***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The soybean is rich in isoflavone phytoestrogens , which are lig and s for estrogen receptors , but it is unknown whether soy/phytoestrogens have similar procoagulant effects to estrogen . In this r and omized double-blind trial , 40 healthy postmenopausal women of age 50 - 75 yr received soy protein isolate ( 40 g soy protein , 118 mg isoflavones ) ( n = 19 ) or casein placebo ( n = 21 ) . Plasma markers of coagulation , fibrinolysis , and endothelial dysfunction were measured at baseline and 3 months . The baseline characteristics of the two groups were similar . Compared with casein placebo , soy decreased triglycerides ( P < 0.005 ) and low-density lipoprotein/high-density lipoprotein ratio ( P < 0.001 ) and increased lipoprotein ( a ) ( P < 0.05 ) . Activity of coagulation factor VII ( VIIc ) decreased similarly in both groups ( P < 0.005 ) . Prothrombin fragments 1 + 2 ( a marker of thrombin generation ) decreased in the soy group ( P < 0.005 ) , but the change was not different from the casein group . There was no effect of soy on soluble fibrin ( a marker of fibrin production ) , plasminogen activator inhibitor-1 ( a marker of fibrinolytic inhibitory potential ) , D-dimer ( a marker of fibrin turnover ) , or von Willebr and factor ( a marker of endothelial damage ) . In conclusion , the results of the current study do not support biologically significant estrogenic effects of soy/phytoestrogens on coagulation , fibrinolysis , or endothelial function Background —Endothelial function is impaired in coronary artery disease and may contribute to its clinical manifestations . Increased oxidative stress has been linked to impaired endothelial function in atherosclerosis and may play a role in the pathogenesis of cardiovascular events . This study was design ed to determine whether endothelial dysfunction and vascular oxidative stress have prognostic impact on cardiovascular event rates in patients with coronary artery disease . Methods and Results —Endothelium-dependent and -independent vasodilation was determined in 281 patients with documented coronary artery disease by measuring forearm blood flow responses to acetylcholine and sodium nitroprusside using venous occlusion plethysmography . The effect of the coadministration of vitamin C ( 24 mg/min ) was assessed in a subgroup of 179 patients .  Cardiovascular events , including death from cardiovascular causes , myocardial infa rct ion , ischemic stroke , coronary angioplasty , and coronary or peripheral bypass operation , were studied during a mean follow-up period of 4.5 years . Patients experiencing cardiovascular events ( n=91 ) had lower vasodilator responses to acetylcholine ( P < 0.001 ) and sodium nitroprusside ( P < 0.05 ) , but greater benefit from vitamin C ( P < 0.01 ) . The Cox proportional regression analysis for conventional risk factors demonstrated that blunted acetylcholine-induced vasodilation ( P = 0.001 ) , the effect of vitamin C ( P = 0.001 ) , and age ( P = 0.016 ) remained independent predictors of cardiovascular events . Conclusions —Endothelial dysfunction and increased vascular oxidative stress predict the risk of cardiovascular events in patients with coronary artery disease . These data support the concept that oxidative stress may contribute not only to endothelial dysfunction but also to coronary artery disease activity Background Consumption of chocolate has been often hypothesized to reduce the risk of cardiovascular disease ( CVD ) due to chocolate 's high levels of stearic acid and antioxidant flavonoids . However , debate still lingers regarding the true long term beneficial cardiovascular effects of chocolate overall . Methods We review ed English- language MEDLINE publications from 1966 through January 2005 for experimental , observational , and clinical studies of relations between cocoa , cacao , chocolate , stearic acid , flavonoids ( including flavonols , flavanols , catechins , epicatechins , and procynadins ) and the risk of cardiovascular disease ( coronary heart disease ( CHD ) , stroke ) . A total of 136 publications were selected based on relevance , and quality of design and