facultad de Ciencias, Universidad Santo Tomas, Chile
- Center of Molecular Biology and Pharmacogenetics, Scientific and Technological Bioresource Nucleus, Universidad de La Frontera, Temuco 4811230, Chile
| | - Evelyn L. Jara
- Departamento de Ciencias Básicas, Facultad de Ciencias, Universidad Santo Tomas, Chile
| | - Luis A. Salazar
- Center of Molecular Biology and Pharmacogenetics, Scientific and Technological Bioresource Nucleus, Universidad de La Frontera, Temuco 4811230, Chile
| | - Dorota Kregiel
- Department of Environmental Biotechnology, Lodz University of Technology, Wolczanska 171/173, 90-924 Lodz, Poland
| | - Yadav Uprety
- Amrit Campus, Tribhuvan University, Kathmandu, Nepal
| | - Muhammad Akram
- Department of Eastern Medicine and Surgery, Directorate of Medical Sciences, GC University Faisalabad, Pakistan
| | - Mehwish Iqbal
- Institute of Health Management, Dow University of Health Sciences, Karachi, Pakistan
| | - Miquel Martorell
- Department of Nutrition and Dietetics, Faculty of Pharmacy and Centre for Healthy Living, University of Concepción, 4070386 Concepción, Chile
| | - Margalida Torrens-Mas
- Translational Research In Aging and Longevity (TRIAL Group), Health Research Institute of the Balearic Islands (IdISBA), 07122 Palma, Spain
| | - Daniel Gabriel Pons
- Grupo Multidisciplinar de Oncología Traslacional (GMOT), Institut Universitari d'Investigació en Ciències de la Salut (IUNICS), Universitat de les Illes Balears (UIB), Instituto de Investigación Sanitaria Illes Balears (IdISBa), 07122 Palma, Spain
| | - Sevgi Durna Daştan
- Department of Biology, Faculty of Science, Sivas Cumhuriyet University, 58140 Sivas, Turkey
- Beekeeping Development Application and Research Center, Sivas Cumhuriyet University, 58140 Sivas, Turkey
| | - Natália Cruz-Martins
- Faculty of Medicine, University of Porto, Alameda Professor Hernâni Monteiro, 4200-319 Porto, Portugal
- Institute for Research and Innovation in Health (i3S), University of Porto, 4200-135 Porto, Portugal
- Institute of Research and Advanced Training in Health Sciences and Technologies (CESPU), Rua Central de Gandra, 1317, 4585-116 Gandra, PRD, Portugal
| | - Fethi Ahmet Ozdemir
- Department of Molecular Biology and Genetics, Faculty of Science and Art, Bingol University, Bingol 1200, Turkey
| | - Manoj Kumar
- Chemical and Biochemical Processing Division, ICAR–Central Institute for Research on Cotton Technology, Mumbai 400019, India
| | - William C. Cho
- Department of Clinical Oncology, Queen Elizabeth Hospital, Kowloon, Hong Kong
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12
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Dietary Soy Consumption and Cardiovascular Mortality among Chinese People with Type 2 Diabetes. Nutrients 2021; 13:nu13082513. [PMID: 34444673 PMCID: PMC8398979 DOI: 10.3390/nu13082513] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 07/20/2021] [Accepted: 07/20/2021] [Indexed: 11/16/2022] Open
Abstract
Randomized controlled trials showed that soy intervention significantly improved blood lipids in people with diabetes. We sought to prospectively examine the association of soy consumption with the risk of cardiovascular death among individuals with diabetes. A total of 26,139 participants with a history of diabetes were selected from the Chinese Kadoorie Biobank study. Soy food consumption was assessed by a food frequency questionnaire. Causes of death were coded by the 10th International Classification of Diseases. The Cox proportional hazard regression was used to compute the hazard ratios. During a median follow-up of 7.8 years, a total of 1626 deaths from cardiovascular disease (CVD) were recorded. Compared with individuals who never consumed soy foods, the multivariable-adjusted risks (95% confidence intervals) of CVD mortality were 0.92 (0.78, 1.09), 0.89 (0.75, 1.05), and 0.77 (0.62, 0.96) for those who consumed soy foods monthly, 1–3 days/week, and ≥4 days/week, respectively. For cause-specific cardiovascular mortality, significant inverse associations were observed for coronary heart disease and acute myocardial infarction. Higher soy food consumption was associated with a lower risk of cardiovascular death, especially death from coronary heart disease and acute myocardial infarction, in Chinese adults with diabetes.
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13
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Messina M, Mejia SB, Cassidy A, Duncan A, Kurzer M, Nagato C, Ronis M, Rowland I, Sievenpiper J, Barnes S. Neither soyfoods nor isoflavones warrant classification as endocrine disruptors: a technical review of the observational and clinical data. Crit Rev Food Sci Nutr 2021; 62:5824-5885. [PMID: 33775173 DOI: 10.1080/10408398.2021.1895054] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Soybeans are a rich source of isoflavones, which are classified as phytoestrogens. Despite numerous proposed benefits, isoflavones are often classified as endocrine disruptors, based primarily on animal studies. However, there are ample human data regarding the health effects of isoflavones. We conducted a technical review, systematically searching Medline, EMBASE, and the Cochrane Library (from inception through January 2021). We included clinical studies, observational studies, and systematic reviews and meta-analyses (SRMA) that examined the relationship between soy and/or isoflavone intake and endocrine-related endpoints. 417 reports (229 observational studies, 157 clinical studies and 32 SRMAs) met our eligibility criteria. The available evidence indicates that isoflavone intake does not adversely affect thyroid function. Adverse effects are also not seen on breast or endometrial tissue or estrogen levels in women, or testosterone or estrogen levels, or sperm or semen parameters in men. Although menstrual cycle length may be slightly increased, ovulation is not prevented. Limited insight could be gained about possible impacts of in utero isoflavone exposure, but the existing data are reassuring. Adverse effects of isoflavone intake were not identified in children, but limited research has been conducted. After extensive review, the evidence does not support classifying isoflavones as endocrine disruptors.
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Affiliation(s)
- Mark Messina
- Department of Nutrition, Loma Linda University, Loma Linda, California, USA
| | - Sonia Blanco Mejia
- Department of Nutritional Sciences, University of Toronto, Toronto, Canada
| | - Aedin Cassidy
- Nutrition and Preventive Medicine, Queen's University, Belfast, Northern Ireland, UK
| | - Alison Duncan
- College of Biological Sciences, University of Guelph, Guelph, Canada
| | - Mindy Kurzer
- Department of Food Science and Nutrition, University of Minnesota, Minneapolis, Minnesota, USA
| | - Chisato Nagato
- Graduate School of Medicine, Gifu University, Gifu, Japan
| | - Martin Ronis
- Health Sciences Center, Louisiana State University Health Sciences Center, Baton Rouge, New Orleans, USA
| | - Ian Rowland
- Human Nutrition, University of Reading, Reading, England, UK
| | | | - Stephen Barnes
- Department of Pharmacology and Toxicology, University of Alabama, Alabama, USA
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14
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Xu Y, Le Sayec M, Roberts C, Hein S, Rodriguez-Mateos A, Gibson R. Dietary Assessment Methods to Estimate (Poly)phenol Intake in Epidemiological Studies: A Systematic Review. Adv Nutr 2021; 12:1781-1801. [PMID: 33684195 PMCID: PMC8483972 DOI: 10.1093/advances/nmab017] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 01/06/2021] [Accepted: 01/29/2021] [Indexed: 11/25/2022] Open
Abstract
Nutritional epidemiological studies have frequently reported associations between higher (poly)phenol intake and a decrease in the risk or incidence of noncommunicable diseases. However, the assessment methods that have been used to quantify the intakes of these compounds in large-population samples are highly variable. This systematic review aims to characterize the methods used to assess dietary (poly)phenol intake in observational studies, report the validation status of the methods, and give recommendations on method selection and data reporting. Three databases were searched for publications that have used dietary assessment methods to measure (poly)phenol intake and 549 eligible full texts were identified. Food-frequency questionnaires were found to be the most commonly used tool to assess dietary (poly)phenol intake (73%). Published data from peer-reviewed journals were the major source of (poly)phenol content data (25%). An increasing number of studies used open-access databases such as Phenol-Explorer and USDA databases on flavonoid content since their inception, which accounted for 11% and 23% of the data sources, respectively. Only 16% of the studies reported a method that had been validated for measuring the target (poly)phenols. For future research we recommend: 1) selecting a validated dietary assessment tool according to the target compounds and target period of measurement; 2) applying and combining comprehensive (poly)phenol content databases such as USDA and Phenol-Explorer; 3) detailing the methods used to assess (poly)phenol intake, including dietary assessment method, (poly)phenol content data source; 4) follow the Strengthening the Reporting of Observational Studies in Epidemiology-Nutritional Epidemiology (STROBE-nut) framework; and 5) complementing dietary intake assessment based on questionnaires with measurement of (poly)phenols in biofluids using appropriate and validated analytical methods.
