Determinants for urinary and plasma isoflavones in humans after soy intake

Evaluating serum S-Equol, indoxyl sulfate, and TMAO in predicting urinary stones in children: a prospective study

Gut microbiota is vital in maintaining health and has been implicated in urinary stone disease. Patients with and without stones have different microbial compositions. In this context, we assessed serum levels of S-equol, indoxyl sulfate (IS), and trimethylamine N-oxide (TMAO), which are metabolites thought to be associated with gut microbiota, and their prognostic values in predicting stone formation in children with urinary stone disease. The study population consisted of children aged between one month and 18 years with urinary stone disease. The patient group consisted of 44 children with urinary stone disease, and the control group consisted of 44 healthy children who were matched with the patient group in terms of age and gender. The study's primary outcomes were the differences between the groups in serum metabolite levels. Serum S-equol and TMAO levels were significantly lower in the patient group than in the control group. There was no significant difference between the groups in serum IS levels. There were also no significant correlations between serum metabolite levels and age in either group. Children with urinary stone disease had significantly lower serum S-equol and TMAO levels than healthy control subjects, suggesting a possible link between these metabolites and stone formation.

The effects of soymilk plus probiotics supplementation on cardiovascular risk factors in patients with type 2 diabetes mellitus: a randomized clinical trial

OBJECTIVE

Type 2 diabetes mellitus (T2DM) is associated with an increased risk of cardiovascular diseases. This study aimed to assess the effects of soymilk plus probiotics co-administration on cardiovascular risk factors in T2DM patients.

METHODS

One hundred patients with T2DM (aged 40-75 years old) were randomly assigned into 4 groups (soymilk + probiotics supplement, soymilk + placebo, conventional milk + placebo, and probiotics supplement) for 6 weeks. Standard protocols were followed for the collection of fasting blood samples, dietary intakes, and anthropometric measurements.

RESULTS

It was shown that soymilk + probiotics consumption significantly decreased diastolic blood pressure (DBP) (p = 0.001), triglycerides (TG) (P < 0.001), total cholesterol (TC) (p < 0.01), and insulin (P < 0.003) levels and significantly increased high-density lipoprotein cholesterol (HDL-C) (P = 0.002) levels. Soymilk + placebo administration significantly decreased DBP (p = 0.01), insulin (p = 0.006), and TG (p = 0.001) levels and significantly increased HDL-C (p = 0.03) levels. A significant decrease in insulin (p = 0.003) and systolic blood pressure (SBP) (p = 0.01) levels and an increase in HDL-C (p = 0.04) levels were observed after supplementation with probiotics. Findings from between-group comparisons showed a significant decrease in SBP levels in the probiotics supplement group compared to conventional milk group (p < 0.05).

CONCLUSION

Soymilk and probiotics consumption might improve some cardiovascular risk factors in patients with T2DM. However, possible synergic effects while consumption of soymilk plus probiotics supplement didn't show in this study which warranted further research.

Adoption of improved soybean and gender differential productivity and revenue impacts: Evidence from Nigeria

Despite the considerable soybean varietal improvement and dissemination efforts in Nigeria and other parts of Sub-Saharan Africa, empirical evidence on farm-level yield and revenue impacts of improved soybean varieties (ISVs) from a gender perspective are limited. In this paper, we analyze the impact of the adoption of ISVs on soybean yield and net revenue, and the associated gender differential effects in northern Nigeria. We use the endogenous and exogenous switching treatment effects regression frameworks to estimate the impacts. We find that the adoption of ISVs significantly increased soybean yield and net revenue of the soybean-producing households by 26% and 32%, respectively. In addition, we find that the gender gap in yield between male and female-headed soybean-producing households was small, with a yield gap of about 1%. However, we find a substantial gender gap in soybean net revenue, as the net revenue of female-headed households was lower by about 20%, as compared to male-headed households. Overall, our findings show that policymakers and their development partners can leverage varietal improvement to boost the yields of both male- and female-headed households. However, closing the gender gap in crop income necessitates reducing the disparity in market linkages so that the female farmers can equally have better market access.

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.

Neither soyfoods nor isoflavones warrant classification as endocrine disruptors: a technical review of the observational and clinical data

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.

Pharmacokinetics and safety profile of single-dose administration of an estrogen receptor β-selective phytoestrogenic (phytoSERM) formulation in perimenopausal and postmenopausal women

OBJECTIVE

Selected estrogen receptor β-selective phytoestrogen (phytoSERM), a preparation of genistein, daidzein, and S-equol, has an 83-fold selective affinity for estrogen receptor (ER) β, and may promote neuronal survival and estrogenic mechanisms in the brain without exerting feminizing activity in the periphery. The aim of this study was to assess the safety, tolerability, and single-dose pharmacokinetics of the phytoSERM formulation in perimenopausal and postmenopausal women.

METHODS

Eighteen women aged 45 to 60 years from a 12-week clinical trial evaluating cognitive performance and vasomotor symptoms were randomly assigned to placebo, 50 mg, or 100 mg phytoSERM treatment groups. Plasma levels of the three parent phytoestrogens and their metabolites were measured before and at 2, 4, 6, 8, and 24 hours after ingestion by isotope dilution high-performance liquid chromatography (HPLC) electrospray ionization tandem mass spectrometry.

RESULTS

Plasma concentrations of genistein, daidzein, and S-equol peaked at 9, 6, and 4 hours, respectively, for the 50-mg dose, and at 6, 6, and 5 hours, respectively, for the 100-mg dose. The maximum concentration (Cmax) and area under the curve (AUC) for the three parent compounds were greater in the 100-mg dose group, indicating a dose-dependent change in concentration with the phytoSERM treatment. No adverse events were elicited.

CONCLUSIONS

A single-dose oral administration of the phytoSERM formulation was well-tolerated and did not elicit any adverse events. It was rapidly absorbed, reached high plasma concentrations, and showed a linear dose-concentration response in its pharmacokinetics. These findings are consistent with previously reported parameters for each parent compound (Clinicaltrials.gov NCT01723917).

Effect of Short-Course Oral Ciprofloxacin on Isoflavone Pharmacokinetics following Soy Milk Ingestion in Healthy Postmenopausal Women

Soy isoflavones have several potential benefits related to postmenopausal health. Isoflavone glycosides, found predominantly in nonfermented soy products, e.g., soy milk, require conversion by gut microbiota to their respective bioavailable aglycones prior to absorption into portal circulation. Use of short-course oral ciprofloxacin for the treatment of acute uncomplicated cystitis, the incidence of which is increasing among postmenopausal women, might adversely affect gut microbiota. The objective of this one-group pre-post treatment study was to determine the effect of short-course oral ciprofloxacin on isoflavone pharmacokinetics in healthy postmenopausal women. Eleven postmenopausal subjects were assigned to consume a single oral dose of 375 mL UHT soy milk (SOY phase). Blood samples were collected immediately before soy milk ingestion and at specific times for 32 hours after soy milk ingestion. Following a washout period of at least seven days, subjects were assigned to take 250 mg oral ciprofloxacin after breakfast and dinner for three days, followed by a single oral dose of 375 mL UHT soy milk the next day (CIPRO/SOY phase). Blood samples were collected at the same time points as in the SOY phase. Plasma samples were treated with β-glucuronidase/sulfatase and plasma concentrations of aglycones (genistein and daidzein) were determined using high-performance liquid chromatography. Cmax, AUC0-t, and AUC0-∞ of both aglycones and Tmax of genistein obtained from the CIPRO/SOY phase were significantly lower than those obtained from the SOY phase, while Tmax of daidzein and t1/2 of both aglycones in the two phases were not significantly different.

