Urinary isoflavone excretion as a compliance measure in a soy intervention among young girls: a pilot study

OBJECTIVE: To investigate the compliance of young girls with a soy intervention. DESIGN: An 8-week dietary intervention and urine sample collection. SETTING: Free-living girls. SUBJECTS: A convenience sample of 8- to 14-y-old girls (20 started and 17 finished the study) recruited through flyers distributed to staff members and previous study participants. INTERVENTION: The girls consumed one daily serving of soymilk, soy nuts, or tofu, completed 3-day food records, kept daily soy intake logs, and collected weekly urine samples. MAIN OUTCOME MEASURES: Compliance with the intervention was evaluated by daily soy intake logs, 3-day food records analyzed by the center's Food Composition and Food Groups Servings Databases, and weekly urinary isoflavone excretion using high-pressure liquid chromatography. The statistical analysis included paired t-tests, analysis of variance, and Spearman's rank-order correlation coefficients. RESULTS: Daily soy intake logs indicated a mean intake of 6.28 servings out of a maximum of 7.0 servings per week. The food records revealed a six-fold increase in isoflavone intake during the study period (P<0.01) which was confirmed by an increase in urinary isoflavone excretion of similar magnitude (23.3-142.1 nmol/mg creatinine, P=0.02). CONCLUSIONS: This study demonstrated the ability of young girls to consume one daily soy serving and the usefulness of urinary isoflavones as a primary compliance measure. The high urinary isoflavone excretion levels detected in girls as compared to adult women suggest less intestinal degradation and/or greater absorption of isoflavones in nonadult populations. This finding requires further investigations into the pharmacokinetics of isoflavones.     

Urinary isoflavonoids as a dietary compliance measure among premenopausal women

Clinical trials investigating the effects of soy food intake require high compliance with a dietary protocol. Measuring soy isoflavonoids in bodily fluids is the most objective method currently available in determining compliance to a soy diet. In the present study, we investigated how frequently the urinary isoflavonoid excretion rate (UIER) should be analyzed to provide a reasonably accurate measurement of dietary compliance without being a burden on the participants. Nineteen premenopausal women who were on a daily soy diet protocol collected first-morning urine samples over one menstrual cycle. Spearman rank order correlation coefficients (r) between the UIERs of total isoflavonoids for a single day, for a week, and for all weeks combined with the monthly UIER were high for all samples (single day: r = 0.89; Week 1: r = 0.89; Week 2:r = 0.85; Week 3: r = 0.75; all weeks combined UIER: r = 0.94) and remained high after stratification by ethnicity, body mass index, and equol-excretor status. According to these results, the analysis of UIERs from a single or weekly first-morning sample provides a highly accurate and more feasible method of determining dietary compliance among women with regular soy consumption than that from urine samples collected every morning during one month.     

Serum prostate-specific antigen but not testosterone levels decrease in a randomized soy intervention among men

BACKGROUND: Low prostate cancer incidence and high soy intake in Asian countries suggest a possible protective effect of soy foods against prostate cancer. The goal of this pilot study was to evaluate the feasibility of a randomized, crossover soy trial among men and to investigate the effects of daily soy intake on serum prostate-specific antigen (PSA) and testosterone levels. METHODS: We randomized 24 men to a high or a low soy diet for 3 months. After a 1-month washout period, the men crossed over to the other treatment. During the high soy diet, the men consumed two daily soy servings; during the low soy diet, they maintained their usual diet. During the entire study each man donated four blood samples and five overnight urine samples. Dietary compliance was assessed by soy calendars, 24-h dietary recalls, and urinary isoflavone excretion measured by high-pressure liquid chromatography with photodiode array detection. Blood samples were analyzed for serum testosterone and PSA by radioimmunoassay. When necessary, variables were log transformed. Two sample t-tests compared the two groups before each study period. Mixed models incorporating the repeated measurements were used to evaluate the effect of the soy diet on urinary isoflavone excretion and serum analytes. RESULTS: Twenty-three men aged 58.7+/-7.2 years completed the study. The compliance with the study regimen was high according to self-reported soy food intake and urinary isoflavone excretion. No significant between-group and within-group differences were detected. During the high soy diet, dietary isoflavone intake and urinary isoflavone excretion increased significantly as compared to the low soy diet. A 14% decline in serum PSA levels (P=0.10), but no change in testosterone (P=0.70), was observed during the high soy diet in contrast to the low soy diet. CONCLUSION: The high adherence as shown by three measures of compliance in this pilot trial demonstrated the feasibility of an intervention based on soy foods among free-living men.     

