European Journal of Nutrition (v.51, #8)

Antimicrobial peptides (AMPs) are synthesized and secreted by immune and epithelial cells that are constantly exposed to environmental microbes. AMPs are essential for barrier defense, and deficiencies lead to increased susceptibility to infection. In addition to their ability to disrupt the integrity of bacterial, viral and fungal membranes, AMPs bind lipopolysaccharides, act as chemoattractants for immune cells and bind to cellular receptors and modulate the expression of cytokines and chemokines. These additional biological activities may explain the role of AMPs in inflammatory diseases and cancer. Modulating the endogenous expression of AMPs offers potential therapeutic treatments for infection and disease.The present review examines the published data from both in vitro and in vivo studies reporting the effects of nutrients and by-products of microbial metabolism on the expression of antimicrobial peptide genes in order to highlight an emerging appreciation for the role of dietary compounds in modulating the innate immune response.Vitamins A and D, dietary histone deacetylases and by-products of intestinal microbial metabolism (butyrate and secondary bile acids) have been found to regulate the expression of AMPs in humans. Vitamin D deficiency correlates with increased susceptibility to infection, and supplementation studies indicate an improvement in defense against infection. Animal and human clinical studies with butyrate indicate that increasing expression of AMPs in the colon protects against infection.These findings suggest that diet and/or consumption of nutritional supplements may be used to improve and/or modulate immune function. In addition, by-products of gut microbe metabolism could be important for communicating with intestinal epithelial and immune cells, thus affecting the expression of AMPs. This interaction may help establish a mucosal barrier to prevent invasion of the intestinal epithelium by either mutualistic or pathogenic microorganisms.
Keywords: Antimicrobial peptide; Innate immune; Vitamin; Dietary; Supplement; Infection

Effect of tart cherry juice (Prunus cerasus) on melatonin levels and enhanced sleep quality by Glyn Howatson; Phillip G. Bell; Jamie Tallent; Benita Middleton; Malachy P. McHugh; Jason Ellis (909-916).
Tart Montmorency cherries have been reported to contain high levels of phytochemicals including melatonin, a molecule critical in regulating the sleep-wake cycle in humans.The aim of our investigation was to ascertain whether ingestion of a tart cherry juice concentrate would increase the urinary melatonin levels in healthy adults and improve sleep quality.In a randomised, double-blind, placebo-controlled, crossover design, 20 volunteers consumed either a placebo or tart cherry juice concentrate for 7 days. Measures of sleep quality recorded by actigraphy and subjective sleep questionnaires were completed. Sequential urine samples over 48 h were collected and urinary 6-sulfatoxymelatonin (major metabolite of melatonin) determined; cosinor analysis was used to determine melatonin circadian rhythm (mesor, acrophase and amplitude). In addition, total urinary melatonin content was determined over the sampled period. Trial differences were determined using a repeated measures ANOVA.Total melatonin content was significantly elevated (P < 0.05) in the cherry juice group, whilst no differences were shown between baseline and placebo trials. There were significant increases in time in bed, total sleep time and sleep efficiency total (P < 0.05) with cherry juice supplementation. Although there was no difference in timing of the melatonin circardian rhythm, there was a trend to a higher mesor and amplitude.These data suggest that consumption of a tart cherry juice concentrate provides an increase in exogenous melatonin that is beneficial in improving sleep duration and quality in healthy men and women and might be of benefit in managing disturbed sleep.
Keywords: Tart cherries; Melatonin; Sleep; Recovery

Nutrient and food intakes of middle-aged adults at low risk of cardiovascular disease: the international study of macro-/micronutrients and blood pressure (INTERMAP) by Christina M. Shay; Jeremiah Stamler; Alan R. Dyer; Ian J. Brown; Queenie Chan; Paul Elliott; Liancheng Zhao; Nagako Okuda; Katsuyuki Miura; Martha L. Daviglus; Linda Van Horn (917-926).
Individuals with favorable levels of readily measured cardiovascular disease (CVD) risk factors (low risk, LR) experience low long-term rates of CVD mortality and greater longevity. The purpose of the current study was to compare nutrient/food intakes of LR participants with participants not LR in the INTERMAP study.Men and women (40–59 years) from 17 population samples in four countries (China, Japan, UK, US) provided four 24-h dietary recalls and two timed 24-h urine collections. LR was defined as meeting all of the following CVD risk criteria: systolic/diastolic blood pressure (BP) ≤120/≤80 mmHg; no drug treatment for high BP, hyperlipidemia, or CVD; non-smoking; BMI <25.0 kg/m2 (US, UK) or <23.0 kg/m2 (China, Japan); alcohol consumption <26.0 g/day (men)/<13.0 g/day (women); and no history of diabetes or CVD. Multivariate logistic regression was used to examine associations of nutrient/food intakes with LR.LR individuals reported higher intake of vegetable protein, fiber, magnesium, non-heme iron, potassium; lower energy intake; lower intake of cholesterol, saturated fatty acids, animal protein; and lower 24-h urinary sodium compared with individuals not LR. With regard to foods, LR individuals reported higher intake of fruits, vegetables, grains, pasta/rice, fish; lower intakes of meats, processed meats, high-fat dairy, and sugar-sweetened beverages than individuals not LR.Lower energy intake and differential intake of multiple specific nutrients and foods are characteristic of individuals at low risk for developing CVD. Identification of dietary habits associated with LR is important for further development of public health efforts aimed at reduction/prevention of CVD.
Keywords: Cardiovascular disease; Diet; Foods; Low cardiovascular risk; Nutrients; Risk factors

