Effect of soy isoflavones on blood pressure: a meta-analysis of randomized controlled trials

A comprehensive analysis of fruit, vegetable, and legume consumption and the risk of hypertension: results from the KoGES_CAVAS cohort

PURPOSE

This study aimed to investigate the association between total consumption of fruits (F), vegetables (V), and legumes (L) and their subgroups and hypertension risk in adults aged ≥ 40 years in the Cardiovascular Disease Association Study (CAVAS).

METHODS

We analyzed data from 10,325 normotensive participants using cumulative average dietary consumption from repeated food frequency questionnaires during the follow-up. Incidence rate ratios (IRRs) were estimated with a modified Poisson regression model and a robust error estimator to evaluate the association between hypertension risk and total consumption of fruits, vegetables, and legumes, as well as their 17 subgroups.

RESULTS

During an average follow-up of 5.20 years, 2159 cases of hypertension were recorded. Total consumption of FVL, FV, fruits, vegetables, and legumes showed overall inverse trends with hypertension risk. Considering multiplicity, fruit consumption was inversely associated with hypertension risk in both men (IRR 0.64; 95% CI 0.52-0.79) and women (IRR 0.76; 95% CI 0.64-0.91). Vegetables were inversely associated with hypertension in women (IRR 0.67; 95% CI 0.53-0.86). Most subgroups showed inverse associations, especially in men with overweight/obesity. However, frequent pickled green leafy vegetable consumption was positively associated with hypertension risk in postmenopausal women but not in premenopausal women (Pinteraction = 0.0004).

CONCLUSION

Consumption of FVL, including their subgroups, generally shows inverse associations with hypertension risk. However, caution is advised for recommending pickled vegetables, particularly for postmenopausal women, due to the potential adverse effects of sodium. The benefits of these foods in preventing hypertension are especially pronounced in men with overweight/obesity.

A Mendelian Randomization Study about Causal Associations between Tofu Consumption and Stroke as well as Related Subtypes

OBJECTIVE

Consuming soy in the diet is beneficial for health, and tofu possess the richest source of dietary soy. However, the specific association with stroke and related subtypes remains controversial. In this study, the genetic causal relationship among tofu and stroke as well as the subtypes was investigated by utilizing the data in a number of genome-wide association study (GWAS) based on population.

METHODS

The tofu intake GWAS analysis is derived from the Medical Research Council (MRC) Integrative Epidemiology Unit at the University of Bristol (MRC-IEU) Consortium. The two-sample Mendelian randomization (MR) study was carried out, utilizing multiple analysis methods to analyze the associations with stroke and related subtypes. The sensitivity, heterogeneity, and potential pleiotropy could be investigated by multiple analysis method.

RESULTS

We found that tofu intake had no causal relationship with stroke. However, in stroke subtype, there is a causal relationship among tofu intake with the risk of intracerebral hemorrhage (ICH) (odds ratio, OR = 1.24 × 10-5, 95% CI: 1.54 × 10-8-9.95 × 10-3, p = 9.300 × 10-4), while tofu intake does not affect the risk of ischemic stroke (OR = 1.07 × 10-1, 95% CI: 3.84 × 10-4-2.97 × 101, p = 4.362 × 10-1) and subarachnoid hemorrhage (SAH) (OR = 3.33 × 10-3, 95% CI: 1.79 × 10-6-6.18, p = 1.373 × 10-1). Both the Mendelian randomization PRESSO (MR-PRESSO) global test and Cochran's Q test did not detect any sensitivity and heterogeneity.

CONCLUSIONS

While tofu consumption is associated with a higher risk of ICH, it does not show a significant relationship with ischemic stroke or SAH. The varying effects of tofu on different stroke subtypes underscore the need for considering potential confounding dietary and lifestyle factors in future studies.

A systematic review of randomized controlled trials on the health effects of chocolate enriched/fortified/supplemented with functional components

The most significant contributor to global mortality are cardiovascular diseases. Dietary factors significantly impact the risk, advancement, and treatment of cardiometabolic conditions. Chocolate, known for its adaptability and capacity to stimulate pleasure centers, emerges as a promising vehicle for integrating different bioactive elements. This systematic review analyzed 10 randomized controlled trials investigating the health effects of consuming enriched, fortified, or supplemented chocolate. These trials varied in chocolate intake amounts (ranging from 5 to 101 g day-1), incorporated bioactive components (co-crystalized astaxanthin, lycopene, wood-based phytosterol-phytostanol mixture, canola sterol esters, etc.), and duration (from 2 weeks to 1 year). Some enriched chocolates were found to reduce total and LDL cholesterol and influence markers of oxidative damage, inflammation, immune function, and skin parameters. However, certain trials showed a minimal impact on health outcomes. Therefore, while enriched chocolate holds promise as a carrier for beneficial bioactive compounds, rigorous scientific inquiry and methodological rigor are crucial to fully substantiate these claims. Comprehensive evaluations covering cardiovascular health, metabolic function, immune response, and other aspects are needed to understand its potential benefits and limitations. Advancing robust research initiatives could help realize the full potential of enriched chocolate in promoting human health and well-being.

Animal vs Plant-Based Meat: A Hearty Debate

Plant-based meat alternatives (PBMAs) are highly processed food products that typically replace meat in the diet. In Canada, the growing demand for PBMAs coincides with public health recommendations to reduce ultra-processed food consumption, which prompts the need to investigate the long-term health implications of PBMAs. This review assesses the available literature on PBMAs and cardiovascular disease (CVD), including an evaluation of their nutritional profile and impact on CVD risk factors. Overall, the nutritional profiles of PBMAs vary considerably but generally align with recommendations for improving cardiovascular health; compared with meat, PBMAs are usually lower in saturated fat and higher in polyunsaturated fat and dietary fibre. Some dietary trials that have replaced meat with PBMAs have reported improvements in CVD risk factors, including total cholesterol, low-density lipoprotein cholesterol, apolipoprotein B-100, and body weight. No currently available evidence suggests that the concerning aspects of PMBAs (eg, food processing and high sodium content) negate the potential cardiovascular benefits. We conclude that replacing meat with PBMAs may be cardioprotective; however, long-term randomised controlled trials and prospective cohort studies that evaluate CVD events (eg, myocardial infarction, stroke) are essential to draw more definitive conclusions.

The effect of soy isoflavones supplementation on metabolic status in patients with non-alcoholic fatty liver disease: a randomized placebo controlled clinical trial

BACKGROUND

Non-alcoholic fatty liver disease (NAFLD) accounts as a crucial health concern with a huge burden on health and economic systems. The aim of this study is to evaluate the effect of soy isoflavones supplementation on metabolic status in patients with NAFLD.

METHODS

In this randomized clinical trial, 50 patients with NAFLD were randomly allocated to either soy isoflavone or placebo groups for 12 weeks. The soy isoflavone group took 100 mg/d soy isoflavone and the placebo group took the similar tablets containing starch. Anthropometric indices, blood lipids, glycemic parameters and blood pressure were measured at the beginning and at the end of the study.

RESULTS

At the end of week 12 the level of serum triglyceride (TG), low density lipoprotein (LDL) and total cholesterol (TC) was significantly decreased only in soy isoflavone group compared to baseline (P < 0.05). Although waist circumference (WC) decreased significantly in both groups after 12 weeks of intervention (P < 0.05), hip circumference (HC) decreased significantly only in soy isoflavone group (P = 0.001). No significant changes observed regarding high density lipoprotein (HDL) and blood pressure in both groups. At the end of the study, serum glucose level was significantly decreased in the placebo group compared to baseline (P = 0.047). No significant changes demonstrated in the soy isoflavone group in regard to glycemic parameters (P > 0.05).