methods . An up date d meta- analysis of flavonoid intake and CHD mortality was also conducted . Results The body of short-term r and omized feeding trials suggests cocoa and chocolate may exert beneficial effects on cardiovascular risk via effects on lowering blood pressure , anti-inflammation , anti-platelet function , higher HDL , decreased LDL oxidation . Additionally , a large body of trials of stearic acid suggests it is indeed cholesterol-neutral . However , epidemiologic studies of serum and dietary stearic acid are inconclusive due to many method ologic limitations . Meanwhile , the large body of prospect i ve studies of flavonoids suggests the flavonoid content of chocolate may reduce risk of cardiovascular mortality . Our up date d meta- analysis indicates that intake of flavonoids may lower risk of CHD mortality , RR = 0.81 ( 95 % CI : 0.71–0.92 ) comparing highest and lowest tertiles . Conclusion Multiple lines of evidence from laboratory experiments and r and omized trials suggest stearic acid may be neutral , while flavonoids are likely protective against CHD mortality . The highest priority now is to conduct larger r and omized trials to definitively investigate the impact of chocolate consumption on long-term cardiovascular outcomes Background —Moderate red wine consumption is inversely associated with coronary ischemia , and both red wine and purple grape juice ( PGJ ) contain flavonoids with antioxidant and antiplatelet properties believed to be protective against cardiovascular events . Acute cardiac events are also associated with decreased platelet-derived nitric oxide ( NO ) release . In this study , the effects of PGJ and PGJ-derived flavonoids on platelet function and platelet NO production were determined . Methods and Results —Incubation of platelets with dilute PGJ led to inhibition of aggregation , enhanced release of platelet-derived NO , and decreased superoxide production . To confirm the in vivo relevance of these findings , 20 healthy subjects consumed 7 mL · kg−1 · d−1 of PGJ for 14 days . Platelet aggregation was inhibited after PGJ supplementation , platelet-derived NO production increased from 3.5±1.2 to 6.0±1.5 pmol/108 platelets , and superoxide release decreased from 29.5±5.0 to 19.2±3.1 arbitrary units ( P < 0.007 and P < 0.05 , respectively ) . & agr;-Tocopherol levels increased significantly after PGJ consumption ( from 15.6±0.7 to 17.6±0.9 & mgr;mol/L;P < 0.009 ) , and the plasma protein – independent antioxidant activity increased by 50.0 % ( P < 0.05 ) . Last , incubation of platelets with select flavonoid fractions isolated from PGJ consistently attenuated superoxide levels but had variable effects on whole-blood aggregation , platelet aggregation , and NO release . Conclusions —Both in vitro incubation and oral supplementation with PGJ  decrease platelet aggregation , increase platelet-derived NO release , and decrease superoxide production . These findings may be a result of antioxidant-sparing and /or direct effects of select flavonoids found in PGJ . The suppression of platelet-mediated thrombosis represents a potential mechanism for the beneficial effects of purple grape products , independent of alcohol consumption , in cardiovascular disease Background : Postmenopausia and hypercholesterolemia are related to endothelial dysfunction , a pathogenic event in atherosclerosis . Soy protein reduces plasma cholesterol , but there is scanty information about its effect on endothelial function . Objective : To evaluate the effect of isolated soy protein compared to caseinate on plasma lipoproteins and endothelial function in postmenopausal hypercholesterolemic women . Design : R and omized , double-blind , cross-over trial . Setting : Outpatient clinic of the Catholic University of Chile . Subjects : Eighteen healthy , postmenopausal women with hypercholesterolemia were recruited , included and completed the protocol . Interventions : During the trial , all patients followed a low fat/low cholesterol diet and were r and omly assigned to receive isolated soy protein or matching caseinate for 4 weeks , and then the alternative treatment until week 8 . At pre- study and at the end of the first