Research Article| Volume 42, ISSUE 4, P295-300, August 30, 2002

Efficacy of a soy rich diet in preventing postmenopausal osteoporosis: the Menfis randomized trial


      Objectives: To compare the effect of a soy rich diet and hormone replacement therapy (HRT) on the main biomarkers of bone turnover and bone mineral density (BMD) at postmenopausal age. Methods: 187 healthy asymptomatic postmenopausal women, aged 39–60, were recruited and randomized into a soy rich diet group, a HRT group, and a control group. Bone biomarkers and BMD were evaluated at baseline and after 6 months at the end of the study. Results: Diet is not as effective as HRT in reducing the postmenopausal turnover; however diet stimulates bone osteoblastic activity, as evidenced by significant increase in osteocalcin concentrations. BMD decreases significantly only in the control group, but not in the intervention groups. Conclusions: Our data suggest that soy products could be effective in reducing the risk of osteoporosis in asymptomatic postmenopausal women, but our findings should be confirmed before recommending the diet as a valid alternative to HRT.


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        • Dempster W.
        • Lindsay R.
        Pathogenesis of osteoporosis.
        The Lancet. 1993; 341: 797-805
        • Kanis J.A.
        The menopause and the skeleton: key issues.
        Baillière's Clin. Obstet. Genaecol. 1996; 10: 469-481
        • Lindsay R.
        • Hart D.M.
        • Aitken J.M.
        • MacDonald E.B.
        • Anderson J.
        • Clarke A.C.
        Long term prevention of postmenopausal osteoporosis by oestrogen: evidence for an increased bone mass after delayed onset of oestrogen treatment.
        Lancet. 1976; 1: 1038-1041
        • Kiel D.P.
        • Felson D.T.
        • Anderson J.J.
        • Wilson P.W.F.
        • Moskowitz M.A.
        Hip fracture and the use of estrogens in postmenopausal women. The Framingham study.
        N. Engl. J. Med. 1987; 317: 1169-1174
        • Lindsay R.
        • Hart D.M.
        • MacLean A.
        • Clark A.C.
        • Kraszewski A.
        • Garwood J.
        Bone response to termination of oestrogen treatment.
        Lancet. 1978; 1: 1325-1327
        • Kanis J.A.
        Treatment of osteoporosis in elderly women.
        Am. J. Med. 1995; S2A: 60-66
        • Felson D.
        • Zhang Y.
        • Hannan M.
        • Kiel D.P.
        • Wilson P.W.
        • Anderson J.J.
        The effect of postmenopausal estrogen therapy on bone density in elderly women.
        N. Engl. J. Med. 1993; 329: 1141-1146
        • Stern M.P.
        • Brown B.W.
        • Haskell W.L.
        • Farquhar T.W.
        • Wherle C.L.
        • Wood P.D.
        Cardiovascular risk and use of estrogens or estrogen-progestagen combinations. Stanford three-community study.
        JAMA. 1976; 235: 811-815
      1. Surgically confirmed gallbladder disease, venous thromboembolism, and breast tumors in relation to postmenopusal estrogen therapy. A report from the Boston Collaborative Drug Surveillance Program. Boston University Medical Center. N Engl J Med 1974;290:15–19.

