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Soy milk lowers blood pressure
in men and women with mild to moderate essential hypertension.
Reference: J Nutr 2002;132(7):1900-2
Soy-based diets reduce blood pressure in spontaneously hypertensive
rats, but apparently not in hypertensive humans. In the present
study, the antihypertensive potential of soy milk (500 mL twice
daily) compared with cow's milk was investigated in a 3-mo
double-blind randomized study of 40 men and women with
mild-to-moderate hypertension. Before initiation of the study,
urinary isoflavonoids (measured by HPLC) were undetectable in most
cases (for genistein, they were always <100 micromol/L). After 3 mo
of soy milk consumption, systolic blood pressure decreased by 18.4
+/- 10.7 mmHg compared with 1.4 +/- 7.2 mmHg in the cow's milk group
(P < 0.0001), diastolic blood pressure decreased by 15.9 +/- 9.8
mmHg vs. 3.7 +/- 5.0 mmHg in the cow's milk group (P < 0.0001) and
mean blood pressure decreased by 16.7 +/- 9.0 mmHg compared with 3.0
+/- 4.6 mmHg in the cow's milk group (P < 0.0001). Urinary genistein
was strongly (r = -0.588) and significantly (P = 0.002) correlated
with the decrease in blood pressure, particularly for diastolic
values. In conclusion, chronic soy milk consumption had modest, but
significant hypotensive action in essential hypertensive subjects.
This hypotensive action was correlated with the urinary excretion of
the isoflavonoid genistein.
Effects of high- and low-isoflavone
soyfoods on blood lipids, oxidized LDL, homocysteine, and blood
pressure in hyperlipidemic men and women
Reference: AJCN 2002;76(2):365-72.
Background: Many of the benefits of soy have been attributed to
soy isoflavones.
Objective: The objective was to determine the effects of high-
and low-isoflavone soy-protein foods on both lipid and nonlipid
risk factors for coronary artery disease (CAD).
Methods: Forty-one hyperlipidemic men and postmenopausal women
participated in a study with three 1-mo diets: a low-fat dairy
food control diet and high- (50 g soy protein and 73 mg
isoflavones daily) and low- (52 g soy protein and 10 mg
isoflavones daily) isoflavone soyfood diets. All 3 diets were
very low in saturated fat (< 5% of energy) and cholesterol (< 50
mg/d). Fasting blood samples were drawn and blood pressure was
measured at the start and end of each diet.
Results: No significant differences were seen between the high-
and low-isoflavone soy diets. Compared with the control diet,
however, both soy diets resulted in significantly lower total
cholesterol, estimated CAD risk, and ratios of total to HDL
cholesterol, LDL to HDL cholesterol, and apolipoprotein B to
A-I. No significant sex differences were observed, except for
systolic blood pressure, which in men was significantly lower
after the soy diets than after the control diet. On the basis of
blood lipid and blood pressure changes, the calculated CAD risk
was significantly lower with the soy diets, by 10.1 ± 2.7%.
Conclusion: Substitution of soyfoods for animal products,
regardless of isoflavone concentration, reduces the CAD risk
because of both modest reductions in blood lipids and reductions
in oxidized LDL, homocysteine, and blood pressure.
Enteral and parenteral nutrition in acute pancreatitis.
Reference: Best Pract Res Clin Gastroenterol 2002;16(3):391-7.
In the last 5 years naso-enteric feeding has increasingly been used
in clinical practice in patients with severe acute pancreatitis.
Randomized clinical studies in both mild and severe forms of the
disease have demonstrated not only the feasibility but also the
safety of this approach. The majority of patients have been fed by
variously placed nasojejunal tubes with varied problems in
maintaining both location and patency. Most have been surprised to
find that it is possible to feed the patients in this way with the
potential of improving gut barrier function and immune response, at
reduced cost and greater safety than with parenteral nutrition. The
current evidence points to nasojejunal feeding being preferable to
parenteral feeding, but evidence has yet to be produced to prove
beyond reasonable doubt that such feeding is an improvement on
conservative
management without feeding. Finally, the most recent development has
indicated that fine-bore nasogastric feeding may well be a realistic
alternative to nasojejunal feeding even in the more severe forms of
this disease. A small percentage of patients may still need
parenteral nutrition
Branched chain amino acids in
heptatic encephalopathy
Reference: Am J Surg 2002; 183(4):424-429.
Background: Early theories or hepatic encephalopathy focused on
ammonia-driven disruption of the Krebs cycle and cellular energy
production. The "false-neurotransmitter" theory directed attention
toward the interactions of amino acids, metabolism, the blood-brain
barrier and neurotransmission. As they evolved, these studies
revealed surprising and subtle effects of ammonia on brain amino
acid uptake.
Data Sources: Research over a 15-year period in Josef E. Fischer's
laboratory explored many aspects of these interactions. Subsequent
studies by others have confirmed and extended them into other areas.
Insights from this work continue to stimulate attempts to confirm or
disprove the clinical utility of branched chain amino acids.
Conclusions: Increased understanding of the factors affecting
ammonia, amino acid and neurotransmitter disturbances in chronic
liver failure have made a significant and ongoing contribution to
the study of metabolism in health and disease.
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Soy milk lowers blood pressure in men and women with mild to
moderate essential hypertension.