Effect of exercise training combined with isoflavone supplementation on bone and lipids in postmenopausal women: A randomized clinical trial
What this study found
Isoflavone supplementation showed modest benefits, but combining isoflavone with exercise did not add skeletal benefit and was associated with greater hip BMD loss than either intervention alone. At 2 years, total hip BMD change was -0.005 g/cm2 [95% CI -0.01, 0.001] with exercise, -0.005 [-0.011, 0.001] with isoflavone, and -0.018 [-0.024, -0.012] with exercise plus isoflavone. LDL cholesterol decreased in the isoflavone groups, with changes of -0.20 [-0.37, -0.02] mmol/L and -0.23 [-0.40, -0.06] mmol/L; p = 0.003. Exercise improved backward tandem walking time at year 2 (p = 0.017), and…
- Study & population
- Randomized, parallel-group clinical trial in community-dwelling postmenopausal women in Saskatoon, Canada.
- Intervention
- Oral soy isoflavone tablets were given at 165 mg/day total isoflavone (105 mg aglycone equivalents/day; 35 mg aglycone equivalents three times daily) for 2 years.
- Key limitation
- This was a single-center trial in selected community-dwelling postmenopausal women, limiting generalizability to other populations.
View source
Open PDFOriginal abstract
We determined the effects of 2 years of exercise training and soy isoflavone supplementation on bone mass and lipids in postmenopausal women provided with calcium and vitamin D. Women were randomized to four groups: exercise training (Ex); isoflavone supplementation (Iso: 165 mg/d [105 mg/d aglycone equivalent]); combined Ex and Iso (ExIso); and placebo (control). Exercise included resistance training (2 days/week) and walking (4 days/week). Our primary outcomes were lumbar spine and hip bone mineral density (BMD). Secondary outcomes included hip geometry, tibia and radius speed of sound (SOS), dynamic balance (6 m backward tandem walking), blood lipids, mammography, and endometrial thickness. A total of 351 women (Ex = 86, Iso = 90, ExIso = 87, control = 88) were randomized, with 298 analyzed at 2 years (Ex = 77, Iso = 76, ExIso = 72, control = 73). There was a significant interaction for total hip BMD (p < 0.001) such that ExIso had a greater rate of decrease (absolute change [95% confidence interval] = −0.018 [−0.024, −0.012] g/cm2) than either the Ex or Iso groups alone (−0.005 [−0.01, 0.001] and −0.005 [−0.011, 0.001] g/cm2, respectively). There were no differences between groups for changes in lumbar spine BMD and minimal significant changes in hip geometric properties and bone SOS. Exercise groups improved dynamic balance as measured by a decrease in backward tandem walking time over 6 m (p = 0.017). Isoflavone groups decreased low density lipoproteins (Iso: −0.20 [−0.37, −0.02] mmol/L; ExIso: −0.23 [−0.40, −0.06] mmol/L; p = 0.003) compared to non‐isoflavone groups (Ex: 0.01 [−0.16, 0.18] mmol/L; control: −0.09 [−0.27, 0.08] mmol/L) and had lower adverse reports of menopausal symptoms (14% versus 33%; p = 0.01) compared to non‐isoflavone groups. Isoflavone supplementation did not increase endometrial thickness or abnormal mammograms. We conclude exercise training and isoflavone supplementation maintain hip BMD compared to control, but these two interventions interfere with each other when combined. Isoflavone supplementation decreased LDL and adverse events related to menopausal symptoms. © 2013 American Society for Bone and Mineral Research.