> April 3, 2008 -- Intake of soy protein had beneficial effects on
> cardiovascular risk factors and kidney-related biomarkers in patients
> with type 2 diabetes and nephropathy, according to the results of a
> longitudinal, randomized trial published in the April issue of
> Diabetes Care.

> "Several short-term trials on the effect of soy consumption on
> cardiovascular risks are available, but little evidence exists
> regarding the impact of long-term soy protein consumption among type 2
> diabetic patients with nephropathy," write Leila Azadbakht, PhD, from
> the Isfahan University of Medical Sciences in Isfahan, Iran, and
> colleagues. "To determine the effects of long-term soy consumption on
> cardiovascular risks, we measured C-reactive protein (CRP) and kidney
> function indexes among type 2 diabetic patients with nephropathy."

> Of 41 patients with type 2 diabetes and nephropathy who were enrolled
> in this study, 18 were men and 23 were women. The soy protein group (n
> = 20) was assigned to a diet containing 0.8 g protein/kg body weight
> (35% animal proteins, 35% textured soy protein, and 30% vegetable
> proteins), whereas the control group
> (n = 21) was assigned to a similar diet containing 70% animal proteins
> and 30% vegetable proteins. Duration of the study was 4 years.

> The soy protein group fared better than the control group regarding
> effects on cardiovascular risk factors. Mean change in the soy protein
> vs control groups for fasting plasma glucose levels was
> -18 3 vs 11 2 mg/dL (P = .03); for total cholesterol levels,
> -23 5 vs 10 3 mg/dL (P =.01); for low-density lipoprotein (LDL)
> cholesterol levels, -20 5 vs 6 2 mg/dL (P = .01); and for serum
> triglyceride levels, -24 6 vs -5 2 mg/dL (P = .01).

> Compared with the control group, the soy protein group also had
> greater decreases in serum CRP levels (1.31 0.6 vs 0.33 0.1 mg/L;
> P = .02) and significant reductions in proteinuria (-0.15 0.03 vs
> 0.02 0.01 g/day;
> P = .001) and urinary creatinine levels (-1.5 0.9 vs 0.6 0.3 mg/
> dL; P = .01).

> Limitations of the study include evaluation of only CRP rather than
> other inflammatory markers, evaluation of only a single dosage range
> and formulation of soy protein, lack of data on the effects of soy
> protein according to estrogen receptor genotype, and measurement of
> urinary urea nitrogen and urinary creatinine as concentrations rather
> than as 24-hour excretions.

> "Longitudinal soy protein consumption significantly affected
> cardiovascular risk factors and kidney-related biomarkers among type 2
> diabetic patients with nephropathy," the study authors write. "As
> diabetic nephropathy is a progressive disease, we expected that the
> conditions of these patients would have gotten worse after 4 years,
> but because of medical and dietary control, their conditions improved
> in some respects."

> The costs of publication of this article were defrayed in part by the
> payment of page charges, mandating that it must therefore be hereby
> marked "advertisement" solely to indicate this fact.

> Diabetes Care. 2008;31:648-654.

> Clinical Context
> Diet is a cornerstone of the management of diabetes, and the authors
> of the current study previously demonstrated that the inclusion of soy
> and vegetable protein can improve laboratory variables in the short
> term among patients with diabetes. They performed a crossover clinical
> trial among 14 patients with diabetes and nephropathy, which was
> published in the October 2003 issue of the European Journal of
> Clinical Nutrition. In this study, the use of a diet in which 35% of
> the protein was derived from soy and another 30% from vegetable
> sources improved levels of total cholesterol, triglycerides, and LDL
> cholesterol after 7 weeks. The soy and vegetable protein diet also
> reduced proteinuria but did not affect levels of high-density
> lipoprotein (HDL) cholesterol.

> The current study observes a larger patient cohort for a longer period
> to determine the significance of a soy protein diet among patients
> with type 2 diabetes and nephropathy.

> Study Highlights
> Participants in the current study had type 2 diabetes and proteinuria,
> with a total urinary protein excretion between 300 and 1000 mg/day.
> Participants' serum creatinine level was between 1 and 2.5 mg/dL, and
> the serum urea nitrogen level was between 20 and 40 mg/dL. Subjects'
> systolic and diastolic blood pressure was greater than 140 and 90 mm
> Hg, respectively.
> Subjects were randomized to a control diet consisting of 0.8 g protein/
> kg body weight, with 70% animal protein and 30% vegetable protein; or
> a soy protein group consisting of 0.8 g protein/kg body weight, with
> 35% animal protein, 35% soy protein, and 30% vegetable proteins.
> Participants received visits with a dietician to encourage adherence
> to their randomized diet.
> The outcomes of the study were renal function, degree of proteinuria,
> serum lipid levels, and CRP levels. These outcomes were assessed every
> 6 months for 4 years.
> 41 participants provided data for analysis. 43% of subjects were men,
> and the mean age of subjects was 62.1 years. The mean duration of
> diabetes was 10 years, and the mean glycated hemoglobin level was
> 6.2%.
> There was no difference in total mean energy intake or activity levels
> between groups during the trial.
> Mean body weight was similar between diet groups at 4 years.
> Mean fasting plasma glucose levels decreased by 18 mg/dL in the soy
> protein diet group but increased by 11 mg/dL in the control group,
> which is a significant difference.
> Total cholesterol levels decreased by 23 mg/dL in the soy protein diet
> group and increased by 5 mg/dL in the control group, which was also
> statistically significant. LDL cholesterol and triglyceride levels
> also were reduced more significantly in the soy protein vs the control
> diet groups. HDL cholesterol levels were similar in both groups.
> CRP levels decreased by 1.31 in the soy protein diet group and 0.33 in
> the control group, which is a significant difference.
> Proteinuria decreased slightly in the soy protein diet group and
> increased slightly in the control group, and this difference was also
> statistically significant.
> Urinary urea nitrogen and urinary creatinine levels were improved in
> the soy protein vs control diet groups, but serum creatinine and serum
> urea nitrogen levels and the glomerular filtration rate were similar
> at 4 years between groups.
> The favorable effects of the soy protein diet on proteinuria were
> independent of its effects on plasma glucose, but not lipid, levels.
> Pearls for Practice
> A small trial of a soy-based and vegetable-based protein diet among
> patients with diabetes and nephropathy demonstrated that this diet
> could reduce levels of total cholesterol, triglycerides, and LDL
> cholesterol and decrease proteinuria in the short term.
> The current study finds that a soy protein diet can reduce levels of
> fasting plasma glucose, cholesterol, and CRP and decrease proteinuria
> vs a control diet among patients with type 2 diabetes and nephropathy.
> However, body weight was similar between the 2 groups.

> Who loves ya.
> Tom

> Jesus Was A Vegetarian!
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