Some but not all randomized controlled trials (RCTs) of soy isoflavones showed their beneficial effect on arterial stiffness, a predictor of cardiovascular events, dementia, and all-cause mortality, independent of traditional risk factors. To test the hypothesis that supplementation of soy isoflavones reduces arterial stiffness, we performed a systematic review and meta-analysis of RCTs of soy isoflavones on arterial stiffness.
The protocol of this systematic review was registered with PROSPERO (CRD42019126128) and written in accordance with PRISMA. The PubMed, Embase, and clinicaltrials.gov databases were searched using the following criteria: human subjects, soy isoflavones as intervention, and arterial stiffness as primary outcome. A random-effects meta-analysis was used to pool estimates across studies. Standardized mean difference (SMD) was used to synthesize quantitative results.
Among 998 articles retrieved, 8 articles met our criteria. Duration of intervention was relatively short (maximum of 12 weeks). Outcome measurements extracted were pulse wave velocity (PWV), systemic arterial compliance (SAC), augmentation index (AI), and cardio-ankle vascular index (CAVI). Soy isoflavones reduced arterial stiffness compared to placebo (standardized mean difference − 0.33, 95% confidence interval − 0.47, − 0.19). Subgroup analyses showed no difference between treatment effects for intervention duration (< 6 weeks vs. ≥ 6 weeks) or gender (women only vs. men only vs. combined). Sensitivity analysis showed no difference in the effect of soy isoflavones between PWV, CAVI, SAC, and AI.
Supplementation of soy isoflavones reduced arterial stiffness. Longer duration trials with larger number of participants are warranted.
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The present systematic review and meta-analysis is funded in part by the National Institutes of Health (NIH) grants (NIEHS) R21 ES029734 and (NIA) RF1 AG051615.
Conflict of interest
The authors declare no conflicts of interest in relation to this research.
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Online Resource Figure 1a-f. Standardized mean difference (SMD) in arterial stiffness was presented for each study, displayed by four measurements of outcomes. Studies with multiple measurements of outcomes were removed individually to determine their effect on overall results. The summary SMD was calculated by a random effects model. (Sup 1) (PDF 213 kb)
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Man, B., Cui, C., Zhang, X. et al. The effect of soy isoflavones on arterial stiffness: a systematic review and meta-analysis of randomized controlled trials. Eur J Nutr (2020). https://doi.org/10.1007/s00394-020-02300-6
- Soy isoflavones
- Arterial stiffness
- Randomized controlled trials