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Affiliation(s)
- Yifan Xu
- Department of Nutritional Sciences, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
| | - Melanie Le Sayec
- Department of Nutritional Sciences, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
| | - Caroline Roberts
- Department of Nutritional Sciences, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
| | - Sabine Hein
- Department of Nutritional Sciences, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom,School of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom
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15
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Micek A, Godos J, Del Rio D, Galvano F, Grosso G. Dietary Flavonoids and Cardiovascular Disease: A Comprehensive Dose-Response Meta-Analysis. Mol Nutr Food Res 2021; 65:e2001019. [PMID: 33559970 DOI: 10.1002/mnfr.202001019] [Citation(s) in RCA: 78] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 01/18/2021] [Indexed: 12/13/2022]
Abstract
SCOPE Dietary flavonoids have shown potential in the prevention of noncommunicable diseases. The aim of the present study is to conduct a dose-response meta-analysis on the association between dietary intake of total, subclasses and individual flavonoids and risk of cardiovascular disease (CVD). METHODS AND RESULTS Electronic databases are searched. A total of 39 prospective cohort studies are included, comprising 1 501 645 individuals and a total of 33 637 cases of CVD, 23 664 of coronary heart disease (CHD), and 11 860 of stroke. Increasing dietary intake of total flavonoids is linearly associated with a lower risk of CVD. Among the main classes of flavonoids, increasing intake of anthocyanins and flavan-3-ols is inversely associated with risk of CVD, while flavonols and flavones with CHD. Only increasing flavanones showed a linear inverse association with stroke risk. Catechins showed a favorable effect toward all cardiovascular outcomes. Among individual compounds, intake of quercetin and kaempferol is linearly associated with lower risk of CHD and CVD, respectively. However, higher intake of all the aforementioned compounds is associated, with a various extent, with a lower risk of CVD when considering comparison of extreme categories of consumption. CONCLUSION The results of this study provide evidence of potential cardiovascular benefits of a flavonoid-rich diet.
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Affiliation(s)
- Agnieszka Micek
- Department of Nursing Management and Epidemiology Nursing, Faculty of Health Sciences, Jagiellonian University Medical College, Kraków, Poland
| | - Justyna Godos
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Daniele Del Rio
- School of Advanced Studies on Food and Nutrition, University of Parma, Parma, Italy.,Department of Veterinary Science, University of Parma, Parma, Italy
| | - Fabio Galvano
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Giuseppe Grosso
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
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16
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Jung SM, Haddad EH, Kaur A, Sirirat R, Kim AY, Oda K, Rajaram S, Sabaté J. A Non-Probiotic Fermented Soy Product Reduces Total and LDL Cholesterol: A Randomized Controlled Crossover Trial. Nutrients 2021; 13:nu13020535. [PMID: 33562090 PMCID: PMC7915103 DOI: 10.3390/nu13020535] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 01/26/2021] [Accepted: 02/03/2021] [Indexed: 02/04/2023] Open
Abstract
Traditional Asian fermented soy food products are associated with reduced cardiovascular disease risk in prospective studies, but few randomized controlled trials have been conducted in at-risk populations. The aim of this study was to investigate the effect of a commercial non-probiotic fermented soy product on blood lipids in adults with cardiovascular risk biomarkers. In a randomized, crossover, intervention study, 27 men and women (aged 29–75 y) exhibiting at least two risk factors, consumed two packets (12.5 g each) daily of a fermented powdered soy product, or an isoenergic control powder made from germinated brown rice for 12 weeks each. The consumption of the fermented soy product resulted in a significantly greater mean change from baseline (compared to the germinated rice, all p < 0.05) in total cholesterol of −0.23 mmol/L (CI: −0.40, −0.06) compared with 0.14 mmol/L (CI: −0.03, 0.31), respectively; and low density lipoprotein (LDL) cholesterol −0.18 mmol/L (CI: −0.32, −0.04) compared with 0.04 mmol/L (CI: −0.01, 0.018) respectively. This was accompanied by an increase in high density lipoprotein (HDL) cholesterol in the germinated rice group, a decrease in apolipoprotein B (ApoB) in the fermented soy group, and a between-treatment effect in apolipoprotein A1 (ApoA1); however, the ratio of the LDL:HDL and of Apo B:ApoA1 did not differ between the groups. The ratio of total cholesterol:LDL decreased in men in the fermented soy group (p < 0.001). Twenty-four-hour urine collection at the end of each treatment period resulted in an increased excretion expressed as a ratio in μmol/d between treatments of 10.93 (CI: 5.07, 23.54) for daidzein; 1.24 (CI: 1.14, 4.43) for genistein; and, 8.48 (CI: 4.28, 16.80) for glycitein, all p < 0.05. The fermented soy powder consumed by participants in this study without implementing other changes in their typical diets, decreased the total and LDL cholesterol, and may serve as a dietary strategy to manage blood lipids. The trial was registered at ClinicalTrials.gov as NCT03429920.
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17
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Parmenter BH, Croft KD, Hodgson JM, Dalgaard F, Bondonno CP, Lewis JR, Cassidy A, Scalbert A, Bondonno NP. An overview and update on the epidemiology of flavonoid intake and cardiovascular disease risk. Food Funct 2020; 11:6777-6806. [PMID: 32725042 DOI: 10.1039/d0fo01118e] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
There is an accumulating body of literature reporting on dietary flavonoid intake and the risk of cardiovascular disease (CVD) in prospective cohort studies. This makes apparent the need for an overview and update on the current state of the science. To date, at least 27 prospective cohorts (in 44 publications) have evaluated the association between estimated habitual flavonoid intake and CVD risk. At this time, the totality of evidence suggests long-term consumption of flavonoid-rich foods may be associated with a lower risk of fatal and non-fatal ischemic heart disease (IHD), cerebrovascular disease, and total CVD; disease outcomes which are principally, though not exclusively, composed of cases of atherosclerotic CVD (ASCVD). To date, few studies have investigated outcome specific ASCVD, such as peripheral artery disease (PAD) or ischemic stroke. Of the flavonoid subclasses investigated, evidence more often implicates diets rich in anthocyanins, flavan-3-ols, and flavonols in lowering the risk of CVD. Although inferences are restricted by confounding and other inherent limitations of observational studies, causality appears possible based on biological plausibility, temporality, and the relative consistency of the reported associations. However, whether the associations observed represent a benefit of the isolated bioactives per se, or are a signal of the bioactives acting in concert with the co-occurring nutrient matrix within flavonoid-bearing foods, are issues of consideration. Thus, the simple interpretation, and the one most relevant for dietary advice, is that consumption of flavonoid-rich foods or diets higher in flavonoids, appear nutritionally beneficial in the prevention of CVD.
