One year soy protein supplementation has positive effects on bone formation markers but not bone density in postmenopausal women

Bahram H Arjmandi, Edralin A Lucas, Dania A Khalil, Latha Devareddy, Brenda J Smith, Jennifer McDonald, Andrea B Arquitt, Mark E Payton, Claudia Mason, Bahram H Arjmandi, Edralin A Lucas, Dania A Khalil, Latha Devareddy, Brenda J Smith, Jennifer McDonald, Andrea B Arquitt, Mark E Payton, Claudia Mason

Abstract

Background: Although soy protein and its isoflavones have been reported to reduce the risk of osteoporosis in peri- and post-menopausal women, most of these studies are of short duration (i.e. six months). The objective of this study was to examine if one year consumption of soy-containing foods (providing 25 g protein and 60 mg isoflavones) exerts beneficial effects on bone in postmenopausal women.

Methods: Eighty-seven eligible postmenopausal women were randomly assigned to consume soy or control foods daily for one year. Bone mineral density (BMD) and bone mineral content (BMC) of the whole body, lumbar (L1-L4), and total hip were measured using dual energy x-ray absorptiometry at baseline and after one year. Blood and urine markers of bone metabolism were also assessed.

Results and discussion: Sixty-two subjects completed the one-year long study. Whole body and lumbar BMD and BMC were significantly decreased in both the soy and control groups. However, there were no significant changes in total hip BMD and BMC irrespective of treatment. Both treatments positively affected markers of bone formation as indicated by increased serum bone-specific alkaline phosphatase (BSAP) activity, insulin-like growth factor-I (IGF-I), and osteocalcin (BSAP: 27.8 and 25.8%, IGF-I: 12.8 and 26.3%, osteocalcin: 95.2 and 103.4% for control and soy groups, respectively). Neither of the protein supplements had any effect on urinary deoxypyridinoline excretion, a marker of bone resorption.

Conclusion: Our findings suggest that although one year supplementation of 25 g protein per se positively modulated markers of bone formation, this amount of protein was unable to prevent lumbar and whole body bone loss in postmenopausal women.

Figures

Figure 1
Figure 1
Mean percent change from baseline values in bone mineral density (BMD) of the whole body, lumbar (L1-L4), and hip after one year of supplementation with control or soy foods. Bars represent least square means ± SE.
Figure 2
Figure 2
Mean percent change from baseline values in bone mineral content (BMC) of the whole body, lumbar (L1-L4), and hip after one year of supplementation with control or soy foods. Bars represent least square means ± SE.