Pro-inflammatory effects of the mushroom Agaricus blazei and its consequences on atherosclerosis development by Juliana L. Gonçalves; Eric H. Roma; Ana Cristina Gomes-Santos; Edenil C. Aguilar; Daniel Cisalpino; Luciana R. Fernandes; Angélica T. Vieira; Dirce R. Oliveira; Valbert N. Cardoso; Mauro M. Teixeira; Jacqueline I. Alvarez-Leite (927-937).
Extracts of the mushroom Agaricus blazei (A. blazei) have been described as possessing immunomodulatory and potentially cancer-protective activities. However, these effects of A. blazei as a functional food have not been fully investigated in vivo.Using apolipoprotein E-deficient (ApoE−/−) mice, an experimental model of atherosclerosis, we evaluated the effects of 6 or 12 weeks of A. blazei supplementation on the activation of immune cells in the spleen and blood and on the development of atherosclerosis.Food intake, weight gain, blood lipid profile, and glycemia were similar between the groups. To evaluate leukocyte homing and activation, mice were injected with 99mTc-radiolabeled leukocytes, which showed enhanced leukocyte migration to the spleen and heart of A. blazei-supplemented animals. Analysis of the spleen showed higher levels of activation of neutrophils, NKT cells, and monocytes as well as increased production of TNF-α and IFN-γ. Circulating NKT cells and monocytes were also more activated in the supplemented group. Atherosclerotic lesion areas were larger in the aorta of supplemented mice and exhibited increased numbers of macrophages and neutrophils and a thinner fibrous cap. A. blazei-induced transcriptional upregulation of molecules linked to macrophage activation (CD36, TLR4), neutrophil chemotaxy (CXCL1), leukocyte adhesion (VCAM-1), and plaque vulnerability (MMP9) were seen after 12 weeks of supplementation.This is the first in vivo study showing that the immunostimulatory effect of A. blazei has proatherogenic repercussions. A. blazei enhances local and systemic inflammation, upregulating pro-inflammatory molecules, and enhancing leukocyte homing to atherosclerosis sites without affecting the lipoprotein profile.
Keywords: A. blazei ; Diet; Atherosclerosis; Inflammation; ApoE−/− mice

The effect of 40 μg (1,600 IU) per day of vitamin D3 on serum 25-hydroxyvitamin D (25(OH)D) and markers of bone and mineral metabolism was evaluated.This intervention study was designed as a double-blind randomised controlled trial. Forty-five community-dwelling subjects (32 females), age 55–84 years, at 58° North latitude were supplemented for 1 year with 40 μg vitamin D3 plus 1,000 mg calcium per day, or with 1,000 mg calcium per day for controls. Safety parameters and 25(OH)D, intact parathyroid hormone (PTH), ionized calcium, bone-specific alkaline phosphatase (BALP), and tartrate-resistant acid phosphatase isoform 5b (TRACP5b) were measured over the study period.All subjects supplemented with vitamin D3 reached a 25(OH)D level above 50 nmol/L. Mean (SD) serum 25(OH)D increased from 50.4 (13.5) nmol/L to 84.2 (17.5) nmol/L, range 55.0–125.0 nmol/L in the vitamin D3 supplemented group and the corresponding levels for the control group were 47.3 (14.1) nmol/L and 45.7 (13.4) nmol/L, range 26.0–73.0 nmol/L. No serious adverse event was recorded and the highest 25(OH)D level reached, 125.0 nmol/L, is well below toxic levels. BALP and TRACP5b did not change significantly over the study period.This trial suggests that a daily supplementation with 40 μg vitamin D3 is sufficient to secure a 25(OH)D level of 50 nmol/L. No side effects were observed in the study group.
Keywords: 25-Hydroxyvitamin D; Vitamin D insufficiency; Hyperparathyroidism; Bone turnover; Calcium; Parathyroid hormone