CONCLUSIONS

This study revealed that soy isoflavones could significantly reduce TG, LDL TC, WC and HC in NAFLD patients.

TRIAL REGISTRATION

The Ethics committee of Ahvaz Jundishapur University of Medical Sciences approved the protocol of the present clinical research (IR.AJUMS.REC.1401.155). The study was in accordance with the Declaration of Helsinki. This study's registered number and date are IRCT20220801055597N1 and 20.09.2022, respectively at https://fa.irct.ir .

Effect of soy isoflavone supplementation on blood pressure: a meta-analysis of randomized controlled trials

BACKGROUND

Previous experimental studies have suggested that the consumption of soy isoflavones may have a potential impact on lowering blood pressure. Nevertheless, epidemiological studies have presented conflicting outcomes concerning the correlation between soy isoflavone consumption and blood pressure levels. Consequently, a comprehensive meta-analysis of all eligible randomized controlled trials (RCTs) was conducted to explore the influence of soy isoflavones on systolic blood pressure (SBP) and diastolic blood pressure (DBP) in adults.

METHODS

A thorough search of PubMed, Embase, and the Cochrane Library for relevant literature up to April 30, 2023 was conducted. RCTs involving adults that compared soy isoflavone supplementation with a placebo (the same matrix devoid of soy isoflavone) were included. The combined effect size was presented as the weighted mean difference (WMD) along with 95% confidence interval (CI), employing a fixed-effects model.

RESULTS

Our meta-analysis included a total of 24 studies involving 1945 participants. The results revealed a significant reduction in both SBP and DBP with soy isoflavone supplementation. Subgroup analyses suggested more pronounced reductions in SBP and DBP for interventions lasting ≥6 months, in individuals receiving mixed-type soy isoflavone, and among patients with metabolic syndrome or prehypertension. However, we did not detect significant nonlinear associations between supplementation dosage and intervention duration concerning both SBP and DBP. The overall quality of evidence was deemed moderate.

CONCLUSIONS

The current meta-analysis revealed that supplementation with soy isoflavones alone effectively reduces blood pressure. Additional high-quality studies are required to investigate the efficacy of blood pressure reduction through supplementation with an optimal quantity and proportion of soy isoflavone.

Prevalence and Factors Associated with Prehypertension and Hypertension Among Adults: Baseline Findings of PURE Malaysia Cohort Study

Background

Although prehypertension and hypertension can be detected at the primary healthcare level and low-cost treatments can effectively control its complications, hypertension is still the world's leading preventable risk factor. Therefore, the present study aimed to determine its prevalence and its risk factors among Malaysian adults.

Methods

A cross-sectional study involving 7585 adults was performed covering the rural and urban areas. Respondents with systolic blood pressure (SBP) of 120-139 mmHg and/or diastolic blood pressure (DBP) of 80-89 mmHg were categorized as prehypertensive, and hypertensive categorization was used for respondents with an SBP of ≥140 mmHg and/or DBP of ≥90 mmHg.

Results

Respondents reported to have prehypertension and hypertension were 40.7% and 38.0%, respectively. Those residing in a rural area, older age, male, family history of hypertension, and overweight or obese were associated with higher odds of prehypertension and hypertension. Unique to hypertension, the factors included low educational level (AOR: 1.349; 95% CI: 1.146, 1.588), unemployment (1.350; 1.16, 1.572), comorbidity of diabetes (1.474; 1.178, 1.844), and inadequate fruit consumption (1.253; 1.094, 1.436).

Conclusions

As the prehypertensive state may affect the prevalence of hypertension, proactive strategies are needed to increase early detection of the disease among specific group of those residing in a rural area, older age, male, family history of hypertension, and overweight or obese.

Development of an indirect competitive enzyme-linked immunosorbent assay for formononetin and its application in a cell-based assay using MC3T3-E1 cells

Formononetin (FMN) is a methoxy isoflavone found abundantly in leguminous plants and associated foods. Several analytical methods have been developed to detect FMN. However, they are costly, complicated, and time-consuming. This study describes an indirect competitive enzyme-linked immunosorbent assay (icELISA) to determine FMN content in food samples using a monoclonal antibody (mAb) against FMN produced by a newly established hybridoma cell line. Validation studies were conducted, and this assay was found to be sufficiently reliable, with an analytical measurement range of 19.53-1250 ng/mL and a detection limit of 17.42 ng/mL. Furthermore, icELISA was successfully applied for a cell-based assay in which the amount of FMN and ononin uptake was quantified in MC3T3-E1 cells. Hence, icELISA is a simple and reliable method for the detection and quantification of FMN, as well as elucidation of its functions and underlying mechanisms of action.

Micronutrient Supplementation to Reduce Cardiovascular Risk

BACKGROUND

Healthy dietary patterns are rich in micronutrients, but their influence on cardiovascular disease (CVD) risks has not been systematically quantified.

OBJECTIVES

The goal of this study was to provide a comprehensive and most up-to-date evidence-based map that systematically quantifies the impact of micronutrients on CVD outcomes.

METHODS

This study comprised a systematic review and meta-analysis of randomized controlled intervention trials of micronutrients on CVD risk factors and clinical events.

RESULTS

A total of 884 randomized controlled intervention trials evaluating 27 types of micronutrients among 883,627 participants (4,895,544 person-years) were identified. Supplementation with n-3 fatty acid, n-6 fatty acid, l-arginine, l-citrulline, folic acid, vitamin D, magnesium, zinc, α-lipoic acid, coenzyme Q10, melatonin, catechin, curcumin, flavanol, genistein, and quercetin showed moderate- to high-quality evidence for reducing CVD risk factors. Specifically, n-3 fatty acid supplementation decreased CVD mortality (relative risk [RR]: 0.93; 95% CI: 0.88-0.97), myocardial infarction (RR: 0.85; 95% CI: 0.78-0.92), and coronary heart disease events (RR: 0.86; 95% CI: 0.80-0.93). Folic acid supplementation decreased stroke risk (RR: 0.84; 95% CI: 0.72-0.97), and coenzyme Q10 supplementation decreased all-cause mortality events (RR: 0.68; 95% CI: 0.49-0.94). Vitamin C, vitamin D, vitamin E, and selenium showed no effect on CVD or type 2 diabetes risk. β-carotene supplementation increased all-cause mortality (RR: 1.10; 95% CI: 1.05-1.15), CVD mortality events (RR: 1.12; 95% CI: 1.06-1.18), and stroke risk (RR: 1.09; 95% CI: 1.01-1.17).

CONCLUSIONS

Supplementation of some but not all micronutrients may benefit cardiometabolic health. This study highlights the importance of micronutrient diversity and the balance of benefits and risks to promote and maintain cardiovascular health in diverse populations. (Antioxidant Supplementation in the Prevention and Treatment of Cardiovascular Diseases; CRD42022315165).

