human
***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 aim of this study was to test the hypothesis that increased dietary intake of phytoestrogens reduces the health impact of the menopause .  To test this hypothesis , a double-blind , r and omized , entry-exit , cross-over study was conducted to assess the effects of three dietary manipulations -- soy and linseed diets ( high in phytoestrogens ) and a wheat diet ( low in phytoestrogens ) .  Postmenopausal women were recruited and r and omly assigned to one of the three dietary regimens . Urinary phytoestrogen concentrations , hot flush rate , vaginal smears , bone mineral density and bone mineral content were assessed for two 12-week periods . Comparative analysis showed no significant differences , but , when analyzed separately , groups consuming high phytoestrogen diets had between 10 and 30 times higher urinary excretion of phytoestrogens compared to those consuming the low phytoestrogen diet ( p < 0.01 ) . Study participants consuming soy , linseed and wheat diets had a 22 % ( not significant , n.s . ) , 41 % ( p < 0.009 ) and 51 % ( p < 0.001 ) reduction in hot flush rate ; a 103 % ( p < 0.04 ) , 5.5 % ( n.s . ) and 11 % ( n.s . ) increase in vaginal cytology maturation index ; and a 5.2 % ( p < 0.04 ) , 5.2 % ( n.s . ) and 3.8 % ( n.s . ) increase in bone mineral content , respectively . No changes were detected in bone mineral density . The differential effects of high phytoestrogen dietary manipulations on outcomes may represent tissue-specific responses to isoflavones and lignans contained in soy and linseed , respectively . Whilst health outcome measures were not significantly different between groups , the data obtained from separate analysis suggest that phytoestrogens in soy and linseed may be of use in ameliorating some of the symptoms of menopause . Furthermore , the significant decrease in hot flush rate in the wheat group can not be attributable to phytoestrogens measured in this study . Due to subject variability , larger studies are still needed to evaluate population benefit BACKGROUND Concerns regarding the risk of estrogen replacement have result ed in a significant increase in the use of soy products by menopausal women who , despite the lack of evidence of the efficacy of such products , seek alternatives to menopausal hormone therapy . Our goal was to determine the efficacy of soy isoflavone tablets in preventing bone loss and menopausal symptoms . METHODS The study design was a single-center , r and omized , placebo-controlled , double-blind clinical trial conducted from July 1 , 2004 , through March 31 , 2009 . Women aged 45 to 60 years within 5 years of menopause and with a bone mineral density T score of -2.0 or higher in the lumbar spine or total hip were r and omly assigned , in equal proportions , to receive daily soy isoflavone tablets , 200 mg , or placebo . The primary outcome was changes in bone mineral density in the lumbar spine , total hip , and femoral neck at the 2-year follow-up . Secondary outcomes included changes in menopausal symptoms , vaginal cytologic characteristics , N -telopeptide of type I bone collagen , lipids , and thyroid function . RESULTS After 2 years , no significant differences were found between the participants receiving soy tablets ( n = 122 ) and those receiving placebo ( n = 126 ) regarding changes in bone mineral density in the spine ( -2.0 % and -2.3 % , respectively ) , the total hip ( -1.2 % and -1.4 % , respectively ) , or the femoral neck ( -2.2 % and -2.1 % , respectively ) . A significantly larger proportion of participants in the soy group experienced hot flashes and constipation compared with the control group . No significant differences were found between groups in other outcomes . CONCLUSIONS In this population , the daily administration of tablets containing 200 mg of soy isoflavones for 2 years did not prevent bone loss or menopausal symptoms . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00076050 Objective : Postmenopausal decreases in body composition , physical performance , and bone mass have been shown to be reversed by estrogen , but given the concerns regarding its use , women are looking for alternatives such as soy isoflavones . Most studies on the effects of soy on bone mineral density ( BMD ) in postmenopausal women have been short-term , that is , 3 to 6 months , and failed to provide conclusive evidence . There is no evidence of its effects on physical performance . The aim of the present study was to investigate the effects of soy plus isoflavones on BMD and physical performance in postmenopausal women . Methods : This was a 2-year r and omized controlled trial . A total of 203 healthy postmenopausal women were given either 25 g of soy protein without isoflavones , 25 g of soy protein with 90 mg of isoflavones , or 25 g of milk protein ( casein and whey ) as a control agent for 24 months . Women were followed every 6 months with BMD and physical performance measurements for 2 years . Primary analysis was intent-to-treat analysis . Analysis of variance , & khgr;2 and Fisher 's exact tests , and analysis of covariance were used . Results : There was a significant decrease in the BMD of the lumbar spine and femoral neck in