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Affiliation(s)
- Benjamin H Parmenter
- School of Biomedical Sciences, University of Western Australia, Royal Perth Hospital Research Foundation, Perth, Australia.
| | - Kevin D Croft
- School of Biomedical Sciences, University of Western Australia, Royal Perth Hospital Research Foundation, Perth, Australia.
| | - Jonathan M Hodgson
- School of Medical and Health Sciences, Edith Cowan University, Perth, Australia and Medical School, University of Western Australia, Perth, Australia
| | - Frederik Dalgaard
- Department of Cardiology, Herlev & Gentofte University Hospital, Copenhagen, Denmark
| | - Catherine P Bondonno
- School of Medical and Health Sciences, Edith Cowan University, Perth, Australia and Medical School, University of Western Australia, Perth, Australia
| | - Joshua R Lewis
- School of Medical and Health Sciences, Edith Cowan University, Perth, Australia and Medical School, University of Western Australia, Perth, Australia and Centre for Kidney Research, School of Public Health, The University of Sydney, Sydney, Australia
| | - Aedín Cassidy
- Institute for Global Food Security, Queen's University, Belfast, Northern Ireland
| | - Augustin Scalbert
- Biomarkers Group, International Agency for Research on Cancer, Lyon, France
| | - Nicola P Bondonno
- School of Biomedical Sciences, University of Western Australia, Royal Perth Hospital Research Foundation, Perth, Australia. and School of Medical and Health Sciences, Edith Cowan University, Perth, Australia and Institute for Global Food Security, Queen's University, Belfast, Northern Ireland
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18
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Abstract
Soybeans are among the most popular foods worldwide, and intake of soy-containing foods has been associated with many health benefits in part because of it structure similar to estrogen. Epidemiologic studies have demonstrated that soy consumption improves serum profiles of hypercholesterolemic patients. Several studies have also indicated an inverse relationship between the consumption of soy isoflavones and the incidence of cardiovascular diseases (CVD). Soy is a rich dietary source of isoflavones. The main soy isoflavones are daidzein and genistein; equol, another isoflavone and a major intestinal bacterial metabolite of daidzein, is generated by enterobacterial effects. Many isoflavones have antioxidative effects and anti-inflammatory actions, as well as induce nitric oxide production to maintain a healthy endothelium and prevent endothelial cell dysfunction. These effects may limit the development of atherosclerosis and CVD and restore healthy endothelial function in altered endothelia. Although the evidence supporting the benefits of soy isoflavones in CVD prevention continues to increase, the association between soy isoflavones and disease is not fully understood. This review summarized recent progress in identifying the preventive mechanisms of action of dietary soybean isoflavones on vascular endothelial cells. Furthermore, it describes the beneficial roles that these isoflavones may have on endothelial dysfunction-related atherosclerosis.
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Katagiri R, Sawada N, Goto A, Yamaji T, Iwasaki M, Noda M, Iso H, Tsugane S. Association of soy and fermented soy product intake with total and cause specific mortality: prospective cohort study. BMJ 2020; 368:m34. [PMID: 31996350 PMCID: PMC7190045 DOI: 10.1136/bmj.m34] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To investigate the association between several types of soy products and all cause and cause specific mortality. DESIGN Population based cohort study. SETTING Japan Public Health Centre-based Prospective Study, which includes 11 public health centre areas in Japan. PARTICIPANTS 92 915 participants (42 750 men and 50 165 women) aged 45 to 74 years. EXPOSURES Intake of total soy products, fermented soy products (natto and miso), non-fermented soy products, and tofu from a five year survey questionnaire. MAIN OUTCOME MEASURES All cause and cause specific mortality (cancer, total cardiovascular disease, heart disease, cerebrovascular disease, respiratory disease, and injury) obtained from residential registries and death certificates. RESULTS During 14.8 years of follow-up, 13 303 deaths were identified. In the multivariable adjusted models, intake of total soy products was not significantly associated with total mortality. Compared with the lowest fifth of total soy product intake, the hazard ratios in the highest fifth were 0.98 (95% confidence interval 0.91 to 1.06, Ptrend=0.43) in men and 0.98 (0.89 to 1.08, Ptrend=0.46) in women. Intake of fermented soy products was inversely associated with all cause mortality in both sexes (highest versus lowest fifth: 0.90 (0.83 to 0.97), Ptrend=0.05 in men, and 0.89 (0.80 to 0.98), Ptrend=0.01 in women). Natto showed significant and inverse associations with total cardiovascular disease related mortality in both sexes. CONCLUSIONS In this study a higher intake of fermented soy was associated with a lower risk of mortality. A significant association between intake of total soy products and all cause mortality was not, however, observed. The findings should be interpreted with caution because the significant association of fermented soy products might be attenuated by unadjusted residual confounding.
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Affiliation(s)
- Ryoko Katagiri
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Centre, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
| | - Norie Sawada
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Centre, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
| | - Atsushi Goto
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Centre, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
| | - Taiki Yamaji
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Centre, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
| | - Motoki Iwasaki
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Centre, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
| | - Mitsuhiko Noda
- Department of Diabetes, Metabolism and Endocrinology, Ichikawa Hospital, International University of Health and Welfare, Ichikawa, Chiba, Japan
| | - Hiroyasu Iso
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita-shi, Osaka, Japan
| | - Shoichiro Tsugane
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Centre, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
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Nogueira-de-Almeida CA, Ferraz IS, Ued FDV, Almeida ACF, Ciampo LAD. Impact of soy consumption on human health: integrative review. BRAZILIAN JOURNAL OF FOOD TECHNOLOGY 2020. [DOI: 10.1590/1981-6723.12919] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Abstract Soy consumption is a millenary habit of populations of the eastern world and has recently increased in the western world. The risks and benefits of this practice have been extensively studied, with a current fundamental need of integration of available information. The aim of this study was to carry out an integrative review on this topic, in order to consolidate the available information. Based on the main question: “What is the impact of soy consumption on human health?”, were reviewed publications classified as original articles and reviews published from 1998 to 2020 in the databases Scopus, PubMed, SciELO, Web of Science, and Cochrane Library. A total of 97 studies were selected. In the present review were described the general impact of soy on human health and its protein quality, the effects of early exposure using soy formulas, and the effects of soy consumption on breast cancer, endometrial and ovarian cancer, prostate cancer, gastrointestinal cancer, cardiovascular disease, glucose metabolism and type 2 diabetes, obesity, reproductive health, menopause, female and male osteoporosis, microbiota, immunity and immunomodulation, thyroid function, attention-deficit hyperactivity disorder, and renal function.
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21
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Talaei M, Feng L, Yuan JM, Pan A, Koh WP. Dairy, soy, and calcium consumption and risk of cognitive impairment: the Singapore Chinese Health Study. Eur J Nutr 2019; 59:1541-1552. [PMID: 31161350 DOI: 10.1007/s00394-019-02010-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 05/23/2019] [Indexed: 02/01/2023]
Abstract
PURPOSE It is unclear if midlife consumption of dairy and soy food intake, and their components of calcium and isoflavones (in soy), is related to cognitive impairment in elderly. METHODS We used baseline data on lifestyle and habitual diet of 16,948 participants collected during their recruitment into the Singapore Chinese Health Study from 1993 to 1998, and data on their cognitive function, measured using a 30-item Singapore modified Mini-Mental State Examination, during follow-up interviews from 2014 to 2016. We used multivariable logistic regression models to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) for developing cognitive impairment. RESULTS Higher dairy intake was associated with a lower risk of cognitive impairment in a dose-dependent manner (P for trend = 0.009). Compared to the lowest quartile of dairy intake, ORs (95% CIs) were 0.93 (0.81-1.07) for the second, 0.88 (0.76-1.01) for the third, and 0.82 (0.72-0.94) for the fourth quartiles of intake. Similar results were found for dairy calcium intake (P for trend = 0.008). However, there was no statistically significant association for intake of soy (OR comparing extreme quartiles 0.99, 95% CI 0.87-1.14, P for trend = 0.92), isoflavones (OR 1.01, 95% CI 0.88-1.15, P for trend = 0.90) or non-dairy calcium (OR 1.06, 95% CI 0.86-1.30, P for trend = 0.81) with risk of cognitive impairment. CONCLUSIONS Dairy intake at midlife could have a protective association against cognitive impairment that may not be attributed to its calcium content alone, while soy or isoflavone intake was not associated with the cognition of elderly in our study.
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Affiliation(s)
- Mohammad Talaei
- National University Health System (NUHS) Centre for Healthy Ageing, Singapore, Singapore.
- Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
- Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
| | - Lei Feng
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Jian-Min Yuan
- Division of Cancer Control and Population Sciences, UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - An Pan
- Department of Epidemiology and Biostatistics, MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Woon-Puay Koh
- Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore.