Native Mass Spectrometry Coupled to Spectroscopic Methods to Investigate the Effect of Soybean Isoflavones on Structural Stability and Aggregation of Zinc Deficient and Metal-Free Superoxide Dismutase

The deficiency or wrong combination of metal ions in Cu, Zn-superoxide dismutase (SOD1), is regarded as one of the main factors causing the aggregation of SOD1 and then inducing amyotrophic lateral sclerosis (ALS). A ligands-targets screening process based on native electrospray ionization ion mobility mass spectrometry (ESI-IMS-MS) was established in this study. Four glycosides including daidzin, sophoricoside, glycitin, and genistin were screened out from seven soybean isoflavone compounds and were found to interact with zinc-deficient or metal-free SOD1. The structure and conformation stability of metal-free and zinc-deficient SOD1 and their complexes with the four glycosides was investigated by collision-induced dissociation (CID) and collision-induced unfolding (CIU). The four glycosides could strongly bind to the metal-free and copper recombined SOD1 and enhance the folding stability of these proteins. Additionally, the ThT fluorescence assay showed that these glycosides could inhibit the toxic aggregation of the zinc-deficient or metal-free SOD1. The competitive interaction experiments together with molecular docking indicate that glycitin, which showed the best stabilizing effects, binds with SOD1 between β-sheet 6 and loop IV. In short, this study provides good insight into the relationship between inhibitors and different SOD1s.

Higher habitual dietary flavonoid intake associates with lower central blood pressure and arterial stiffness in healthy older adults

Flavonoids have shown anti-hypertensive and anti-atherosclerotic properties: the impact of habitual flavonoid intake on vascular function, central haemodynamics and arterial stiffness may be important. We investigated the relationship between habitual flavonoid consumption and measures of central blood pressure and arterial stiffness. We performed cross-sectional analysis of 381 non-smoking healthy older adults (mean age 66·0 (sd 4·1) years; BMI, 26·4 (sd 4·41) kg/m2; 41 % male) recruited as part of the Australian Research Council Longevity Intervention study. Flavonoid intake (i.e. flavonols, flavones, flavanones, anthocyanins, isoflavones, flavan-3-ol monomers, proanthocyanidins, theaflavins/thearubigins and total consumption) was estimated from FFQ using the US Department of Agriculture food composition databases. Measures of central haemodynamics and arterial stiffness included systolic blood pressure (cSBP), diastolic blood pressure (cDBP), mean arterial pressure (cMAP) and augmentation index (cAIx). After adjusting for demographic and lifestyle confounders, each sd/d higher intake of anthocyanins ((sd 44·3) mg/d) was associated with significantly lower cDBP (-1·56 mmHg, 95 % CI -2·65, -0·48) and cMAP (-1·62 mmHg, 95 % CI -2·82, -0·41). Similarly, each sd/d higher intake of flavanones ((sd 19·5) mg/d) was associated with ~1 % lower cAIx (-0·93 %, 95 % CI -1·77, -0·09). These associations remained significant after additional adjustment for (1) a dietary quality score and (2) other major nutrients that may affect blood pressure or arterial stiffness (i.e. Na, K, Ca, Mg, n-3, total protein and fibre). This study suggests a possible benefit of dietary anthocyanin and flavanone intake on central haemodynamics and arterial stiffness; these findings require corroboration in further research.

From Foods to Chemotherapeutics: The Antioxidant Potential of Dietary Phytochemicals

Food plants have been recognized for their medicinal properties for millennia, a concept supported by epidemiological studies indicating long-term health benefits for people consuming greater amounts of fruits and vegetables. As our technology and instrumentation advance, researchers have the ability to identify promising phytochemicals, and examine their potential benefits, or detriments, to human health. While results from trials investigating single chemical supplementation have sometimes produced negative health results, studies investigating the synergistic action of phytochemicals—either within our diet or as an adjuvant to radiation or chemotherapy—appear promising. Utilizing phytochemicals as synergistic agents may lower the chemotherapeutic doses needed to incur physiological results, while also using chemicals with fewer toxic effects. This review investigates a variety of plant-produced chemicals humans typically ingest, their impacts on overall health patterns, molecular mechanisms associated with their health impacts, and the potential of their synergistic use for therapeutic purposes.

The role of soy and soy isoflavones on women's fertility and related outcomes: an update

Soy is a key food in human nutrition. It is widely used in eastern traditional cuisine and it has recently diffused among self-conscious and vegetarian diets. The success of soy mainly depends on versatility and supposed healthy properties of soy foods and soy components. Meanwhile, the possible influence on endocrine system, in particular by isoflavones, raised concerns among some researchers. The present paper aims to conduct a review of available data on the effect of soy, soy foods and soy components on women's fertility and related outcomes. Eleven interventional studies, eleven observational studies and one meta-analysis have been selected from the results of queries. A weak, not clinically relevant effect has been highlighted on cycle length and hormonal status. However, a suggestive positive influence has been shown among women with fertility issues and during assisted reproductive technologies. Overall, soy and soy components consumption do not seem to perturb healthy women's fertility and can have a favourable effect among subjects seeking pregnancy. However, because of the paucity of studies exploring the impact of soy intake on women's fertility, as well as the limited population sample size, the frequently incomplete specimens’ collection to investigate all cycle phases and the insufficient characterisation of participants, the evidence is suggestive and it needs further in-depth research taking into account all these aspects.

Trending Nutrition Controversies #3: Top Controversies in 2021

Each year, patients are bombarded with diverging and even contradictory reports concerning the impact of certain additives, foods, and nutrients on cardiovascular health and its risk factors. Accordingly, this third review of nutrition controversies examines the impact of artificial sweeteners, cacao, soy, plant-based meats, nitrates, and meats from grass compared to grain-fed animals on cardiovascular and other health outcomes with the goal of optimizing clinician-led diet counseling.

Soy Food Intake Associated with Obesity and Hypertension in Children and Adolescents in Guangzhou, Southern China

The associations between soy food intake and cardio-metabolic risk factors in children remain unclear due to limited evidence. We aim to explore soy food intake and its association with the risks of obesity and hypertension in Chinese children and adolescents. A total of 10,536 children and adolescents aged 7–18 years (5125 boys and 5411 girls) were enrolled in a cross-sectional study in Guangzhou City, southern China. Data on demographic characteristics and dietary consumption were collected using self-reported questionnaires, and anthropometric characteristics were measured. Obesity, abdominal obesity, and hypertension were defined using Chinese criteria for children and adolescents. A multiple logistic regression model was applied to estimate the association between soy food intake and obesity and hypertension. Roughly 39.5% of the participants consumed soy food more than three times per week. The mean amounts of liquid and solid soy food intake were 0.35 ± 0.54 cups/day and 0.46 ± 0.63 servings/day, respectively. The adjusted odds ratios (OR) of hypertension among those with high liquid soy food intake and a high frequency of all soy food intake (more than three times/week) were 0.79 (95% confidence interval (CI), 0.67–0.94), and 0.83 (95% CI, 0.70–0.97) compared to those with no intake. Additionally, the adjusted OR of obesity among those with high solid soy food intake and a high frequency of all soy food intake were 1.34 (95% CI, 1.09–1.63) and 1.30 (95% CI, 1.07–1.58), respectively. In conclusion, 39.5% of southern Chinese children and adolescents had high soy food intake (more than three times/week), which was significantly associated with a lower prevalence of hypertension and a greater prevalence of obesity.