Gut Microbiota-Mediated Drug-Antibiotic Interactions

Xenobiotic metabolism involves the biochemical modification of drugs and phytochemicals in living organisms, including humans and other animals. In the intestine, the gut microbiota catalyzes the conversion of hydrophilic drugs into absorbable, hydrophobic compounds through hydroxyzation and reduction. Drugs and phytochemicals are transformed into bioactive (sulfasalazine, lovastatin, and ginsenoside Rb1), bioinactive (chloramphenicol, ranitidine, and metronidazole), and toxic metabolites (nitrazepam), thus affecting the pharmacokinetics of the original compounds. Antibiotics suppress the activities of drug-metabolizing enzymes by inhibiting the proliferation of gut microbiota. Antibiotic treatment might influence xenobiotic metabolisms more extensively and potently than previously recognized and reduce gut microbiota-mediated transformation of orally administered drugs, thereby altering the systemic concentrations of intact drugs, their metabolites, or both. This review describes the effects of antibiotics on the metabolism of drugs and phytochemicals by the gut microbiota.

Plasma bioavailability and changes in PBMC gene expression after treatment of ovariectomized rats with a commercial soy supplement

The health effects of soy supplementation in (post)menopausal women are still a controversial issue. The aim of the present study was to establish the effect of the soy isoflavones (SIF) present in a commercially available supplement on ovariectomized rats and to investigate whether these rats would provide an adequate model to predict effects of SIF in (post)menopausal women. Two dose levels (i.e. 2 and 20 mg/kg b.w.) were used to characterize plasma bioavailability, urinary and fecal concentrations of SIF and changes in gene expression in peripheral blood mononuclear cells (PBMC). Animals were dosed at 0 and 48 h and sacrificed 4 h after the last dose. A clear dose dependent increase of SIF concentrations in plasma, urine and feces was observed, together with a strong correlation in changes in gene expression between the two dose groups. All estrogen responsive genes and related biological pathways (BPs) that were affected by the SIF treatment were regulated in both dose groups in the same direction and indicate beneficial effects. However, in general no correlation was found between the changes in gene expression in rat PBMC with those in PBMC of (post)menopausal women exposed to a comparable dose of the same supplement. The outcome of this short-term study in rats indicates that the rat might not be a suitable model to predict effects of SIF in humans. Although the relative exposure period in this rat study is comparable with that of the human study, longer repetitive administration of rats to SIF may be required to draw a final conclusion on the suitability of the rat a model to predict effects of SIF in humans.

Absorption, distribution, metabolism, and excretion of isoflavonoids after soy intake

Soy is the major source of dietary exposure to isoflavonoids (IFLs). Accumulating evidence supports a role for soy and IFLs in the protection against many chronic diseases including cancer. After soy intake we found a biphasic IFL appearance pattern in plasma as well as in urine that we suggest to be due to IFL absorption in the small intestine (ca. 10%) during the first 2h after intake and IFL absorption in the large intestine (ca. 90%) 4-6 h after intake. While each IFL disappears from the circulation at different times excellent correlations between urinary and circulating IFL values were discovered and algorithms to convert urinary excretion values into circulating levels were established. We suggest the term 'apparent bioavailability' when using urinary data to describe IFL exposure. The IFL bioavailability was found to be influenced by gut bacteria, oral antibiotic treatment (OABX), and an individual's age and health status. While daidzein (DE) and genistein start to be absorbed minutes after intake, equol (EQ) appears in plasma only after a minimum of 8h following soy intake owing to the required transit time of DE to the colon where the conversion of DE to EQ takes place by intestinal microbiota. We have also shown that the apparent IFL bioavailability is higher in children than adults, higher in healthy versus non-healthy individuals, and decreased in children but increased in adults during OABX. Finally, we propose to use a urinary EQ/DE ratio of 0.018 with a DE threshold to identify EQ producers. With this cutoff definition we observed that EQ production is inconsistent over time in 5-30% of both premenopausal and postmenopausal women.

Effect of synbiotic fermented milk on oral bioavailability of isoflavones in postmenopausal women

The purpose of this study was to investigate the effect of synbiotic fermented milk, containing Lactobacillus paracasei and inulin, on oral bioavailability and pharmacokinetics of isoflavones in healthy postmenopausal women. The study was a one-group pre-post treatment study. Twelve subjects were assigned to consume a single oral dose of 375 mL of soy beverage. Blood samples were collected immediately before and at various time points until 32 hours after the administration of the soy beverage. After a washout period, subjects were requested to consume 180 mL of synbiotic fermented milk after breakfast and dinner for 14 days, followed by a single oral dose of 375 mL of soy beverage on the next day. Collection of blood samples after the administration of the soy beverage were performed at the same time points as the former phase. Plasma isoflavone concentrations were measured by using high-performance liquid chromatography (HPLC) technique. In conclusion, this study highlighted that continuous consumption of synbiotic fermented milk followed by a single oral administration of soy beverage significantly enhanced oral bioavailability of isoflavones compared with a single oral dose of soy beverage alone.

Urinary isoflavonoid excretion as a biomarker of dietary soy intake during two randomized soy trials

We evaluated urinary isoflavonoid excretion as a biomarker of dietary isoflavone intake during two randomized soy trials (13-24 months) among 256 premenopausal women with a total of 1,385 repeated urine samples. Participants consumed a high-soy diet (2 servings/day) and a low-soy diet (<3 servings/week), completed 7 unannounced 24-hour dietary recalls, and donated repeated urine samples, which were analyzed for isoflavonoid excretion by liquid chromatography methods. We computed Spearman correlation coefficients and applied logistic regression to estimate the area under the curve. Median overall daily dietary isoflavone intakes at baseline, during low- and high-soy diet were 2.3, 0.2, and 60.4 mg aglycone equivalents, respectively. The corresponding urinary isoflavonoid excretion values were 0.4, 1.0, and 32.4 nmol/mg creatinine. Across diets, urinary isoflavonoid excretion was significantly associated with dietary isoflavone intake (rs=0.51, AUC=0.85; p<0.0001) but not within diet periods (rs=0.05-0.06, AUC=0.565-0.573). Urinary isoflavonoid excretion is an excellent biomarker to discriminate between low- and high-soy diets across populations, but the association with dietary isoflavone intake is weak when the range of soy intake is small.

Isoflavone retention during processing, bioaccessibility, and transport by Caco-2 cells: effects of source and amount of fat in a soy soft pretzel

The impact of source and amount of lipid used to prepare a soy soft pretzel on the bioaccessibility and transport of isoflavones was investigated using the coupled in vitro digestion/Caco-2 human cell model. Pretzels were prepared without or with 2.9 or 6.0% exogenous lipid from either shortening, canola oil, ground almond, or ground hazelnut. The isoflavone backbone structure was stable during pretzel production, although there was partial conversion from malonyl and acetyl glucosides to simple glucosides and aglycones. Endogenous β-glucosidase activity in ground almond facilitated partial conversion of simple glucosides to aglycones during proofing, resulting in a slight decrease in bioaccessibility of isoflavones as compared with other sources of lipid. Amount and source of lipid did not affect bioaccessibility or uptake and metabolism of isoflavones by Caco-2 cells, although transport across the monolayer was greater with the lesser amount of shortening. These results suggest that the isoflavone structure, but not source or amount of lipid in a soy pretzel, may affect bioavailability of isoflavones.