大豆异黄酮摄入量估算值与尿液测定值相关性分析

[目的]本文评价膳食调查大豆异黄酮摄入量估算值与尿液中大豆异黄酮代谢物测定值之间的相关性。[方法]采用大豆食物频数问卷(SoyFFQ),对南京市不同社区共469名妇女大豆相关食品摄入量进行调查,利用美国食物成分数据,计算两种大豆异黄酮(染料木黄酮genistein和大豆苷元daidzein)每日摄入量;其中30名调查对象提供尿液样本,采用超高速液相色谱-串联质谱(UPLC-MS/MS)方法测定尿液中大豆异黄酮代谢物的浓度;采用高效液相(HPLC)方法测定部分大豆食品中染料木黄酮(genistein)和大豆苷元(daidzein)的含量。[结果]469名妇女膳食调查摄入量估算值:染料木黄酮(genistein):(50.7±31.6)mg/d,大豆苷元(daidzein):(33.4±35.9)mg/d;30份尿液中大豆异黄酮代谢物测定值:染料木黄酮(genistein):(515.9±674.5)μmol/mol,大豆苷元daidzein:(927.7±1107.2)μmol/mol。染料木黄酮(genistein)和大豆苷元(daidzein)膳食调查摄入量估算值与尿液中大豆异黄酮代谢物测定值相关系数分别为:0.59和0.57(P﹤0.05)。[结论]可以认为染料木黄酮(genistein)和大豆苷元(daidzein)摄入量估算值与尿液测定值具有相关性,为国内进行大豆异黄酮与乳腺癌发生风险的相关研究提供的可靠数据和方法。     

Isoflavonoid and lignan phytoestrogens as dietary biomarkers

Isoflavones and lignans are biologically active plant-food constituents that have potential chemopreventive properties. Quantitation of isoflavones and lignans in humans is necessary to establish the benefits and risks of exposure to these compounds in populations and to determine which components of a mixed diet contribute to the exposure. Isoflavones and lignans are metabolized by colonic bacteria to more biologically active metabolites; thus both the parent compounds and the metabolites are measured routinely. Isoflavonoids (genistein, daidzein, dihydrodaidzein, O-desmethylangolensin and equol) and lignans (enterolactone, enterodiol, matairesinol and secoisolariciresinol) can be quantified in various body fluids. Typically, high concentrations of isoflavonoids in urine and serum are associated with soy consumption, and high concentrations of lignans are associated primarily with intake of whole grains and other fiber-containing plant foods. Controlled feeding studies and nutritional epidemiologic studies demonstrate a linear dose response between dietary intake and urinary excretion of isoflavones. Lignan excretion is associated positively with dietary fiber intake as well as with diets that are on average higher in fiber and carbohydrate and lower in fat; thus lignans have also been proposed as a marker of healthier dietary patterns. The complex interactions between the colonic environment and the external and internal factors that modulate it contribute to significant variation in serum and urinary phytoestrogen levels among individuals. Understanding these sources of variation is important to be able to use these measures effectively as dietary biomarkers.     

Urinary isoflavonoid excretion is similar after consuming soya milk and miso soup in Japanese-American women

Based on the hypothesis that isoflavones are absorbed more efficiently from fermented than from non-fermented soya foods, we compared the urinary isoflavonoid excretion (UIE) after intake of miso soup or soya milk. We recruited twenty-one women with Japanese ancestry who consumed standardized soya portions containing 48 mg isoflavones. On day 1, half the women consumed soya milk, the other half started with miso soup. On day 3, the subjects ate the other soya food and on day 5, they repeated the first food. Each participant collected a spot urine sample before and an overnight urine sample after soya food intake. All urine samples were analysed for daidzein, genistein and equol using LC-MS and were expressed as nmol/mg creatinine. We applied mixed models to evaluate the difference in UIE by food while including the baseline values and covariates. Relative to baseline, both groups experienced significantly higher UIE after consuming any of the soya foods. We observed no significant difference in UIE when soya milk was compared to miso soup (P = 0.87) among all women or in the seven equol producers (P = 0.88). Repeated intake of the same food on different days showed high reproducibility within subjects. These preliminary results indicate similar UIE after consuming a fermented soya food (miso) as compared to a non-fermented soya food (soya milk). Therefore, recommendations favouring fermented soya foods are not justified as long as the intestinal microflora is capable of hydrolysing the isoflavone glucosides from non-fermented soya foods.     