The Association between Plasma Concentration of Phytoestrogens and Hypertension within the Korean Multicenter Cancer Cohort

In order to examine the association between plasma phytoestrogen concentration (genistein, daidzein, equol and enterolactone) and hypertension, we conducted a nested case–control study for 229 hypertension cases including 112 prehypertension and 159 healthy controls derived from the Korean Multi-center Cancer Cohort (KMCC). The concentration of plasma phytoestrogens was measured using time-resolved fluoroimmunoassay. We assessed the association between plasma phytoestrogens and hypertension using logistic regression models using odds ratio (OR) and 95% confidence interval (95%CI). The highest tertile of plasma equol and enterolactone concentration exhibited a significantly decreased risk of hypertension (equol, OR = 0.34, 95%CI 0.20–0.57; enterolactone, OR = 0.32, 95%CI 0.18–0.57), compared with the lowest tertile. Equol and enterolactone showed reduced ORs for prehypertension (the highest tertile relative to the lowest tertile, OR = 0.50, 95%CI 0.26–0.96; OR = 0.38, 95%CI 0.19–0.75, respectively) and hypertension (OR = 0.42, 95%CI 0.22–0.81; OR = 0.28, 95%CI 0.14–0.54, respectively). There was a stronger association in hypertension (the highest tertile relative to the lowest tertile in obesity vs. non-obesity; equol, OR = 0.06 vs. 0.63; enterolactone, OR = 0.07 vs. 0.46; both p-heterogeneity < 0.01). This study suggests that equol and enterolactone may contribute to prevent primarily prehypertension and hypertension, and control cardiovascular disease (CVD) based on the continuum of hypertension and CVD. Further study to assess hypertension risk based on useful biomarkers, including phytoestrogens, may contribute to primary prevention of hypertension.

The Effects of Soy Products on Cardiovascular Risk Factors in Patients with Type 2 Diabetes: A Systematic Review and Meta-analysis of Clinical Trials

Previous studies have suggested that soy products may be beneficial for cardiometabolic health, but current evidence regarding their effects in type 2 diabetes mellitus (T2DM) remain unclear. The aim of this systematic review and meta-analysis was to determine the impact of soy product consumption on cardiovascular risk factors in patients with T2DM. PubMed, Scopus, Embase, and the Cochrane library were systematically searched from inception to March 2021 using relevant keywords. All randomized controlled trials (RCTs) investigating the effects of soy product consumption on cardiovascular risk factors in patients with T2DM were included. Meta-analysis was performed using random-effects models and subgroup analysis was performed to explore variations by dose and baseline risk profile. A total of 22 trials with 867 participants were included in this meta-analysis. Soy product consumption led to a significant reduction in serum concentrations of triglycerides (TG) (WMD: -24.73 mg/dL; 95% CI: -37.49, -11.97), total cholesterol (TC) (WMD: -9.84 mg/dL; 95% CI: -15.07, -4.61), low density lipoprotein (LDL) cholesterol (WMD: -6.94 mg/dL; 95% CI: -11.71, -2.17) and C-reactive protein (CRP) (WMD: -1.27 mg/L; 95% CI: -2.39, -0.16). In contrast, soy products had no effect on high density lipoprotein (HDL) cholesterol, fasting blood sugar (FBS), fasting insulin, hemoglobin A1c (HbA1c), homeostatic model assessment of insulin resistance (HOMA-IR), systolic and diastolic blood pressure (SBP/DBP) or body mass index (BMI) (all P ≥ 0.05). In subgroup analyses, there was a significant reduction in FBS after soy consumption in patients with elevated baseline FBS (>126 mg/dL) and in those who received higher doses of soy intake (>30 g/d). Moreover, soy products decreased SBP in patients with baseline hypertension (>135 mmHg). Our meta-analysis suggests that soy product consumption may improve cardiovascular parameters in patients with T2DM, particularly in individuals with poor baseline risk profiles. However, larger studies with longer durations and improved methodological quality are needed before firm conclusions can be reached.

Potential Protective Effects of Equol (Soy Isoflavone Metabolite) on Coronary Heart Diseases-From Molecular Mechanisms to Studies in Humans

Equol, a soy isoflavone-derived metabolite of the gut microbiome, may be the key cardioprotective component of soy isoflavones. Systematic reviews have reported that soy isoflavones have no to very small effects on traditional cardiovascular disease risk factors. However, the potential mechanistic mode of action of equol on non-traditional cardiovascular risk factors has not been systematically reviewed. We searched the PubMed through to July 2021 by using terms for equol and each of the following markers: inflammation, oxidation, endothelial function, vasodilation, atherosclerosis, arterial stiffness, and coronary heart disease. Of the 231 records identified, 69 articles met the inclusion criteria and were summarized. Our review suggests that equol is more lipophilic, bioavailable, and generally more potent compared to soy isoflavones. Cell culture, animal, and human studies show that equol possesses antioxidative, anti-inflammatory, and vasodilatory properties and improves arterial stiffness and atherosclerosis. Many of these actions are mediated through the estrogen receptor β. Overall, equol may have a greater cardioprotective benefit than soy isoflavones. Clinical studies of equol are warranted because equol is available as a dietary supplement.

The effect of soy products on circulating adiponectin and leptin concentration in adults: A systematic review and meta-analysis of randomised controlled trials

BACKGROUND

Human clinical trials that have investigated the effect of soy product consumption on adipokines have reported inconsistent results. Our objective was to elucidate the role of soy product consumption on adiponectin and leptin in adults through a systematic review and meta-analysis of available randomised placebo-controlled trials (RCTs).

METHODS

The systematic search included PubMed, Scopus, Web of Science, EmBase, Google Scholar and Cochrane database from inception to July 2020. Human clinical trials that reported the effect of soy product consumption on leptin and adiponectin were included. The pooled weighted mean difference (WMD) was calculated by the random-effects model. Heterogeneity, sensitivity analysis, and publication bias were reported using standard methods. Quality assessment was performed using Cochrane risk of bias assessment tool.

RESULTS

Overall, 13 RCTs with 824 participants were included in this meta-analysis. Our analysis showed that soy product consumption did not significantly affect leptin (WMD: 0.01 ng/mL; 95% CI, -0.16, 0.18; P = .88) and adiponectin (WMD: -0.09 ng/mL; 95% CI, -0.29, 0.12; P = .39) concentration in comparison with control. Furthermore, subgroup analysis indicated that the effect remained non-significant when analysed by study design, participant demographics and intervention characteristics. Based on the Cochrane Collaboration Risk of Bias tool, seven studies were considered good quality and six studies were fair.

CONCLUSION

The present systematic review and meta-analysis suggest that soy product consumption had no significant effect on leptin and adiponectin levels in adults. However, future larger and well-designed trials are still needed to further explore this research area and to address the heterogeneous study design used in the existing literature.

Isoflavones derived from plant raw materials: bioavailability, anti-cancer, anti-aging potentials, and microbiome modulation

Isoflavones are secondary metabolites that represent the most abundant category of plant polyphenols. Dietary soy, kudzu, and red clover contain primarily genistein, daidzein, glycitein, puerarin, formononetin, and biochanin A. The structural similarity of these compounds to β-estradiol has demonstrated protection against age-related and hormone-dependent diseases in both genders. Demonstrative shreds of evidence confirmed the fundamental health benefits of the consumption of these isoflavones. These relevant activities are complex and largely driven by the source, active ingredients, dose, and administration period of the bioactive compounds. However, the preclinical and clinical studies of these compounds are greatly variable, controversial, and still with no consensus due to the non-standardized research protocols. In addition, absorption, distribution, metabolism, and excretion studies, and the safety profile of isoflavones have been far limited. This highlights a major gap in understanding the potentially critical role of these isoflavones as prospective replacement therapy. Our general review exclusively focuses attention on the crucial role of isoflavones derived from these plant materials and critically highlights their bioavailability, possible anticancer, antiaging potentials, and microbiome modulation. Despite their fundamental health benefits, plant isoflavones reveal prospective therapeutic effects that worth further standardized analysis.

