Skip to main content
SpringerLink
Log in

Effects of soy and other natural products on LDL:HDL ratio and other lipid parameters: A literature review

  • Published:
Advances in Therapy Aims and scope Submit manuscript

Abstract

Abnormal lipid levels contribute significantly to the risk of coronary heart disease, a major cardiovascular disease and a serious health problem. Various dietary and pharmacologic treatments have been devised to reduce elevated blood cholesterol levels. Soy protein, soluble fiber, and plant sterol/ester-containing margarines are promising new food-component candidates that may help to realize this goal. Of particular interest in this context is the LDL:HDL ratio, a strong predictor of cardiac events. This report is a review of more than 50 recent trials to determine how such dietary components and garlic affect the LDL:HDL ratio and other lipid parameters. Consumption of new soy products containing high, fixed levels of isoflavones, cotyledon soy fiber, and soy phospholipids (Abacor® and Abalon®) significantly reduced the LDL:HDL ratio by up to 27%. Soluble dietary fibers such as psyllium and beta glucan from oat bran had a variable effect on LDL-cholesterol levels in the studies analyzed. Plant sterol esters, when consumed in margarines, lowered the LDL:HDL ratio by up to 22%. On average, Abacor and Abalon reduced the LDL:HDL ratio by 20%, LDL cholesterol by 15%, total cholesterol by 10%, and triglycerides by 6%, and increased HDL cholesterol by 5%. The new soy-based supplements may therefore play a valuable role in reducing cardiovascular risk.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Isles CG, Paterson JR. Identifying patients at risk for coronary heart disease: implications from trials of lipid-lowering drug therapy.Q J Med. 2000;93:567–574.

    CAS  Google Scholar 

  2. Stamler J, Daviglus ML, Garside DB, Dyer AR, Greenland P, Neaton JD. Relationship of baseline serum cholesterol levels in 3 large cohorts of younger men to long-term coronary, cardiovascular, and all-cause mortality and to longevity.JAMA. 2000;284:311–318.

    Article  PubMed  CAS  Google Scholar 

  3. American Heart Association.2001 Heart and Stroke Statistical Update. Dallas, Tex: American Heart Association; 2000:1–22.

    Google Scholar 

  4. Food and Drug Administration. Food labeling: health claims; oats and coronary heart disease; final rule (21 CFR part 101).Federal Register. January 23, 1997:3583–3601.

    Google Scholar 

  5. Food and Drug Administration. Food labeling: health claims; soluble fiber from certain foods and coronary heart disease; final rule (21 CFR part 101).Federal Register. February 18, 1998:8103–8121.

    Google Scholar 

  6. Food and Drug Administration. Food labeling: health claims; plant sterol/stanol esters and coronary heart disease; interim final rule (21 CFR part 101).Federal Register. September 8, 2000: 54686–54739.

    Google Scholar 

  7. Food and Drug Administration. Food labeling: health claims; soy protein; interim final rule (21 CFR part 101.82).Federal Register. October 26, 1999:57700–57733.

    Google Scholar 

  8. Marsland C. A soy tutorial.Nutritional World. 2000;96–101.

  9. Young VR. Soy protein in relation to human protein and amino acid nutrition.J Am Diet Assoc. 1991;91:828–835.

    PubMed  CAS  Google Scholar 

  10. Anderson JW, Johnstone BM, Cook-Newell ME. Meta-analysis of the effects of soy protein intake on serum lipids.N Engl J Med. 1995;333:276–282.

    Article  PubMed  CAS  Google Scholar 

  11. Puska P, Korpelainen V, Hoie LH, Skovlund E, Lahti T, Smerud KT. Soy in hypercholesterolaemia: a double-blind, placebo-controlled trial.Eur J Clin Nutr. 2002;56:352–357.

    Article  PubMed  CAS  Google Scholar 

  12. Puska P, Korpelainen V, Hoie LH, Skovlund E, Smerud KT. Soy-fibre yogurt improves plasma lipids in hypercholesterolaemia: a double-blind, placebo-controlled trial. In press.

  13. Tonstad S, Hoie L, Smerud KT. Effects of 2 doses of soy protein versus casein on serum lipids and lipoproteins and plasma total homocysteine in hypercholesterolemic subjects.Am J Clin Nutr. 2002;76:78–84.