Intake of soy foods and soy isoflavones by rural adult women in China

This study evaluated the intake of soy foods and soy isoflavones by rural adult women and potential determinant factors. Soy food consumption and information on age, education and medical history were collected on 1,188 subjects in Gansu Province and Hebei Province, China using a food frequency questionnaire to gather data on food intake over the past year. Weight and height were simultaneously measured. The results showed that 1139 (95.9%) rural women consumed soy foods in the past year. The average intake of soy foods and isoflavones was 38.7 +/- 58.2 (median = 23.5) g/d and 17.7 +/- 26.6 (median= 8.9) mg/d, respectively. Tofu accounted for the most contribution to their intake. The soy isoflavone intake ranged between 0-35 mg/day in 89.2% of subjects. Gansu women had higher intakes of soy foods and isoflavones than Henbei women (P< 0.05). Women aged 41-50 years consumed less soy foods and isoflavones than the 20-30-year olds and 31-40 year olds(P < 0.05). The intake of soy foods (P< 0.01) and isoflavones (P< 0.01) by women who experienced secondary education or above was significantly higher than illiterate women. Women without a medical history had a higher soy isoflavone intake than women with a medical history, but the difference was not statistically significant. These results suggest that the intake of soy isoflavones by Chinese rural adult women was much higher than women in Western countries. The distribution of intake was skewed to the right and varied among women in regard to region, age group and education level.     

Urinary isoflavonoid excretion and soy consumption in three generations of Japanese women in Hawaii

OBJECTIVE: To explore soy intake and urinary isoflavonoid excretion within several generations of American-Japanese women based on the hypothesis that earlier generations excrete higher levels of urinary isoflavonoids, in particular the metabolite equol, than later generations. SUBJECTS: A convenience sample of 43 women from 19 families aged 18-78 years, all of whom reported at least 50% Japanese ancestry. INTERVENTIONS: Each woman collected overnight urine samples at baseline and after consuming one serving of soymilk, both samples were analyzed for the isoflavonoids daidzein, genistein and equol using liquid chromatography-mass spectrometry. RESULTS: Median isoflavone intakes during the last year were 7.2 mg/day for the first generation, 7.3 mg/day for the second generation and 6.3 mg/day for the third generation (P=0.36). At baseline, the median isoflavonoid excretion for the first generation was nonsignificantly higher than for later generations (190, 86 and 42 nmol/h; P=0.20) but after intervention, the median urinary isoflavonoid excretion was very similar for the three groups: 2465, 1895 and 2775 nmol/h (P=0.70). Following intervention, a nonsignificantly higher proportion of older than younger women (53 vs 32 and 33%; P=0.41) excreted the metabolite equol. The respective median equol excretion rates by generation following intervention were 39.5, 4.2 and 3.5 nmol/h (P=0.04). CONCLUSIONS: This small investigation among three generations of Japanese-Americans detected a higher equol production among older women after a soy challenge, but no difference in the excretion of total isoflavonoids after a standardized dose of soymilk was observed.     