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
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The association between urinary genistein levels and mortality among adults in the United States. PLoS One 2019; 14:e0211368. [PMID: 30682197 PMCID: PMC6347457 DOI: 10.1371/journal.pone.0211368] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2018] [Accepted: 01/12/2019] [Indexed: 11/19/2022] Open
Abstract
Background Current research on the relationship between phytoestrogens and mortality has been inconclusive. We explored the relationship between genistein, a phytoestrogen, and mortality in a large cohort representative of the United States population. Methods Data were analyzed from the National Health and Nutrition Examination Survey (NHANES) from 1999–2010. Normalized urinary genistein (nUG) was analyzed as a log-transformed continuous variable and in quartiles. Mortality data were obtained from the National Death Index and matched to the NHANES participants. Survival analyses were conducted using the Kaplan-Meier analysis. Cox proportional hazard models were constructed for all-cause and cause-specific mortality without and with adjustment for potential confounding variables. Results Of 11,497 participants, 944 died during the 64,443 person-years follow-up. The all-cause mortality rate was significantly lower in the lowest quartile compared to the highest quartile (incidence rate ratio = 2.14, 95%CI = 1.76 to 2.60). Compared to the lowest quartile, the highest quartile had significantly higher adjusted all-cause (HR = 1.57, 95%CI = 1.23 to 2.00), cardiovascular (HR = 1.67, 95%CI = 1.04 to 2.68), and other-cause (HR = 1.85, 95%CI = 1.33 to 2.57) mortality. Conclusion We found that high urinary genistein levels were associated with increased risk of all-cause, cardiovascular, and other-cause mortality. This is contrary to popular opinion on the health benefits of genistein and needs further research.
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Sekikawa A, Ihara M, Lopez O, Kakuta C, Lopresti B, Higashiyama A, Aizenstein H, Chang YF, Mathis C, Miyamoto Y, Kuller L, Cui C. Effect of S-equol and Soy Isoflavones on Heart and Brain. Curr Cardiol Rev 2019; 15:114-135. [PMID: 30516108 PMCID: PMC6520578 DOI: 10.2174/1573403x15666181205104717] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 11/26/2018] [Accepted: 11/26/2018] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Observational studies in Asia show that dietary intake of soy isoflavones had a significant inverse association with coronary heart disease (CHD). A recent randomized controlled trial (RCT) of soy isoflavones on atherosclerosis in the US, however, failed to show their benefit. The discrepancy may be due to the much lower prevalence of S-equol producers in Westerners: Only 20-30% of Westerners produce S-equol in contrast to 50-70% in Asians. S-equol is a metabolite of dietary soy isoflavone daidzein by gut microbiome and possesses the most antiatherogenic properties among all isoflavones. Several short-duration RCTs documented that soy isoflavones improves arterial stiffness. Accumulating evidence shows that both atherosclerosis and arterial stiffness are positively associated with cognitive decline/dementia. Therefore, potentially, soy isoflavones, especially S-equol, are protective against cognitive decline/dementia. METHODS/RESULTS This narrative review of clinical and epidemiological studies provides an overview of the health benefits of soy isoflavones and introduces S-equol. Second, we review recent evidence on the association of soy isoflavones and S-equol with CHD, atherosclerosis, and arterial stiffness as well as the association of atherosclerosis and arterial stiffness with cognitive decline/ dementia. Third, we highlight recent studies that report the association of soy isoflavones and S-equol with cognitive decline/dementia. Lastly, we discuss the future directions of clinical and epidemiological research on the relationship of S-equol and CHD and dementia. CONCLUSIONS Evidence from observational studies and short-term RCTs suggests that S-equol is anti-atherogenic and improves arterial stiffness and may prevent CHD and cognitive impairment/ dementia. Well-designed long-term (≥ 2years) RCTs should be pursued.
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Affiliation(s)
- Akira Sekikawa
- Address correspondence to this author at the Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, 130 North Bellefield Avenue, Suite 336, Pittsburgh, PA 15213, USA; Tel: 412-383-1063; Fax: 412-648-4401;
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Woo HW, Kim MK, Lee YH, Shin DH, Shin MH, Choi BY. Habitual consumption of soy protein and isoflavones and risk of metabolic syndrome in adults ≥ 40 years old: a prospective analysis of the Korean Multi-Rural Communities Cohort Study (MRCohort). Eur J Nutr 2018; 58:2835-2850. [PMID: 30264377 DOI: 10.1007/s00394-018-1833-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2018] [Accepted: 09/22/2018] [Indexed: 12/19/2022]
Abstract
PURPOSE Although considerable attention has been paid to the potential benefits of soy protein and isoflavones for preventing metabolic syndrome (MetS) and its components, findings linking habitual consumption of these factors to MetS are limited. This study aimed to evaluate the association of MetS incidence with habitual intake of soy protein/isoflavones among Korean men and women aged ≥ 40 years old who did not have MetS at baseline (n = 5509; 2204 men and 3305 women). METHODS Dietary intake of soy protein/isoflavones at baseline and average consumption during follow-up were used. RESULTS A significant inverse association between dietary intake and incidence of MetS was found in women (incidence rate ratios, IRR = 0.60, 95% CI = 0.46-0.78, P for trend = 0.0094 for the highest quintile of average soy protein intake compared with the lowest quintile; IRR = 0.57, 95% CI = 0.44-0.74, P for trend = 0.0048 for the highest quintile of average isoflavones intake compared with the lowest quintile). A tendency towards an inverse association was also found in men, although it was not significant for the highest quintile (IRR = 0.80, 95% CI = 0.58-1.11, P for trend = 0.9759, comparing the lowest to the highest quintile of average soy protein intake; IRR = 0.73, 95% CI = 0.53-1.01, P for trend = 0.8956, comparing the lowest to the highest quintile of average isoflavones intake). In terms of individual abnormalities, a significant inverse association was found between soy protein and isoflavones and the incidence of low-high-density lipoprotein cholesterol in both men and women. Abdominal obesity and elevated blood pressure were inversely related to soy protein/isoflavones only in women, and an inverse association of elevated triglyceride appeared only in men. CONCLUSION Our findings suggest that habitual intake of soy protein and isoflavones is inversely associated with the risk of MetS and its components. There is likely to be a reverse J-shaped association of average intake with MetS.
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Affiliation(s)
- Hye Won Woo
- Department of Preventive Medicine, College of Medicine, Hanyang University, Seoul, South Korea.,Institute for Health and Society, Hanyang University, Seoul, South Korea
| | - Mi Kyung Kim
- Department of Preventive Medicine, College of Medicine, Hanyang University, Seoul, South Korea. .,Institute for Health and Society, Hanyang University, Seoul, South Korea.
| | - Young-Hoon Lee
- Department of Preventive Medicine and Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, South Korea
| | - Dong Hoon Shin
- Department of Preventive Medicine, Keimyung University Dongsan Medical Center, Daegu, South Korea
| | - Min-Ho Shin
- Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, South Korea
| | - Bo Youl Choi
- Department of Preventive Medicine, College of Medicine, Hanyang University, Seoul, South Korea.,Institute for Health and Society, Hanyang University, Seoul, South Korea
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Neelakantan N, Koh WP, Yuan JM, van Dam RM. Diet-Quality Indexes Are Associated with a Lower Risk of Cardiovascular, Respiratory, and All-Cause Mortality among Chinese Adults. J Nutr 2018; 148:1323-1332. [PMID: 29982724 PMCID: PMC6075575 DOI: 10.1093/jn/nxy094] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Accepted: 04/13/2018] [Indexed: 02/07/2023] Open
Abstract
Background Diet-quality indexes have been associated with a lower risk of chronic disease mortality in Western populations, but it is unclear whether these indexes reflect protective dietary patterns in Asian populations. Objective We examined the association between Alternative Healthy Eating Index-2010 (AHEI-2010), alternate Mediterranean diet (aMED), Dietary Approaches to Stop Hypertension (DASH), and Healthy Diet Indicator (HDI) scores and the risk of all-cause cardiovascular disease (CVD), cancer, and respiratory disease mortality. Methods We used data from a prospective cohort of 57,078 Singapore Chinese men and women (aged 45-74 y) who were free of cancer and CVD at baseline (1993-1998) and who were followed up through 2014. The diet-quality index scores were calculated on the basis of data from a validated 165-item food-frequency questionnaire. Cox regression models with adjustment for potential confounders including sociodemographic and lifestyle variables, body mass index, and medical history were used to estimate HRs and 95% CIs. Results During a total of 981,980 person-years of follow-up, 15,262 deaths (CVD: 4871; respiratory: 2690; and cancer: 5306) occurred. Comparing the highest with the lowest quintiles, the multivariable adjusted HRs (95% CIs) for all-cause mortality were 0.82 (0.78, 0.86) for AHEI-2010, 0.80 (0.76, 0.85) for aMED, 0.80 (0.75, 0.84) for DASH, and 0.88 (0.83, 0.92) for HDI scores (all P-trend < 0.001). Higher diet index scores were associated with a 14-28% lower risk of CVD and respiratory mortality, but only a 5-12% lower risk of cancer mortality. Higher consumption of vegetables, fruit, nuts, and long-chain n-3 (ω-3) fatty acids, lower consumption of red meat, and avoidance of high alcohol consumption were the diet index components associated with a lower risk of mortality. Conclusion Adherence to several recommended dietary patterns that emphasize healthy plant-based foods was associated with a substantially lower risk of chronic disease mortality in an Asian population. The Singapore Chinese Health Study was registered at www.clinicaltrials.gov as NCT03356340.
