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Mark Messina

Publications and source records attributed to Mark Messina.

17 recordsLinked to original sources

Addressing the soy and breast cancer relationship: review, commentary, and workshop proceedings.

The impact of soyfood intake on breast cancer risk has been investigated extensively. Much of this focus can be attributed to the soybean being a dietary source that is uniquely rich in isoflavones. The chemical structure of isoflavones is similar to that of estrogen, and isoflavones bind to both estrogen receptors (ER alpha and ER beta) (although they preferentially bind to and activate ER beta) and exert estrogen-like effects under some experimental conditions. Isoflavones also possess nonhormonal properties that are associated with the inhibition of cancer cell growth. Thus, there are several possible mechanisms by which soy may reduce the risk of breast cancer. However, the role of isoflavones in breast cancer has become controversial because, in contrast to the possible beneficial effects, some data from in vitro and animal studies suggest that isoflavones, especially genistein, the aglycone of the main soybean isoflavone genistin, may stimulate the growth of estrogen-sensitive tumors. Limited human data directly address the tumor-promoting effects of isoflavones and soy. Because the use of soyfoods and isoflavone supplements is increasing, it is important from a public health perspective to understand the impact of these products on breast cancer risk in women at high risk of the disease and on the survival of breast cancer patients. To this end, a workshop was held in November 2005 to review the existing literature and to make research recommendations. This paper summarizes the workshop findings and recommendations. The primary research recommendation is that the impact of isoflavones on breast tissue needs to be evaluated at the cellular level in women at high risk for breast cancer.

Animals↗

Effects of soy protein and soybean isoflavones on thyroid function in healthy adults and hypothyroid patients: a review of the relevant literature.

Soy foods are a traditional staple of Asian diets but because of their purported health benefits they have become popular in recent years among non-Asians, especially postmenopausal women. There are many bioactive soybean components that may contribute to the hypothesized health benefits of soy but most attention has focused on the isoflavones, which have both hormonal and nonhormonal properties. However, despite the possible benefits concerns have been expressed that soy may be contraindicated for some subsets of the population. One concern is that soy may adversely affect thyroid function and interfere with the absorption of synthetic thyroid hormone. Thus, the purpose of this review is to evaluate the relevant literature and provide the clinician guidance for advising their patients about the effects of soy on thyroid function. In total, 14 trials (thyroid function was not the primary health outcome in any trial) were identified in which the effects of soy foods or isoflavones on at least one measure of thyroid function was assessed in presumably healthy subjects; eight involved women only, four involved men, and two both men and women. With only one exception, either no effects or only very modest changes were noted in these trials. Thus, collectively the findings provide little evidence that in euthyroid, iodine-replete individuals, soy foods, or isoflavones adversely affect thyroid function. In contrast, some evidence suggests that soy foods, by inhibiting absorption, may increase the dose of thyroid hormone required by hypothyroid patients. However, hypothyroid adults need not avoid soy foods. In addition, there remains a theoretical concern based on in vitro and animal data that in individuals with compromised thyroid function and/or whose iodine intake is marginal soy foods may increase risk of developing clinical hypothyroidism. Therefore, it is important for soy food consumers to make sure their intake of iodine is adequate.

Adult↗

Estimated Asian adult soy protein and isoflavone intakes.

There is substantial interest in the possible anticancer effects of soy foods. In part, this is because of the historically low incidence rates of breast and prostate cancer in Asia. Of the several putative soybean chemopreventive agents, isoflavones have received the most attention. Awareness of this research has led increasing numbers of consumers to use soy foods, isoflavone-fortified foods, and isoflavone supplements. Therefore, there is a need for guidance regarding appropriate isoflavone intake levels. To this end, this article analyzed soy protein (as a surrogate for isoflavones) and isoflavone intake of the major soy food-consuming countries using individual dietary surveys for the bulk of the information. In total, 24 surveys from 4 countries that met the inclusion criteria were identified: Japan (n = 11), China (n = 7), Hong Kong (n = 4), and Singapore (n = 2). The results indicate that older Japanese adults consume approximately 6-11 g of soy protein and 25-50 mg of isoflavones (expressed as aglycone equivalents) per day. Intake in Hong Kong and Singapore is lower than in Japan, whereas significant regional intake differences exist for China. Evidence suggests that < or =10% of the Asian population consumes as much as 25 g of soy protein or 100 mg of isoflavones per day. The applicability of these findings for making soy intake recommendations for non-Asians is discussed.

Adolescent↗

Not all soy products are created equal: caution needed in interpretation of research results.

