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      Efeitos a curto prazo da dieta com proteína da soja em pacientes com glomerulopatias proteinúricas Translated title: Short-term effects of soy protein diet in patients with proteinuric glomerulopathies

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          Abstract

          INTRODUÇÃO: Há indícios de que a proteína da soja poderia contribuir para reduzir a velocidade de progressão da doença renal, diminuindo colesterol sérico e proteinúria em pacientes com nefropatias. Este estudo foi desenvolvido para avaliar o efeito da die>ta com proteína da soja sobre proteinúria e dislipidemia, em pacientes com glomerulopatias proteinúricas. PACIENTES E MÉTODOS: Os pacientes foram divididos em três grupos: o Grupo Controle (n = 9) recebeu dieta com 0,8 g/kg/dia de proteína animal; o Grupo de Estudo 1 (n = 9) recebeu dieta com 0,8 g/kg/dia de proteína da soja e o Grupo 2 (n = 9), dieta com 0,8 g/kg/dia de proteína da soja mais fibras. O período de estudo foi de oito semanas. Durante o período basal e no final do estudo, os pacientes foram submetidos à avaliação laboratorial e antropométrica. RESULTADOS: Não foram observadas diferenças estatisticamente significantes entre os períodos pré e pós-intervenção em nenhum dos grupos estudados, nos parâmetros antropométricos ou na composição corporal entre os três grupos, nem nos níveis de proteinúria (Controle: 0.7 ± 0.6 versus 0.8 ± 0.6; Grupo 1: 2.0 ± 1.7 versus 1.9 ± 1.8; Grupo 2: 2.0 ± 1.4 versus 2.1 ± 2.0). No entanto, observou-se discreta diminuição nos níveis triglicérides (244.8+-275.9 versus 200.5+-34.0), colesterol total (234.0+-59.4 versus 181.2+-110.3) e LDL (136.0+-59.1 versus 104.1+-39.4) no Grupo 1, embora sem atingir significância estatística. CONCLUSÃO: Não foram detectados efeitos benéficos com a substituição da proteína animal pela proteína da soja em relação aos objetivos de reduzir proteinúria e hiperlipidemia; porém, constatou-se que a dieta de proteína da soja não causou alterações deletérias na composição corporal, mantendo um estado nutricional adequado.

          Translated abstract

          INTRODUCTION: It has been suggested that soy protein can slow renal disease progression by decreasing plasma cholesterol and proteinuria in patients with nephropathies. This study was designed to evaluate the effect of soy protein on proteinuria and dyslipidemia, in patients with proteinuric glomerulopathies. PATIENTS AND METHODS: Patients were divided into three groups: Control Group (n = 9) received diet with 0.8 g/kg/day of animal protein; Study Group 1 (n = 9), 0.8 g/kg/day of soy protein; and Group 2 (n = 9), 0.8 g/kg/day of soy protein plus fibers. The study period corresponded to eight weeks. During the baseline period and by the end of the study, patients were submitted to laboratorial and anthropometric evaluation. RESULTS: There was no statistically significant difference between baseline and post-diet periods among the three groups in anthropometric parameters or body composition, neither in proteinuria levels (Control: 0.7 ± 0.6 versus 0.8 ± 0.6; Group 1: 2.0 ± 1.7 versus 1.9 ± 1.8; Group 2: 2.0 ± 1.4 versus 2.1 ± 2.0). However, a slight decrease in triglycerides (244.8 ± 275.9 versus 200.5 ± 34.0), total (234.0 ± 59.4 versus 181.2 ± 110.3) and LDL (136.0 ± 59.1 versus 104.1 ± 39.4) cholesterol in Group 1 was observed, although not significant. CONCLUSION: We have not observed beneficial effects when using soy protein instead of animal protein with the aim of attenuating proteinuria and hyperlipidemia, but we have shown that soy protein has not caused deleterious changes in body composition, ensuring an adequate nutritional state.

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          Most cited references35

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          Meta-Analysis of the Effects of Soy Protein Intake on Serum Lipids