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Affiliation(s)
| | - Woon-Puay Koh
- Saw Swee Hock School of Public Health,Duke-NUS Medical School, Singapore
| | - Jian-Min Yuan
- Division of Cancer Control and Population Sciences, UPMC Hillman Cancer Center, Pittsburgh, PA,Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA
| | - Rob M van Dam
- Saw Swee Hock School of Public Health,Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore,Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA,Address correspondence to RMvD (e-mail: )
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Namazi N, Saneei P, Larijani B, Esmaillzadeh A. Soy product consumption and the risk of all-cause, cardiovascular and cancer mortality: a systematic review and meta-analysis of cohort studies. Food Funct 2018; 9:2576-2588. [PMID: 29666853 DOI: 10.1039/c7fo01622k] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2023]
Abstract
Currently, the association of soy intake with total- and cause-specific mortality is inconsistent. The aim of this study was to systematically review cohort studies on the association between the consumption of soy products and mortality from all-causes, cardiovascular disease (CVD), and cancer. We conducted a systematic search of the PubMed/Medline, ISI Web of Knowledge and Embase electronic databases up to October 2016. Prospective cohort studies that examined the association of soy products with the risk of all-cause, CVD and cancer mortality using the relative risk (RR) or Hazard Ratio (HR) with 95% CIs were considered. Random-effect models were used to pool the study results and heterogeneity was examined using the I2 index and Q test. Finally, 7 studies were included for the meta-analysis; three studies reported the risk of all-cause mortality. Four studies assessed the risk of mortality from CVD and cancer. In total, 39 250 deaths were reported among 627 209 participants in a 7 to 18-year follow-up. A high consumption of soy products was not significantly associated with a lower risk of mortality from all-causes (HR: 0.96, 95% CI: 0.90, 1.02, I2: 38.5%, and Pheterogeneity = 0.14), CVD (HR: 0.95, 95% CI: 0.82, 1.10, I2: 49.9%, and Pheterogeneity = 0.07), and cancer (HR: 0.98, 95% CI: 0.92, 1.05, I2: 0%, and Pheterogeneity = 0.75). These findings indicated no significant association between a high intake of soy products and all-cause, CVD, and cancer mortality. Further studies are needed to clarify the association between the types of soy products and the risk of mortality.
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Affiliation(s)
- Nazli Namazi
- Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Put "gender glasses" on the effects of phenolic compounds on cardiovascular function and diseases. Eur J Nutr 2018; 57:2677-2691. [PMID: 29696400 DOI: 10.1007/s00394-018-1695-0] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Accepted: 04/19/2018] [Indexed: 12/15/2022]
Abstract
INTRODUCTION The influence of sex and gender is particularly relevant in cardiovascular diseases (CVD) as well as in several aspects of drug pharmacodynamics and pharmacokinetics. Anatomical and physiological differences between the sexes may influence the activity of many drugs, including the possibility of their interaction with other drugs, bioactive compounds, foods and beverages. Phenolic compounds could interact with our organism at organ, cellular, and molecular levels triggering a preventive action against chronic diseases, including CVD. RESULTS This article will review the role of sex on the activity of these bioactive molecules, considering the existence of sex differences in oxidative stress. It describes the pharmacokinetics of phenolic compounds, their effects on vessels, on cardiovascular system, and during development, including the role of nuclear receptors and microbiota. CONCLUSIONS Although there is a large gap between the knowledge of the sex differences in the phenolic compounds' activity and safety, and the urgent need for more research, available data underlie the possibility that plant-derived phenolic compounds could differently influence the health of male and female subjects.
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Schreihofer DA, Oppong-Gyebi A. Genistein: mechanisms of action for a pleiotropic neuroprotective agent in stroke. Nutr Neurosci 2017; 22:375-391. [PMID: 29063799 DOI: 10.1080/1028415x.2017.1391933] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Genistein is a plant estrogen promoted as an alternative to post-menopausal hormone therapy because of a good safety profile and its promotion as a natural product. Several preclinical studies of cerebral ischemia and other models of brain injury support a beneficial role for genistein in protecting the brain from injury whether administered chronically or acutely. Like estrogen, genistein is a pleiotropic molecule that engages several different mechanisms to enhance brain health, including reduction of oxidative stress, promotion of growth factor signaling, and immune suppression. These actions occur in endothelial, glial, and neuronal cells to provide a coordinated beneficial action to ischemic challenge. Though many of these protective actions are associated with estrogen-like actions of genistein, additional activities on other receptors and intracellular targets suggest that genistein is more than a mere estrogen-mimic. Importantly, genistein lacks some of the detrimental effects associated with post-menopausal estrogen treatment and may provide an alternative to hormone therapy in those patients at risk for ischemic events.
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Affiliation(s)
- Derek A Schreihofer
- a Center for Neuroscience Discovery and Institute for Healthy Aging , University of North Texas Health Science Center at Fort Worth , 3500 Camp Bowie Boulevard, Fort Worth , TX 76107 , USA
| | - Anthony Oppong-Gyebi
- a Center for Neuroscience Discovery and Institute for Healthy Aging , University of North Texas Health Science Center at Fort Worth , 3500 Camp Bowie Boulevard, Fort Worth , TX 76107 , USA
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Rienks J, Barbaresko J, Nöthlings U. Association of isoflavone biomarkers with risk of chronic disease and mortality: a systematic review and meta-analysis of observational studies. Nutr Rev 2017; 75:616-641. [DOI: 10.1093/nutrit/nux021] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
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Grosso G, Micek A, Godos J, Pajak A, Sciacca S, Galvano F, Giovannucci EL. Dietary Flavonoid and Lignan Intake and Mortality in Prospective Cohort Studies: Systematic Review and Dose-Response Meta-Analysis. Am J Epidemiol 2017; 185:1304-1316. [PMID: 28472215 DOI: 10.1093/aje/kww207] [Citation(s) in RCA: 187] [Impact Index Per Article: 26.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2016] [Accepted: 04/26/2016] [Indexed: 01/21/2023] Open
Abstract
Recent evidence has suggested that flavonoid and lignan intake may be associated with decreased risk of chronic and degenerative diseases. The aim of this meta-analysis was to assess the association between dietary flavonoid and lignan intake and all-cause and cardiovascular disease (CVD) mortality in prospective cohort studies. A systematic search was conducted in electronic databases to identify studies published from January 1996 to December 2015 that satisfied inclusion/exclusion criteria. Risk ratios and 95% confidence intervals were extracted and analyzed using a random-effects model. Nonlinear dose-response analysis was modeled by using restricted cubic splines. The inclusion criteria were met by 22 prospective studies exploring various flavonoid and lignan classes. Compared with lower intake, high consumption of total flavonoids was associated with decreased risk of all-cause mortality (risk ratio = 0.74, 95% confidence intervals: 0.55, 0.99), while a 100-mg/day increment in intake led to a (linear) decreased risk of 6% and 4% of all-cause and CVD mortality, respectively. Among flavonoid classes, significant results were obtained for intakes of flavonols, flavones, flavanones, anthocyanidins, and proanthocyanidins. Only limited evidence was available on flavonoid classes and lignans and all-cause mortality. Findings from this meta-analysis indicated that dietary flavonoids are associated with decreased risk of all-cause and CVD mortality.
