Beyond the Cholesterol-Lowering Effect of Soy Protein: A Review of the Effects of Dietary Soy and Its Constituents on Risk Factors for Cardiovascular Disease
Abstract
:1. Introduction
2. Epidemiological Studies
3. Interventional Studies Involving Soy
3.1. Blood Pressure Lowering Effect of Soy
3.2. Blood Glucose Lowering Effect of Soy
3.3. Non-Protein Effects of Soy on Blood Lipids
3.4. Effects of Soy on Inflammation and Obesity
4. Contribution of Soy Based Foods to Satiety
5. Conclusions
Acknowledgments
Author Contributions
Conflicts of Interest
Abbreviations
AUC | area under the curve |
BMI | body mass index |
cAMP | cyclic adenosine monosphosphate |
CHD | coronary heart disease |
CRP | C-reactive protein |
CVD | cardiovascular disease |
FBG | fasting blood glucose |
HDL-C | high density lipoprotein cholesterol |
HOMA-IR | homeostatic model assessment of insulin resistance |
LDL-C | low density lipoprotein cholesterol |
LDLR | low density lipoprotein cholesterol receptor |
oxLDL | oxidized LDL cholesterol |
MetS | metabolic syndrome |
NO | nitric oxide |
ODMA | O-desmethylangolensin |
PPAR | peroxisome proliferator activated receptor |
PKA | protein kinase A |
RCT | randomized controlled trial |
ROS | reactive oxygen species |
TC | total cholesterol |
TNF-α | tumor necrosis factor alpha |
TG | triglycerides |
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Food | Arginine | Lysine | PDCAAS 2 |
---|---|---|---|
Soy protein isolate | 6670 | 5327 | 1.00 |
Peanuts, dry-roasted | 2832 | 850 | 0.52 |
Almonds, dry-roasted | 2444 | 563 | 0.23 |
Black beans, boiled | 549 | 608 | 0.75 |
Milk, 2% (cow) | 94 | 276 | 1.00 |
Egg, hard-boiled | 755 | 904 | 1.00 |
Beef, chuck, braised | 2054 | 2748 | 0.92 |
Study | Sample Size & Population | Duration | Treatment | Dose; Format | Results | Conclusions |
---|---|---|---|---|---|---|
[89] | 389 osteopenic postmenopausal women | 2 years, parallel RCT | Genistein extract with calcium and Vitamin D3 supplement compared to placebo | Purified supplement (54 mg/day) | Significant reductions in FBG, insulin, HOMA-IR, fibrinogen, F2-isoprostanes, soluble intercellular adhesion molecule-1, and soluble vascular cellular adhesion molecule-1 | Genistein supplements improve markers of glycemic control and other markers of CVD risk |
[97] | 42 postmenopausal women with MetS | 8 weeks, randomized crossover trial | Control diet (Dietary Approaches to Stop Hypertension, DASH); DASH diet with red meat replaced with soy nuts; DASH diet with red meat replaced with soy protein | 30 g soy nut = 1 serving read meat; 30 g soy protein = 1 serving red meat. Normal diet for 3 weeks followed by all 3 diets for 8 weeks each, with 4-week washout period in between each diet | Soy nuts reduced HOMA-IR and fasting plasma glucose more than soy protein (p < 0.01 for both factors) and control (p < 0.01 for both factors) | Soy nuts have greater role in attenuating blood glucose response markers compared to soy protein in postmenopausal women with MetS |
[96] | 75 women with MetS, age 60–70 | 12 weeks, parallel RCT | Soy nuts; textured soy protein (TSP) | 35 g/day soy nut; 35 g/day textured soy protein | Compared to control, serum FBG, HOMA-IR and insulin were lower in soy-nut group (p < 0.05, p < 0.1, p < 0.05) and the mean changes were higher in soy nut group vs. TSP (p < 0.001) | Soy nut leads to greater reductions in markers of glycemic control than soy protein |
[88] | 203 postmenopausal women, age 48–62. | 1 year parallel RCT | Calcium tablet with isoflavones | 40 or 80 mg isoflavones/day compared to calcium with 0 mg isoflavones | Both treatment groups significantly lowered FBG. No dose-response effect. No effect on lipids | Isoflavone supplementation favourably influences FBG in postmenopausal women |