        • Collaborative Group on hormonal Factors in Breast Cancer
        Breast cancer and hormone replacement therapy; collaborative reanalysis of data from 51 epidemiological studies of 52705 women with breast cancer and 108411 women without breast cancer.
        Lancet. 1997; 350: 1047-1059
        • Adami H.O.
        Long term consequences of estrogen and estrogen-progestinreplacement.
        Cancer Causes Control. 1992; 3: 83-90
        • Potter S.M.
        • Baum J.A.
        • Teng H.
        • Stillman R.J.
        • Shay N.F.
        • Erdma Jr., J.W.
        Soy protein and isoflavones: their efects on blood lipids and bone density in postmenopausal women.
        Am. J. Clin. Nutr. 1998; 68: 1375S-1379S
        • Alekel D.L.
        • St. Germain A.
        • Peterson C.T.
        • Hanson K.B.
        • Stewart J.W.
        • Toda T.
        Isoflavone-rich soy protein isolate attenuates bone loss in the lumbar spine of perimenoapusal women.
        Am. J. Clin. Nutr. 2000; 72: 844-852
        • Horiuchi T.
        • Onouchi T.
        • Takahashi M.
        • Ito H.
        • Orimo H.
        Effect of soy protein on bone metabolism in postmenopausal Japanese women.
        Osteoporos Int. 2000; 11: 721-724
        • Wangen K.E.
        • Duncan A.M.
        • Merz-Demlow B.E.
        • Xu X.
        • Marcus R.
        • Phipps W.
        • et al.
        Effects of soy isoflavones on markers of bone turnover in premenopausal and postmenopausal women.
        JCEM. 2000; 85: 3043-3048
        • Hsu C.S.
        • Shen W.W.
        • Hsueh Y.M.
        • Yeh S.L.
        Soy isoflavones supplementation in postmenopausal women. Effects on plasma lipids, antioxidant enzyme activities and bone density.
        J. Reprod. Med. 2001; 46: 221-226
        • Chiechi L.M.
        • Secreto G.
        • Vimercati A.
        • Greco P.
        • Venturelli E.
        • Pansini F.
        • et al.
        The effects of a soy rich diet on serum lipids: the Menfis randomized trial.
        Maturitas. 2002; 41: 97-104
        • Vidal V.
        • Kindblom L.G.
        • Ohlsson C.
        Expression and localization of estrogen receptor β in murine and humane bone.
        J. Bone Miner. Res. 1999; 14: 923-929
        • Nilsson I.O.
        • Boman A.
        • Savendahl L.
        • Grigelioniene G.
        • Ohlsson C.
        • Ritzen E.M.
        • et al.
        Demonstration of estrogen receptor β immunoreactivity in human growth plate cartilage.
        J. Clin. Endocrinol. Metab. 1999; 84: 370-373
        • Kuiper G.G.
        • Lemmen J.G.
        • Carlsson B.
        • Corton J.C.
        • Safe S.H.
        • van der Saas P.T.
        • et al.
        Interaction of estrogenic chemicals and phytoestrogens with estrogen receptor β.
        Endocrinology. 1998; 139: 4259-4263
        • Gustafsson J.A.
        Novel aspects of estrogen action.
        J. Soc. Gynecol. Investig. 2000; 7: S8-S9
        • Scheiber M.D.
        • Rebar R.W.
        Isoflavones and postmenopausal bone health: a viable alternative to estrogen to estrogen therapy?.
        Menopause. 1999; 6: 233-241
        • Gambacciani M.
        • Spinetti A.
        • Piaggesi L.
        • Cappagli B.
        • Taponeco F.
        • Manetti P.
        • et al.
        Ipriflavone prevents the mass reduction in premenopausal women treated with gonadotropin hormone-releasing hormone agonists.
        Bone Miner. 1994; 26: 19-26
        • Yamazaki I.
        • Shino A.
        • Tsukuda R.
        Effect of ipriflavone on osteoporosis induced by ovariectomy in rats.
        J. Bone Miner. Metab. 1986; 3: 205-210
        • Yamazaki I.
        • Shino A.
        • Tsukuda R.
        • Shirakawa Y.
        • Kinioshita M.
        Effect of ipriflavone on glucocorticoid-induced osteoporosis in rats.
        Life Sci. 1986; 38: 951-958
        • Nozaki M.
        • Hashimoto K.
        • Inoue Y.
        • Ogata R.
        • Okuma A.
        • Nakano H.
        Treatment of bone loss in oophorectomized women with a combination of ipriflavone and conjugated equine estrogen.
        Int. J. Gynaecol. Obstet. 1998; 62: 69-75
        • Arjmandi B.H.
        • Getunger M.J.
        • Goyal N.V.
        • Alekel L.
        • Hasler C.M.
        • Juna S.
        • et al.
        Role of soy protein with normal or reduced isoflavones content in reversing bone loss induced by ovarian hormone deficiency in rats.
        Am. J. Clin. Nutr. 1998; 68: 1358S-1363S
        • Arjmandi B.H.
        • Alekel L.
        • Hollis B.W.
        • 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
        • Omi N.
        • Aoi S.
        • Murata K.
        • Eza W.I.
        Evaluation of the effect of soybean milk and soybean peptide on bone metabolism in the rat model with ovariectomized osteoporosis.
        J. Nutr. Sci. Vitamino. (Tokyo). 1994; 40 (Abstract): 201-211
        • Messina M.
        • Messina V.
        Soyfoods, soybean isoflavones, and bone health: a brief overview.
        J. Ren. Nutr. 2000; 10: 63-68