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Affiliation(s)
- Giuseppe Grosso
- NNEdPro Global Centre for Nutrition and Health, Saint John's Innovation Centre, Cambridge, United Kingdom
- Integrated Cancer Registry of Catania-Messina-Siracusa-Enna, Azienda Ospedaliera Policlinico-Universitaria, Catania, Italy
| | - Agnieszka Micek
- Department of Epidemiology and Population Studies, Jagiellonian University Medical College, Krakow, Poland
| | - Justyna Godos
- Integrated Cancer Registry of Catania-Messina-Siracusa-Enna, Azienda Ospedaliera Policlinico-Universitaria, Catania, Italy
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Andrzej Pajak
- Department of Epidemiology and Population Studies, Jagiellonian University Medical College, Krakow, Poland
| | - Salvatore Sciacca
- Integrated Cancer Registry of Catania-Messina-Siracusa-Enna, Azienda Ospedaliera Policlinico-Universitaria, Catania, Italy
| | - Fabio Galvano
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Edward L. Giovannucci
- Department of Epidemiology, T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
- Department of Nutrition, T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
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Nagata C, Wada K, Tamura T, Konishi K, Goto Y, Koda S, Kawachi T, Tsuji M, Nakamura K. Dietary soy and natto intake and cardiovascular disease mortality in Japanese adults: the Takayama study. Am J Clin Nutr 2017; 105:426-431. [PMID: 27927636 DOI: 10.3945/ajcn.116.137281] [Citation(s) in RCA: 83] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Accepted: 11/08/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Whether soy intake is associated with a decreased risk of cardiovascular disease (CVD) remains unclear. A traditional Japanese soy food, natto, contains a potent fibrinolytic enzyme. However, its relation to CVD has not been studied. OBJECTIVE We aimed to examine the association of CVD mortality with the intake of natto, soy protein, and soy isoflavones in a population-based cohort study in Japan. DESIGN The study included 13,355 male and 15,724 female Takayama Study participants aged ≥35 y. At recruitment in 1992, each subject was administered a validated semiquantitative food-frequency questionnaire. Deaths from CVD were ascertained over 16 y. RESULTS A total of 1678 deaths from CVD including 677 stroke and 308 ischemic heart disease occurred during follow-up. The highest quartile of natto intake compared with the lowest intake was significantly associated with a decreased risk of mortality from total CVD after control for covariates: the HR was 0.75 (95% CI: 0.64, 0.88, P-trend = 0.0004). There were no significant associations between the risk of mortality from total CVD and intakes of total soy protein, total soy isoflavone, and soy protein or soy isoflavone from soy foods other than natto. The highest quartiles of total soy protein and natto intakes were significantly associated with a decreased risk of mortality from total stroke (HR = 0.75, 95% CI: 0.57, 0.99, P-trend = 0.03 and HR = 0.68, 95% CI: 0.52, 0.88, P-trend = 0.0004, respectively). The highest quartile of natto intake was also significantly associated with a decreased risk of mortality from ischemic stroke (HR = 0.67, 95% CI:0.47, 0.95, P-trend = 0.03). CONCLUSION Data suggest that natto intake may contribute to the reduction of CVD mortality.
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Affiliation(s)
- Chisato Nagata
- Department of Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Keiko Wada
- Department of Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Takashi Tamura
- Department of Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Kie Konishi
- Department of Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Yuko Goto
- Department of Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Sachi Koda
- Department of Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Toshiyuki Kawachi
- Department of Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Michiko Tsuji
- Department of Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Kozue Nakamura
- Department of Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
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Yan Z, Zhang X, Li C, Jiao S, Dong W. Association between consumption of soy and risk of cardiovascular disease: A meta-analysis of observational studies. Eur J Prev Cardiol 2017; 24:735-747. [PMID: 28067550 DOI: 10.1177/2047487316686441] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Zhaoli Yan
- Department of Neurosurgery, The Affiliated Hospital of Shandong Traditional Chinese Medicine University, China
| | - Xinyue Zhang
- Clinic Medical College, Shandong Traditional Chinese Medicine University, China
| | - Chunlin Li
- Department of Information, The Affiliated Hospital of Shandong Traditional Chinese Medicine University, China
| | - Shouchun Jiao
- Department of Rehabilitation, Laigang Hospital Affiliated to Taishan Medical College, China
| | - Wenyao Dong
- Clinic Medical College, Shandong Traditional Chinese Medicine University, China
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Messina M. Soy and Health Update: Evaluation of the Clinical and Epidemiologic Literature. Nutrients 2016; 8:E754. [PMID: 27886135 PMCID: PMC5188409 DOI: 10.3390/nu8120754] [Citation(s) in RCA: 229] [Impact Index Per Article: 28.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 11/17/2016] [Accepted: 11/18/2016] [Indexed: 01/10/2023] Open
Abstract
Soyfoods have long been recognized as sources of high-quality protein and healthful fat, but over the past 25 years these foods have been rigorously investigated for their role in chronic disease prevention and treatment. There is evidence, for example, that they reduce risk of coronary heart disease and breast and prostate cancer. In addition, soy alleviates hot flashes and may favorably affect renal function, alleviate depressive symptoms and improve skin health. Much of the focus on soyfoods is because they are uniquely-rich sources of isoflavones. Isoflavones are classified as both phytoestrogens and selective estrogen receptor modulators. Despite the many proposed benefits, the presence of isoflavones has led to concerns that soy may exert untoward effects in some individuals. However, these concerns are based primarily on animal studies, whereas the human research supports the safety and benefits of soyfoods. In support of safety is the recent conclusion of the European Food Safety Authority that isoflavones do not adversely affect the breast, thyroid or uterus of postmenopausal women. This review covers each of the major research areas involving soy focusing primarily on the clinical and epidemiologic research. Background information on Asian soy intake, isoflavones, and nutrient content is also provided.
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Affiliation(s)
- Mark Messina
- Nutrition Matters, Inc., 26 Spadina Parkway, Pittsfield, MA 01201, USA.
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Zhang XW, Yang Z, Li M, Li K, Deng YQ, Tang ZY. Association between dietary protein intake and risk of stroke: A meta-analysis of prospective studies. Int J Cardiol 2016; 223:548-551. [DOI: 10.1016/j.ijcard.2016.08.106] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2016] [Accepted: 08/05/2016] [Indexed: 11/27/2022]
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Tang Z, Li M, Zhang X, Hou W. Dietary flavonoid intake and the risk of stroke: a dose-response meta-analysis of prospective cohort studies. BMJ Open 2016; 6:e008680. [PMID: 27279473 PMCID: PMC4908865 DOI: 10.1136/bmjopen-2015-008680] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVE To clarify and quantify the potential association between intake of flavonoids and risk of stroke. DESIGN Meta-analysis of prospective cohort studies. DATA SOURCE Studies published before January 2016 identified through electronic searches using PubMed, Embase and the Cochrane Library. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Prospective cohort studies with relative risks and 95% CIs for stroke according to intake of flavonoids (assessed as dietary intake). RESULTS The meta-analysis yielded 11 prospective cohort studies involving 356 627 participants and more than 5154 stroke cases. The pooled estimate of the multivariate relative risk of stroke for the highest compared with the lowest dietary flavonoid intake was 0.89 (95% CI 0.82 to 0.97; p=0.006). Dose-response analysis indicated that the summary relative risk of stroke for an increase of 100 mg flavonoids consumed per day was 0.91 (95% CI 0.77 to 1.08) without heterogeneity among studies (I(2)=0%). Stratifying by follow-up duration, the relative risk of stroke for flavonoid intake was 0.89 (95% CI 0.81 to 0.99) in studies with more than 10 years of follow-up. CONCLUSIONS Results from this meta-analysis suggest that higher dietary flavonoid intake may moderately lower the risk of stroke.