    PubMed  CAS  Google Scholar 

  14. Hermansen K, Sondergaard M, Hoie L, Carstensen M, Brock B. Beneficial effects of a soy-based dietary supplement on lipid levels and cardiovascular disease risk markers in type 2 diabetic subjects.Diabetes Care. 2001;24:228–233.

    Article  PubMed  CAS  Google Scholar 

  15. Teixeira SR, Potter SM, Weigel R, Hannum S, Erdman JW, Hasler CM. Effects of feeding 4 levels of soy protein for 3 and 6 wk on blood lipids and apolipoproteins in moderately hypercholes-terolemic men.Am J Clin Nutr. 2000;71:1077–1084.

    PubMed  CAS  Google Scholar 

  16. Baum JA, Teng H, Erdman JW, et al. Long-term intake of soy protein improves blood lipid profiles and increases mononuclear cell low-density-lipoprotein receptor messenger RNA in hypercholesterolemic, postmenopausal women.Am J Clin Nutr. 1998;68:545–551.

    PubMed  CAS  Google Scholar 

  17. Crouse JR, Morgan T, Terry JG, Ellis J, Vitolins M, Burke GL. A randomized trial comparing the effect of casein with that of soy protein containing varying amounts of isoflavones on plasma concentrations of lipids and lipoproteins.Arch Intern Med. 1999;159:2070–2076.

    Article  PubMed  CAS  Google Scholar 

  18. Washburn S, Burke GL, Morgan T, Anthony M. Effect of soy protein supplementation on serum lipoproteins, blood pressure, and menopausal symptoms in perimenopausal women.Menopause. 1999;6:7–13.

    Article  PubMed  CAS  Google Scholar 

  19. Wong WW, Smith EO, Stuff JE, Hachey DL, Heird WC, Pownell HJ. Cholesterol-lowering effect of soy protein in normocholesterolemic and hypercholesterolemic men.Am J Clin Nutr. 1998;68:1385S-1389S.

    PubMed  CAS  Google Scholar 

  20. Merz-Demlow BE, Duncan AM, Wangen KE, et al. Soy isoflavones improve plasma lipids in normocholesterolemic, premenopausal women.Am J Clin Nutr. 2000;71:1462–1469.

    PubMed  CAS  Google Scholar 

  21. Wangen KE, Duncan AM, Xu X, Kurzer MS. Soy isoflavones improve plasma lipids in normocholesterolemic and mildly hypercholesterolemic postmenopausal women.Am J Clin Nutr. 2001;73:225–231.

    PubMed  CAS  Google Scholar 

  22. Ashton E, Ball M. Effects of soy as tofu vs meat on lipoprotein concentrations.Eur J Clin Nutr. 2000;54:14–19.

    Article  PubMed  CAS  Google Scholar 

  23. Kurowska EM, Jordan J, Spence JD, et al. Effects of substituting dietary soybean protein and oil for milk protein and fat in subjects with hypercholesterolemia.Clin Invest Med. 1997;20:162–170.

    PubMed  CAS  Google Scholar 

  24. Brown L, Rosner B, Willet WW, Sacks FM. Cholesterol-lowering effects of dietary fiber: a meta-analysis.Am J Clin Nutr. 1999;69:30–42.

    PubMed  CAS  Google Scholar 

  25. Nordgaard I, Hove H, Clausen MR, Mortensen PB. Colonic production of butyrate in patients with previous colonic cancer during long-term treatment with dietary fibre (Plantago ovata seeds).Scand J Gastroenterol. 1996;31:1011–1020.

    Article  PubMed  CAS  Google Scholar 

  26. Lia A, Andersson H, Mekki N, Juhel C, Senft M, Lairon D. Postprandial lipemia in relation to sterol and fat excretion in ileostomy subjects given oat-bran and wheat test meals.Am J Clin Nutr. 1997;66:357–365.

    PubMed  CAS  Google Scholar 

  27. Hendler SS, Rorvik MS, Fleming T, Deutsch M, Wyble C, eds. Psyllium. In:PDR® for Nutritional Supplements. Montvale, NJ: Thomson Healthcare; 2001:384–386.

    Google Scholar 

  28. Anderson JW, Allgood LD, Lawrence A, Altringer LA, Jerdack GR, Hengehold DA. Cholesterollowering effects of psyllium intake adjunctive to diet therapy in men and women with hypercholesterolemia: meta-analysis of 8 controlled trials.Am J Clin Nutr. 2000;71:472–479.