References

    1. National Osteoporosis Foundation America's Bone Health The State of Osteoporosis and Low Bone Mass
    1. Gambacciani M, Ciaponi M. Postmenopausal osteoporosis management. Current Opinion in Obstetrics & Gynecology. 2000;12:189–197.
    1. Scheiber MD, Rebar RW. Isoflavones and postmenopausal bone health: a viable alternative to estrogen therapy? Menopause. 1999;6:233–241.
    1. Branca F. Physical activity, diet and skeletal health. Public Health Nutr. 1999;2:391–396.
    1. Heaney RP. Calcium, dairy products and osteoporosis. J Am Coll Nutr. 2000;19:83S–99S.
    1. Fitzpatrick LA. Phytoestrogens – mechanism of action and effect on bone markers and bone mineral density. Endocrinol Metab Clin North Am. 2003;32:233–252.
    1. Setchell KD, Lydeking-Olsen E. Dietary phytoestrogens and their effect on bone: evidence from in vitro and in vivo, human observational, and dietary intervention studies. Am J Clin Nutr. 2003;78:593S–609S.
    1. Arjmandi BH, Smith BJ. Soy isoflavones' osteoprotective role in postmenopausal women: mechanism of action. J Nutr Biochem. 2002;13:130–137.
    1. Adams C, Cannell S. Women's beliefs about "natural" hormones and natural hormone replacement therapy. Menopause. 2001;8:433–440.
    1. Cassidy A. Dietary phytoestrogens and bone health. J Br Menopause Soc. 2003;9:17–21.
    1. Weaver CM, Liebman M. Biomarkers of bone health appropriate for evaluating functional foods designed to reduce risk of osteoporosis. Br J Nutr. 2002;88:S225–S232.
    1. Valtuena S, Cashman K, Robins SP, Cassidy A, Kardinaal A, Branca F. Investigating the role of natural phyto-oestrogens on bone health in postmenopausal women. Br J Nutr. 2003;89:S87–S99.
    1. Del Mar CB, Glasziou PP, Spinks AB, Sanders SL. Natural remedies for osteoporosis in postmenopausal women. Med J Aust. 2002;176:182–183.
    1. Setchell KD. Soy isoflavones – benefits and risks from nature's selective estrogen receptor modulators: (SERMs) J Am Coll Nutr. 2001;20:354S–362S.
    1. Brzezinski A, Debi A. Phytoestrogens: the "natural" selective estrogen receptor modulators? Eur J Obstet Gynecol Reprod Biol. 1999;85:47–51.
    1. Adlercreutz H, Mazur W. Phyto-oestrogens and Western diseases. Ann Med. 1997;29:95–1201.
    1. Scwartz AV, Kelsey JL, Maggi S, Tuttleman M, et al. International variation in the incidence of hip fractures: cross-national project on osteoporosis for the World Health Organization Program for research on aging. Osteopor Int. 1999;9:242–253.
    1. Chen Z, Zheng W, Custer LJ, et al. Usual dietary consumption of soy foods and its correlation with the excretion rate of isoflavonoids in overnight urine samples among Chinese women in Shanghai. Nutr Cancer. 1999;33:82–87.
    1. Ho SC, Woo J, Lam S, Chen Y, Sham A, Lau J. Soy protein consumption and bone mass in early postmenopausal Chinese women. Osteoporos Int. 2003;14:835–842.
    1. Arjmandi BH, Birnbaum R, Goyal NV, Getlinger MJ, Juma S, Alekel L, et al. Bone-sparing effect of soy protein in ovarian hormone-deficient rats is related to its isoflavone content. Am J Clin Nutr. 1998;68:1364S–1368S.
    1. Arjmandi BH, Getlinger MJ, Goyal NV, Alekel L, Hasler CM, Juma S, et al. Role of soy protein with normal or reduced isoflavone content in reversing bone loss induced by ovarian hormone deficiency in rats. Am J Clin Nutr. 1998;68:1358S–1363S.
    1. Picherit C, Chanteranne B, Bennetau-Pelissero C, Davicco MJ, Lebecque P, Barlet JP, et al. Dose-dependent bone-sparing effects of dietary isoflavones in the ovariectomised rat. Br J Nutr. 2001;85:307–316.
    1. Picherit C, Coxam V, Bennetau-Pelissero C, Kati-Coulibaly S, Davicco MJ, Lebecque P, et al. Daidzein is more efficient than genistein in preventing ovariectomy-induced bone loss in rats. J Nutr. 2000;130:1675–1681.
    1. Fanti P, Monier-Faugere MC, Geng Z, Schmidt J, Morris PE, Cohen D, et al. The phytoestrogen genistein reduces bone loss in short-term ovariectomized rats. Osteoporos Int. 1998;8:274–281.