those who completed the study in all groups . Soy isoflavones prevented major bone loss from baseline at the femoral trochanter with no between-group significance . Physical performance measurements decreased in all the groups . Conclusions : Twenty-five grams of soy protein with 90 mg of isoflavones has no added benefit in preventing bone loss or improving physical performance Phyto-oestrogens have been associated with a decreased risk for osteoporosis , but results from intervention and observational studies in Western countries have been inconsistent . In the present study , we investigated the association between habitual phyto-oestrogen intake and broadb and ultrasound attenuation ( BUA ) of the calcanaeum as a marker of bone density . We collected 7 d records of diet , medical history and demographic and anthropometric data from participants ( aged 45 - 75 years ) in the European Prospect i ve Investigation into Cancer-Norfolk study .  Phyto-oestrogen ( biochanin A , daidzein , formononetin ; genistein , glycitein ; matairesinol ; secoisolariciresinol ; enterolactone ; equol ) intake was determined using a newly developed food composition data base . Bone density was assessed using BUA of the calcanaeum . Associations between bone density and phyto-oestrogen intake were investigated in 2580 postmenopausal women who were not on hormone replacement therapy and 4973 men .  Median intake of total phyto-oestrogens  was 876 ( interquartile range 412 ) μg/d in postmenopausal women and 1212 ( interquartile range 604 ) μg/d in men . The non-soya isoflavones formononetin and biochanin A were marginally significant or significantly associated with BUA in postmenopausal women ( β = 1·2 ; P < 0·1 ) and men ( β = 1·2 ; P < 0·05 ) , respectively ; enterolignans and equol were positively associated with bone density in postmenopausal women , but this association became non-significant when dietary Ca was added to the model . In the lowest quintile of Ca intake , soya isoflavones were positively associated with bone density in postmenopausal women ( β = 1·4 ; P < 0·1 ) . The present results therefore suggest that non-soya isoflavones are associated with bone density independent of Ca , whereas the association with soya or soya isoflavones is affected by dietary Ca OBJECTIVES To compare the effect of a soy rich diet and hormone replacement therapy ( HRT ) on the main biomarkers of bone turnover and bone mineral density ( BMD ) at postmenopausal age . METHODS 187 healthy asymptomatic postmenopausal women , aged 39 - 60 , were recruited and r and omized into a soy rich diet group , a HRT group , and a control group .  Bone biomarkers and BMD were evaluated at baseline and after 6 months at the end of the study . RESULTS Diet is not as effective as HRT in reducing the postmenopausal turnover ; however diet stimulates bone osteoblastic activity , as evidence d by significant increase in osteocalcin concentrations . BMD decreases significantly only in the control group , but not in the intervention groups . CONCLUSIONS Our data suggest that soy products could be effective in reducing the risk of osteoporosis in asymptomatic postmenopausal women , but our findings should be confirmed before recommending the diet as a valid alternative to HRT Objective : Equol is more biologically active than its precursor daidzein , which is the principal isoflavone found in soybean . There are interindividual differences in the ability to produce equol ; these may lead to differences in the effects of isoflavone intervention on human health . This study aim ed to investigate whether the effects of soy isoflavones on bone and fat mass are related to an individual 's equol status . Design : We performed a 1-year double-blind , r and omized trial to compare the effects of isoflavone ( 75 mg of isoflavone conjugates/day ) with those of placebo on bone mineral density , fat mass , and serum isoflavone concentrations in early postmenopausal Japanese women who were classified based on their equol-producer phenotype . Results : After 1 year , the isoflavone intervention significantly increased the serum equol concentration in the equol producers but not in the nonproducers . In the isoflavone group , the annualized changes in the bone mineral density of the total hip and intertrochanteric regions were −0.46 % and −0.04 % , respectively , in the equol producers and −2.28 % and −2.61 % , respectively , in the nonproducers ; these values were significantly different ( P < 0.05 for both the regions ) . Significant differences were observed between the equol producers and nonproducers in the isoflavone group with regard to the annualized changes in the fat mass . No significant difference in the annualized changes in bone mineral density and fat mass was observed between the equol producers and nonproducers in the placebo group . Conclusions : Our data suggest that the preventive effects of isoflavones on bone loss and fat accumulation in early postmenopausal women depend on an individual 's equol-producing capacity Objective : Although estrogen may be linked to biological pathways that maintain higher physical function , the evidence is derived mostly from observational epidemiology and therefore has numerous limitations . We examined