The volume of nipple aspirate fluid is not affected by 6 months of treatment with soy foods in premenopausal women

Based on the hypothesis that soy food consumption may influence breast tissue activity, we examined its effect on the production of nipple aspirate fluid (NAF), a possible indicator of breast cancer risk. Of 310 premenopausal women screened, 112 (36%) produced at least 10 μL of NAF, the minimum for study participation. In a crossover design, we randomized 96 women to 2 groups who, in reverse order, consumed a high-soy diet with 2 soy servings/d (1 serving = 177 mL soy milk, 126 g tofu, or 23 g soy nuts) and a low-soy diet with <3 servings/wk of soy for 6 mo each separated by a 1-mo washout period. During each diet period, 3 NAF samples were obtained (baseline and 3 and 6 mo) using a FirstCyte Aspirator and 4 urine samples (baseline and 1, 3, and 6 mo) were analyzed for isoflavonoids by liquid chromatography tandem MS. Adherence to the study protocol according to 24-h dietary recalls and urinary isoflavonoid excretion was high. The drop-out rate was 15% (n = 14); 82 women completed the intervention. The 2 groups produced similar mean NAF volumes at baseline (P = 0.95) but differed in age and previous soy intake and in their response to the intervention (P = 0.03). In both groups, NAF volume decreased during the first 3 mo of the high-soy diet period and returned to baseline at 6 mo, but there was no effect of the high-soy diet on NAF volume (P = 0.50 for diet; P-interaction = 0.21 for diet with time). Contrary to an earlier report, soy foods in amounts consumed by Asians did not increase breast tissue activity as assessed by NAF volume.     

Assessment of dietary isoflavone intake among middle-aged Chinese men

We evaluated the reproducibility and validity of the FFQ used in the Shanghai Men's Health Study (SMHS) for assessing dietary isoflavone intake, using multiple 24-h dietary recalls (24-HDR) and urinary isoflavones as the reference criteria, with data from the dietary validation study of the SMHS. A total of 196 study subjects completed the 24-HDR and 2 FFQ and donated a quarterly spot urine sample during the 1-y study period. Levels of urinary isoflavones were measured in a random sample of 48 study participants. The correlation coefficient between the 2 FFQ administered 1 y apart was 0.50 for soy protein intake and ranged from 0.50 to 0.51 for isoflavone intake. The correlations of isoflavone intake from the second FFQ with those from the multiple 24-HDR ranged from 0.38 (genistein) to 0.44 (glycitein), and the correlations with urinary isoflavone levels were 0.48 for total isoflavones, 0.44 for daidzein, 0.42 for genistein, and 0.54 for glycitein. The intraclass correlation coefficients for the 4 spot urine samples were 0.36, 0.42, and 0.40 for daidzein, genistein, and glycitein, respectively, and 0.62, 0.68, and 0.55 for their metabolic products equol, dihydrodaidzein, and O-desmethylangolensin, respectively. These results suggest that the SMHS FFQ can reliably and accurately measure usual intake of isoflavones, and that the levels of isoflavones in urine samples are relatively stable among men in Shanghai.     

Food frequency questionnaires and overnight urines are valid indicators of daidzein and genistein intake in U.S. women relative to multiple 24-h urine samples

Data regarding convenient, valid methods for measuring U.S. isoflavone intake are limited. We evaluated a soy food questionnaire (SFQ), the Willett food frequency questionnaire (FFQ), and overnight urine samples relative to excretion in 24-h urine samples. We also described intake among women in a high-risk program for breast or ovarian cancer. Between April 2002 and June 2003, 451 women aged 30 to 50 yr with a family history of breast or ovarian cancer completed the SFQ and FFQ. Of them, 27 provided four 24-h and overnight urine specimens. In these women, 24-h sample measures were correlated with SFQ estimates of daidzein (Spearman r = .48) and genistein (r = .54) intake, moderately correlated with the Willett FFQ (daidzein r = .38, genistein r = .33), and strongly correlated with overnight urine excretion (daidzein r = .84, genistein r = 0.93). Among all 451 SFQ respondents, mean (median) daidzein and genistein intakes were 2.8 (0.24) and 3.9 (0.30) mg/day. Primary sources of both were soymilk, soy nuts, and tofu. We conclude that targeted soy food questionnaires, comprehensive FFQs, and multiple overnight urines are all reasonable options for assessing isoflavone intake in epidemiologic studies.     