Influence of fructooligosaccharide on pharmacokinetics of isoflavones in postmenopausal women

The objective of the present paper was to determine the influence of fructooligosaccharide (FOS) on the pharmacokinetics of isoflavones in healthy postmenopausal women. The study was a fixed-sequence, two-phase, crossover study. Twelve subjects received a single oral dose of 300 mL of a soy beverage. Blood samples were collected before the dose and at 0.5, 1, 2, 4, 6, 8, 10, 12, 24, and 32 h after the administration of the soy beverage. After a washout period of at least 1 week, subjects were assigned to receive oral doses of FOS, 5 g each time, twice a day (after breakfast and dinner) for 14 days, followed by a single oral dose of the same soy beverage on the next day. Blood samples were then collected at the same time points mentioned previously. Plasma isoflavone concentrations were determined by HPLC. Continuous oral administrations of FOS followed by a single oral administration of soy beverage caused significant increases in C_max, AUC_0–32, and AUC_0–∞ of genistein and AUC_0–32 of daidzein, comparing to those obtained following a single oral dose of soy beverage alone. Other pharmacokinetic parameters (T_max and t_1/2 of both aglycones and AUC_0–∞ of daidzein) between both regimens were not significantly different.

Bioavailability of phytochemical constituents from a novel soy fortified lycopene rich tomato juice developed for targeted cancer prevention trials

Studies suggest that tomato and soy foods may contribute to a lower risk of certain cancers. We developed a novel soy germ tomato juice to be used in controlled cancer prevention trials. This study describes an initial test of compliance, phytochemical bioavailability, and effects on biomarkers of blood lipids. Healthy men and women (n = 18) consumed a soy germ-fortified juice daily (300 mL supplying 66 mg isoflavones and 22 mg lycopene) for 8 wk. A single-dose bioavailability study was completed on day 1 and isoflavones in plasma and urine, and lycopene in the plasma, were measured. All subjects completed the trial, with 97.7% ± 3.5% (mean ± SD) of the scheduled juice consumed. No adverse effects were documented. The postprandial study indicated that 3.1% ± 2.3% of lycopene was absorbed and that 49.3% ± 12.1% isoflavones ingested were recovered in 24-h urines. Lycopene plasma concentration changed from 0.60 ± 0.22 to 1.24 ± 0.30 μmol/L during 8 wk of consumption. Juice consumption significantly improved resistance of LDL+VLDL-C to Cu(2+)-mediated oxidation (P = 0.039), HDL-C (47.3 ± 15.8 to 51.7 ± 14.8 mg/dL, P < 0.001), and the ratio of total-C/HDL-C (4.25 ± 1.59 to 3.63 ± 1.16, P < 0.001) at 8 wk. A well-characterized soy-fortified tomato juice can be produced in large scale for multiinstitutional long-term cancer prevention trials and showed excellent compliance with no toxicity, while demonstrating absorption of biologically active phytochemicals.

Equol production changes over time in postmenopausal women

Equol (EQ) is produced by intestinal bacteria from the soy isoflavone daidzein (DE) in 30%-60% of the population and is believed to provide benefits from soy intake. A robust EQ status definition is lacking, and it is uncertain whether EQ is formed consistently within an individual and ceases upon oral antibiotic treatment. In a randomized, double-blind, placebo-controlled soy intervention trial with 350 postmenopausal women, DE and EQ were analyzed by liquid chromatography/tandem mass spectrometry at baseline and every 6 months over 2.5 years in overnight urine, spot urine and plasma. Equol production changes and status (remaining an EQ producer or nonproducer or changing towards an EQ producer or nonproducer) were assessed. Equol status was determined most dependably by overnight urine applying as cutoff a ratio of EQ/DE≥0.018 with a DE threshold ≥2 nmol/mg creatinine: the soy and placebo groups had approximately 30% consistent EQ producers during the study, but 14% and 35%, respectively, changed EQ status (mean 1.4-1.7 times), while 27% and 17%, respectively, had antibiotic treatment (P<.01 for inverse association). No significant trend in change of EQ production or status was observed when overnight urine was limited to collections closest to before and after antibiotic treatment. Similarly, antibiotic type or class, duration, dose or time between antibiotic treatment and overnight urine collection showed no consistent influence on EQ production. Equol production can markedly change intraindividually over 2.5 years, and antibiotic treatment impacts it inconsistently. Factors other than antibiotic treatment must be considered as causes for EQ production changes.

Urine accurately reflects circulating isoflavonoids and ascertains compliance during soy intervention

BACKGROUND

Isoflavonoids (IFL) may protect against chronic diseases, including cancer. IFL exposure is traditionally measured from plasma (PL), but the reliability of urine is uncertain. We assessed whether IFL excretion in overnight urine (OU) or spot urine (SU) reliably reflects IFLs in PL and the usefulness of the three matrices to determine soy intake compliance.

METHODS

In a randomized, double-blind, placebo-controlled soy intervention trial with 350 postmenopausal women, IFLs (daidzein, genistein, glycitein, equol, O-desmethylangolensin, dihydrodaidzein, dihydrogenistein) were analyzed by liquid chromatography/mass spectrometry in OU, SU, and PL collected at baseline and every 6 months over 2.5 years.

RESULTS

High between-subject intraclass correlations between all three matrices (median, 0.94) and high between-subject Pearson correlations (median r(OU-PL) = 0.80; median r(SU-PL) = 0.80; median r(OU-SU) = 0.92) allowed the development of equations to predict IFL values from any of the three matrices. Equations developed from a randomly selected 87% of all available data were valid because high correlations were found on the residual 13% of data between equation-generated and measured IFL values (median r(OU-PL) = 0.86; median r(SU-PL) = 0.78; median r(OU-SU) = 0.84); median absolute IFL differences for OU-PL, SU-PL, and OU-SU were 8.8 nmol/L, 10.3 nmol/L, and 0.28 nmol/mg, respectively. All three matrices showed highly significant IFL differences between the placebo and soy intervention group at study end (P < 0.0001) and highly significant correlations between IFL values and counted soy doses in the intervention group.

CONCLUSIONS

OU and SU IFL excretion reflect circulating PL IFL levels in healthy postmenopausal women accurately.

IMPACT

Noninvasively-collected urine can be used to reliably determine systemic IFL exposure and soy intake compliance.

Guidance from an NIH workshop on designing, implementing, and reporting clinical studies of soy interventions

The NIH sponsored a scientific workshop, "Soy Protein/Isoflavone Research: Challenges in Designing and Evaluating Intervention Studies," July 28-29, 2009. The workshop goal was to provide guidance for the next generation of soy protein/isoflavone human research. Session topics included population exposure to soy; the variability of the human response to soy; product composition; methods, tools, and resources available to estimate exposure and protocol adherence; and analytical methods to assess soy in foods and supplements and analytes in biologic fluids and other tissues. The intent of the workshop was to address the quality of soy studies, not the efficacy or safety of soy. Prior NIH workshops and an evidence-based review questioned the quality of data from human soy studies. If clinical studies are pursued, investigators need to ensure that the experimental designs are optimal and the studies properly executed. The workshop participants identified methodological issues that may confound study results and interpretation. Scientifically sound and useful options for dealing with these issues were discussed. The resulting guidance is presented in this document with a brief rationale. The guidance is specific to soy clinical research and does not address nonsoy-related factors that should also be considered in designing and reporting clinical studies. This guidance may be used by investigators, journal editors, study sponsors, and protocol reviewers for a variety of purposes, including designing and implementing trials, reporting results, and interpreting published epidemiological and clinical studies.