Legumes as Functional Food for Cardiovascular Disease

Legumes are an essential food source worldwide. Their high-quality proteins, complex carbohydrates, dietary fiber, and relatively low-fat content make these an important functional food. Known to possess a multitude of health benefits, legume consumption is associated with the prevention and treatment of cardiovascular diseases (CVD). Legume crude protein isolates and purified peptides possess many cardiopreventive properties. Here, we review selected economically valued legumes, their taxonomy and distribution, biochemical composition, and their protein components and the mechanism(s) of action associated with cardiovascular health. Most of the legume protein studies had shown upregulation of low-density lipoprotein (LDL) receptor leading to increased binding and uptake, in effect significantly reducing total lipid levels in the blood serum and liver. This is followed by decreased biosynthesis of cholesterol and fatty acids. To understand the relationship of identified genes from legume studies, we performed gene network analysis, pathway, and gene ontology (GO) enrichment. Results showed that the genes were functionally interrelated while enrichment and pathway analysis revealed involvement in lipid transport, fatty acid and triglyceride metabolic processes, and regulatory processes. This review is the first attempt to collate all known mechanisms of action of legume proteins associated with cardiovascular health. This also provides a snapshot of possible targets leading to systems-level approaches to further investigate the cardiometabolic potentials of legumes.

Moderate Consumption of Red Meat, Compared to Soy or Non-Soy Legume, Has No Adverse Effect on Cardio-Metabolic Factors in Patients with Type 2 Diabetes

BACKGROUND

Recently, it has been proposed that red meat consumption could enhance risk of diabetes and worsen lipid profile and glycemic status, in comparison with soy or non-soy legume, but the results of clinical trials are controversial.

OBJECTIVES

This study aimed to compare the effect of red meat, soy bean, and non-soy legume consumption on cardio-metabolic factors in patients with type 2 diabetes.

METHODS

This was a randomized controlled clinical trial which included 75 patients with diabetes, aged 40-65 years. Participants were randomly allocated to receive two servings of red meat (control group), soy bean, or non-soy legume, 3 days a week for 8 weeks. All groups also received a balanced-macronutrients weight maintenance diet. Body composition and cardio-metabolic factors including fasting blood glucose (FBG), fasting insulin, glycated hemoglobin (HbA1c), serum lipids, and blood pressure were measured at baseline and endpoint of the study. Quantitative insulin sensitivity check index (QUICKI) score and Framingham risk score (FRS) were also computed.

RESULTS

We found no significant differences in changes of FBG, fasting insulin, HbA1c, QUICKI score, serum lipids, FRS, and systolic and diastolic blood pressure among the 3 groups. Within group analysis showed that FRS reduced significantly in all groups (P<0.05). In addition, systolic (P=0.01) and diastolic (P=0.03) blood pressure reduced within red meat group.

CONCLUSIONS

Compared to soy bean or non-soy legume, moderate consumption of red meat had no adverse effect on cardio-metabolic factors including FBG, fasting insulin, HbA1C, QUICKI score, total cholesterol, low-density lipoprotein , high-density lipoprotein , and blood pressure in adults with type 2 diabetes.

Pleiotropic Effects of Isoflavones in Inflammation and Chronic Degenerative Diseases

Isoflavones are phytoestrogens of plant origin, mostly found in the members of the Fabaceae family, that exert beneficial effects in various degenerative disorders. Having high similarity to 17-β-estradiol, isoflavones can bind estrogen receptors, scavenge reactive oxygen species, activate various cellular signal transduction pathways and modulate growth and transcription factors, activities of enzymes, cytokines, and genes regulating cell proliferation and apoptosis. Due to their pleiotropic activities isoflavones might be considered as a natural alternative for the treatment of estrogen decrease-related conditions during menopause. This review will focus on the effects of isoflavones on inflammation and chronic degenerative diseases including cancer, metabolic, cardiovascular, neurodegenerative diseases, rheumatoid arthritis and adverse postmenopausal symptoms.

Nutraceuticals and blood pressure control: a European Society of Hypertension position document

: High-normal blood pressure (BP) is associated with an increased risk of cardiovascular disease, however the cost-benefit ratio of the use of antihypertensive treatment in these patients is not yet clear. Some dietary components and natural products seems to be able to significantly lower BP without significant side effects. The aim of this position document is to highlight which of these products have the most clinically significant antihypertensive action and wheter they could be suggested to patients with high-normal BP. Among foods, beetroot juice has the most covincing evidence of antihypertensive effect. Antioxidant-rich beverages (teas, coffee) could be considered. Among nutrients, magnesium, potassium and vitamin C supplements could improve BP. Among nonnutrient-nutraceuticals, soy isoflavones could be suggested in perimenopausal women, resveratrol in insulin-resistant patients, melatonin in study participants with night hypertension. In any case, the nutracutical approach has never to substitute the drug treatment, when needed.

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

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

Production of Bovine Equol-Enriched Milk: A Review

Simple Summary

Milk and dairy products contain many substances beneficial to human health; moreover, the contents of some of these substances can be enhanced. This is also the case of isoflavones which are compounds of plant origin that can be ingested and metabolized by cattle and, subsequently, secreted into bovine milk. An especially healthful substance called equol is ranked among isoflavone metabolites, commonly produced in the digestive tract of cattle. Equol content in milk can be modified by using feedstuffs with different contents of isoflavones or by milk processing and storage.

Abstract

Milk and dairy products are important sources of nutrients in the human diet because they contain a number of essential substances and other biologically active components. Many of these substances can be modified, and thus offer opportunities to use milk and dairy products as functional food. Isoflavones are particularly important in human nutrition due to their diverse pharmacological and antioxidant properties. The clinical effectiveness of isoflavone-rich products is believed to be dependent on their ability to metabolize daidzein to equol, which may directly exert cancer preventive effects. However, only approximately 30–40% of humans are able to produce equol, while animals, in general, produce equol. Equol is the predominant product of bacterial metabolism of isoflavones and can be found in various amounts in some food of animal origin, especially in milk. Therefore, milk and dairy products can be considered to be sources of equol for humans who are not able to produce this metabolite. When the content of isoflavones in milk is to be modified, two groups of factors should be considered, i.e., dietary factors that include the source of isoflavones and the processing effects on feedstuffs and animal factors that include the intake of isoflavones, ruminal and postruminal changes, and the health and physiological status of animals. The approximate content of isoflavones in milk can be predicted using carry-over rates for different dietary sources or using a formula that describes the relationship between equol concentration in milk and formononetin intake. Processing and storage can affect the content and profile of isoflavones in milk and dairy products.

Impact of functional foods and nutraceuticals on high blood pressure with a special focus on meta-analysis: review from a public health perspective

In recent times many researchers are expressing immense interest in nutraceuticals and functional foods for combating various diseases or abnormal conditions, especially against hypertension (HT). Persistent HT is medically referred to as chronic high blood pressure (BP) and considered to be one of the major risk factors for the deadliest diseases including cardiovascular disease (CVD) and cerebrovascular diseases. Hence HT poses a serious socio-economic burden worldwide, particularly to developing countries. The current treatment strategy for HT includes standard anti-hypertensive drugs, which are associated with many adverse effects and lower drug adherence rates. Therefore, an alternative or complementary natural therapy (functional foods or nutraceuticals or dietary supplements) would be the alternate choice along with a modified lifestyle pattern that might help to manage or combat HT and its related complications. During this review, the author would like to shed light on the basic science behind HT including pathophysiology and the impact of dietary salt on HT and the impact of various functional foods or nutraceuticals against HT in humans (meta-analysis and systemic review). This contribution gives a better idea (public health perspective) for choosing the best functional foods/nutraceuticals for the prevention, management or delaying the onset of HT and its associated conditions along with modified lifestyle patterns and standard anti-hypertensive drugs.