In vitro and in vivo assessment of the glycemic index of bakery products: influence of the reformulation of ingredients by A. Ferrer-Mairal; C. Peñalva-Lapuente; I. Iglesia; L. Urtasun; P. De Miguel-Etayo; S. Remón; E. Cortés; L. A. Moreno (947-954).
To evaluate whether the modification of ingredients of two bakery products, muffins and bread, reduces their glycemic index, by means of in vitro and in vivo procedures.In vitro and in vivo glycemic index were evaluated for two types of bread and two types of muffins including one standard product for each category. For the in vitro determination, kinetics of starch digestion method was used. For the in vivo procedure, postprandial glucose measured as IAUC was obtained in a group of eighteen healthy volunteers (ten did the test with muffins and eight with breads).In in vitro, a reduction in the expected glycemic index regarding the control muffin was achieved with the partial substitution of wheat flour by a mixture of resistant starch, dextrin and lentil flour. In breads, with the partial substitution of wheat flour by a mixture of resistant starch and dextrins, a decrease in the expected glycemic index was also observed. In in vivo, a reduction in GI was also achieved both in muffin and in bread. All the obtained GI was higher in in vitro method.Despite the fact that in vitro overestimate in vivo method, the trend in the reduction in GI seems to be similar in both methods. With the substitution assayed, a reduction in the expected glycemic index and the glycemic index were obtained both in muffins and in breads.
Keywords: Glycemic index; In vitro; In vivo; Bakery products; Starch hydrolysis; Blood glucose response

Olive oil contains several phenolic compounds possessing antioxidant activity. The aim of this study was to investigate the protective effects of olive oil phenolic extract (OOPE) and one of its constituents, gallic acid (GA) against H2O2-induced oxidative stress and apoptotic cell death in HeLa cells, a model for human epithelial cells.The cells were pretreated with nontoxic doses of OOPE or GA for 4, 24 and 48 h, and the intracellular reactive oxygen species (ROS) level was determined, before and after oxidative stress induction with H2O2. As an indicator of apoptosis, caspase 9 activity was measured.All pretreatments reduced ROS generation. Four hour incubation with OOPE or GA completely inhibited ROS generation. Increases in caspase 9 activity by OOPE and GA pretreatment under harsh stress conditions were inhibited 92 and 67.8%, respectively.These results suggest that OOPE and GA act as powerful antioxidants against oxidative stress and exert anti-apoptotic effects.
Keywords: Anti-apoptotic effect; Gallic acid; Olive; Oxidative stress; Phenolic compounds

Purple corn anthocyanins retard diabetes-associated glomerulosclerosis in mesangial cells and db/db mice by Jing Li; Min-Kyung Kang; Jin-Kyu Kim; Jung-Lye Kim; Sang-Wook Kang; Soon Sung Lim; Young-Hee Kang (961-973).
Diabetic glomerulosclerosis is the hardening of the renal glomeruli that can lead to kidney failure. In the early stage of glomerulosclerosis occur renal mesangial expansion and renal filtration dysfunction. Purple corn has been classified as a functional food and is rich in anthocyanins exerting potential disease-preventive activities. The in vitro study using human renal mesangial cells examined that anthocyanin-rich purple corn butanol fraction (PCB) can attenuate high glucose (HG)-promoted mesangial cell proliferation and matrix accumulation.Cells were cultured for 3 days in media containing 33 mM glucose in the presence of 1–20 μg/mL PCB. In the in vivo animal study, db/db mice were treated with 10 mg/kg anthocyanin-rich polyphenolic extracts of purple corn (PCE) for 8 weeks.HG enhanced mesangial production of the fibrosis biomarkers of collagen IV and connective tissue growth factor (CTGF), which was markedly attenuated by adding PCB. Such mesangial fibrosis entailed interleukin-8 activation via eliciting Tyk2-STAT signaling pathway. PCB dampened HG-promoted mesangial hyperplasia that appeared to be attributed to increased expression of platelet-derived growth factor. The 8-week administration of PCE lowered plasma glucose level of db/db mice and ameliorated severe albuminuria. Moreover, PCE lessened collagen fiber accumulation in kidney glomeruli and CTGF expression via retarding TGF-β signaling. Protein expressions of nephrin and podocin, key proteins for filtration barrier function of the glomerular capillary wall, were repressed by treating mice with PCE.Purple corn may be a potent therapeutic agent for the treatment for diabetes-associated glomerulosclerosis accompanying proteinuria and kidney filtration dysfunction.
Keywords: db/db mice; Glomerulosclerosis; High glucose; Mesangial cells; Purple corn anthocyanin; Renal fibrosis