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Affiliation(s)
- Zhenyu Tang
- Department of Neurology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, People's Republic of China
| | - Min Li
- Department of Neurology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, People's Republic of China
| | - Xiaowei Zhang
- Department of Neurology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, People's Republic of China
| | - Wenshang Hou
- Department of Neurology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, People's Republic of China
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Kolodziejczyk-Czepas J. Trifolium species - the latest findings on chemical profile, ethnomedicinal use and pharmacological properties. ACTA ACUST UNITED AC 2016; 68:845-61. [PMID: 27230819 DOI: 10.1111/jphp.12568] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Accepted: 04/10/2016] [Indexed: 12/21/2022]
Abstract
OBJECTIVES Clovers (Trifolium, Fabaceae) have a long history of use in folk medicine. Furthermore, during last 3 years, a considerable growth in scientific interest in these plants has been observed. This article summarizes and critically reviews an over 3-year progress of knowledge of ethnomedicinal use, phytochemical profile, physiological effects and possible therapeutic action of various clover species. It contains the latest literature (over 80 papers), originated from international databases (MEDLINE/PubMed, Science Direct/Elsevier, Springer Link, Wiley Online Library) and reports from other international and local scientific periodicals. KEY FINDINGS Traditional uses of T. pratense and T. repens have been confirmed, while the folk medicine recommendations for administration of other clovers such as T. burchellianum, T. fragiferum, T. hybridum, T. minus and T. purpureum were reported for the first time. Furthermore, several other clover species were also investigated in terms of their antioxidant, antimicrobial and phytoestrogenic effects for the first time. Only T. alexandrinum, T. pratense and T. medium were examined in animal studies. SUMMARY Besides T. pratense, other clovers may be a rich source of bioactive phytochemicals. However, in contradiction to red clover, the therapeutic use of other clovers is still limited by the lack of in-vivo evidence.
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Affiliation(s)
- Joanna Kolodziejczyk-Czepas
- Department of General Biochemistry, Faculty of Biology and Environmental Protection, University of Lodz, Lodz, Poland
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Nadadur M, Stanczyk FZ, Tseng CC, Kim L, Wu AH. The Effect of Reduced Dietary Fat and Soy Supplementation on Circulating Adipocytokines in Postmenopausal Women: A Randomized Controlled 2-Month Trial. Nutr Cancer 2016; 68:554-9. [PMID: 27145207 DOI: 10.1080/01635581.2016.1158294] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The reduced risk of breast cancer observed in Asia has been linked with diets rich in soy foods, and observational studies suggest that regular soy food intake is related to lower circulating levels of some inflammatory markers which have been implicated in breast cancer risk. However, short-term intervention studies with soy-based diets in small numbers of women have shown few significant changes in adipocytokine levels. This 8-wk dietary intervention study in 57 healthy postmenopausal women investigated whether soy food supplementation (50 mg isoflavones or 15 g soy protein in the form of tofu) or a very low-fat diet (11.3% of total energy), similar to the traditional Asian diet, is associated with beneficial effects on serum levels of the following adipocytokines: TNF-α, IL-6, adiponectin, and resistin. We found no statistically significant changes in the levels of these adipocytokines in association with the very low-fat diet or soy supplementation. Only the change in TNF-α levels between the very low-fat and control diet groups had borderline statistical significance. We conclude that ingestion of a very low-fat diet or a soy food supplemented diet for 8 wk does not significantly alter important circulating adipocytokines.
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Affiliation(s)
- Malini Nadadur
- a Department of Obstetrics and Gynecology , Keck School of Medicine of USC , Los Angeles , California
| | - Frank Z Stanczyk
- b Departments of Obstetrics and Gynecology and Preventive Medicine , Keck School of Medicine of USC , Los Angeles , California
| | - Chiu-Chen Tseng
- c Department of Preventive Medicine , Keck School of Medicine of USC , Los Angeles , California
| | - Lila Kim
- a Department of Obstetrics and Gynecology , Keck School of Medicine of USC , Los Angeles , California
| | - Anna H Wu
- c Department of Preventive Medicine , Keck School of Medicine of USC , Los Angeles , California
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Huang PH, Hu SCS, Lee CW, Yeh AC, Tseng CH, Yen FL. Design of acid-responsive polymeric nanoparticles for 7,3',4'-trihydroxyisoflavone topical administration. Int J Nanomedicine 2016; 11:1615-27. [PMID: 27143883 PMCID: PMC4841439 DOI: 10.2147/ijn.s100418] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
7,3',4'-Trihydroxyisoflavone (734THIF) is a secondary metabolite of daidzein and has been recently found to possess antioxidant, melanin inhibition, and skin cancer chemopreventive activities. However, the poor water solubility of 734THIF impedes its absorption and skin penetration and, therefore, limits its pharmacological effects when applied topically to the skin. We seek to use the nanoprecipitation method to prepare optimal eudragit E100 (EE)-polyvinyl alcohol (PVA)-loaded 734THIF nanoparticles (734N) to improve its physicochemical properties and thereby increase its water solubility, skin penetration, and biological activities. EE-PVA-loaded 734THIF nanoparticles (734N) were prepared, and their morphology and particle size were evaluated using a particle size analyzer and by electron microscopy. The drug loading and encapsulation efficiencies and in vitro solubility were determined using high-performance liquid chromatography. Hydrogen-bond formation was evaluated by (1)H-nuclear magnetic resonance and Fourier transform infrared spectroscopy, and crystalline-to-amorphous transformation was determined by differential scanning calorimetry and X-ray diffractometry. In vitro skin penetration was analyzed using fresh pig skin mounted on Franz diffusion cells, and cytotoxicity against human keratinocyte HaCaT cells was evaluated using the MTT assay. Antioxidant activity was determined by 2,2-diphenyl-1-picrylhydrazyl-free radical scavenging ability. EE-PVA-loaded 734THIF nanoparticles showed good drug loading and encapsulation efficiencies and were characterized by improved physicochemical properties, including reduction in particle size, amorphous transformation, and intermolecular hydrogen-bond formation. This is associated with increased water solubility and enhanced in vitro skin penetration, with no cytotoxicity toward HaCaT cells. In addition, 734THIF nanoparticles retained their antioxidant activity. In conclusion, 734THIF nanoparticles are characterized by improved physicochemical properties, increased water solubility, and enhanced skin penetration, and these may have potential use in the future as a topical delivery formulation for the treatment of skin diseases.
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Affiliation(s)
- Pao-Hsien Huang
- Department of Fragrance and Cosmetic Science, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Stephen Chu-Sung Hu
- Department of Dermatology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Dermatology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Chiang-Wen Lee
- Research Center for Industry of Human Ecology, Chang Gung University of Science and Technology, Kweishan, Taoyuan, Taiwan; Department of Nursing, Division of Basic Medical Sciences, Chang Gung University of Science and Technology, Chia-Yi, Taiwan
| | - An-Chi Yeh
- Department of Cosmetics and Fashion Styling, Cheng Shiu University, Kaohsiung, Taiwan
| | - Chih-Hua Tseng
- School of Pharmacy, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Feng-Lin Yen
- Department of Fragrance and Cosmetic Science, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan; Lipid Science and Aging Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan; Institute of Biomedical Sciences, National Sun Yat-Sen University, Kaohsiung, Taiwan
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Urine phyto-oestrogen metabolites are not significantly associated with risk of type 2 diabetes: the Singapore Chinese health study. Br J Nutr 2016; 115:1607-15. [PMID: 26949260 DOI: 10.1017/s0007114516000581] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
We evaluated the relationship between urine concentrations of phyto-oestrogens (isoflavones and lignans) and risk of incident type 2 diabetes in middle-aged and elderly Chinese residing in Singapore. Urine metabolites of isoflavones and lignans were assayed by HPLC among 564 diabetes cases and 564 matched controls in a case-control study nested within the Singapore Chinese Health Study cohort. Participants were free of diagnosed diabetes, CVD and cancer at morning urine collections during 1999-2004. Cases were participants who reported to have physician-diagnosed diabetes at follow-up visits during 2006-2010, whereas controls were randomly selected among those who remained free of diabetes and were matched to the index cases by age, sex, dialect group and date of urine collection. Conditional logistic regression models were used to calculate OR and 95 % CI with adjustment for potential confounders. The mean age of the participants at the time of urine collection was 59·8 years, and the average interval between urine collection and diabetes diagnosis was 4·0 years. The multivariate-adjusted OR for diabetes were 1·00 (reference), 0·76 (95 % CI 0·52, 1·11), 0·78 (95 % CI 0·53, 1·14) and 0·79 (95 % CI 0·54, 1·15) across quartiles of urine isoflavones (P for trend=0·54), and were 1·00 (reference), 0·87 (95 % CI 0·60, 1·27), 1·10 (95 % CI 0·77, 1·56) and 0·93 (95 % CI 0·63, 1·37) for lignans (P for trend=0·93). The results were similar in men and women, as well as for individual metabolites of isoflavones (genistein, daidzein, glycitin and equol) or lignans (enterodiol and enterolactone). The present study did not find a significant association between urine phyto-oestrogen metabolites and risk of type 2 diabetes in Chinese adults.