Overnight urinary excretion of isoflavones as an indicator for dietary isoflavone intake in Korean girls of pubertal age

Little is known about the bioavailability of isoflavones in children. Previous studies have shown that children excrete more isoflavone in urine compared with adults. Thus we examined the relationship between usual dietary isoflavone intake and the urinary excretion of isoflavonoids in Korean girls of pubertal age. Twelve girls each were selected from the lowest and the highest quartiles of isoflavone intake among 252 Korean girls aged 8–11 years. Age, BMI and sexual maturation stage were matched between the two groups. Dietary intakes for 3 d by diet record and overnight urine samples were collected at baseline and at 6 and 12 months. Total and individual isoflavone (daidzein, genistein and glycitein) intakes were calculated from diet records. The parent isoflavone compounds (daidzein, genistein and glycitein) and their metabolites (equol,O-desmethylangolensin (O-DMA), dihydrodaidzein and dihydrogenistein) present in the urine samples were analysed using liquid chromatography–MS. Intake levels of total and individual isoflavone compounds were significantly higher in the high isoflavone (HI) group than the levels in the low isoflavone (LI) group (P < 0·05). Urinary excretion of all isoflavone parent compounds was significantly higher in the HI group than in the LI group (P < 0·0001). Among isoflavone metabolites, onlyO-DMA and total metabolites were significantly different (P < 0·05). Total isoflavone intake was highly correlated with the urinary excretion of total parent compounds (r0·68;P < 0·01), parent compounds plus their metabolites (r0·66–0·69;P < 0·01) and total isoflavonoids (r0·72;P < 0·0001). In conclusion, overnight urinary excretion of total isoflavonoids is a reliable biomarker of usual isoflavone intake in Korean girls of pubertal age.

Urinary phytoestrogen excretion and prostate cancer risk: a nested case-control study in the Multiethnic Cohort

BACKGROUND

Phytoestrogens are of special interest in prostate cancer research because populations in Asia with a high consumption of phytoestrogens have a lower incidence of the disease than comparable populations in Western countries.

METHODS

This case-control study is nested within a large multiethnic cohort in Hawaii and California. Urine samples were analysed for daidzein, genistein, equol, and enterolactone among 249 incident prostate cancer cases and 404 controls matched on age, race/ethnicity, date/time of specimen collection, and fasting status.

RESULTS

The median excretion of daidzein was 0.173 nmol mg(-1) creatinine in cases and 0.291 in controls (P=0.01), and the median excretion of genistein was 0.048 in cases and 0.078 in controls (P=0.05). An inverse association was seen for daidzein overall (odds ratio for the highest vs lowest quintile=0.55, 95% confidence interval=0.31-0.98, P(trend)=0.03) and seemed to apply to localized (P(trend)=0.08) as well as advanced or high-grade cancer (P(trend)=0.09). This association was consistent across the four ethnic groups examined. Although the relationship was weaker for genistein, the odds ratios and trends were similarly inverse. Urinary excretion of equol and enterolactone was not significantly related to prostate cancer risk.

CONCLUSION

Our findings suggest that high intake of isoflavones, as reflected by urinary excretion of daidzein and genistein, may be protective against prostate cancer.

Apparent bioavailability of isoflavones after intake of liquid and solid soya foods

Isoflavone (IFL) intake may provide numerous health benefits, but IFL bioavailability differences among soya foods remains uncertain. Urinary IFL excretion (UIE) was shown to provide a reliable surrogate for systemic IFL exposure and therefore can be used as a measure of 'apparent bioavailability' (AB). We investigated the AB of IFL in fourteen healthy adults, consuming two liquid and two solid soya foods in a crossover designed study. Volunteers consumed the foods with a self-selected breakfast, which was kept identical for all four soya items (soya nuts, soya milk, soya protein bar and soya protein powder drink in water; average 23.7 mg IFL, 88-96 % glycosides, by HPLC analysis) and collected all urine up to 26 h. Liquid foods showed initially higher UIE values than solid foods, but this difference was considerably reduced or disappeared entirely after 24-26 h. Conclusive AB results were obtained only after 24-26 h; earlier collections were not reliable. At 26 h, adjusted UIE values for daidzein (DE) were 20 micromol in the milk and bar and 17 micromol for the nut and powder; urinary genistein excretion was the highest in the milk group (10 micromol) followed by the nut, bar (both 6 micromol) and powder groups (5 micromol); the UIE for glycitein was the highest for bars (4 micromol), followed by powder and nuts (3 micromol), and milk (2 micromol). DE makes the largest contribution to urinary total IFL. The AB of IFL was found to be variable depending on the analyte and soya food consumed.

Prostatic soy isoflavone concentrations exceed serum levels after dietary supplementation

BACKGROUND

The effects of soy isoflavones on prostate cancer may be concentration-dependent. The impact of soy supplementation on isoflavone concentrations in prostate tissues and serum remain unclear.

OBJECTIVE

To assess and compare concentrations of soy isoflavones in prostate tissue and serum among 19 men with prostate cancer who had elected to undergo radical prostatectomy.

METHODS

Participants were randomized to receive either daily soy supplements (82 mg/day aglycone equivalents) or placebos for 2 weeks (14 days) prior to surgery. Serum samples were obtained at the time of the surgery. Isoflavone concentrations were measured by HPLC/ESI-MS-MS.

RESULTS

The median (25th, 75th percentile) total isoflavone concentration in the isoflavone-supplemented group was 2.3 micromol/L (1.2, 6.9) in the prostate tissue and 0.7 micromol/L (0.2, 1.2) in the serum. Total isoflavone concentrations in this group were an average of approximately 6-fold higher in prostate tissue compared to serum; the tissue versus serum ratio was significantly lower for genistein than daidzein, 4-fold versus 10-fold, P = 0.003. Tissue and serum levels of isoflavones among the placebo group were negligible with a few exceptions.

CONCLUSIONS

The findings from the present study suggest that prostate tissue may have the ability to concentrate dietary soy isoflavones to potentially anti-carcinogenic levels.

Isoflavones in urine, saliva, and blood of infants: data from a pilot study on the estrogenic activity of soy formula

In the United States, about 25% of infant formula sold is based on soy protein, which is an important source of estrogenic isoflavones in the human food supply. Nevertheless, few studies report isoflavone levels in infants. We did a partly cross-sectional and partly longitudinal pilot study to examine children's exposure to isoflavones from different feeding methods. A total of 166 full-term infants between birth and 1 year of age were recruited into soy formula, cow milk formula, or breast milk regimens according to their feeding histories. A total of 381 urine, 361 saliva, and 88 blood samples were collected at 382 visits. We used automated online solid-phase extraction coupled to high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) for measuring three isoflavones (daidzein, genistein, and equol) in urine, and used similar LC/MS/MS techniques for saliva and blood spots. Concentrations of daidzein and genistein were undetectable in most blood or saliva samples from children fed breast milk or cow milk formula. The proportion of non-detectable values was somewhat lower in urine than in the other matrices. Concentrations of equol were detectable only in a few urine samples. For both daidzein and genistein, urine contained the highest median concentrations, followed by blood and then saliva. Urinary concentrations of genistein and daidzein were about 500 times higher in the soy formula-fed infants than in the cow milk formula-fed infants. The correlations between matrices for either analyte were strikingly lower than the correlation between the two analytes in any single matrix. We did not find significant correlations between isoflavone concentrations and the levels of certain hormones in children fed soy formula. Our results, based on much larger numbers of infants, strongly confirm previous reports, but whether phytoestrogens in soy formula are biologically active in infants is still an open question. We plan further longitudinal studies focusing on physical and developmental findings reflecting the effects of estrogen exposure.

Phytoestrogenic isoflavonoids in epidemiologic and clinical research

Isoflavones (IFLs) are natural products to which humans have been traditionally exposed predominantly through soy foods; more recently humans are also exposed to them through soy protein addition to processed foods or through supplements. They are structurally similar to steroidal estrogens and can exert estrogenic or antiestrogenic effects depending on their concentrations and on the tissue considered. These properties qualify IFLs to be classified as phytoestrogens and are believed to account for many of the biological effects observed for soy and/or IFL exposure including benefits for bone and heart health or prevention of menopausal symptoms and certain types of cancer. In order to evaluate the function of IFLs, alone or when exposure happens through soy intake, pharmacokinetics and bioavailability are critical issues to be considered in epidemiologic and clinical research. For this purpose precise, accurate, robust, fast, and affordable techniques for IFL analyses are required.