          In laboratory animals, the consumption of soy protein, rather than animal protein, decreases serum cholesterol concentrations, but studies in humans have been inconclusive. In this meta-analysis of 38 controlled clinical trials, we examined the relation between soy protein consumption and serum lipid concentrations in humans. We used a random-effects model to quantify the average effects of soy protein intake on serum lipids in the studies we examined and used hierarchical mixed-effects regression models to predict variation as a function of the characteristics of the studies. In most of the studies, the intake of energy, fat, saturated fat, and cholesterol was similar when the subjects ingested control and soy-containing diets; soy protein intake averaged 47 g per day. Ingestion of soy protein was associated with the following net changes in serum lipid concentrations from the concentrations reached with the control diet: total cholesterol, a decrease of 23.2 mg per deciliter (0.60 mmol per liter); 95 percent confidence interval, 13.5 to 32.9 mg per deciliter [0.35 to 0.85 mmol per liter]), or 9.3 percent; low-density lipoprotein (LDL) cholesterol, a decrease of 21.7 mg per deciliter (0.56 mmol per liter); 95 percent confidence interval, 11.2 to 31.7 mg per deciliter [0.30 to 0.82 mmol per liter]), or 12.9 percent; and triglycerides, a decrease of 13.3 mg per deciliter (0.15 mmol per liter; 95 percent confidence interval, 0.3 to 25.7 mg per deciliter [0.003 to 0.29 mmol per liter]), or 10.5 percent. The changes in serum cholesterol and LDL cholesterol concentrations were directly related to the initial serum cholesterol concentration (P < 0.001). The ingestion of soy protein was associated with a nonsignificant 2.4 percent increase in serum concentrations of high-density lipoprotein (HDL) cholesterol. In this meta-analysis we found that the consumption of soy protein rather than animal protein significantly decreased serum concentrations of total cholesterol, LDL cholesterol, and triglycerides without significantly affecting serum HDL cholesterol concentrations.
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            Renal, metabolic and hormonal responses to ingestion of animal and vegetable proteins.

            Renal and hormonal responses were studied in a group of healthy individuals fed, in random order, for three weeks, a vegetable protein diet (N = 10), an animal protein diet (N = 10), or an animal protein diet supplemented with fiber (N = 7), all containing the same amount of total protein (chronic study). In seven additional subjects the acute renal, metabolic and hormonal response to ingestion of a meat or soya load of equivalent total protein content was investigated (acute study). In the chronic study GRF, RPF and fractional clearance of albumin and IgG were significantly higher on the animal than the vegetable protein diets (GFR: 121 +/- 4 vs. 111 +/- 4 ml/min/1.73 m2, P less than 0.001; RPF: 634 +/- 29 vs. 559 +/- 26 ml/min/1.73 m2, P less than 0.001; theta alb: 19.5 +/- 3.1 vs. 10.2 +/- 1.6 x 10(-7), P less than 0.01; theta IgG: 11.6 +/- 3.1 vs. 7.5 +/- 1.7 x 10(-7), P less than 0.05). Renal vascular resistance was lower on the animal than vegetable protein diet (82 +/- 5 vs. 97 +/- 5 mmHg/min/liter; P less than 0.001). Fiber supplementation to APD did not have any effect on the renal variables measured which were indistinguishable from APD. In the acute study, GFR and RPF both rose significantly by approximately 16% (P less than 0.005) and approximately 14% (P less than 0.05), respectively, after the meat load, while RVR fell by approximately 12% (P less than 0.05). There were no significant changes in these parameters following the soya load.(ABSTRACT TRUNCATED AT 250 WORDS)
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              Cardiovascular and renal benefits of dry bean and soybean intake.

              Dry beans and soybeans are nutrient-dense, fiber-rich, and are high-quality sources of protein. Protective and therapeutic effects of both dry bean and soybean intake have been documented. Studies show that dry bean intake has the potential to decrease serum cholesterol concentrations, improve many aspects of the diabetic state, and provide metabolic benefits that aid in weight control. Soybeans are a unique source of the isoflavones genistein and diadzein, which have numerous biological functions. Soybeans and soyfoods potentially have multifaceted health-promoting effects, including cholesterol reduction, improved vascular health, preserved bone mineral density, and reduction of menopausal symptoms. Soy appears to have salutary effects on renal function, although these effects are not well understood. Whereas populations consuming high intakes of soy have lower prevalences of certain cancers, definitive experimental data are insufficient to clarify a protective role of soy. The availability of legume products and resources is increasing, incorporating dry beans and soyfoods into the diet can be practical and enjoyable. With the shift toward a more plant-based diet, dry beans and soy will be potent tools in the treatment and prevention of chronic disease.
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                Author and article information

                Journal
                jbn
                Brazilian Journal of Nephrology
                Braz. J. Nephrol.
                Sociedade Brasileira de Nefrologia (São Paulo, SP, Brazil )
                0101-2800
                2175-8239
                June 2011
                : 33
                : 2
                : 150-159
                Affiliations
                [01] orgnameUniversidade Federal de São Paulo orgdiv1Department of Medicine orgdiv2Glomerulopathies Section
                [02] orgnameSBN orgdiv1Department of Epidemiology and Kidney Diseases Prevention
                Article
                S0101-28002011000200006 S0101-2800(11)03300200006
                10.1590/S0101-28002011000200006
                ac40b35d-e50f-4c4d-bc49-141b30420947

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 24 March 2010
                : 20 November 2010
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 35, Pages: 10
                Product

                SciELO Brazil

                Categories
                Artigos Originais

                glomerulonefrite,alimentos de soja,proteinúria,dieta,glomerulonephritis,soy foods,proteinuria,diet

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