Interest in the health benefits of soy foods has been intense among the research community, health professionals, and the public. At the same time, potential concerns associated with soy consumption, especially as related to soy isoflavones, have tempered the enthusiasm for making public health recommendations. On both accounts, the primary soybean isoflavone, genistein, has received the most attention. Because consumers are becoming increasingly confused by the often conflicting dietary messages, a balanced and accurate view of the risks and benefits of soy foods and soy food components is essential. Even among health professionals, confusion exists about proper nomenclature and about the precise composition of the agents under investigation. Levels of isoflavones are frequently assumed to be constant within categories of soy foods, and intakes are estimated rather than being directly analyzed. Furthermore, all too often research dealing singularly with genistein is interpreted by both health professionals and the media as equating directly with soy. Researchers often fail to fully understand the implications of their research outcomes and the context in which those outcomes should be placed. With the hundreds of publications yearly on soy and isoflavones, it is especially important to consider the literature in its entirety when making pronouncements about health effects. Efforts are needed by all to reduce the public confusion by adapting standardized approaches to the reporting of data. This paper provides a framework for both standardization of nomenclature and appropriate interpretation of data.

Genistein↗

Skeletal benefits of soy isoflavones: a review of the clinical trial and epidemiologic data.

PURPOSE OF REVIEW: Osteoporosis is a worldwide problem of immense magnitude that is expected to worsen in many countries with aging populations. Consequently, there is a need to identify ways to reduce the risk of developing this disease. This is especially true in light of clinical trial data showing the long-term harm of conventional hormone therapy outweighs the benefits. It is well established that many dietary components impact the skeletal system; in this regard there is particular interest in the possible skeletal benefits of soybean isoflavones. The purpose of this review is to evaluate the clinical and epidemiologic studies relevant to the hypothesis that isoflavones promote bone health. RESULTS: Fifteen clinical trials were identified that examined the effects of isoflavones or isoflavone-rich soy protein on bone mineral density. Most trials were conducted for 1 year or less and involved relatively few (<30) participants per group. The findings from these studies are inconsistent but generally suggest that isoflavones reduce bone loss in younger postmenopausal women. Similarly, the limited epidemiologic data generally show that among Asian populations isoflavone intake is associated with higher bone mineral density. The clinical data suggest that approximately 80 mg/day isoflavones are needed to derive skeletal benefits whereas the epidemiologic data suggest lower amounts are efficacious. SUMMARY: Until more definite data are available, although soy foods and isoflavones can not be viewed as substitutes for established anti-osteoporotic medications health professionals can feel justified in encouraging postmenopausal women concerned about bone health to incorporate soyfoods into their diet.

Age Factors↗

Soy, garlic, and ginkgo biloba: their potential role in cardiovascular disease prevention and treatment.

There are hundreds of foods, nutrients, herbs, and botanicals that have "bioactive" constituents with potential human health benefits. Three of these are discussed in this review: soy, garlic, and ginkgo biloba. Each of these three choices involves an ingestible item composed of a complex mixture of bioactive agents. For each of these three, there is a large and growing body of research suggesting potential cardiovascular health benefits. And for each there is at least some level of disagreement or controversy. The focus of this review is on results from recent human clinical trials.

Cardiovascular Diseases↗

Efficacy of soyfoods and soybean isoflavone supplements for alleviating menopausal symptoms is positively related to initial hot flush frequency.

Soy has received attention as an alternative to conventional hormone replacement therapy (HRT) largely because it is a unique dietary source of isoflavones. Isoflavones are diphenolic compounds that have both hormonal and nonhormonal properties and are considered to be selective estrogen receptor modulators. The estrogen-like effects of isoflavones in combination with the low reported frequency of hot flushes in Japan has prompted investigation of the effect of soy on menopausal symptoms. The purpose of this review is to evaluate the efficacy of soyfoods and isoflavone supplements for the alleviation of hot flushes. Nineteen trials (13 using a parallel design) involving more than 1,700 women were identified. Six trials were excluded from analysis: two that involved breast cancer patients, two that reported data on severity but not hot flush frequency, one that was not blinded, and one that did not include a control group. Based on a simple regression analysis of the remaining data set (13 trials), there was a statistically significant relationship (P =.01) between initial hot flush frequency and treatment efficacy. Initial hot flush frequency explained about 46% of the treatment effects, and hot flush frequency decreased by about 5% (above placebo or control effects) for every additional initial hot flush per day in women whose initial hot flush frequency was five or more per day. Although conclusions based on this analysis should be considered tentative, the available data justify the recommendation that patients with frequent hot flushes consider trying soyfoods or isoflavone supplements for the alleviation of their symptoms.