Soy intake is associated with lowering blood pressure in adults: A systematic review and meta-analysis of randomized double-blind placebo-controlled trials

BACKGROUND

Soy has several beneficial effects on cardiovascular disease (CVD); however, results of clinical trial studies are equivocal. Thus, the present study sought to discern the efficacy of soy intake on blood pressure.

METHODS

The search process was conducted in PubMed, Scopus, Web of Science, and Cochrane Library, to ascertain studies investigating the efficacy of soy intake on blood pressure in adults, published up to June 2020. A random-effects model was applied to pool mean difference and 95 % confidence interval (CI). Begg's and Egger's methods were conducted to assess publication bias.

RESULTS

Pooled effects from 17 effect sizes revealed a significant improvement in systolic blood pressure (SBP) (-1.70; -3.34 to -0.06 mmHg; I² = 45.4 %) and diastolic blood pressure (DBP) (-1.27; -2.36 to -0.19 mmHg, I² = 43.9 %) following soy consumption, in comparison with controls. Subgroup analysis demonstrated a reduction in both SBP and DBP in younger participants with lower baseline DBP and intervention durations of <16 weeks.

CONCLUSION

Our results suggest that soy intake is associated with an ameliorating effect on blood pressure in adults.

Soy protein supplementation in men following radical prostatectomy: a 2-year randomized, placebo-controlled clinical trial

BACKGROUND

Many studies have addressed effects of dietary supplementation with soy protein, but most have been inconsistent and few have been long-term studies in men.

OBJECTIVES

This study was a secondary analysis of body weight, blood pressure, thyroid hormones, iron status, and clinical chemistry in a 2-y trial of soy protein supplementation in middle-aged to older men.

METHODS

Data were analyzed as secondary outcomes of a randomized controlled trial of dietary supplementation with 20 g/d soy protein isolate, providing 41 mg/d total isoflavones and 23 mg/d genistein, in 44- to 75-y-old men who were at risk of cancer recurrence following prostatectomy randomized to soy (n = 50) or a casein-based placebo (n  = 43). Weight, blood pressure, and blood samples were collected at baseline, every 2 mo in year 1, and every 3 mo in year 2.

RESULTS

Compared with casein, soy supplementation did not affect body weight, blood pressure, serum total cholesterol, calcium, phosphorus, and thyroid hormones. Serum ferritin concentrations doubled over 2 y in both groups (117-129%), whereas hemoglobin and hematocrit increased slightly. In an exploratory subgroup analysis of soy group data, weight increased in subjects producing equol but not in nonproducers. Blood pressure was reduced in nonequol producers but not in producers. Other endpoints were not affected by equol production status.

CONCLUSIONS

Soy protein supplementation for 2 y compared with a casein-based placebo did not affect body weight, blood pressure, serum total cholesterol, iron status parameters, calcium, phosphorus, and thyroid hormones. Exploratory analysis suggests that equol production status of subjects on soy may modify effects of soy on body weight and possibly blood pressure. This trial was registered at clinicaltrials.gov as NCT00765479.

The Vascular Effects of Isolated Isoflavones-A Focus on the Determinants of Blood Pressure Regulation

Isoflavones are phytoestrogen compounds with important biological activities, including improvement of cardiovascular health. This activity is most evident in populations with a high isoflavone dietary intake, essentially from soybean-based products. The major isoflavones known to display the most important cardiovascular effects are genistein, daidzein, glycitein, formononetin, and biochanin A, although the closely related metabolite equol is also relevant. Most clinical studies have been focused on the impact of dietary intake or supplementation with mixtures of compounds, with only a few addressing the effect of isolated compounds. This paper reviews the main actions of isolated isoflavones on the vasculature, with particular focus given to their effect on the determinants of blood pressure regulation. Isoflavones exert vasorelaxation due to a multitude of pathways in different vascular beds. They can act in the endothelium to potentiate the release of NO and endothelium-derived hyperpolarization factors. In the vascular smooth muscle, isoflavones modulate calcium and potassium channels, leading to hyperpolarization and relaxation. Some of these effects are influenced by the binding of isoflavones to estrogen receptors and to the inhibition of specific kinase enzymes. The vasorelaxation effects of isoflavones are mostly obtained with plasma concentrations in the micromolar range, which are only attained through supplementation. This paper highlights isolated isoflavones as potentially suitable alternatives to soy-based foodstuffs and supplements and which could enlarge the current therapeutic arsenal. Nonetheless, more studies are needed to better establish their safety profile and elect the most useful applications.

Dietary Patterns and Muscle Mass, Muscle Strength, and Physical Performance in the Elderly: A 3-Year Cohort Study

OBJECTIVES

Nutritional support effectively prevents and treats sarcopenia; however, the influence of overall dietary patterns on sarcopenia parameters is less investigated. This study aimed to determine the association between adherence to Mediterranean-style diet (MD), Dietary Approaches to Stop Hypertension (DASH), Japanese Food Guide Spinning Top (JFG-ST), and modified JFG-ST (mJFG-ST) and muscle mass, muscle strength, and physical performance in community-dwelling Japanese elderly.

DESIGN AND SETTINGS

This prospective cohort study recruited individuals aged over 60 years from a community college in Nagoya, Japan.

PARTICIPANTS AND MEASUREMENTS

A total of 666 participants were followed up annually from 2014 to 2017. Demographic data, anthropometric measurements, and sarcopenia parameters including walking speed (WS), hand grip strength in the dominant hand (HGS), and skeletal mass index (SMI) were recorded. Self-recall dietary intake was assessed using a validated food frequency questionnaire comprising 29 food groups. Adherence to MD, DASH, JFG-ST, and mJFG-ST was determined by tertiles.

RESULTS

At baseline, the mean age of all participants (56.5% women) was 69.4±4.4 years. WS, HGS, and SMI were 1.4±0.2 (m/s), 28.9±8.1 (kg), and 6.7±1.0 (kg/m2), respectively. In longitudinal analysis, participants with higher JFG-ST adherence scores were more likely to have higher SMI (Q3 vs. Q1: mean difference, 0.048; p=0.04) after adjustment, and its benefits were more evident in men (Q2 vs. Q1: mean difference, 0.098; p=0.047; Q3 vs. Q1: mean difference, 0.091; p=0.017) than in women. WS and HGS were not associated with any type of dietary pattern.

CONCLUSIONS

Adherence to JFG-ST was positively associated with SMI in Japanese community-dwelling elderly adults aged over 60 years, specifically in men. The country-specific dietary recommendations are required to be developed for sarcopenia prevention.