    PubMed  CAS  Google Scholar 

  29. Davidson MH, Maki KC, Kong JC, et al. Long-term effects of consuming foods containing psyllium seed husk on serum lipids in subjects with hypercholesterolemia.Am J Clin Nutr. 1998;67:367–376.

    PubMed  CAS  Google Scholar 

  30. Anderson JW, Davidson MH, Blonde L, et al. Long-term cholesterol-lowering effects of psyllium as an adjunct to diet therapy in the treatment of hypercholesterolemia.Am J Clin Nutr. 2000;71:1433–1438.

    PubMed  CAS  Google Scholar 

  31. MacMahon M, Carless J. Ispaghula husk in the treatment of hypercholesterolaemia: a double-blind controlled study.J Cardiovasc Risk. 1998;5:167–172.

    Article  PubMed  CAS  Google Scholar 

  32. Rodriguez-Morán M, Guerrero-Romero F, Lazcano-Burciaga G. Lipid- and glucose-lowering efficacy of plantago psyllium in type II diabetes.J Diabetes Complications. 1998;12:273–278.

    Article  PubMed  Google Scholar 

  33. Romero AL, Romero JE, Galaviz S, Fernandez ML. Cookies enriched with psyllium or oat bran lower plasma LDL cholesterol in normal and hypercholesterolemic men from northern Mexico.JAm Coll Nutr. 1998;17:601–608.

    CAS  Google Scholar 

  34. Gerhardt AL, Gallo NB. Full-fat rice bran and oat bran similarly reduce hypercholesterolemia in humans.J Nutr. 1998;128:865–869.

    PubMed  CAS  Google Scholar 

  35. Behall KM, Scholfield DJ, Hallfrisch J. Effect of beta-glucan level in oat fiber extracts on blood lipids in men and women.J Am Coll Nutr. 1997;16:46–51.

    PubMed  CAS  Google Scholar 

  36. Önning G, Wallmark A, Persson M, Akesson B, Elmstahl S, Öste R. Consumption of oat milk for 5 weeks lowers serum cholesterol and LDL cholesterol in free-living men with moderate hypercholesterolemia.Ann Nutr Metab. 1999;43:301–309.

    Article  PubMed  Google Scholar 

  37. Lovegrove JA, Clohessy A, Milon H, Williams CM. Modest doses of β-glucan do not reduce concentrations of potentially atherogenic lipoproteins.Am J Clin Nutr. 2000;72:49–55.

    PubMed  CAS  Google Scholar 

  38. Beer MU, Arrigoni E, Amadò R. Effects of oat gum on blood cholesterol levels in healthy young men.Eur J Clin Nutr. 1995;49:517–522.

    PubMed  CAS  Google Scholar 

  39. Pick ME, Hawrysh ZJ, Gee MI, Toth E, Garg ML, Hardin RT. Oat bran concentrate bread products improve long-term control of diabetes: a pilot study.J Am Diet Assoc. 1996;96:1254–1261.

    Article  PubMed  CAS  Google Scholar 

  40. Plat J, Mensink RP. Vegetable oil based versus wood based stanol ester mixtures: effects on serum lipids and hemostatic factors in non-hypercholesterolemic subjects.Atherosclerosis. 2000;148:101–112.

    Article  PubMed  CAS  Google Scholar 

  41. Ling WH, Jones PJH. Minireview. Dietary phytosterols: a review of metabolism, benefits and side effects.Life Sci. 1995;57:195–206.

    Article  PubMed  CAS  Google Scholar 

  42. Miettinen TA, Puska P, Gylling H, Vanhanen H, Vartiainen E. Reduction of serum cholesterol with sitostanol-ester margarine in a mildly hypercholesterolemic population.N Engl J Med. 1995;333:1308–1312.

    Article  PubMed  CAS  Google Scholar 

  43. Miettinen TA, Vuoristo M, Nissinen M, Järvinen HJ, Gylling H. Serum, biliary, and fecal cholesterol and plant sterols in colectomized patients before and during consumption of stanol ester margarine.Am J Clin Nutr. 2000;71:1095–1102.