Adult↗

Isoflavone supplements do not affect thyroid function in iodine-replete postmenopausal women.

Despite the safety review conducted by the U.S. Food and Drug Administration in the process of awarding a health claim for the cholesterol-lowering properties of soy protein, concerns about the possible goitrogenic effects of soybean isoflavones persist. Concerns are based primarily on in vitro research, animal studies, and older reports of goiter in infants fed soy formula not fortified with iodine. In a randomized, double blind, placebo-controlled study, we investigated the effect on thyroid function of a daily supplement containing 90 mg (aglycone weight) of total isoflavones/day versus placebo in 38 postmenopausal women, 64-83 years old, not on hormone replacement therapy. Serum thyroid-stimulating hormone (TSH), thyroxine (T4), and triiodothyronine (T3) were measured at baseline and after 90 and 180 days. In the supplement group, at baseline and 6 months, TSH (micro U/ml), T4 (nM), and T3 (nM) levels (mean +/- SE) were 3.00 +/- 0.44, 149.00 +/- 5.04, and 1.53 +/- 0.13, respectively, and 3.49 +/- 0.52, 154.52 +/- 2.09, and 1.78 +/- 0.12, respectively. In the control group, levels at baseline and at 6 months were 3.35 +/- 0.51, 145.39 +/- 6.69, and 1.55 +/- 0.18, respectively, and 3.63 +/- 0.57, 153.77 +/- 6.64, and 1.75 +/- 0.10, respectively. Intragroup differences for all three measures were statistically indistinguishable at 6 months, and levels were similar between the isoflavone supplement and placebo groups at each measurement. These results indicate that in this group of healthy iodine-replete subjects, soy isoflavones do not adversely affect thyroid function.

Aged↗

Gaining insight into the health effects of soy but a long way still to go: commentary on the fourth International Symposium on the Role of Soy in Preventing and Treating Chronic Disease.

Research into the health effects of soyfoods and soybean constituents has increased at a phenomenal pace over the past decade. This research includes a wide range of areas, such as cancer, coronary heart disease, osteoporosis, cognitive function, menopausal symptoms and renal function. Importantly, there are an increasing number of clinical studies being conducted in this field, which was quite evident from the findings presented at the Fourth International Symposium on the Role of Soy in Preventing and Treating Chronic Disease, November 4-7, 2001, in San Diego, California. There is no doubt that progress in understanding the health effects of soy is being made, but much of the data are frustratingly inconsistent. For example, there were conflicting results presented at the symposium on the role of isoflavones in bone health. Similarly, presentations painted an unclear picture of the role of isoflavones in cholesterol reduction. The relatively short duration and small sample size of many of the human studies in this field likely contribute to the inconsistent results. Although there are some controversies regarding the safety of soy for certain subsets of the population, special sessions at the symposium on breast cancer and cognitive function did much to alleviate concerns that soy could have detrimental effects in these areas. Furthermore, published data and new research presented at this meeting suggest that the consumption of even 10 g (typical of Asian intake) of isoflavone-rich soy protein per day may be associated with health benefits. If this modest amount of soy protein were to be incorporated in the American diet, it would represent only approximately 15% of total U. S. protein intake.

Animals↗

An overview of the health effects of isoflavones with an emphasis on prostate cancer risk and prostate-specific antigen levels.

Soybean isoflavones possess hormonal and nonhormonal properties that may reduce the risk of coronary heart disease, osteoporosis, and certain cancers, and alleviate hot flashes in menopausal women. Among the various cancers whose risk may be reduced by isoflavones, there is particular interest in prostate cancer. Eleven trials have examined the effects of isoflavones on serum prostate-specific antigen (PSA) levels. The dose of isoflavones in these trials from supplements or soy protein ranged from 60 to 900 mg/day (typical Japanese intake is 30-50 mg/day), subject number/group ranged from 8 to 62, and study duration from 20 days to 1 year. Isoflavones did not affect serum PSA in healthy subjects. In contrast, in 4 of 8 trials involving prostate cancer patients, isoflavones significantly favorably affected PSA although in no studies was there an absolute decrease in PSA concentrations. The mechanism by which isoflavones affect PSA could not be determined from the existing research, although hormonal changes do not seem to be a factor. The clinical evidence is sufficiently encouraging to justify considering additional Phase II and III clinical trials investigating the efficacy of soy isoflavones in different populations of prostate cancer patients alone and in combination with other treatments.

Animals↗