and second period , plasma lipoprotein levels and endothelial function ( flow-mediated dilatation ( FMD ) of the brachial artery ) were evaluated . Results : Plasma total and low density lipoprotein (LDL)-cholesterol concentration were significantly lower with the low fat/low cholesterol diet compared to pre- study , either with caseinate or soy protein . No significant differences in plasma lipid concentration between caseinate or soy protein interventions were observed . FMD did not change with the caseinate . In contrast , when soy protein was administered , FMD was significantly higher compared to pre- study ( 9.471.8 % vs 5.371.2 % ; P<0.05 ) and compared to caseinate intervention ( 9.471.8 % vs 4.971.5 % ; P<0.033 ) . Conclusions : These results suggest that in postmenopausal hypercholesterolemic women , soy protein improves endothelial function , regardless of changes in plasma lipoproteins . Sponsorship : Pontificia Universidad Católica ( DIPUC99/09E ) , Protein Technology International and Gynopharm Laboratory ( Recalcine Group ) Seven men and seven women participated in a r and omized crossover trial to study the effect of intake of parsley ( Petroselinum crispum ) , containing high levels of the flavone apigenin , on the urinary excretion of flavones and on biomarkers for oxidative stress . The subjects received a strictly controlled diet low in flavones and other naturally occurring antioxidants during the 2 weeks of intervention . This basic diet was supplemented with parsley providing 3.73 - 4.49 mg apigenin/MJ in one of the intervention weeks . Urinary excretion of apigenin was 1.59 - 409.09 micrograms/MJ per 24 h during intervention with parsley and 0 - 112.27 micrograms/MJ per 24 h on the basic diet ( P < 0.05 ) . The fraction of apigenin intake excreted in the urine was 0.58 ( SE 0.16)% during parsley intervention . Erythrocyte glutathione reductase ( EC 1.6.4.1 ; GR ) and superoxide dismutase ( EC 1.15.1.1 ; SOD ) activities increased during intervention with parsley ( P < 0.005 ) as compared with the levels on the basic diet , whereas erythrocyte catalase ( EC 1.11.1.6 ) and glutathione peroxidase ( EC 1.11.1.9 ) activities did not change . No significant changes were observed in plasma protein 2-adipic semialdehyde residues , a biomarker of plasma protein oxidation . In this short-term investigation , an overall decreasing trend in the activity of antioxidant enzymes was observed during the 2-week study . The decreased activity of SOD was strongly correlated at the individual level with an increased oxidative damage to plasma proteins . However , the intervention with parsley seemed , partly , to overcome this decrease and result ed in increased levels of GR and SOD The effects of different polyphenol-containing beverages on Fe absorption from a bread meal were estimated in adult human subjects from the erythrocyte incorporation of radio-Fe . The test beverages contained different polyphenol structures and were rich in either phenolic acids ( chlorogenic acid in coffee ) , monomeric flavonoids ( herb teas , camomile ( Matricaria recutita L. ) , vervain ( Verbena officinalis L. ) , lime flower ( Tilia cor data Mill . ) , pennyroyal ( Mentha pulegium L. ) and peppermint ( Mentha piperita L. ) , or complex polyphenol polymerization products ( black tea and cocoa ) . All beverages were potent inhibitors of Fe absorption and reduced absorption in a dose-dependent fashion depending on the content of total polyphenols . Compared with a water control meal , beverages containing 20 - 50 mg total polyphenols/serving reduced Fe absorption from the bread meal by 50 - 70 % , whereas beverages containing 100 - 400 mg total polyphenols/serving reduced Fe absorption by 60 - 90 % . Inhibition by black tea was 79 - 94 % , peppermint tea 84 % , pennyroyal 73 % , cocoa 71 % , vervain 59 % , lime flower 52 % and camomile 47 % . At an identical concentration of total polyphenols , black tea was more inhibitory than cocoa , and more inhibitory than herb teas camomile , ver 
    Output:
    
Data presented support the concept that certain flavonoids in the diet can be associated with significant health benefits , including heart health .