A Non-Probiotic Fermented Soy Product Reduces Total and LDL Cholesterol: A Randomized Controlled Crossover Trial

Sarah M Jung, Ella H Haddad, Amandeep Kaur, Rawiwan Sirirat, Alice Y Kim, Keiji Oda, Sujatha Rajaram, Joan Sabaté, Sarah M Jung, Ella H Haddad, Amandeep Kaur, Rawiwan Sirirat, Alice Y Kim, Keiji Oda, Sujatha Rajaram, Joan Sabaté

Abstract

Traditional Asian fermented soy food products are associated with reduced cardiovascular disease risk in prospective studies, but few randomized controlled trials have been conducted in at-risk populations. The aim of this study was to investigate the effect of a commercial non-probiotic fermented soy product on blood lipids in adults with cardiovascular risk biomarkers. In a randomized, crossover, intervention study, 27 men and women (aged 29-75 y) exhibiting at least two risk factors, consumed two packets (12.5 g each) daily of a fermented powdered soy product, or an isoenergic control powder made from germinated brown rice for 12 weeks each. The consumption of the fermented soy product resulted in a significantly greater mean change from baseline (compared to the germinated rice, all p < 0.05) in total cholesterol of -0.23 mmol/L (CI: -0.40, -0.06) compared with 0.14 mmol/L (CI: -0.03, 0.31), respectively; and low density lipoprotein (LDL) cholesterol -0.18 mmol/L (CI: -0.32, -0.04) compared with 0.04 mmol/L (CI: -0.01, 0.018) respectively. This was accompanied by an increase in high density lipoprotein (HDL) cholesterol in the germinated rice group, a decrease in apolipoprotein B (ApoB) in the fermented soy group, and a between-treatment effect in apolipoprotein A1 (ApoA1); however, the ratio of the LDL:HDL and of Apo B:ApoA1 did not differ between the groups. The ratio of total cholesterol:LDL decreased in men in the fermented soy group (p < 0.001). Twenty-four-hour urine collection at the end of each treatment period resulted in an increased excretion expressed as a ratio in μmol/d between treatments of 10.93 (CI: 5.07, 23.54) for daidzein; 1.24 (CI: 1.14, 4.43) for genistein; and, 8.48 (CI: 4.28, 16.80) for glycitein, all p < 0.05. The fermented soy powder consumed by participants in this study without implementing other changes in their typical diets, decreased the total and LDL cholesterol, and may serve as a dietary strategy to manage blood lipids. The trial was registered at ClinicalTrials.gov as NCT03429920.

Keywords: LDL cholesterol; Q-Can natural; fermented soy powder; isoflavones; total cholesterol.

Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
Study design of a randomized, controlled, crossover study in which participants with at least two risk factors for cardiovascular disease (CVD) consumed daily 2 packets of a powdered fermented soy product Q-Can Natural or 2 packets of a powdered germinated rice food, each dissolved in a liquid for a period of 12 weeks each, separated by a 2-week washout period. The packets were taken in a beverage of their choice—either water, low-fat milk or a plant-based milk—but participants had to be consistent in their choice of beverage. Anthropometric and blood pressure measurements and fasted blood were collected on study visits at baseline and weeks 11 and 12. A 24 h urine sample was collected at week 12.
Figure 2
Figure 2
Consolidated standards of reporting trials diagram indicating sample sizes at each stage during the study.
Figure 3
Figure 3
Estimated marginal means for the 24 h urine excretion of isoflavones (daidzein, genistein, glycitein) following the fermented soy and germinated rice intervention. Note: The y axis on a log10 scale.

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