Dietary sources and determinants of soy isoflavone intake among midlife Chinese Women in Hong Kong

The dietary sources, intake levels, and determinants of soy isoflavone intake were examined using 3217 dietary recalls (DR) collected from 141 Hong Kong Chinese women aged 50-61 y. Multiple-pass 24-h DR were administered by phone by trained interviewers on 23 random, nonconsecutive days to participants over a 12-mo period from 2001 to 2002. We calculated isoflavone intake using analytical values in the Chinese University of Hong Kong Soy Isoflavone Database. Results indicated that the daily intake of total isoflavones was 7.8 +/- 5.6 mg in the study population. Non-Cantonese women had a higher intake of 10.7 +/- 7.6 mg compared with 7.3 +/- 5.0 mg in Cantonese women (P = 0.04). Altogether, 22 foods contributed approximately 90% of the total isoflavone intake. Soft tofu alone accounted for approximately 21% of the isoflavone intake, followed by bean curd skin (7.1%), name-brand soybean milk (6.3%), homemade soybean milk (6.2%), and generic soybean milk (5.8%). Combined, these 5 food items contributed 46% of the total dietary isoflavones. Multiple linear regression analysis indicated dialect group, self-reported health, and age group were significant independent predictors of soy isoflavone consumption. The data provide the basis for elucidating the patterns, determinants, and assessment of dietary soy isoflavone intake in Asian women.     

Determinants for urinary and plasma isoflavones in humans after soy intake

Consumption of soy foods leads to a biphasic appearance pattern of isoflavones (IFLs) in blood and urine, with peaks appearing at 1-2 h and 4-8 h after intake, but its causes are not understood. IFLs were measured repeatedly from plasma and/or urine after intake of soy foods, IFL glucosides, or aglycons without or with a mildly or radically reduced gut flora as a result of oral antibiotic (AB) treatment, or this combined with mechanical bowel preparation (AB+MBP). The typical biphasic IFL pattern in blood and/or urine was observed when a soy protein drink without (control) or with AB treatment or when IFL glucosides or aglycons were consumed. Soy intake combined with AB+MBP or consumption of puerarin led to a shift of the second peak to much later times. The first peak was absent after puerarin intake. Total urinary IFL recovery was more than 50% lower in the first 24 h, but overall 61% higher after AB+MBP vs. the control. When the area under the curves for corresponding time intervals were compared, individual or total urinary IFL excretion rates were highly correlated with individual or total plasma IFL levels (r=0.85-0.91; P <0.001). At the same urinary excretion rate three times more genistein than daidzein remained in the circulation. We conclude that urinary IFL excretion rates reflect circulating IFL levels, with daidzein appearing less in blood and more in urine than genistein. The first and second IFL peaks are due to uptake in the small and large intestine, respectively. The latter is the major locus of uptake (90%) at usual dietary IFL doses (0.15-1.5 mmol/kg body weight). A reduced gut flora delayed IFL uptake but led overall to increased urinary recovery because of less bacterial degradation in the intestine.     

Three measures show high compliance in a soy intervention among premenopausal women

OBJECTIVE: To evaluate adherence to a soy-based diet among premenopausal women. DESIGN: First year of a 2-year, randomized dietary intervention. SUBJECTS: 220 healthy premenopausal women who reported low baseline soy intake. INTERVENTION: 5 counseling visits, 7 follow-up phone calls, and 12 group meetings. Main outcome measures Self-reported soy intake logs; food frequency questionnaires; repeated, randomly timed 24-hour recalls; and analysis of urinary isoflavone excretion by high-pressure liquid chromatography. Statistical analyses Frequency distributions, means, t tests, and mixed effects models. RESULTS: At baseline, the 2 groups did not differ in dietary soy intake (P=.51) or urinary isoflavone excretion (P=.16). According to the 24-hour recalls and the food frequency questionnaires, the intervention group's estimated isoflavone intake increased more than 10 times compared with baseline and with the control group (P<.0001). During follow-up, urinary isoflavone excretion results showed no change in the control group, but a 6-fold increase for intervention subjects (P<.0001). Intake logs showed a strong preference for soymilk and tofu over the other foods and indicated that intervention participants consumed at least 12 servings of soy foods per week during 84 out of 100 follow-up contacts. CONCLUSIONS: These data indicate a high level of compliance with the study regimen, which we attribute to the following strategies: repeated contact with the study subjects, personal relationships with the dietitians, wide choice of soy foods, easy access to soy foods at no cost, and recipes that allowed substitution of previously eaten foods with soy products.     

