Soy Protein and Cardiovascular Disease

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Abstract
Cardiovascular disease (CVD) is the leading cause of death in the United States.1 Diet has a major impact on several modifiable risk factors for heart disease: hypercholesterolemia, hypertriglyceridemia, elevated LDL cholesterol, low HDL cholesterol, hypertension, obesity, and diabetes. The recommended low-saturated-fat, low-cholesterol diet1 does help lower risk of CVD.2 3 However, other dietary factors may offer additional benefits. There is increasing evidence that consumption of soy protein in place of animal protein lowers blood cholesterol levels and may provide other cardiovascular benefits. Epidemiologists have long noted that Asian populations who consume soy foods as a dietary staple have a lower incidence of CVD than those who consume a typical Western diet.4 Soy protein consumption in Japan is reported to be as much as 55 g/d,5 compared with <5 g/d in the United States.6 In 1998, deaths from CVD per 100 000 people between the ages of 35 and 74 years were as follows: 401 for US men, 201 for Japanese men, 197 for US women, and 99 for Japanese women.1 There are many differences in dietary patterns and lifestyle factors that could account for differences in disease patterns among countries. The American Heart Association (AHA) Dietary Guidelines for Healthy American Adults2 stated that although there was some evidence that when soy protein was substituted for animal protein, total and LDL cholesterol could be reduced, the findings were inconclusive. The AHA Nutrition Committee concluded that the use of soy foods was consistent with the AHA Dietary Guidelines, but no recommendation was made to include soy protein in the diet. More research on the mechanisms explaining the effects of soy protein and related phytochemicals on blood lipids was recommended. This AHA Science Advisory provides an update on recent research reports. The following description is …