Dose-dependent absorption, metabolism, and excretion of genistein in rats

Genistein (4',5,7-trihydroxyisoflavone), a naturally occurring phenolic compound, possesses well-known preventive activity in breast and prostate cancer, cardiovascular diseases, and postmenopausal problems. The aim of this study is to investigate the distribution and dose-dependent absorption, metabolism, and excretion of genistein in rats. Genistein was orally administered to rats at different doses. At various time intervals, blood, bile, and urine samples were collected and incubated with glucuronidase to hydrolyze the glucuronidated genistein. Genistein was detected by HPLC. High levels of glucuronidated genistein were detected in the plasma, bile, and urine after genistein administration. When genistein was administered to rats at 6.25, 12.5, and 50 mg x kg (-1) doses, the AUC (0- t) values for genistein were 23.5, 80.9, and 177.9 mg x min x L (-1); the oral absolute bioavailabilities were 21.9, 33.5, and 19.0%; the AUC (0- t) values of glucuronidated genistein were 173.8, 470.7, and 1721.2 mg x min x L (-1), respectively. The cumulative biliary excretion of genistein respective to each dose was 42.6 +/- 6.5, 75.2 +/- 18.9, and 126.6 +/- 34.8 microg; the cumulative biliary excretion of glucuronidated genistein was 108.5 +/- 35.2, 423.5 +/- 158.3, and 853.7 +/- 320.8 microg for each dose, respectively. The cumulative urinary excretion of genistein was 34.8 +/- 10.8, 187.3 +/- 67.0 and 213.6 +/- 30.6 microg for each dose, respectively; the cumulative levels of glucuronidated genistein excreted in the urine were 217.8 +/- 52.1, 583.1 +/- 106.9, and 1108.4 +/- 88.1 microg, respectively. These results indicated that at high doses absorption, biotransformation, and excretion of genistein occurred in a nonlinear dose-dependent manner. Therefore, the results of these pharmacokinetic studies raise important questions about the therapeutic significance of consuming large quantities of genistein, genistein analogues, or soy-based neutraceuticals.

Effects of isoflavone supplements vs. soy foods on blood concentrations of genistein and daidzein in adults

The objective of this investigation was to examine the pharmacokinetics of isoflavone concentrations over a 24-h period among healthy adults consuming either soy foods or soy isoflavone tablets at different doses. This randomized, cross-over trial was conducted with 12 generally healthy adults. The three phases of the intervention included isoflavone tablets at (1) 144 mg/day or (2) 288 mg/day and (3) soy foods designed to provide a calculated 96 mg isoflavones/day (doses in aglycone equivalents). Doses were spread out over three meals per day. After 6 days on each study phase, plasma isoflavone concentrations were determined on the seventh day at 0, 4, 8, 10, 12 and 24 h. Average levels of total isoflavone concentrations at 8, 10 and 12 h were >4 micromol/L for the soy food phase and for the higher dose tablet phase. Genistein concentrations were higher overall in the soy food vs. both the lower and the higher dose supplement phases of the study (P<.05). When comparing plasma concentrations for the two doses of tablets, saturation appeared more evident for genistein than for daidzein at the higher dose level. In conclusion, we observed important differences in the pharmacokinetics of genistein and daidzein contrasting the sources and doses of isoflavones when administered three times daily, including a possible advantage for increasing serum concentrations of isoflavones from consuming soy foods relative to isoflavone supplements.

Oral antibiotics decrease urinary isoflavonoid excretion in children after soy consumption

How oral antibiotics (OABX) alter isoflavones (IFLs) in soy-consuming children is unknown. We evaluated OABX effects on urinary IFL excretion rates (UIERs) in 17 children, ages 4 to 17 yr, who provided 2 urine collections in pairs of a baseline urine and an overnight urine collection after consuming a body-weight-adjusted dose of soy nuts. The first collection was during OABX treatment for a bacterial infection and the second when healthy and off antibiotics. IFL food levels and UIERs were measured for nonmetabolites (NM), namely, daidzein, genistein (GE), and glycitein, and the metabolites (M) dihydrodaidzein, dihydrogenistein, equol, and O-desmethylangolensin (DMA), by liquid chromatography mass spectrometry. Urinary IFLs were hypothesized to change after OABX due to intestinal microflora alterations. A total of 11 children completed the study correctly. During OABX use, UIER (nmol/h/kg) for GE (6.4 +/- 1.0 vs. 10.1 +/- 1.6), all NM (27.5 +/- 4.8 vs. 36.2 +/- 4.7), and total IFLs (all NM + all M; 29.4 +/- 5.0 vs. 38.8 +/- 4.8) was reduced (P < 0.05) vs. when healthy. In contrast, a trend toward more DMA production during OABX was observed (1.2 +/- 0.6 vs. 0.4 +/- 0.3, P = 0.13). The reduction in urinary IFL appearance could be due to the changes of intestinal bacteria by OABX and/or due to processes related to the infection.

Pharmacokinetics of the soybean isoflavone daidzein in its aglycone and glucoside form: a randomized, double-blind, crossover study

BACKGROUND

There are conflicting results in the literature on the bioavailability of isoflavones in the aglycone and the glucoside forms.

OBJECTIVE

The objective was to investigate the pharmacokinetics of the soy isoflavone daidzein (DAI) on oral administration of both the aglycone and glucoside form in a human intervention study. In addition, the pharmacokinetics of the bacterial and oxidative metabolites of DAI was assessed.

DESIGN

Seven German men aged 22-30 y participated in a randomized, double-blind study in a crossover design. After ingestion of pure DAI or pure daidzein-7-O-beta-d-glucoside (DG) (1 mg DAI aglycone equivalent/kg body weight), blood samples were drawn before isoflavone administration and 1, 2, 3, 4.5, 6, 8, 10, 12, 24, and 48 h after the dose. Urine was collected before and 0-6, 6-12, and 12-24 h after the intake of the isoflavones. The concentrations of DAI and its major bacterial and oxidative metabolites in plasma and urine were measured with isotope dilution capillary gas chromatography-mass spectrometry.

RESULTS

The systemic bioavailability (area under the curve; AUC(inf)), the maximal plasma concentration (C(max)), and the cumulative recovery of DAI in urine after administration of DG were 3-6 times greater than after the ingestion of DAI. Except for equol, which was formed by only one volunteer, all other quantified metabolites exhibited 2-12 times greater AUC(inf), C(max), and urinary recoveries after consumption of DG.

CONCLUSION

Our results show that DG exhibits a greater bioavailability than its aglycone when ingested in an isolated form.

The relation of soy intake and isoflavone levels in nipple aspirate fluid

Given the possible breast cancer preventive effects of isoflavones, substances with an estrogen-like structure occurring in soybeans, it is of interest to assess levels directly in the breast. The objective of this pilot study was to measure isoflavones in nipple aspirate fluid. In a pilot study with 11 women, nipple aspirate fluid and urine samples were collected at baseline and after 1 month of consuming two servings of soymilk per day. In a parallel investigation, one woman donated nipple aspirate fluid, blood, and urine on the same day after consuming different amounts of soy for 9 days. Nipple aspirate fluid was collected with an aspirator, diluted 1 : 11, and stored at -20 degrees C. Isoflavonoids in nipple aspirate fluid, serum, and urine were liquid-liquid extracted after enzymatic hydrolysis followed by liquid chromatography electrospray ionization high resolution tandem mass spectrometry analysis using triply C labeled internal isoflavonoid standards. After the 30-day soy intervention, median nipple aspirate fluid yield changed very little (P=0.47), whereas urinary isoflavonoid excretion (P=0.04) and isoflavonoid levels in nipple aspirate fluid (P=0.12) increased substantially. For the nine samples collected in one participant, isoflavonoids measured in nipple aspirate fluid, plasma, and urine were highly correlated with the number of daily soy servings and with each other. This pilot study indicates that isoflavonoids in nipple aspirate fluid are 10 times lower than in plasma and are closely related to levels of isoflavonoids in urine and plasma. These findings show that isoflavonoids are present in breast fluid and may act directly on breast tissue.