whether hormone therapy affected physical function in women 65 to 79 years of age at enrollment . Methods : This study involves an analysis of the Women 's Health Initiative r and omized controlled trials of hormone therapy in which 922 nondisabled women who had previous hysterectomies were r and omized to receive estrogen therapy or a placebo and 1,458 nondisabled women with intact uteri were r and omized to receive estrogen + progestin therapy or a placebo . Changes in physical function were analyzed for treatment effect , and subgroup differences were evaluated . All women completed performance-based measures of physical function ( grip strength , chair st and s , and timed walk ) at baseline . These measures were repeated after 1 , 3 , and 6 years . Results : Overall , participants ' grip strength declined by 12.0 % , chair st and s declined by 3.5 % , and walk pace slowed by 11.4 % in the 6 years of follow-up ( all P values < 0.0001 ) . Hormone therapy , as compared with placebo , was not associated with an increased or decreased risk of decline in physical function in either the intention-to-treat analyses or in analyses restricted to participants who were compliant in taking study pills . Conclusions : Hormone therapy provided no overall protection against functional decline in nondisabled postmenopausal women 65 years or older in 6 years of follow-up . This study did not address the influence of hormone therapy for women of younger ages BACKGROUND Isoflavone phytoestrogen therapy has been proposed as a natural alternative to hormone replacement therapy ( HRT ) . HRT has a beneficial effect on bone , but few trials in humans have investigated the effects of isoflavones on bone . OBJECTIVE The objective of the study was to determine the effect on bone density of a red clover-derived isoflavone supplement that provided a daily dose of 26 mg biochanin A , 16 mg formononetin , 1 mg genistein , and 0.5 mg daidzein for 1 y. Effects on biochemical markers of bone turnover and body composition were also studied . DESIGN Women aged 49 - 65 y ( n = 205 ) were enrolled in a double-blind , r and omized , placebo-controlled trial ; 177 completed the trial .  Bone density , body composition , bone turnover markers , and diet were measured at baseline and after 12 mo . RESULTS Loss of lumbar spine bone mineral content and bone mineral density was significantly ( P = 0.04 and P = 0.03 , respectively ) lower in the women taking the is 
    Output:
    
agent
Conclusions : Isoflavone treatments exert a moderately beneficial effect against  estrogen-deficient bone loss in women .
The effect appears dependent on whether isoflavone treatments are in aglycone form ; we conclude that beneficial effects against bone loss may be enhanced for isoflavone aglycones
***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 aim of this study was to test the hypothesis that increased dietary intake of phytoestrogens reduces the health impact of the menopause .  To test this hypothesis , a double-blind , r and omized , entry-exit , cross-over study was conducted to assess the effects of three dietary manipulations -- soy and linseed diets ( high in phytoestrogens ) and a wheat diet ( low in phytoestrogens ) .  Postmenopausal women were recruited and r and omly assigned to one of the three dietary regimens . Urinary phytoestrogen concentrations , hot flush rate , vaginal smears , bone mineral density and bone mineral content were assessed for two 12-week periods . Comparative analysis showed no significant differences , but , when analyzed separately , groups consuming high phytoestrogen diets had between 10 and 30 times higher urinary excretion of phytoestrogens compared to those consuming the low phytoestrogen diet ( p < 0.01 ) . Study participants consuming soy , linseed and wheat diets had a 22 % ( not significant , n.s . ) , 41 % ( p < 0.009 ) and 51 % ( p < 0.001 ) reduction in hot flush rate ; a 103 % ( p < 0.04 ) , 5.5 % ( n.s . ) and 11 % ( n.s . ) increase in vaginal cytology maturation index ; and a 5.2 % ( p < 0.04 ) , 5.2 % ( n.s . ) and 3.8 % ( n.s . ) increase in bone mineral content , respectively . No changes were detected in bone mineral density . The differential effects of high phytoestrogen dietary manipulations on outcomes may represent tissue-specific responses to isoflavones and lignans contained in soy and linseed , respectively . Whilst health outcome measures were not significantly different between groups , the data obtained from separate analysis suggest that phytoestrogens in soy and linseed may be of use in ameliorating some of the symptoms of menopause . Furthermore , the significant decrease in hot flush rate in the wheat group can not be attributable to phytoestrogens measured in this study . Due to subject variability , larger studies are still needed to evaluate population benefit BACKGROUND Concerns regarding the risk of estrogen replacement have result ed in a significant increase in the use of soy products by menopausal women who , despite the lack of evidence of the efficacy of such products , seek alternatives to menopausal hormone therapy . Our goal was to determine the efficacy of soy isoflavone tablets in preventing bone loss and menopausal symptoms . METHODS The