[90] | 180 postmenopausal women with hyperglycemia | 6 months parallel RCT | Soy protein isolate with or without isoflavone conjugates | 15 g soy protein and 100 mg isoflavones, 15 g milk protein and 100 mg isoflavones, or 15 g milk protein | No significant improvements in fasting and 2-h postload glucose, fasting and postload insulin, glycated serum protein, HOMA-IR. and beta-cell function | Soy protein isolate with or without isoflavones does not improve glycemic control and insulin sensitivity |
[99] | 20 healthy males and females | 1 day; within-subject design with 1 week intervals in between interventions | Intervention (1) Bar-type cake made of whole soy powder; (2) cooked paddy-rice; (3) cooked paddy rice with whole soy powder cake | 114 g whole soy powder cake containing 50 g carbohydrates, 144 g cooked paddy-rice containing 50 g carbohydrates; 144 g cooked paddy-rice with 60 g whole soy powder sake | (1) Blood glucose and insulin levels were lower than control (2) Blood was lower, while insulin levels were increased slightly | Postprandial blood glucose and insulin response may be improved with whole soy powder food; beneficial effects of combining soy products with carbohydrate-rich foods are less clear |
[87] | 120 postmenopausal women with Metabolic Syndrome (60 received treatment; 60 received placebo) | 1 year, randomized, double-blind, placebo-controlled trial | Genistein | 54 mg/day in 2 tablets | Fasting blood glucose, fasting insulin and HOMA-IR were significantly decreased in the treatment group (p < 0.001) | Soy isoflavone, genistein, significantly lowers hyperglycemia and reduces insulin resistance |
[98] | 10 type 2 diabetes patients in the 80 kcal meal tolerance test (Study 1); 11 diabetic patients in the 592 kcal meal tolerance test (Study 2) | 1 day, crossover study | Soybean nutrition bar | Study 1: 1 soybean nutrition bar containing 7.0 g carbohydrates, 4.3 g fat, 1.9 g fiber, 2.7 g protein, 8.2 mg isoflavones Study 2: 4.3 soybean nutrition bars, each containing 50.9 g carbohydrates, 31.3 g fat, 14.4 g fiber, 19.6 g protein, 14 mg isoflavones | Blood glucose was lower in both studies with the soybean nutrition bar intervention (p < 0.001); Insulin AUC was lower than the control in study 2 only; no significant changes in blood TGs and non-esterified fatty acids between treatment and control groups in either study | Soybean nutrition bars may have a role in preventing postprandial hyperglycemia in patients with type 2 diabetes compared to isocaloric cookies |
[91] | 165 women with impaired glucose regulation, aged 30–70 | 24 week parallel RCT | Soy protein with or without daidzein or genistein extract | 10 g soy protein without isoflavones, or with 50 mg daidzein, or 50 mg genistein | No significant changes in FBG, 2-h glucose, HbA1c, fasting, and 2-h insulin, AUC of glucose and insulin. | Purified extracts of daidzein and genistein do not improve glycemic control and insulin sensitivity |
Study | Sample Size & Population | Duration | Treatment | Dose; Format | Results | Conclusions |
---|---|---|---|---|---|---|
[146] | 25 abdominally obese men and women | 12 weeks, parallel RCT | Soy protein meal replacement | 4 replacement meals/day: 44 g soy protein, 60–135 mg isoflavones/day | No significant variations in body composition (including weight, BMI, % fat and % lean mass) or cardiometabolic risk factors were observed in the soy replacement meal compared to control | Soy protein affects weight loss to same extent as other proteins |
[28] | 39 overweight and obese adults | Daily breakfast for 12 weeks | Soy fiber supplemented biscuits | 100 g soy fiber/day | LDL-C, TC and BMI decreased after 12 weeks (p < 0.05) | Soy fiber supplementation may help in weight management and lowering cholesterol levels |
[144] | 45 patients with non-alcoholic fatty liver disease | 8 weeks, parallel RCT | 3 diets: low-calorie; low- calorie, low carbohydrate; low-calorie, low soy diet | 30 g soy nuts containing: 7 g fat, 9 g fiber, 11.3 g protein, 10 mg sodium, 102 mg phytoestrogens | Soy group had greatest decline in serum liver enzymes and fibrinogens, and malondialdehyde. There were no changes in BMI or weight between the two groups | Soy may mitigate inflammation when combined with a low-calorie diet, but may not affect weight loss in those with non-alcoholic fatty liver disease. |