Isoflavones in children and adults consuming soy

Soy and their isoflavones (IFLs) are believed to protect against breast cancer, particularly when exposure occurs during childhood. Little is known about the bioavailability of IFLs in children and how this is affected by oral antibiotics (OABX). We measured IFLs by LC/MS and found that the urinary IFL excretion rate (UIER) reflects circulating IFLs accurately when area-under-curve (AUC) and identical time intervals are used (r=0.93; p<0.001). UIER in children and adults was determined when healthy and when on OABX by collecting urine in pairs of baseline and overnight specimen before and after consuming soy nuts, respectively. Compared to when healthy, children on OABX showed significantly decreased UIER but adults on OABX showed increased UIER (p<0.05). All 37 healthy children showed significantly higher UIERs compared to all 34 healthy adults. UIER is an adequate surrogate for determining IFL bioavailability and for measuring soy or IFL exposure in epidemiologic and other studies.

Urinary isoflavonoid excretion is similar after consuming soya milk and miso soup in Japanese-American women

Based on the hypothesis that isoflavones are absorbed more efficiently from fermented than from non-fermented soya foods, we compared the urinary isoflavonoid excretion (UIE) after intake of miso soup or soya milk. We recruited twenty-one women with Japanese ancestry who consumed standardized soya portions containing 48 mg isoflavones. On day 1, half the women consumed soya milk, the other half started with miso soup. On day 3, the subjects ate the other soya food and on day 5, they repeated the first food. Each participant collected a spot urine sample before and an overnight urine sample after soya food intake. All urine samples were analysed for daidzein, genistein and equol using LC-MS and were expressed as nmol/mg creatinine. We applied mixed models to evaluate the difference in UIE by food while including the baseline values and covariates. Relative to baseline, both groups experienced significantly higher UIE after consuming any of the soya foods. We observed no significant difference in UIE when soya milk was compared to miso soup (P = 0.87) among all women or in the seven equol producers (P = 0.88). Repeated intake of the same food on different days showed high reproducibility within subjects. These preliminary results indicate similar UIE after consuming a fermented soya food (miso) as compared to a non-fermented soya food (soya milk). Therefore, recommendations favouring fermented soya foods are not justified as long as the intestinal microflora is capable of hydrolysing the isoflavone glucosides from non-fermented soya foods.

Higher bioavailability of isoflavones after a single ingestion of a soya-based supplement than a soya-based food in young healthy males

Soya isoflavones, genistein and daidzein, are the focus of numerous studies investigating their potential effects on health and results remain controversial. Bioavailability is clearly a crucial factor influencing their bioefficacy and could explain these discrepancies. This study aimed at assessing: (1) the isoflavone content of sixty-nine European soya-derivative products sold on the French market; (2) the bioavailability of isoflavones comparing supplement with food. Twelve healthy volunteers were recruited in a randomized two-way crossover trial and received 35 mg isoflavones equivalent aglycone either through supplements or through cheese, both containing different patterns of isoflavone conjugates and different daidzein:genistein ratios. A specific ELISA method was used to assess the plasma and urinary concentrations of isoflavones and thus the pharmacokinetic parameters, which were then normalized to mg of each isoflavone ingested. Results showed that the normalized Cmax of daidzein (P = 0.002) and similarly the normalized AUC0 --> infinity and Cmax of genistein (P = 0.002) from soya-based capsules were higher than that from soya-based cheese. In conclusion, this work completes studies on isoflavone bioavailability and presents new data regarding isoflavone concentrations in soya-derivative products. Assuming that isoflavone conjugation patterns do not influence isoflavone bioavailability, this study shows that isoflavones contained in capsules are more bioavailable than those contained in soya-based cheese. Although the supplement is more bioavailable, the relative importance of this is difficult to interpret as there is little evidence that supplements are biologically active in human subjects to date and further studies will be necessary for this specific supplement to prove its efficacy.

Urinary isoflavones are increased in adults, but decreased in children, consuming soy when on oral antibiotic therapy

The goal of this study was to evaluate how oral antibiotics (OABX) change the appearance of isoflavones (IFLs) in adults and children after soy consumption. The urinary IFL excretion rate (UIER) known to reflect circulating IFLs was hypothesized to change due to intestinal microflora changes by OABX. Subjects provided urine collections in pairs of a baseline urine and an overnight urine before and after consuming soy nuts first during OABX treatment and then again when healthy. During OABX versus when healthy, UIER (nmol/h/kg) in adults (n = 12) was increased (P < 0.05) for daidzein (35.2 +/- 7.2 vs. 18.9 +/- 2.4), daidzein + genistein + glycitein [nonmetabolites (NM); 42.6 +/- 8.0 vs. 23.6 +/- 2.9), and total isoflavonoids (Total IFLs; daidzein + genistein + glycitein + dihydrodaidzein + dihydrogenistein + equol + O-desmethylangolensin) (51.5 +/- 10.3 versus 29.6 +/- 4.7). In contrast, children (n = 7) showed reduced UIER (P < 0.05) when on OABX versus when healthy for daidzein (36.3 +/- 6.4 vs. 46.8 +/- 4.7), dihydrodaidzein (1.2 +/- 0.6 vs. 3.0 +/-1.1), NM (46.3 +/- 8.2 vs. 59.5 +/- 6.0), dihydrodaidzein + dihydrogenistein + equol + O-desmethylangolensin (1.0 +/- 0.8 vs. 4.3 +/- 1.3), and Total IFLs (48.2 +/- 8.5 vs. 63.8 +/- 6.4).

Molecular and pharmacodynamic properties of estrogenic extracts from the traditional Chinese medicinal herb, Epimedium

The Chinese medicinal herb, Epimedium, used traditionally for bone health exerts estrogenic activity (EA) in vitro. A genetically characterized Epimedium brevicornum (EB) extract induced biphasic responses in the mRNA and protein expression of the estrogen-regulated progesterone receptor gene in breast cancer (MCF-7) cells. These changes were mirrored changes in estrogenic receptor (ERalpha) content. In male Sprague-Dawley rats, administration of the estrogenic prodrug, estradiol valerate increased area-under-curve of serum effects for ERalpha (AUC difference: 18,900EA(ERalpha) min; 95% CI: 0-37,800; p = 0.05) and breast cancer cell (MCF-7) growth (AUC difference: 30,200EA(MCF-7) min; 95% CI: 24,200-36,200; p<0.001), compared to placebo. Oral administration of Epimedium brevicornum increased ERalpha activity (1320EA(ERalpha) min, p<0.01). Our data indicate that estrogen-responsive bioassays can measure the pharmacokinetic/pharmacodynamics of estrogenic activity in serum. Epimedium brevicornum extract increases estrogenic activity in serum and human studies are required to evaluate whether Epimedium extracts have utility for estrogen replacement therapy.

The bioavailability and disposition kinetics of genistein in cats

The absorption and disposition kinetics of the soy isoflavone genistein were determined in cats (n = 6). An oral dose of 100 mg/kg was administered, which has previously been demonstrated to be the minimum oral estrogenic dose, and was administered intravenously at a dose of 20 mg/kg, being the largest practical dose that could be safely administered. Plasma free, and total (conjugated + free) genistein concentrations were determined by HPLC following organic extraction. Noncompartmental analysis revealed a half-life of 21.67 +/- 7.9 h (free) and 9.95 +/- 2.7 h (conjugated), volume of distribution 31.94 +/- 10.38 L/kg (free) and 11.82 +/- 3.96 L/kg (conjugated) following intravenous administration. Following oral administration the half-lives were determined to be 17 +/- 4.8 h (free) and 8.56 +/- 4.65 h (conjugated), with tmax = 4.4 +/- 0.6 h (free) and 4.42 +/- 0.99 h (conjugated), and Cmax = 0.276 +/- 0.1 microg/mL (free) and 6.24 +/- 6.58 microg/mL (conjugated). Oral bioavailabilities were 1.379 +/- 0.9% (free) and 29.85 +/- 22.61% (conjugated). The ratio of total:free genistein ranged from 25.9 to 5.5. Poor oral absorption and efficient conjugation explain the low bioavailability of free genistein. Accumulation of genistein in peripheral lipophilic compartments may occur.

