Re: Another soy protein/hypertension reduction article. From Medscape.

[Guest guest]

Hi All,

The reference, which is pdf-available for Al Young's message, is:

He J, Gu D, Wu X, Chen J, Duan X, Chen J, Whelton PK.

Effect of soybean protein on blood pressure: a randomized, controlled trial.

Ann Intern Med. 2005 Jul 5;143(1):1-9.

Summary for patients in:

Ann Intern Med. 2005 Jul 5;143(1):I11.

PMID: 15998749

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=pubmed & dopt=Abstra\

ct & list_uids=15998749 & query_hl=32

However, note that in the pdf-available:

Kelemen LE, Kushi LH, s DR Jr, Cerhan JR.

Associations of dietary protein with disease and mortality in a prospective

study of

postmenopausal women.

Am J Epidemiol. 2005 Feb 1;161(3):239-49.

PMID: 15671256

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=pubmed & dopt=Abstra\

ct & list_uids=15671256 & query_hl=39

it is reported that:

" Among women in the highest intake quintile, CHD mortality decreased by 30% from

an

isoenergetic substitution of vegetable protein for carbohydrate (95% confidence

interval (CI): 0.49, 0.99) and of vegetable for animal protein (95% CI: 0.51,

0.98),

following multivariable adjustment. Although no association was observed with

any

outcome when animal protein was substituted for carbohydrate, CHD mortality was

associated with red meats (risk ratio = 1.44, 95% CI: 1.06, 1.94) and dairy

products

(risk ratio = 1.41, 95% CI: 1.07, 1.86) when substituted for servings per 1,000

kcal

(4.2 MJ) of carbohydrate foods. Long-term adherence to high-protein diets,

without

discrimination toward protein source, may have potentially adverse health

consequences. "

--- Al Young <acyoung@...> wrote:

> Another soy protein/hypertension reduction article. From Medscape.

>

>

> Laurie Barclay, MD;

>

>

>

> July 5, 2005 - Soy protein supplements can significantly reduce blood

> pressure in hypertensive patients, according to the results of a randomized,

> double-blind study published in the July 5 issue of the ls of Internal

> Medicine. The editorialists suggest that recommending soy protein would be

> premature because of incomplete evidence, but they do advocate the Dietary

> Approaches to Stop Hypertension (DASH) diet.

>

> " Epidemiologic studies suggest that vegetable protein intake is inversely

> related to blood pressure, " write Jiang He, MD, PhD, from Tulane University

> in New Orleans, Louisiana, and colleagues. " The effect of dietary

> macronutrients on blood pressure has not been well studied, although

> clinical trials indicate that diets rich in fruits, vegetables, and low-fat

> dairy products and with reduced saturated and total fat (DASH diet) lower

> blood pressure. "

>

> In three communities in the People's Republic of China, 302 participants

> with an initial untreated systolic blood pressure of 130 to 159 mm Hg,

> diastolic blood pressure of 80 to 99 mm Hg, or both were randomized to

> receive 40 g of isolated soybean protein supplements daily or complex

> carbohydrate control for 12 weeks. Age range was 35 to 64 years. Mean

> systolic blood pressure was 135.0 ± 10.9 mm Hg, and diastolic blood pressure

> was 84.7 ± 6.9 mm Hg at baseline.

>

> Of the 302 participants, 91.4% completed the 12-week trial. Neither group

> reported significant adverse effects. Compared with the control group, the

> net blood pressure changes in the soy group after the intervention

> were -4.31 mm Hg systolic (95% confidence interval [CI], -2.11 to -6.51 mm

> Hg; P < .001) and -2.76 mm Hg diastolic (95% CI, -1.35 to -4.16 mm Hg; P <

> .001), respectively.

>

> In participants with hypertension, the net changes in systolic and diastolic

> blood pressure were -7.88 mm Hg (95% CI, -4.66 to -11.1 mm Hg) and -5.27 mm

> Hg (95% CI, -3.05 to -7.49 mm Hg), respectively. In participants without

> hypertension, the net changes were -2.34 mm Hg (95% CI, 0.48 to -5.17 mm Hg)

> and -1.28 mm Hg (95% CI, 0.52 to -3.07 mm Hg).

>

> Study limitations were inability to determine whether the blood pressure

> reduction was related to protein or isoflavones in soybean and failure to

> control dietary nutrient intake as strictly as is possible in a feeding

> study.

>

> " Soybean protein supplementation resulted in a reduction in systolic and

> diastolic blood pressure, " the authors write. " These findings suggest that

> increased intake of soybean protein may play an important role in preventing

> and treating hypertension. "

>

> However, they note that 40 g of soybean protein is approximately equivalent

> to one soy burger plus one to two cups of soy milk, which may be difficult

> to consume daily.

>

> The Tulane University Health Sciences Center; National Heart, Lung, and

> Blood Institute in Bethesda, land; and the National Ninth Five-Year Plan

> Key Program from the Ministry of Science and Technology of the People's

> Republic of China supported this study. The authors report no potential

> financial conflicts of interest.

>

> In an accompanying editorial, A. Cutler, MD, and Eva Obarzanek, PhD,

> from the National Heart, Lung, and Blood Institute, cite some evidence of an

> association between soy protein and increased risk for bladder cancer. They

> wonder if a mixed vegetable protein product would produce the same blood

> pressure lowering effect without increased bladder cancer risk. An ongoing

> large trial should help address some of these issues, with results

> anticipated later this year.

>

> " We should require good evidence of benefit and safety before recommending

> soybean protein to the much larger population that is at risk for

> hypertension, " Drs. Cutler and Obarzanek write. " However, higher protein

> intake may prove to be healthful, and we agree with current blood pressure

> control guidelines that recommend diets higher in total protein, such as the

> DASH diet. "

>

> Ann Intern Med. 2005;143:1-9, 74-75

Al Pater, PhD; email: old542000@...

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