Association between Soy Food and Dietary Soy Isoflavone Intake and the Risk of Cardiovascular Disease in Women: A Prospective Cohort Study in Korea

The association between soy food and soy isoflavone intake and cardiovascular disease (CVD) risk is uncertain, especially in women. We aimed to investigate this association in Korean women. We analyzed data from the Korean Genome and Epidemiology Study, including 4713 Korean women aged 40–69 years with no CVD or cancer at baseline. Dietary information was obtained using a validated semi-quantitative food frequency questionnaire, and the incidence of CVD was assessed using biennial self-reported questionnaires on medical history. The mean follow-up time was 7.4 years, during which 82 premenopausal and 200 postmenopausal women reported CVD incidence. The highest tofu, total soy foods, and dietary soy isoflavone intake groups were significantly associated with a decreased CVD risk in premenopausal women (tofu: hazard ratio (HR) 0.39; 95% confidence interval (CI), 0.19–0.80; total soy food: HR 0.36; 95% CI, 0.18–0.70; dietary soy isoflavones: HR 0.44; 95% CI, 0.22–0.89), whereas no association was observed in postmenopausal women. Other soy foods showed no association with CVD incidence. Dietary soy isoflavones and total soy foods are associated with a decreased CVD risk in premenopausal women. Among soy foods, only tofu showed significant health benefits.     

Soybean isoflavones reduce postmenopausal bone resorption in female Japanese immigrants in Brazil: a ten-week study

OBJECTIVE: Some human studies and animal models of experimental osteoporosis have shown that soy isoflavones may be effective on bone health. In this study, we carried out an intervention study to explore the effects of dietary isoflavone on bone metabolism. METHODS: Forty healthy female postmenopausal Japanese immigrants living in Brazil were divided into two groups: isoflavone-administered (n = 20) or placebo (n = 20). Subjects in the isoflavone-administered group ingested 37.3 mg per day for 10 weeks. The collection of 24-hour urine and the measurement of bone stiffness were performed at 0 and 10 weeks. Urinary excretion of isoflavones and bone resorption markers were analyzed. RESULTS: Urinary isoflavone excretion in the isoflavone-administered group was significantly increased at weeks 3 and 10. Urinary excretion of bone resorption markers was reduced in the isoflavone-administered group, while the placebo group did not show any significant reduction. Differences in levels of urinary isoflavones and bone resorption markers between the two groups were significant. CONCLUSION: This study demonstrated that the bone resorption was associated with the intake of soy isoflavones in postmenopausal women, and continuous dietary intake of isoflavone may inhibit postmenopausal osteoporosis.     

Urinary excretion of lignans and isoflavonoid phytoestrogens in Japanese men and women consuming a traditional Japanese diet.

Epidemiologic studies revealed low mortality in hormone-dependent cancer in Japanese women and men consuming a traditional diet. We previously found that certain diphenolic food components, lignans and isoflavonoids, which are converted to biologically active hormone-like substances by intestinal microflora, may be cancer-protective agents. Therefore, we studied urinary excretion of these compounds (enterolactone, enterodiol, daidzein, equol, and O-desmethylangolensin) in 10 women and 9 men in a rural village south of Kyoto, Japan. The subjects consumed a typical low-fat diet with much rice and soy products, fish, and vegetables. An isotope-dilution gas chromatographic-mass spectrometric method was used for the assays. The urinary excretion of lignans was low but that of the isoflavonoids was very high. The excretion of isoflavonoids correlated with soybean-product intake. The low mortality in breast and prostate cancer of Japanese women and men, respectively, may be due to the high intake of soybean products.     

