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Soy isoflavones not associated with reductions in bone loss

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Daily administration of soy isoflavone tablets does not appear to reduce bone loss in women within the first 5 years of menopause, according to a new report in the Archives of Internal Medicine.

“Estrogen therapy with or without progesterone prevents most of these changes,” study author Silvinia Levis, MD, and colleagues wrote. “However, as a result of the Women’s Health Initiative findings suggesting that the overall risks outweigh the benefits, most menopausal women now decline estrogen therapy, increasingly seeking other alternatives. Soy-derived products have been proposed to provide comparable benefits to estrogens but without the risks.”

The researchers conducted the NIH-funded, randomized controlled, double blind Soy Phytoestrogens as Replacement Estrogens (SPARE) trial from July 2004 to March 2009 to determine the effectiveness of soy isoflavone tablets in preventing bone loss and other menopausal symptoms.

The study included 248 women aged 45 to 60 years. Women were eligible if they were within 5 years of menopause and had a bone mineral density T score of –2 or higher in the lumbar spine or total hip. A placebo tablet was randomly assigned to 126 women and a 200 mg soy isoflavone tablet to 122 women daily. The soy isoflavone dose was equivalent to approximately two times the highest intake through food sources in a typical Asian diet, according to the researchers.

During 2 years of follow-up, the soy isoflavone and placebo groups did not differ regarding bone mineral density at the spine (–2% vs. –2.3%), the total hip (–1.2% vs. –1.4%) or the femoral neck (–2.2% vs. –2.1%), respectively.

“Because of concerns regarding the risk of estrogens, a need exists for alternative interventions that could provide the beneficial effects of estrogens in bone and menopausal symptoms without the adverse effects on breast and cardiovascular health,” the researchers concluded. However, “we found that our population of women in the first 5 years of menopause, on average, had low rates of bone loss and that 200 mg of soy isoflavone tablets taken once daily does not prevent bone loss or reduce bone turnover or menopausal symptoms.”

Reference:

• Levis S, Strickman-Stein N, Ganjei-Azar P, et al. Arch Intern Med. 2011. doi:10.1001/archinternmed.2011.330

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