Food Bioactive Compounds and Emerging Techniques for Their Extraction: Polyphenols as a Case Study

Experimental studies have provided convincing evidence that food bioactive compounds (FBCs) have a positive biological impact on human health, exerting protective effects against non-communicable diseases (NCD) including cancer and cardiovascular (CVDs), metabolic, and neurodegenerative disorders (NDDs). These benefits have been associated with the presence of secondary metabolites, namely polyphenols, glucosinolates, carotenoids, terpenoids, alkaloids, saponins, vitamins, and fibres, among others, derived from their antioxidant, antiatherogenic, anti-inflammatory, antimicrobial, antithrombotic, cardioprotective, and vasodilator properties. Polyphenols as one of the most abundant classes of bioactive compounds present in plant-based foods emerge as a promising approach for the development of efficacious preventive agents against NCDs with reduced side effects. The aim of this review is to present comprehensive and deep insights into the potential of polyphenols, from their chemical structure classification and biosynthesis to preventive effects on NCDs, namely cancer, CVDs, and NDDS. The challenge of polyphenols bioavailability and bioaccessibility will be explored in addition to useful industrial and environmental applications. Advanced and emerging extraction techniques will be highlighted and the high-resolution analytical techniques used for FBCs characterization, identification, and quantification will be considered.

Phenolic compounds: current industrial applications, limitations and future challenges

Phenolic compounds are natural bioactive molecules found mainly in plant tissues that have shown interesting bioactivities, such as antioxidant, antimicrobial, anti-inflammatory, and antiproliferative activities, among others, which has led to great interest in their use by several industries. However, despite the large number of scientific studies on this topic, some issues still need to be studied and solved, such as the understanding of the main actions of these compounds in organisms. Besides their large potential applicability in industry, phenolic compounds still face some issues making it necessary to develop strategies to improve bioavailability, sustainable technologies of extraction and refinement, and stability procedures to increase the range of applicability. This review focuses on the most recent advances in the applications of phenolic compounds in different technological and medicinal areas. In addition, techniques to improve their sustainable resourcing, stability and bioavailability will be presented and discussed.

Isoflavone Supplementation Does Not Potentiate the Effect of Combined Exercise Training on Resting and Ambulatory Blood Pressure in Non-Obese Postmenopausal Women: A Randomized Double-Blind Controlled Trial-A Pilot Study

Physical exercise and isoflavone supplementation are potential strategies to prevent and treat cardiovascular diseases in postmenopausal women. The aim of this study was to investigate whether there are additive effects of isoflavone supplementation when associated with combined aerobic and resistance exercise on resting and ambulatory blood pressure monitoring (ABPM) and in blood pressure variability (BPV). Thirty-one non-obese postmenopausal women were randomly allocated into two groups: placebo and exercise (Placebo n = 19); and isoflavone supplementation (100 mg/day) and exercise (isoflavone n = 19). ABPM and BPV were evaluated before and after 10 weeks of moderate combined (aerobic and resistance) exercise training. Generalized Estimating Equation (GEE) with Bonferroni correction and intention-to-treat analysis was used to compare the effects of interventions on resting BP, ABPM and BPV. Combined exercise training decreased resting systolic (SBP) and diastolic blood pressure (DBP) and reduced 24 h and awake ambulatory SBP, DBP and mean blood pressure over time, with no additional effects of isoflavone supplementation. No changes were observed in sleep period, or in BPV indexes (Standard Deviation of 24 h (SD), daytime and nighttime interval (SDdn) and average real variability (ARV) in both groups. We conclude that isoflavone supplementation does not potentiate the effects of combined training on resting and ambulatorial systolic and diastolic blood pressure in non-obese postmenopausal women.

Soy isoflavones interact with calcium and contribute to blood pressure homeostasis in women: a randomized, double-blind, placebo controlled trial

BACKGROUND

Estrogens and calcium regulate vascular health but caused adverse cardiovascular events in randomized trials.

OBJECTIVES

Whether phytoestrogenic soy isoflavones modulate the physiological effects of calcium on blood pressure was explored.

DESIGN

A double-blind, randomized study assigned 99 premenopausal women to 136.6 mg isoflavones (as aglycone equivalents) and 98 to placebo for 5 days per week for up to 2 years. Blood pressure, serum calcium and urinary excretion of daidzein (DE) and genistein (GE) were measured repeatedly before and during treatment.

RESULTS

Isoflavones did not affect blood pressure per intake dose assignment (i.e. intention-to-treat, n = 197), but significantly affected blood pressure per measured urinary excretion of isoflavones (i.e. per protocol analysis, n = 166). Isoflavones inversely moderated calcium effects on systolic blood pressure (SBP) (interaction term β-estimates: - 3.1 for DE, - 12.86 for GE, all P < 0.05), and decreased diastolic blood pressure (DBP) (β-estimates: - 0.84 for DE, - 2.82 for GE, all P < 0.05) after controlling for calcium. The net intervention effects between the maximum and no isoflavone excretion were - 17.7 and + 13.8 mmHg changes of SBP, respectively, at serum calcium of 10.61 and 8.0 mg/dL, and about 2.6 mmHg decrease of DBP.

CONCLUSIONS

Moderation by isoflavones of the physiological effect of calcium tends to normalize SBP, and this effect is most significant when calcium concentrations are at the upper and lower limits of the physiological norm. Isoflavones decrease DBP independent of calcium levels. Further studies are needed to assess the impact of this novel micronutrient effect on blood pressure homeostasis and cardiovascular health.

TRIAL REGISTRATION

www.clinicaltrials.gov identifier: NCT00204490.

Soy food intake associates with changes in the metabolome and reduced blood pressure in a gut microbiota dependent manner

BACKGROUND AND AIMS

Consumption of soy foods has been associated with protection against cardiometabolic disease, but the mechanisms are incompletely understood. We hypothesized that habitual soy food consumption associates with gut microbiome composition, metabolite production, and the interaction between diet, microbiota and metabolites.

METHODS AND RESULTS

We analyzed dietary soy intake, plasma and stool metabolites, and gut microbiome data from two independent cross-sectional samples of healthy US individuals (N = 75 lean or overweight, and N = 29 obese). Habitual soy intake associated with several circulating metabolites. There was a significant interaction between soy intake and gut microbiome composition, as defined by gut enterotype, on metabolites in plasma and stool. Soy consumption associated with reduced systolic blood pressure, but only in a subset of individuals defined by their gut microbiome enterotype, suggesting that responsiveness to soy may be dependent on microbiome composition. Soy intake was associated with differences in specific microbial taxa, including two taxa mapping to genus Dialister and Prevotella which appeared to be suppressed by high soy intake We identified context-dependent effects of these taxa, where presence of Prevotella was associated with higher blood pressure and a worse cardiometabolic profile, but only in the absence of Dialister.

CONCLUSIONS

The gut microbiome is an important intermediate in the interplay between dietary soy intake and systemic metabolism. Consumption of soy foods may shape the microbiome by suppressing specific taxa, and may protect against hypertension only in individuals with soy-responsive microbiota.

CLINICAL TRIALS REGISTRY

NCT02010359 at clinicaltrials.gov.

The effect of soy isoflavones on arterial stiffness: a systematic review and meta-analysis of randomized controlled trials

PURPOSE

Some but not all randomized controlled trials (RCTs) of soy isoflavones showed their beneficial effect on arterial stiffness, a predictor of cardiovascular events, dementia, and all-cause mortality, independent of traditional risk factors. To test the hypothesis that supplementation of soy isoflavones reduces arterial stiffness, we performed a systematic review and meta-analysis of RCTs of soy isoflavones on arterial stiffness.

