Effects of a Low-Calorie, Low-Carbohydrate Soy Containing Diet on Systemic Inflammation Among Patients with Nonalcoholic Fatty Liver Disease: A Parallel Randomized Clinical Trial

Abstract

Few studies have focused on the effects of a soy containing diet on inflammation and serum leptin level among patients with nonalcoholic fatty liver disease (NAFLD). Therefore, we aimed to determine the effects of such a diet in patients with NAFLD. Forty-five patients with NAFLD participated in this parallel randomized clinical trial for 8 weeks. Patients were randomly allocated to these 3 groups: 1) a low-calorie diet, 2) low-calorie low-carbohydrate diet, and 3) low-calorie low-carbohydrate soy containing diet. Low-calorie low-carbohydrate soy containing diet reduced fasting blood sugar (FBS) and serum insulin level significantly compared to other 2 groups (-11.6±2.8 vs. -6.3±1.7 and -3.1±1.0 mg/dl for FBS; and -5.1±1.2 vs. -1.2±0.3 and -1.7±0.5 mg/dl for serum insulin level). Serum hs-CRP level was also reduced significantly following low-calorie low-carbohydrate soy containing diet (-0.8±0.1 vs. -0.1±0.06 and -0.1±0.06 mg/dl). Both systolic and diastolic blood pressures were reduced significantly. Changes in leptin level tended to be different among 3 groups. After trial, 5 patients in each intervention group did not have NAFLD. From 6 patients in grade 2 at the beginning only 1 patient remained and others moved to grade 1. Low-calorie low-carbohydrate soy containing diet could reduce glycemic indices, hs CRP, systolic and diastolic blood pressure in a significant level in patients with NAFLD. However, these effects were dependent on baseline weight and further studies are needed to clarify the effect of such interventions in subjects with different BMI categories.

Can soy isoflavones plus soy protein change serum levels of interlukin‐6? A systematic review and meta‐analysis of randomized controlled trials

“…By reading full texts, 21 articles were also excluded due to the following reasons: taking other supplements by participants besides soy intervention ( n = 6), subjects aged less than 18 years old ( n = 1), measuring postprandial levels of IL‐6 ( n = 2), non‐English articles ( n = 2), studies conducted on patients with acute inflammatory disease ( n = 2), having no comparison group ( n = 1), and taking only soy protein or soy isoflavones as intervention ( n = 7) (Figure 1). At the final stage, 18 randomized clinical trials were considered as eligible to be included in this systematic review (Azadbakht et al, 2007; Beavers et al, 2009; Charles et al, 2009; Christie et al, 2010; Hilpert et al, 2005; Jenkins et al, 2002; Kani et al, 2017; Mangano et al, 2013; Maskarinec, Oum, Chaptman, & Ognjanovic, 2009a; Maskarinec, Steude, Franke, & Cooney, 2009b; Miraghajani, Esmaillzadeh, Najafabadi, Mirlohi, & Azadbakht, 2012; Mohammad‐Shahi, Mowla, Haidari, Zarei, & Choghakhori, 2016; Nadadur, Stanczyk, Tseng, Kim, & Wu, 2016; Nasca, Zhou, & Welty, 2008; Nourieh, Keshavarz, Attar, & Azadbakht, 2012; Rebholz et al, 2013; Reverri, LaSalle, Franke, & Steinberg, 2015; Simão et al, 2012). We could not include four articles in meta‐analysis due to the following reasons: reporting inadequate data for meta‐analysis ( n = 2) (Hilpert et al, 2005; Nasca et al, 2008), and not reporting the dose of protein in soy products ( n = 2) (Maskarinec, Oum, et al, 2009a; Maskarinec, Steude, et al, 2009b).…”

“…Therefore, only 14 articles were eligible for meta-analysis. Beavers et al, 2009;Charles et al, 2009;Kani et al, 2017;Mangano et al, 2013;Mohammad-Shahi et al, 2016;Nadadur et al, 2016;Nourieh et al, 2012;Reverri et al, 2015;Simão et al, 2012) (Table 1).…”

Is Chickpea a Potential Substitute for Soybean? Phenolic Bioactives and Potential Health Benefits

“…A decreased sensitivity to leptin in obesity jeopardizes detection of satiety even when high levels of this hormone and high energy stores occur. Among the mechanisms listed in Figure 2, human evidence on the role of soybean isoflavones in modulating sensitivity to leptin is still inconclusive [264,265,266] and needs further investigation. Furthermore, to the best of our knowledge, there is still a gap in the available literature with respect to the effects of isoflavones from chickpea.…”

Analysis of the intricate effects of polyunsaturated fatty acids and polyphenols on inflammatory pathways in health and disease

“…In T2DM patients, a one-year nutritional ketosis intervention resulted in a lower cardiovascular risk (Bhanpuri et al, 2018). Importantly, these beneficial effects are amplified by physical exercises (Alves et al, 2016;Asle Mohammadi Zadeh et al, 2018;Myette-Cote et al, 2018), and by the diet supplementation with nuts (Hou et al, 2018), soy (Kani et al, 2017), or even carefully choosing the types of ingested carbohydrates. In obese and overweight adolescents and adults, a diet based on low glycaemic index food improved inflammation, metabolic as well as cardiovascular risk factors (Rouhani et al, 2016), while the addition of functional foods resulted in further benefits (Izadi et al, 2018).…”