    1. Arjmandi BH, Alekel L, Hollis BW, Amin D, Stacewicz-Sapuntzakis M, Guo P, et al. Dietary soybean protein prevents bone loss in an ovariectomized rat model of osteoporosis. J Nutr. 1996;126:161–167.
    1. Harrison E, Adjei A, Ameho C, Yamamoto S, Kono S. The effect of soybean protein on bone loss in a rat model of postmenopausal osteoporosis. J Nutr Sci Vitaminol (Tokyo) 1998;44:257–268.
    1. Dalais FS, Rice GE, Wahlqvist ML, Grehan M, Murkies AL, Medley G, et al. Effects of dietary phytoestrogens in postmenopausal women. Climacteric. 1998;1:124–129.
    1. Potter SM, Baum JA, Teng H, Stillman RJ, Shay NF, Erdman JW., Jr Soy protein and isoflavones: their effects on blood lipids and bone density in postmenopausal women. Am J Clin Nutr. 1998;68:1375S–1379S.
    1. Alekel DL, Germain AS, Peterson CT, Hanson KB, Stewart JW, Toda T. Isoflavone-rich soy protein isolate attenuates bone loss in the lumbar spine of perimenopausal women. Am J Clin Nutr. 2000;72:844–852.
    1. Vitolins M, Anthony M, Lenschik L, Bland DR, Burke GL. Does soy protein and its isoflavones prevent bone loss in peri- and postmenopausal women? Results of a two year randomized clinical trial. J Nutr. 2002;132:582S.
    1. Kreijkamp-Kaspers S, Kok L, Grobbee DE, de Haan EHF, Aleman A, Lampe J, van der Schouw YT. Effect of soy protein containing isoflavones on cognitive function, bone mineral density, and plasma lipids in postmenopausal women. JAMA. 2004;292:65–74.
    1. Gallagher JC, Satpathy R, Rafferty K, Haynatzka V. The effect of soy protein isolate on bone metabolism. Menopause. 2004;11:290–298.
    1. Leydeking-Olsen E, Jensen JBE, Setchell KD, Jensen TH. Soymilk or progesterone for the prevention of bone loss. A 2 year randomized, placebo-controlled trial. Eur J Nutr. 2004;12:12.
    1. Chiechi LM, Secreto G, D'Amore M, Fanelli M, Venturelli E, Cantatore F, et al. Efficacy of a soy rich diet in preventing postmenopausal osteoporosis: the Menfis randomized trial. Maturitas. 2002;42:295–300.
    1. United States Food and Drug Administration Food Labeling: Health Claims; Soy Protein and Coronary Heart Disease; Final Rule. Federal Register 64 FR 57699 October 26. 1999.
    1. Arjmandi BH, Khan DA, Juma S, Drum ML, Abdul Kadir KB, Venatesh S, et al. Whole flaxseed consumption lowers serum LDL -cholestrol and lipoprotein(a) concentrations in postmenopausal women. Nutr Res. 1998;18:1203–1214.
    1. Arjmandi BH, Juma S, Lucas EA, Wei L, Venkatesh S, Khan DA. Flaxseed supplementation positively influence bone metabolism in postmenopausal women. JANA. 1998;1:27–32.
    1. Garnero P, Delmas PD. Assessment of the serum levels of bone alkaline phosphatase with a new immunoradiometric assay in patients with metabolic bone disease. J Clin Endocrinol Metab. 1993;77:1046–1053.
    1. Robins SP, Woitge H, Hesley R, Ju J, Seyedin S, Seibel MJ. Direct, enzyme-linked immunoassay for urinary deoxypyridinoline as a specific marker for measuring bone resorption. J Bone Miner Res. 1994;9:1643–1649.
    1. Baird DD, Umbach DM, Lansdell L, Hughes CL, Setchell KD, Weinberg CR, et al. Dietary intervention study to assess estrogenicity of dietary soy among postmenopausal women. J Clin Endocrinol Metab. 1995;80:1685–1690.
    1. Duncan AM, Underhill KE, Xu X, Lavalleur J, Phipps WR, Kurzer MS. Modest hormonal effects of soy isoflavones in postmenopausal women. J Clin Endocrinol Metab. 1999;84:3479–3484.
    1. Xu X, Duncan AM, Wangen KE, Kurzer MS. Soy consumption alters endogenous estrogen metabolism in postmenopausal women. Cancer Epidemiol Biomarkers Prev. 2000;9:781–786.
    1. Tham DM, Gardner CD, Haskell WL. Clinical review 97: Potential health benefits of dietary phytoestrogens: a review of the clinical, epidemiological, and mechanistic evidence. J Clin Endocrinol Metab. 1998;83:2223–2235.
    1. Yamamoto S, Sobue T, Kobayashi M, Sasaki S, Tsugane S. Soy, isoflavones, and breast cancer risk in Japan. J Natl Cancer Inst. 2003;95:906–913.