[158] | 11 overweight and obese men | 1 day, parallel RCT | Soy protein breakfast meal replacement, followed by standardized lunch 4 h later | Meal replacement, containing 28.7 soy protein (34.6 g total protein), 19.8 g carbohydrate | Meal replacement group had lower glucose levels, glucose and insulin AUC, ghrelin concentrations following breakfast; Fat oxidation was lower after lunch | Soy protein could have a potential hypoglycemic effect, as well as mediating metabolic risk factors and improving weight management |
[150] | 380 women, BMI of 30–40 kg/m2, 76 of whom took the soy meal replacement | 12 months, with meal replacement taken for a maximum of 3 months (most did so during first 3 months of study) | Soy-based meal replacement (in addition to baseline lifestyle program administered to both control and treated groups) | Soy-yogurt-honey product: 83% soy-protein isolate, 17% milk protein | Weight loss was greater in meal replacement group (p = 0.1); health-related quality of life scores also increased more compared to control | Soy protein consumption may enhance weight loss when combined with a lifestyle intervention program focusing on diet and physical activity |
[149] | 64 overweight/obese subjects | 12 weeks, parallel RCT | Black soy peptide (BSP) supplementation | 4.5 g/day in tablet form | After 12 weeks, BSP group had statistically significant decrease in body weight, body fat mass, body fat % and plasma leptin (vs. no change in placebo); no change in inflammatory markers or lipid profiles between groups | Black soy peptide seems to have a role in weight and fat mass regulation in overweight subjects, perhaps by altering leptin levels |
[156] | 116 healthy men and women | 6 weeks, parallel RCT | Soy muffins (vs. control wheat muffins) | 12.5 g soy protein muffin; 2 muffins/day | Higher fullness scores in soy muffin group on a Visual Analog Scale (p = 0.002) vs. control group | Replacing wheat flour with soy flour may increase perceived satiety |
[145] | 38 obese men and women | 8 weeks, parallel RCT | Whole soy powder bar (vs. wheat control) | 1 bar eaten 1–2 h before dinner daily | Compared to control, soy group had lower BMI, waist circumference and body fat % (p < 0.05). No significant differences in weight loss, TC, LDL = C, or insulin were found between the two groups | Whole soy can complement the benefits of a weight-loss program; whether it does so by mediating glycemic response remains unclear based on this study. |
[147] | 48 obese Japanese adults | 20 weeks, parallel RCT | Soy protein | Soy protein intervention containing 12 g soy protein, 9 g milk protein; consumed at breakfast | Visceral and subcutaneous fat, body weight and BMI decreased significantly after 20 weeks of milk protein ingestion, but not after ingestion of soy protein containing milk protein | Milk protein has a more substantial impact on markers of weight loss compared to a combination of milk and soy protein |
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Ramdath, D.D.; Padhi, E.M.T.; Sarfaraz, S.; Renwick, S.; Duncan, A.M. Beyond the Cholesterol-Lowering Effect of Soy Protein: A Review of the Effects of Dietary Soy and Its Constituents on Risk Factors for Cardiovascular Disease. Nutrients 2017, 9, 324. https://doi.org/10.3390/nu9040324
Ramdath DD, Padhi EMT, Sarfaraz S, Renwick S, Duncan AM. Beyond the Cholesterol-Lowering Effect of Soy Protein: A Review of the Effects of Dietary Soy and Its Constituents on Risk Factors for Cardiovascular Disease. Nutrients. 2017; 9(4):324. https://doi.org/10.3390/nu9040324
Chicago/Turabian StyleRamdath, D. Dan, Emily M. T. Padhi, Sidra Sarfaraz, Simone Renwick, and Alison M. Duncan. 2017. "Beyond the Cholesterol-Lowering Effect of Soy Protein: A Review of the Effects of Dietary Soy and Its Constituents on Risk Factors for Cardiovascular Disease" Nutrients 9, no. 4: 324. https://doi.org/10.3390/nu9040324