    PubMed  CAS  Google Scholar 

  44. Blair SN, Capuzzi DM, Gottlieb SO, Nguyen T, Morgan JM, Cater NB. Incremental reduction of serum total cholesterol and low-density lipoprotein cholesterol with the addition of plant stanol ester-containing spread to statin therapy.Am J Cardiol. 2000;86:46–52.

    Article  PubMed  CAS  Google Scholar 

  45. Hallikainen MA, Uusitupa MIJ. Effects of 2 low-fat stanol ester-containing margarines on serum cholesterol concentrations as part of a low-fat diet in hypercholesterolemic subjects.Am J Clin Nutr. 1999;69:403–410.

    PubMed  CAS  Google Scholar 

  46. Hallikainen MA, Sarkkinen ES, Uusitupa MIJ. Plant stanol esters affect serum cholesterol concentrations of hypercholesterolemic men and women in a dose-dependent manner.J Nutr. 2000;130:767–776.

    PubMed  CAS  Google Scholar 

  47. Gylling H, Miettinen TA. Cholesterol reduction by different plant stanol mixtures and with variable fat intake.Metabolism. 1999;48:575–580.

    Article  PubMed  CAS  Google Scholar 

  48. Weststrate JA, Meijer GW. Plant sterol-enriched margarines and reduction of plasma total- and LDL-cholesterol concentrations in normocholesterolaemic and mildly hypercholesterolaemic subjects.Eur J Clin Nutr. 1998;52:334–343.

    Article  PubMed  CAS  Google Scholar 

  49. Jones PJ, Raeini-Sarjaz M, Ntanios FY, Vanstone CA, Feng JY, Parsons WE. Modulation of plasma lipid levels and cholesterol kinetics by phytosterol versus phytostanol esters.J Lipid Res. 2000;41:697–705.

    PubMed  CAS  Google Scholar 

  50. Jones PJH, Ntanios FY, Raeini-Sarjaz M, Vanstone CA. Cholesterol-lowering efficacy of a sitostanolcontaining phytosterol mixture with a prudent diet in hyperlipidemic men.Am J Clin Nutr. 1999;69:1144–1150.

    PubMed  CAS  Google Scholar 

  51. Denke MA. Lack of efficacy of low-dose sitostanol therapy as an adjunct to a cholesterol-lowering diet in men with moderate hypercholesterolemia.Am J Clin Nutr. 1995;61:392–396.

    PubMed  CAS  Google Scholar 

  52. Hendriks HFJ, Weststrate JA, van Vliet T, Meijer GW. Spreads enriched with three different levels of vegetable oil sterols and the degree of cholesterol lowering in normocholesterolaemic and mildly hypercholesterolaemic subjects.Eur J Clin Nutr. 1999;53:319–327.

    Article  PubMed  CAS  Google Scholar 

  53. Ayesh R, Weststrate A, Drewitt PN, Hepburn PA. Safety evaluation of phytosterol esters, Part 5: faecal short-chain fatty acid and microflora content, faecal bacterial enzyme activity and serum female sex hormones in healthy normolipidaemic volunteers consuming a controlled diet either with or without a phytosterol ester-enriched margarine.Food Chem Toxicol. 1999;37:1127–1138.

    Article  PubMed  CAS  Google Scholar 

  54. Silagy C, Neil A. Garlic as a lipid lowering agent—a meta-analysis.J R Coll Physicians Lond. 1994;28:2–8.

    Google Scholar 

  55. Warshafsky S, Kamer RS, Sivak SL. Effect of garlic on total serum cholesterol.Ann Intern Med. 1993;119:599–605.

    PubMed  CAS  Google Scholar 

  56. Stevinson C, Pittler MH, Ernst E. Garlic for treating hypercholesterolemia. A meta-analysis of randomized clinical trials.Ann Intern Med. 2000;133:420–429.

    PubMed  CAS  Google Scholar 

  57. Neil HAW, Silagy CA, Lancaster T, et al. Garlic powder in the treatment of moderate hyperlipidaemia: a controlled trial and meta-analysis.J R Coll Physicians Lond. 1996;30:329–334.

    PubMed  CAS  Google Scholar 

  58. Simons LA, Balasubramaniam S, Königsmark M, Parfitt A, Simons J, Peters W. On the effect of garlic on plasma lipids and lipoproteins in mild hypercholesterolaemia.Atherosclerosis. 1995;113:219–225.