study design was a single-center , r and omized , placebo-controlled , double-blind clinical trial conducted from July 1 , 2004 , through March 31 , 2009 . Women aged 45 to 60 years within 5 years of menopause and with a bone mineral density T score of -2.0 or higher in the lumbar spine or total hip were r and omly assigned , in equal proportions , to receive daily soy isoflavone tablets , 200 mg , or placebo . The primary outcome was changes in bone mineral density in the lumbar spine , total hip , and femoral neck at the 2-year follow-up . Secondary outcomes included changes in menopausal symptoms , vaginal cytologic characteristics , N -telopeptide of type I bone collagen , lipids , and thyroid function . RESULTS After 2 years , no significant differences were found between the participants receiving soy tablets ( n = 122 ) and those receiving placebo ( n = 126 ) regarding changes in bone mineral density in the spine ( -2.0 % and -2.3 % , respectively ) , the total hip ( -1.2 % and -1.4 % , respectively ) , or the femoral neck ( -2.2 % and -2.1 % , respectively ) . A significantly larger proportion of participants in the soy group experienced hot flashes and constipation compared with the control group . No significant differences were found between groups in other outcomes . CONCLUSIONS In this population , the daily administration of tablets containing 200 mg of soy isoflavones for 2 years did not prevent bone loss or menopausal symptoms . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00076050 Objective : Postmenopausal decreases in body composition , physical performance , and bone mass have been shown to be reversed by estrogen , but given the concerns regarding its use , women are looking for alternatives such as soy isoflavones . Most studies on the effects of soy on bone mineral density ( BMD ) in postmenopausal women have been short-term , that is , 3 to 6 months , and failed to provide conclusive evidence . There is no evidence of its effects on physical performance . The aim of the present study was to investigate the effects of soy plus isoflavones on BMD and physical performance in postmenopausal women . Methods : This was a 2-year r and omized controlled trial . A total of 203 healthy postmenopausal women were given either 25 g of soy protein without isoflavones , 25 g of soy protein with 90 mg of isoflavones , or 25 g of milk protein ( casein and whey ) as a control agent for 24 months . Women were followed every 6 months with BMD and physical performance measurements for 2 years . Primary analysis was intent-to-treat analysis . Analysis of variance , & khgr;2 and Fisher 's exact tests , and analysis of covariance were used . Results : There was a significant decrease in the BMD of the lumbar spine and femoral neck in those who completed the study in all groups . Soy isoflavones prevented major bone loss from baseline at the femoral trochanter with no between-group significance . Physical performance measurements decreased in all the groups . Conclusions : Twenty-five grams of soy protein with 90 mg of isoflavones has no added benefit in preventing bone loss or improving physical performance Phyto-oestrogens have been associated with a decreased risk for osteoporosis , but results from intervention and observational studies in Western countries have been inconsistent . In the present study , we investigated the association between habitual phyto-oestrogen intake and broadb and ultrasound attenuation ( BUA ) of the calcanaeum as a marker of bone density . We collected 7 d records of diet , medical history and demographic and anthropometric data from participants ( aged 45 - 75 years ) in the European Prospect i ve Investigation into Cancer-Norfolk study .  Phyto-oestrogen ( biochanin A , daidzein , formononetin ; genistein , glycitein ; matairesinol ; secoisolariciresinol ; enterolactone ; equol ) intake was determined using a newly developed food composition data base . Bone density was assessed using BUA of the calcanaeum . Associations between bone density and phyto-oestrogen intake were investigated in 2580 postmenopausal women who were not on hormone replacement therapy and 4973 men .  Median intake of total phyto-oestrogens  was 876 ( interquartile range 412 ) μg/d in postmenopausal women and 1212 ( interquartile range 604 ) μg/d in men . The non-soya isoflavones formononetin and biochanin A were marginally significant or significantly associated with BUA in postmenopausal women ( β = 1·2 ; P < 0·1 ) and men ( β = 1·2 ; P < 0·05 ) , respectively ; enterolignans and equol were positively associated with bone density in postmenopausal women , but this association became non-significant when dietary Ca was added to the model . In the lowest quintile of Ca intake , soya isoflavones were positively associated with bone density in postmenopausal women ( β = 1·4 ; P < 0·1 ) . The present results therefore suggest that non-soya isoflavones are associated with bone density independent of Ca , whereas the association with soya or soya isoflavones is affected by dietary Ca OBJECTIVES To compare the effect of a soy rich diet and hormone replacement therapy ( HRT ) on the main biomarkers of bone turnover and bone mineral density ( BMD ) at postmenopausal age . METHODS 187 healthy asymptomatic postmenopausal women , aged 39 - 60 , were recruited and r and omized into a soy rich diet group , a HRT group , and a control group .  