Food Frequency Questionnaires and Overnight Urines Are Valid Indicators of Daidzein and Genistein Intake in U.S. Women Relative to Multiple 24-h Urine Samples

Data regarding convenient, valid methods for measuring U.S. isoflavone intake are limited. We evaluated a soy food questionnaire (SFQ), the Willett food frequency questionnaire (FFQ), and overnight urine samples relative to excretion in 24-h urine samples. We also described intake among women in a high-risk program for breast or ovarian cancer. Between April 2002 and June 2003, 451 women aged 30 to 50 yr with a family history of breast or ovarian cancer completed the SFQ and FFQ. Of them, 27 provided four 24-h and overnight urine specimens. In these women, 24-h sample measures were correlated with SFQ estimates of daidzein (Spearman r = .48) and genistein (r = .54) intake, moderately correlated with the Willett FFQ (daidzein r = .38, genistein r = .33), and strongly correlated with overnight urine excretion (daidzein r = .84, genistein r = 0.93). Among all 451 SFQ respondents, mean (median) daidzein and genistein intakes were 2.8 (0.24) and 3.9 (0.30) mg/day. Primary sources of both were soymilk, soy nuts, and tofu. We conclude that targeted soy food questionnaires, comprehensive FFQs, and multiple overnight urines are all reasonable options for assessing isoflavone intake in epidemiologic studies.     

A 4-day sodium-controlled diet reduces variability of overnight sodium excretion in free-living normotensive adolescents

The present analysis examined changes in the variability of overnight sodium excretion in 84 free-living adolescents (ages 15 to 19 years) on a 4-day sodium-controlled diet in which foods provided were selected by adolescents from an extensive list of menu items. The only selection criterion imposed was that foods selected for each day contain 4,000+/-200 mg sodium. Adolescents collected overnight urine samples. Repeated measures analysis of variance tested the effect of diet day on overnight sodium excretion, overnight urinary sodium concentration, and overnight urinary volume. Variance ratio test evaluated changes in overnight sodium excretion variance across days. Day 4 overnight sodium excretion was statistically lower than days 1 to 3 (1.84 vs 6.54, 5.94, and 5.52 mEq/h [1.84 vs 6.54, 5.94, and 5.52 mmol/h]). Day 4 overnight urinary sodium concentration was lower than days 1 to 3 (32.16 vs 119.64, 109.61, and 111.32 mEq/L [32.16 vs 119.64, 109.61, and 111.32 mmol/L]). The variance of overnight sodium excretion from day 1 to day 4 was reduced 10-fold from 20.1 mEq/h (20.1 mmol/h) to 1.90 mEq/h (1.90 mmol/h). Daily overnight urine volumes remained constant, averaging 451.7 mL/day. The dietary protocol successfully reduced the variability of sodium intake as estimated by overnight sodium excretion in free-living adolescents. The protocol could be expanded to include baseline values, additional days of sodium control, and varying levels of dietary sodium intake.     

Associations between microalbuminuria and animal foods, plant foods, and dietary patterns in the Multiethnic Study of Atherosclerosis

BACKGROUND: The balance between the intake of animal and the intake of plant foods may influence renal vascular integrity as reflected by urinary albumin excretion. OBJECTIVE: We assessed cross-sectional associations between urinary albumin excretion and dietary patterns and intake of plant and animal foods. DESIGN: At baseline, diet (food-frequency questionnaire) and the urinary albumin-to-creatinine ratio (ACR; spot urine collection) were measured in 5042 participants in the Multi-Ethnic Study of Atherosclerosis who were aged 45-84 y and were without clinical cardiovascular disease, diabetes, or macroalbuminuria (sex-adjusted ACR >or= 250). We derived dietary patterns by principal components analysis. We also summed food groups to characterize plant food intake (fruit, fruit juice, vegetables, nuts, legumes, whole grains, and refined grains), animal food intake (red meat, processed meat, poultry, fish, high-fat dairy, and low-fat dairy), and nondairy animal food intake. RESULTS: After adjustment for multiple demographic and lifestyle confounders, a dietary pattern characterized by high consumption of whole grains, fruit, vegetables, and low-fat dairy foods was associated with 20% lower ACR across quintiles (P for trend = 0.004). Neither total animal nor total plant food intake was associated with ACR. However, greater low-fat dairy consumption was associated with 13% lower ACR across quartiles (P for trend = 0.03). Total nondairy animal food consumption was associated with 11% higher ACR across quintiles (P for trend = 0.03). CONCLUSIONS: A high intake of low-fat dairy foods and a dietary pattern rich in whole grains, fruit, and low-fat dairy foods were both associated with lower ACR. In contrast, collectively, nondairy animal food intake was positively associated with ACR.