Isoflavones from soya foods are more bioavailable in children than adults

The purpose of the present study was to determine whether children experience a higher systemic exposure to isoflavonoids when consuming a body weight-adjusted dose of soya compared with adults. Forty study participants were recruited from a local Waldorf school, including twenty-one children and nineteen adults. Participants collected a baseline urine sample and ate immediately thereafter a body weight-adjusted dose of soya nuts (15 g/54.4 kg equivalent to 0.615 (SD 0.036) mg total isoflavones/kg) followed by a 12 h urine collection. Nineteen children and eighteen adults completed the protocol correctly (fourteen child-parent pairs). Children, compared with adults, showed a statistically significant (P < 0.05 by unpaired t test) higher urinary isoflavone excretion rate for daidzein (+39%), genistein (+44%), all non-metabolites (daidzein + genistein + glycitein; +41%) and total isoflavonoids (+32%). Isoflavones are more bioavailable in children v. adults. Urine is an excellent medium to determine systemic isoflavone exposure in children due to its non-invasiveness and high compliance, in particular when collected overnight; it also allows evaluation of completeness of specimen collection.

Bone mass and soy isoflavones in socially housed, premenopausal macaques

BACKGROUND

Soy consumption is associated with a lower incidence of hip fracture in Asian than in Western women, an effect often attributed to estrogen-like compounds (isoflavones) in soy. It is not known whether premenopausal soy exposure initiated in adulthood can increase bone mass and thereby reduce fracture risk.

OBJECTIVE

We aimed to determine whether a high-isoflavone soy diet influences bone mass in soy-naïve, premenopausal cynomolgus monkeys (Macaca fascicularis).

DESIGN

Ninety-four skeletally mature females were randomly assigned to consume diets whose protein content came from either high-isoflavone soy or casein and lactalbumin. Animals were socially housed. Bone mass and circulating isoflavone concentrations were measured at baseline and 19 and 31 mo after the start of treatment; bone biomarkers were measured at baseline and 31 mo.

RESULTS

There were no significant differences at any timepoint in whole-body bone mineral content between casein-fed (112.5 +/- 2.1, 119.2 +/- 1.9, and 120.7 +/- 2.1 g) and soy-fed (117.2 +/- 2.1, 122.4 +/- 2.0, and 125.4 +/- 2.3 g; P=0.12) monkeys. Similar results were seen for spinal bone mineral density (casein-fed: 0.46 +/- 0.01, 0.50 +/- 0.01, and 0.52 +/- 0.01 g/cm(2); soy-fed: 0.47 +/- 0.01, 0.51 +/- 0.01, and 0.52 +/- 0.01 g/cm(2); P=0.30) and bone biomarker measurements-bone-specific alkaline phosphatase (soy-fed: 82.3 +/- 4.1 and 63.2 +/- 3.4 ng/mL; casein-fed: 94.1 +/- 4.5 and 61.7 +/- 4.3 ng/mL; P=0.22) and C-terminal crosslink of type 1 collagen (soy-fed: 0.944 +/- 0.06 and 0.89 +/- 0.08 nmol/L; casein-fed: 0.97 +/- 0.07 and 0.78 +/- 0.06 nmol/L; P=0.20).

CONCLUSION

A soy diet high in isoflavones does not significantly affect bone characteristics in initially soy-naïve premenopausal monkeys.

Isoflavonoid glucosides are deconjugated and absorbed in the small intestine of human subjects with ileostomies

BACKGROUND

Although soy isoflavonoids have a number of health-promoting benefits, information concerning the sites of their absorption and metabolism in humans remains limited. Isoflavonoid absorption from the gut requires deconjugation of glucosides to aglycones.

OBJECTIVE

The objective was to investigate the role of the small intestine in isoflavonoid absorption and metabolism in humans.

DESIGN

Human subjects with fully functional gastrointestinal tracts (n = 6) and ileostomy subjects (n = 6) were fed a single soy meal containing 64.8 mg isoflavonoid aglycone equivalents (95% as glucosides). Metabolism of isoflavonoids in the upper gastrointestinal tract was examined by analyzing ileal effluent from ileostomy subjects, and absorption was assessed indirectly by quantifying isoflavonoids and several metabolites in 24-h urine pools.

RESULTS

Chyme contained 36.7% of ingested isoflavonoid aglycone equivalents, primarily (95.8%) as aglycones. Qualitative profiles (x +/- SEM) of isoflavonoid excretion in urine (daidzein > glycitein > genistein) and the quantity of isoflavonoid equivalents were not significantly different between the control (18.4 +/- 2.2 mg) and ileostomy (13.5 +/- 3.2 mg) subjects. Dihydrodaidzein was present in the urine of all subjects, although the amount excreted by ileostomy subjects was less than that excreted by the control subjects. The percentage of producers and mean quantities of dihydrogenistein, equol, and O-desmethylangolensin in the urine of ileostomy subjects also were lower than those of control subjects.

CONCLUSIONS

Ileostomy subjects efficiently deglycosylate isoflavonoid glucosides in the small intestine and appear to absorb aglycones with an efficiency comparable with that of control subjects. However, the production of microbial metabolites of isoflavonoids is limited in ileostomy subjects.

Puerarin, an isoflavonoid derived from Radix puerariae, potentiates endothelium-independent relaxation via the cyclic AMP pathway in porcine coronary artery

Puerarin, an isoflavonoid derived from the Chinese medicinal herb Radix puerariae, has been suggested to be useful in the management of various cardiovascular disorders. The present study examined the effect of acute exposure (30 min) to puerarin on vascular relaxation. Rings from porcine coronary artery of either sex were used. The highest concentration of puerarin (100 microM) produced a small but statistically significant relaxation of U46619-contracted rings. Vascular relaxations were also studied in the presence of lower concentrations of puerarin (0.1, 1 and 10 microM) which had no direct relaxation effect. Puerarin enhanced vasorelaxation to endothelium-independent relaxing agents, sodium nitroprusside and cromakalim. However, puerarin had no effect on vasorelaxation induced by endothelium-dependent relaxing agents, bradykinin and calcium ionophore A23187. The potentiating action of puerarin (10 microM) on sodium nitroprusside-mediated relaxation was not affected by the nitric oxide synthase inhibitor, N(omega)-nitro-L-arginine methyl ester (L-NAME; 300 microM), or by the disruption of the endothelium with Triton X-100. The effect of puerarin was reversible following a washout period. The potentiating effects were comparable with the 3'-5'-cyclic adenosine monophosphate (cyclic AMP) analogues, 8-bromoadenosine-3'-5'-cyclic monophosphate (8-Br-cyclic AMP; 10 muM) and Sp-isomer [S nomenclature refers to phosphorus] of adenosine-3', 5'-cyclic monophosphorothioate (Sp-cyclic AMPS; 3 microM), but not the 3'-5'-cyclic guanosine monophosphate (cyclic GMP) analogue, 8-bromoguanosine-3'-5'-cyclic monophosphate (8-Br-cyclic GMP; 3 microM). The cyclic AMP antagonist, Rp-isomer [R nomenclature refers to phosphorus] of 8-bromoadenosine-3', 5'-cyclic monophosphorothioate (Rp-8-Br-cyclic AMPS; 10 microM), but not cyclic GMP antagonist, Rp-isomer of 8-bromoguanosine-3', 5'-cyclic monophosphorothioate (Rp-8-Br-cyclic GMPS; 10 microM), reversed the effects of puerarin (10 microM) on the enhancement of vasorelaxation to sodium nitroprusside. Our results demonstrated that puerarin enhanced sodium nitroprusside-induced relaxation, possibly via the cyclic AMP-dependent pathway.