Bone biomarkers and BMD were evaluated at baseline and after 6 months at the end of the study . RESULTS Diet is not as effective as HRT in reducing the postmenopausal turnover ; however diet stimulates bone osteoblastic activity , as evidence d by significant increase in osteocalcin concentrations . BMD decreases significantly only in the control group , but not in the intervention groups . CONCLUSIONS Our data suggest that soy products could be effective in reducing the risk of osteoporosis in asymptomatic postmenopausal women , but our findings should be confirmed before recommending the diet as a valid alternative to HRT Objective : Equol is more biologically active than its precursor daidzein , which is the principal isoflavone found in soybean . There are interindividual differences in the ability to produce equol ; these may lead to differences in the effects of isoflavone intervention on human health . This study aim ed to investigate whether the effects of soy isoflavones on bone and fat mass are related to an individual 's equol status . Design : We performed a 1-year double-blind , r and omized trial to compare the effects of isoflavone ( 75 mg of isoflavone conjugates/day ) with those of placebo on bone mineral density , fat mass , and serum isoflavone concentrations in early postmenopausal Japanese women who were classified based on their equol-producer phenotype . Results : After 1 year , the isoflavone intervention significantly increased the serum equol concentration in the equol producers but not in the nonproducers . In the isoflavone group , the annualized changes in the bone mineral density of the total hip and intertrochanteric regions were −0.46 % and −0.04 % , respectively , in the equol producers and −2.28 % and −2.61 % , respectively , in the nonproducers ; these values were significantly different ( P < 0.05 for both the regions ) . Significant differences were observed between the equol producers and nonproducers in the isoflavone group with regard to the annualized changes in the fat mass . No significant difference in the annualized changes in bone mineral density and fat mass was observed between the equol producers and nonproducers in the placebo group . Conclusions : Our data suggest that the preventive effects of isoflavones on bone loss and fat accumulation in early postmenopausal women depend on an individual 's equol-producing capacity Objective : Although estrogen may be linked to biological pathways that maintain higher physical function , the evidence is derived mostly from observational epidemiology and therefore has numerous limitations . We examined whether hormone therapy affected physical function in women 65 to 79 years of age at enrollment . Methods : This study involves an analysis of the Women 's Health Initiative r and omized controlled trials of hormone therapy in which 922 nondisabled women who had previous hysterectomies were r and omized to receive estrogen therapy or a placebo and 1,458 nondisabled women with intact uteri were r and omized to receive estrogen + progestin therapy or a placebo . Changes in physical function were analyzed for treatment effect , and subgroup differences were evaluated . All women completed performance-based measures of physical function ( grip strength , chair st and s , and timed walk ) at baseline . These measures were repeated after 1 , 3 , and 6 years . Results : Overall , participants ' grip strength declined by 12.0 % , chair st and s declined by 3.5 % , and walk pace slowed by 11.4 % in the 6 years of follow-up ( all P values < 0.0001 ) . Hormone therapy , as compared with placebo , was not associated with an increased or decreased risk of decline in physical function in either the intention-to-treat analyses or in analyses restricted to participants who were compliant in taking study pills . Conclusions : Hormone therapy provided no overall protection against functional decline in nondisabled postmenopausal women 65 years or older in 6 years of follow-up . This study did not address the influence of hormone therapy for women of younger ages BACKGROUND Isoflavone phytoestrogen therapy has been proposed as a natural alternative to hormone replacement therapy ( HRT ) . HRT has a beneficial effect on bone , but few trials in humans have investigated the effects of isoflavones on bone . OBJECTIVE The objective of the study was to determine the effect on bone density of a red clover-derived isoflavone supplement that provided a daily dose of 26 mg biochanin A , 16 mg formononetin , 1 mg genistein , and 0.5 mg daidzein for 1 y. Effects on biochemical markers of bone turnover and body composition were also studied . DESIGN Women aged 49 - 65 y ( n = 205 ) were enrolled in a double-blind , r and omized , placebo-controlled trial ; 177 completed the trial .  Bone density , body composition , bone turnover markers , and diet were measured at baseline and after 12 mo . RESULTS Loss of lumbar spine bone mineral content and bone mineral density was significantly ( P = 0.04 and P = 0.03 , respectively ) lower in the women taking the is 
    Output:
    