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Reply to AH Lichtenstein and NR Matthan

Department of Nutrition
One Shields Avenue
University of California, Davis
Davis, CA 95616
E-mail: fmsteinberg{at}ucdavis.edu

Dear Sir:

I would like to respond to the letter by Lichtenstein and Matthan regarding my editorial comments (1) concerning their recent publication (2). The statements in contention refer to the change from baseline in lipid values and to the hypocholesterolemic effects of soy proteins compared with those of animal proteins. These statements were meant to call attention to the very phenomenon that the authors describe in their letter; ie, that lipid and lipoprotein values observed at an initial screening have less favorable cardiovascular risk profiles than do those observed during intervention periods. This was the case in their latest study (2), in which all treatment groups showed improvement, as has been reported numerous times before. The editorial comments refer to this in a qualitative manner and were not meant to imply that statistical analyses were performed to examine that relation. It is well appreciated that the nature of the study was a randomized crossover design and that the statistical analysis used analysis of variance with the main effect of diet and subject as repeated measures for each outcome variable with pairwise comparisons between endpoint values for each of the treatment groups.

There is also no misunderstanding that the conclusions stated by the authors in their publication referred to outcomes from treatments based on differently processed soy products compared relative to each other and with animal protein and to a comparison between the effects of animal protein and soy protein on CVD risk factors. In summary, we agree that soyfoods included in the diet could be beneficial for overall cardiovascular disease risk reduction through displacement of atherogenic dietary components or other mechanisms that have yet to be elucidated.

ACKNOWLEDGMENTS

The author had no conflict of interest to declare.

REFERENCES

1. Steinberg FM. Soybeans or soymilk: does it make a difference for cardiovascular protection? Does it even matter? Am J Clin Nutr 2007;85:927-8.[Free Full Text]
2. Matthan NR, Jalbert SM, Ausman LM, Kuvin JT, Karas RH, Lichtenstein AH. Effect of soy protein from differently processed products on cardiovascular disease risk factors and vascular endothelial function in hypercholesterolemic subjects. Am J Clin Nutr 2007;85:960-6.[Abstract/Free Full Text]

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