    Article  PubMed  CAS  Google Scholar 

  59. Bordia A, Verma SK, Srivastava KC. Effect of garlic (Allium sativum) on blood lipids, blood sugar, fibrinogen and fibrinolytic activity in patients with coronary artery disease.Prostaglandins, Leukot Essent Fatty Acids. 1998;58:257–263.

    Article  CAS  Google Scholar 

  60. Yeh YY, Liu L. Cholesterol-lowering effect of garlic extracts and organosulfur compounds: human and animal studies.J Nutr. 2001;131:989S-993S.

    PubMed  CAS  Google Scholar 

  61. Gardner CD, Chatterjee LM, Carlson JJ. The effect of a garlic preparation on plasma lipid levels in moderately hypercholesterolemic adults.Atherosclerosis. 2001;154:213–220.

    Article  PubMed  CAS  Google Scholar 

  62. Superko HR, Krauss RM. Garlic powder: effect on plasma lipids, postprandial lipemia, lowdensity lipoprotein particle size, high-density lipoprotein subclass distribution and lipoprotein (a).JAm Coll Cardiol. 2000;35:321–326.

    Article  CAS  Google Scholar 

  63. Lash JP, Cardoso LR, Mesler PM, Walczak DA, Pollak R. The effect of garlic on hypercholesterolemia in renal transplant patients.Transplant Proc. 1998;30:189–191.

    Article  PubMed  CAS  Google Scholar 

  64. Isaacsohn JL, Moser M, Stein EA, et al. Garlic powder and plasma lipids and lipoproteins. A multicenter, randomized, placebo-controlled trial.Arch Intern Med. 1998;158:1189–1194.

    Article  PubMed  CAS  Google Scholar 

  65. Hendler SS, Rorvik MS, Fleming T, Deutsch M, Wyble C, eds. Soy isoflavones, soy proteins. In:PDR®for Nutritional Supplements. Montvale, NJ: Thomson Healthcare; 2001:428–431.

    Google Scholar 

  66. Olson BH, Anderson SM, Becker MP, et al. Psyllium-enriched cereals lower blood total cholesterol and LDL cholesterol, but not HDL cholesterol, in hypercholesterolemic adults: results of a metaanalysis.J Nutr. 1997;127:1973–1980.

    PubMed  CAS  Google Scholar 

  67. Wood PJ, Beer MU. Functional oat products. In: Mazza G, ed.Functional Foods. Basel: Technomic; 1998:1–37.

    Google Scholar 

  68. Lo GS, Goldberg AP, Lim A, Grundhauser JJ, Anderson C, Schonfeld G. Soy fiber improves lipid and carbohydrate metabolism in primary hyperlipidemic subjects.Atherosclerosis. 1986;62:239–248.

    Article  PubMed  CAS  Google Scholar 

  69. Anderson JW, Deakins DA, Floore TL, Smith BM, Whitis SE. Dietary fiber and coronary heart disease.Crit Rev Food Sci Nutr. 1990;29:95–147.

    Article  PubMed  CAS  Google Scholar 

  70. Miettinen TA. Stanol esters in treatment of hypercholesterolaemia.Eur Heart J Suppl. 1999;1(suppl S):S50-S57.

    CAS  Google Scholar 

  71. Spigelski D, Jones PJH. Efficacy of garlic supplementation in lowering serum cholesterol levels.Nutr Rev. 2001;59:236–244.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Endocrinology and Metabolism, Aarhus University Hospital, Aarhus, Denmark

    Kjeld Hermansen MD, DMSc

  2. Nutri Pharma ASA, Copenhagen, Denmark

    Bo Dinesen MSc & Lars H. Hoie MD

  3. Nutri Pharma GmbH, Berlin, Germany

    Eve Morgenstern PhD & Joerg Gruenwald PhD

Authors
  1. Kjeld Hermansen MD, DMSc
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Bo Dinesen MSc
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Lars H. Hoie MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Eve Morgenstern PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Joerg Gruenwald PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hermansen, K., Dinesen, B., Hoie, L.H. et al. Effects of soy and other natural products on LDL:HDL ratio and other lipid parameters: A literature review. Adv Therapy 20, 50–78 (2003). https://doi.org/10.1007/BF02850119

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02850119

Keywords

Search

Navigation