    1. Kritz-Silverstein D, Von Muhlen D, Barrett-Connor E, Bressel MA. Isoflavones and cognitive function in older women: the Soy and Postmenopausal Health In Aging: (SOPHIA) Study. Menopause. 2003;10:196–202.
    1. Merz-Demlow BE, Duncan AM, Wangen KE, Xu X, Carr TP, Phipps WR, et al. Soy isoflavones improve plasma lipids in normocholesterolemic, premenopausal women. Am J Clin Nutr. 2000;71:1462–1469.
    1. Messina M, Hughes C. Efficacy of soyfoods and soybean isoflavone supplements for alleviating menopausal symptoms is positively related to initial hot flush frequency. J Med Food. 2003;6:1–11.
    1. Messina M. Soy, soy phytoestrogens: (isoflavones), and breast cancer. Am J Clin Nutr. 1999;70:574–575.
    1. Messina MJ, Loprinzi CL. Soy for breast cancer survivors: a critical review of the literature. J Nutr. 2001;131:3095S–3108S.
    1. Messina MJ. Emerging evidence on the role of soy in reducing prostate cancer risk. Nutr Rev. 2003;61:117–131.
    1. Geinoz G, Rapin CH, Rizzoli R, Kraemer R, Buchs B, Slosman D, et al. Relationship between bone mineral density and dietary intakes in the elderly. Osteoporos Int. 1993;3:242–248.
    1. Hannan MT, Tucker KL, Dawson-Hughes B, Cupples LA, Felson DT, Kiel DP. Effect of dietary protein on bone loss in elderly men and women: the Framingham Osteoporosis Study. J Bone Miner Res. 2000;15:2504–2512.
    1. Massey LK. Dietary animal and plant protein and human bone health: a whole foods approach. J Nutr. 2003;133:862S–865S.
    1. Kerstetter JE, O'Brien KO, Insogna KL. Dietary protein, calcium metabolism, and skeletal homeostasis revisited. Am J Clin Nutr. 2003;78:584S–592S.
    1. Kerstetter JE, O'Brien K, Insogna K. Dietary protein and intestinal calcium absorption. Am J Clin Nutr. 2001;73:990–992.
    1. Chen YM, Ho SC, Lam SS, Ho SS, Woo JL. Beneficial effect of soy isoflavones on bone mineral content was modified by years since menopause, body weight, and calcium intake: a double-blind, randomized, controlled trial. Menopause. 2004;11:246–254.
    1. Morabito N, Crisafulli A, Vergara C, Gaudio A, Lasco A, Frisina N, et al. Effects of genistein and hormone-replacement therapy on bone loss in early postmenopausal women: a randomized double-blind placebo-controlled study. J Bone Miner Res. 2002;17:1904–1912.
    1. Clifton-Bligh PB, Baber RJ, Fulcher GR, Nery ML, Moreton T. The effect of isoflavones extracted from red clover: (Rimostil) on lipid and bone metabolism. Menopause. 2001;8:259–265.
    1. Atkinson C, Compston JE, Day NE, Dowsett M, Bingham SA. The effects of phytoestrogen isoflavones on bone density in women: a double-blind, randomized, placebo-controlled trial. Am J Clin Nutr. 2004;79:326–333.
    1. Lu LJW, Anderson KE, Grady JJ, Nagamani M. Chronic soy consumption influences serum levels of steroid and peptide hormones without uterine effects in postmenopausal women. J Nutr. 2002;132:615S.
    1. Scheiber MD, Liu JH, Subbiah MT, Rebar RW, Setchell KD. Dietary inclusion of whole soy foods results in significant reductions in clinical risk factors for osteoporosis and cardiovascular disease in normal postmenopausal women. Menopause. 2001;8:384–392.
    1. Arjmandi BH, Khalil DA, Smith BJ, Lucas EA, Juma S, Payton ME, et al. Soy protein has a greater effect on bone in postmenopausal women not on hormone replacement therapy, as evidenced by reducing bone resorption and urinary calcium excretion. J Clin Endocrinol Metab. 2003;88:1048–1054.
    1. Wong WW. Effects of soy isoflavones on blood lipids, blood pressure and biochemical markers of bone metabolism in postmenopausal women. J Nutr. 2000;130:686S.
    1. Pansini F, Bonaccorsi G, Albertazzi P, et al. Soy phytoestrogens and bone. Proceedings of the North American Menopause Society. 1997. p. 44.
    1. Adlercreutz H, Hockerstedt K, Bannwart C, Bloigu S, Hamalainen E, Fotsis T, et al. Effect of dietary components, including lignans and phytoestrogens, on enterohepatic circulation and liver metabolism of estrogens and on sex hormone binding globulin: (SHBG) J Steroid Biochem. 1987;27:1135–1144.

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