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Yu D, Shu XO, Li H, Yang G, Cai Q, Xiang YB, Ji BT, Franke AA, Gao YT, Zheng W, Zhang X. Dietary isoflavones, urinary isoflavonoids, and risk of ischemic stroke in women. Am J Clin Nutr 2015; 102:680-6. [PMID: 26245809 PMCID: PMC4548177 DOI: 10.3945/ajcn.115.111591] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Accepted: 07/13/2015] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Hormone therapy has been shown to increase risk of ischemic stroke in women. Plant-derived estrogens, particularly soy isoflavones, are known to have some estrogenic effects and have been marketed as natural alternatives to hormone therapy. Concerns have been raised about whether high isoflavone exposure may be related to ischemic stroke risk as well. OBJECTIVE We examined the dietary intake of isoflavones and the urinary excretion of isoflavonoids in relation to risk of ischemic stroke in women. DESIGN A prospective cohort study was conducted in 66,832 Chinese women (aged 40-70 y) who had no cardiovascular disease or cancer at baseline. Usual dietary intakes were assessed via in-person interviews with the use of a validated food-frequency questionnaire. Incident strokes were ascertained during follow-up home visits and confirmed by medical records. We also conducted a nested case-control study in postmenopausal women who had never used hormone therapy, including 1422 incident ischemic stroke cases and 1422 controls individually matched by age, date and time of urine sample collection, time since last meal, and use of antibiotics. Urinary isoflavonoids were measured with the use of high-performance liquid chromatography coupled with mass spectrometry. RESULTS During a mean follow-up of 10 y, 3110 incident ischemic strokes were verified. Dietary isoflavone intake was associated with increased risk of ischemic stroke; multivariable-adjusted HRs from lowest to highest quintiles were 1.00, 1.05, 1.10, 1.11, and 1.24, respectively (95% CI: 1.08, 1.42; P-trend = 0.002). In the case-control study, a similar positive association was observed for dietary isoflavones, but no significant associations were shown for the urinary isoflavonoid concentration [OR: 1.01 (95% CI: 0.77, 1.32) for comparison of extreme quintiles]. CONCLUSIONS A habitually high intake of soy isoflavones may be associated with a modest but significant increase in risk of ischemic stroke in women. However, no association was shown for the urinary excretion of isoflavonoids.
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Affiliation(s)
- Danxia Yu
- Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN
| | - Xiao-Ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN
| | - Honglan Li
- Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Gong Yang
- Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN
| | - Qiuyin Cai
- Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN
| | - Yong-Bing Xiang
- Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Bu-Tian Ji
- Division of Cancer Epidemiology and Genetics, National Cancer Institute/NIH, Bethesda, MD; and
| | | | - Yu-Tang Gao
- Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN
| | - Xianglan Zhang
- Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN;
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Talaei M, Pan A. Role of phytoestrogens in prevention and management of type 2 diabetes. World J Diabetes 2015; 6:271-283. [PMID: 25789108 PMCID: PMC4360420 DOI: 10.4239/wjd.v6.i2.271] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2014] [Revised: 11/04/2014] [Accepted: 12/17/2014] [Indexed: 02/05/2023] Open
Abstract
Type 2 diabetes (T2D) has become a major public health threat across the globe. It has been widely acknowledged that diet plays an important role in the development and management of T2D. Phytoestrogens are polyphenols that are structurally similar to endogenous estrogen and have weak estrogenic properties. Emerging evidence from pre-clinical models has suggested that phytoestrogens may have anti-diabetic function via both estrogen-dependent and estrogen-independent pathways. In the current review, we have summarized the evidence linking two major types of phytoestrogens, isoflavones and lignans, and T2D from epidemiological studies and clinical trials. The cross-sectional and prospective cohort studies have reported inconsistent results, which may due to the large variations in different populations and measurement errors in dietary intakes. Long-term intervention studies
using isoflavone supplements have reported potential beneficial effects on glycemic parameters in postmenopausal women, while results from short-term small-size clinical trials are conflicting. Taken together, the current evidence from different study designs is complex and inconsistent. Although the widespread use of phytoestrogens could not be recommended yet, habitual consumption of phytoestrogens, particularly their intact food sources like soy and whole flaxseed, could be considered as a component of overall healthy dietary pattern for prevention and management of T2D.
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Giordano E, Dávalos A, Crespo MC, Tomé-Carneiro J, Gómez-Coronado D, Visioli F. Soy isoflavones in nutritionally relevant amounts have varied nutrigenomic effects on adipose tissue. Molecules 2015; 20:2310-22. [PMID: 25647572 PMCID: PMC6272387 DOI: 10.3390/molecules20022310] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Revised: 12/11/2014] [Accepted: 01/22/2015] [Indexed: 01/08/2023] Open
Abstract
Soy consumption has been suggested to afford protection from cardiovascular disease (CVD). Indeed, accumulated albeit controversial evidence suggests that daily consumption of ≥25 g of soy protein with its associated phytochemicals intact can improve lipid profiles in hypercholesterolemic humans. However, the belief that soy foods and supplements positively impact human health has become increasingly controversial among the general public because of the reported estrogenic activities of soy isoflavones. In this study, we investigated the nutrigenomic actions of soy isoflavones (in nutritionally-relevant amounts) with a specific focus on the adipose tissue, due to its pivotal role in cardiometabolism. Young C57BL/6 mice were maintained for eight weeks under two different diet regimes: (1) purified control diet; or (2) purified control diet supplemented with 0.45 g% soybean dry purified extract (a genistein/daidzein mix). Soy isoflavones increased plasma total cholesterol concentrations and decreased triglyceride ones. Circulating leptin levels was also increased by soy consumption. Differentially expressed genes in adipose tissue were classified according to their role(s) in cellular or metabolic pathways. Our data show that soy isoflavones, administered in nutritionally-relevant amounts, have diverse nutrigenomic effects on adipose tissue. Taking into account the moderate average exposure to such molecules, their impact on cardiovascular health needs to be further investigated to resolve the issue of whether soy consumption does indeed increase or decrease cardiovascular risk.
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Affiliation(s)
- Elena Giordano
- Laboratory of Functional Foods, Madrid Institute for Advanced Studies (IMDEA)-Food, CEI UAM+CSIC, Carretera de Cantoblanco 8, Madrid 28049, Spain.
| | - Alberto Dávalos
- Laboratory of Functional Foods, Madrid Institute for Advanced Studies (IMDEA)-Food, CEI UAM+CSIC, Carretera de Cantoblanco 8, Madrid 28049, Spain.
| | - Maria Carmen Crespo
- Laboratory of Functional Foods, Madrid Institute for Advanced Studies (IMDEA)-Food, CEI UAM+CSIC, Carretera de Cantoblanco 8, Madrid 28049, Spain.
| | - Joao Tomé-Carneiro
- Laboratory of Functional Foods, Madrid Institute for Advanced Studies (IMDEA)-Food, CEI UAM+CSIC, Carretera de Cantoblanco 8, Madrid 28049, Spain.
| | - Diego Gómez-Coronado
- Servicio de Bioquímica-Investigación, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid 28034, Spain.
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid 28029, Spain.
| | - Francesco Visioli
- Laboratory of Functional Foods, Madrid Institute for Advanced Studies (IMDEA)-Food, CEI UAM+CSIC, Carretera de Cantoblanco 8, Madrid 28049, Spain.
- Department of Molecular Medicine, University of Padova, Padova 35121, Italy.
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