Isoflavones in breastfed infants after mothers consume soy

BACKGROUND

The bioavailability of isoflavones in children after soy exposure is uncertain.

OBJECTIVE

We aimed to compare isoflavone patterns in infants exposed to isoflavone-containing breast milk (BF), in tofu-fed (TF) infants, and in mothers consuming a soy beverage.

DESIGN

Eighteen nursing mothers who were not feeding soy foods to their infants consumed one daily serving of a soy protein beverage for 2-4 d and collected their own milk and urine and infant urine. Plasma was collected from infants if venous blood draws were ordered by pediatricians. Blood and urine were collected from additional children after they consumed tofu. Isoflavones were measured by liquid chromatography-mass spectrometry.

RESULTS

In 7 subjects, isoflavone values increased significantly from baseline after mothers ate soy: in maternal urine (x +/- SEM) from 18.4 +/- 13.0 to 135.1 +/- 26.0 nmol/mg creatinine, in breast milk from 5.1 +/- 2.2 to 70.7 +/- 19.2 nmol/L, and in infant urine from 29.8 +/- 11.6 to 111.6 +/- 18.9 nmol/mg creatinine. The mean isoflavone concentration in plasma obtained from 11 BF infants was 19.7 +/- 13.2 nmol/L. TF infants had much higher mean isoflavone values (urine, 229 +/- 129 nmol/mg creatinine; plasma, 1049 +/- 403 nmol/L). Statistically significant correlations were observed between the types of fluids investigated within mothers, between mothers and infants, and within infants. Urinary isoflavone excretion per hour adjusted for dose per body weight was 81% lower for BF infants and 24% higher for TF infants than for their mothers after eating soy.

CONCLUSIONS

More isoflavones appear in children than in adults after adjustment for isoflavone intake. Systemic isoflavone exposure in infants can be determined by urinary analysis.

Bioavailability of isoflavones after ingestion of soy beverages in healthy adults

It is unknown whether the bioavailability of isoflavones is affected by the concomitant ingestion of glucosides or aglycones. This study was designed to investigate the effects of soymilk-based beverages containing different types of isoflavones on their absorption, excretion, and metabolism. Twelve healthy volunteers consumed 3 kinds of soymilk: untreated soymilk, beta-glucosidase-treated soymilk, and fermented soymilk. Blood samples were collected after 0, 1, 2, 3, 4, 5, 6, 7, 8, and 24 h. Urine samples were collected from 0 to 48 h. Concentrations of isoflavones and daidzein metabolites in serum and urine were measured by liquid chromatography-mass spectrometry. After the ingestion of soymilk, the total concentration of isoflavones in serum rose slowly and reached a maximum of 0.94 +/- 0.39 micromol/L at 6.0 +/- 1.2 h. However, beta-glucosidase-treated soymilk and fermented soymilk increased the serum isoflavone concentration significantly more quickly with maximum concentrations at 1.0 h of 1.75 +/- 0.33 micromol/L and 2.05 +/- 0.32 micromol/L, respectively. The urinary excretion of isoflavones after ingesting of these aglycone-enriched preparations was significantly greater than after consumption of untreated soymilk up to 8 h after injection, but not thereafter. The total and individual concentrations of isoflavones in serum and urine did not differ when subjects consumed the 2 aglycone-enriched soymilks. However, in equol producers (n = 5), the ingestion of ESM tended to increase urinary excretion of equol compared with the consumption of FSM (P = 0.08). These results demonstrated that the isoflavone aglycones of soymilk were absorbed faster and in greater amounts than their glucosides in healthy adults and that the metabolism of isoflavones might be affected by the type of soymilk consumed.

Urinary isoflavonoid excretion and soy consumption in three generations of Japanese women in Hawaii

OBJECTIVE

To explore soy intake and urinary isoflavonoid excretion within several generations of American-Japanese women based on the hypothesis that earlier generations excrete higher levels of urinary isoflavonoids, in particular the metabolite equol, than later generations.

SUBJECTS

A convenience sample of 43 women from 19 families aged 18-78 years, all of whom reported at least 50% Japanese ancestry.

INTERVENTIONS

Each woman collected overnight urine samples at baseline and after consuming one serving of soymilk, both samples were analyzed for the isoflavonoids daidzein, genistein and equol using liquid chromatography-mass spectrometry.

RESULTS

Median isoflavone intakes during the last year were 7.2 mg/day for the first generation, 7.3 mg/day for the second generation and 6.3 mg/day for the third generation (P=0.36). At baseline, the median isoflavonoid excretion for the first generation was nonsignificantly higher than for later generations (190, 86 and 42 nmol/h; P=0.20) but after intervention, the median urinary isoflavonoid excretion was very similar for the three groups: 2465, 1895 and 2775 nmol/h (P=0.70). Following intervention, a nonsignificantly higher proportion of older than younger women (53 vs 32 and 33%; P=0.41) excreted the metabolite equol. The respective median equol excretion rates by generation following intervention were 39.5, 4.2 and 3.5 nmol/h (P=0.04).

CONCLUSIONS

This small investigation among three generations of Japanese-Americans detected a higher equol production among older women after a soy challenge, but no difference in the excretion of total isoflavonoids after a standardized dose of soymilk was observed.

Pharmacokinetic Profile of the Isoflavone Puerarin After Acute and Repeated Administration of a Novel Kudzu Extract to Human Volunteers

OBJECTIVES

This study was undertaken to assess the pharmacokinetic profile of puerarin, the major isoflavone found in a kudzu (Pueraria lobata) extract after acute and repeated administration.

METHODS

Participants were given either single or repeated doses of kudzu extract, and blood samples were collected for either 8 or 72 hours for subsequent pharmacokinetic analyses of puerarin.

RESULTS

Using WinNonlin pharmacokinetic data analysis software, puerarin was found to be rapidly absorbed via the oral route, reach peak levels at 2 hours, and have a half-life of approximately 4.3 hours. The elimination half-life was not significantly altered after repeated administration.

CONCLUSIONS

A formulation of kudzu extract delivers a large amount of the principal isoflavone in a rapid manner. The elimination rate constants and the mono-exponential decline in blood levels suggest that a one compartment model adequately explains how puerarin is handled by the body. Three times a day dosing is recommended as accumulation will not occur, and plasma levels remain at levels that are biologically active, even 8 hours after the last steady-state dose.

Optimizing dough proofing conditions to enhance isoflavone aglycones in soy bread

Native beta-glucosidase activity in soy bread can convert isoflavone glucosides to aglycones during proofing, and this study determined the time-temperature dependence of this process. Samples were taken every hour for 4 h during proofing at 22, 32, and 48 degrees C to determine beta-glucosidase activity and isoflavone profiles of the dough. After 1-2 h, the beta-glucosidase activity increased 43-84% achieving a plateau value at 22 degrees C but declining when proofed beyond 2 h at 32 degrees C and 48 degrees C. Large increases in aglycones and corresponding decreases in the simple glucosides were observed during proofing. The level of malonyl-glucosides decreased 3-15%, and acetyl-glucosides were fairly constant. The two higher temperatures drove more rapid conversion: 70-73% of simple glucosides in 2-4 h. The extent of conversion in the early proofing periods corresponded to beta-glucosidase activity. The optimum time-temperature protocol was 2 h at 48 degrees C resulting in a rapid, high conversion.