METHODS

The protocol of this systematic review was registered with PROSPERO (CRD42019126128) and written in accordance with PRISMA. The PubMed, Embase, and clinicaltrials.gov databases were searched using the following criteria: human subjects, soy isoflavones as intervention, and arterial stiffness as primary outcome. A random-effects meta-analysis was used to pool estimates across studies. Standardized mean difference (SMD) was used to synthesize quantitative results.

RESULTS

Among 998 articles retrieved, 8 articles met our criteria. Duration of intervention was relatively short (maximum of 12 weeks). Outcome measurements extracted were pulse wave velocity (PWV), systemic arterial compliance (SAC), augmentation index (AI), and cardio-ankle vascular index (CAVI). Soy isoflavones reduced arterial stiffness compared to placebo (standardized mean difference - 0.33, 95% confidence interval - 0.47, - 0.19). Subgroup analyses showed no difference between treatment effects for intervention duration (< 6 weeks vs. ≥ 6 weeks) or gender (women only vs. men only vs. combined). Sensitivity analysis showed no difference in the effect of soy isoflavones between PWV, CAVI, SAC, and AI.

CONCLUSION

Supplementation of soy isoflavones reduced arterial stiffness. Longer duration trials with larger number of participants are warranted.

Impact of soy consumption on human health: integrative review

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.

Seeds

A wide variety of plant species provide edible seeds. Seeds are the dominant source of human calories and protein. The most important and popular seed food sources are cereals, followed by legumes and nuts. Their nutritional content of fiber, protein, and monounsaturated/polyunsaturated fats make them extremely nutritious. They are important additions to our daily food consumption. When consumed as part of a healthy diet, seeds can help reduce blood sugar, cholesterol, and blood pressure.

Legume Consumption and Cardiometabolic Health

Legumes are key components of several plant-based diets and are recognized as having a wide range of potential health benefits. Previous systematic reviews and meta-analyses have summarized the evidence regarding different cardiometabolic outcomes, such as cardiovascular disease (CVD) and type 2 diabetes (T2D), and legume consumption. However, those studies did not differentiate between nonsoy and soy legumes, which have different nutritional profiles. The aim of the present updated review, therefore, was to summarize and meta-analyze the published evidence regarding legume consumption (making a distinction between nonsoy and soy legumes) and cardiometabolic diseases. In addition, we reviewed randomized clinical trials assessing the effect of legume consumption on CVD risk factors in order to understand their associations. The results revealed a prospective, significant inverse association between total legume consumption and CVD and coronary heart disease risk, whereas a nonsignificant association was observed with T2D and stroke. In the stratified analysis by legume subtypes, only nonsoy legumes were associated with lower risk of T2D. Unfortunately, owing to the paucity of studies analyzing legumes and CVD, it was not possible to stratify the analysis for these outcomes. Because of the high degree of heterogeneity observed for most of the outcomes and the few studies included in some analyses, further prospective studies are warranted to determine the potential role of legume consumption on CVD and T2D.

Biological Effect of Soy Isoflavones in the Prevention of Civilization Diseases

Scientific advancements in recent years have shed new light on the relationship between diet and human health. Nutrients play an important role in the prevention of many civilization diseases, such as osteoporosis, type II diabetes, hypercholesterolemia, and cardiovascular diseases. The biological activity of natural plant components allows their use in the treatment of various diseases, especially civilization diseases, to be speculated. Special attention is paid to phenolic compounds that have numerous health-promoting properties. Isoflavones, phenolic compounds, are commonly found in legumes, especially in soybeans. Their structural similarity to 17-β-estradiol (E2), the main female sex hormone, allows them to induce estrogenic and antiestrogenic effects by binding to estrogen receptors, and their consumption has been associated with a decreased risk of hormone-related cancers. In addition, numerous epidemiological studies and related meta-analyses suggest that soy consumption may be associated with a lower incidence of certain diseases. However, there are some doubts about the potential effects on health, such as the effectiveness of cardiovascular risk reduction or breast cancer-promoting properties. The purpose of this review is to present the current knowledge on the potential effects of soy isoflavone consumption with regard to civilization diseases.

Novel process of hydration, followed by incubation and thermal processing, for high isoflavone bioconversion in soybeans

The potentially bioavailable aglyconic isoflavone content of soybeans was increased by a process based on the controlled hydration of whole beans, followed by an incubation step and cooking. For developing the process, the effects of three operation variables: temperature, intermittent soaking and incubation time on the isoflavone profile of the processed soybeans were assessed. By hydrating the whole beans under controlled conditions (54 °C; 15 rpm for a rotating soaking basket) and holding the beans for an appropriate incubation time, it was possible to substantially increase the total aglycone content from (μmol·10-2·g-1) ~5 in the raw, to ~95 in the processed soybean. A conventional thermal treatment (1 kg⋅cm-2, 5 min), necessary to attain the nutritional and sensory characteristics, produced additional hydrolysis of glucosides, accounting for extra 14% of total aglycone yield. The entire process avoided the need to grind the bean and permitted an overall 21.8-fold increase (per-mole basis) conversion of all forms of isoflavone glucosides to aglycones, particularly to the (S)-equol precursor, daidzein, and with minimal back-diffusion or leaching to the outside medium.

Dietary Polyphenol Intake, Blood Pressure, and Hypertension: A Systematic Review and Meta-Analysis of Observational Studies

Background: Dietary polyphenols, including flavonoids, have been the focus of major recent attentions due to their wide content in a variety of foods commonly consumed and the findings from numerous studies showing evidence of an association with positive outcomes on human health. Methods: A systematic search using electronic databases PubMed and EMBASE was performed to retrieve English language studies published from the earliest indexing year of each database to April 2019, reporting on the association between dietary flavonoids intake and hypertension. Results: The search strategy resulted in the final selection of 20 studies including 15 cross-sectional investigations and 7 prospective cohorts (1 study reported on 3 prospective cohorts). 5 prospective cohorts, comprising 200,256 individuals and 45,732 cases of hypertension were included in the quantitative analysis. Analysis by extreme quantiles of intake of flavonoid showed a non-significant association with decreased risk of hypertension (RR (risk ratio): 0.96, 95% CI (confidence interval): 0.89, 1.03). Taking into consideration individual flavonoid subclasses, dietary anthocyanins intake was associated with 8% reduction in risk of hypertension, when comparing highest vs. lowest exposure (RR: 0.92, 95% CI: 0.88, 0.97). Conclusions: Further studies are needed to strengthen the retrieved association between anthocyanins consumption and decreased risk of hypertension and clarify whether total flavonoids or rather individual subclasses may exert beneficial effects on blood pressure.

Isoflavones

Phytoestrogens are naturally occurring nonsteroidal phenolic plant compounds that, due to their molecular structure and size, resemble vertebrate steroids estrogens. This review is focused on plant flavonoids isoflavones, which are ranked among the most estrogenic compounds. The main dietary sources of isoflavones for humans are soybean and soybean products, which contain mainly daidzein and genistein. When they are consumed, they exert estrogenic and/or antiestrogenic effects. Isoflavones are considered chemoprotective and can be used as an alternative therapy for a wide range of hormonal disorders, including several cancer types, namely breast cancer and prostate cancer, cardiovascular diseases, osteoporosis, or menopausal symptoms. On the other hand, isoflavones may also be considered endocrine disruptors with possible negative influences on the state of health in a certain part of the population or on the environment. This review deals with isoflavone classification, structure, and occurrence, with their metabolism, biological, and health effects in humans and animals, and with their utilization and potential risks.