title: Effect of exercise training combined with isoflavone supplementation on bone and lipids in postmenopausal women: a randomized clinical trial.
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/cm(2) ) than either the Ex or Iso groups alone (-0.005 [-0.01, 0.001] and -0.005 [-0.011, 0.001] g/cm(2) , 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.
authors.affiliation: College of Kinesiology, University of Saskatchewan, Saskatoon, SK, Canada. phil.chilibeck@usask.ca
authors.forename: Philip D
authors.initials: PD
authors.lastname: Chilibeck
authors.forename: Hassanali
authors.initials: H
authors.lastname: Vatanparast
authors.forename: Roger
authors.initials: R
authors.lastname: Pierson
authors.forename: Allison
authors.initials: A
authors.lastname: Case
authors.forename: Olufemi
authors.initials: O
authors.lastname: Olatunbosun
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Whiting
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Beck
authors.forename: Punam
authors.initials: P
authors.lastname: Pahwa
authors.forename: H Jay
authors.initials: HJ
authors.lastname: Biem
mesh_terms: D015502:Absorptiometry, Photon; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure / Q000187:drug effects; D001823:Body Composition / Q000187:drug effects; D015519:Bone Density / Q000187:drug effects; D001842:Bone and Bones / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000502:physiology; D004032:Diet; D019587:Dietary Supplements; D015444:Exercise; D005260:Female; D006615:Hip / Q000000981:diagnostic imaging / Q000473:pathology / Q000502:physiology; D006801:Humans; D007529:Isoflavones / Q000494:pharmacology*; D008055:Lipids / Q000097:blood*; D008875:Middle Aged; D009043:Motor Activity; D017698:Postmenopause / Q000097:blood* / Q000187:drug effects*; D014463:Ultrasonography
chemical_list: D001786:Blood Glucose; D007529:Isoflavones; D008055:Lipids