Alpha-lipoic acid preserves the structural and functional integrity of red blood cells by adjusting the redox disturbance and decreasing O-GlcNAc modifications of antioxidant enzymes and heat shock proteins in diabetic rats by Mihailović Mirjana; Arambašić Jelena; Uskoković Aleksandra; Dinić Svetlana; Grdović Nevena; Marković Jelena; Poznanović Goran; Vidaković Melita (975-986).
The aim of this study was to investigate whether the daily administration of α-lipoic acid (LA) during 4 weeks prevents the redox disturbance in red blood cells (RBC) described in diabetesMultiple low-dose streptozotocin (STZ) diabetes was induced in rats by the administration of 40 mg/kg STZ intraperitoneally (i.p.) for 5 consecutive days. LA was applied at a dose of 10 mg/kg i.p. for 4 weeks, starting from the last day of STZ administration.The LA-treated diabetic rats exhibited a general systemic improvement, revealed as the near restoration of body weight and of essential biochemical parameters. The latter was displayed as decreased hyperglycemia, lower triglyceride levels and lower serum activities of alanine aminotransferases and aspartate aminotransferases that point to a general improvement of diabetes-linked organ “lesions”. The LA-treated diabetic rats also exhibited significant alleviation of oxidative stress, manifested as decreased lipid peroxidation and lower glycation levels of serum proteins and hemoglobin, while the RBC exhibited increased activities of antioxidant enzymes and elevated levels of reduced glutathione. In RBC, this was accompanied by decreased post-translational glycosylation by O-bound β-N-acetylglucosamine (O-GlcNAc) of the antioxidant enzymes superoxide dismutase and catalase and of heat shock proteins HSP70 and HSP90.LA through its powerful antioxidant activity preserves the structural and functional integrity of RBC in diabetes. The RBC can then assume a more efficient role as the first line of systemic defense against diabetic complications arising from oxidative stress–induced damage of other tissues and organs.
Keywords: Red blood cells; Diabetes; Lipoic acid; O-GlcNAc; Antioxidative enzymes; Heat shock proteins

Effect of docosahexaenoic acid on hypoxia/reoxygenation injury in human coronary arterial smooth muscle cells by Guan-Ming Feng; Jia-Huei Chen; Cheng-I Lin; Jung-Mou Yang (987-995).
Hypoxia and reoxygenation (H/R) occur in a wide variety of important clinical conditions such as myocardial infarction. H/R injury is a complex phenomenon involving not only intracellular damage processes but also an injurious inflammatory response. Docosahexaenoic acid (DHA), an n-3 polyunsaturated fatty acid, has long been proved to be protective against several types of cardiovascular disease. However, its beneficial effect during H/R is inconclusive. In this study, we employed an in vitro model to examine whether DHA is protective against H/R-induced cell damage in human coronary artery smooth muscle cells (HCASMCs).HCASMCs in the absence or presence of DHA (1, 3, 10, and 30 μM) were subjected to control or H/R treatment using a modular incubator chamber to create hypoxic condition. Cell viability was evaluated by MTT assay. Spectrophotometric and spectrofluorometric assays were used to measure the generation of nitric oxide (NO) and reactive oxygen species (ROS), respectively. Inflammatory cytokines were determined by enzyme-linked immunosorbent assay. Intracellular calcium mobilization was estimated microfluorimetrically using calcium indicator dye, fura 2-acetomethyl ester.Hypoxia/reoxygenation caused significant injury in cultured HCASMCs. DHA at low concentrations (1, 3, and 10 μM) did not afford protection, whereas at 30 μM, it caused deleterious effects, presumably by enhancing the production of NO, ROS, IL-1β, and IL-6 and altering the intracellular calcium dynamics.Our results do not support the protective function of DHA in H/R-injured coronary arterial smooth muscle cells.
Keywords: Hypoxia/reoxygenation; Coronary artery; Smooth muscle cells; Docosahexaenoic acid

Bias in protein and potassium intake collected with 24-h recalls (EPIC-Soft) is rather comparable across European populations by Sandra P. Crispim; Anouk Geelen; Jeanne H. M. de Vries; Heinz Freisling; Olga W. Souverein; Paul J. M. Hulshof; Marga C. Ocke; Hendriek Boshuizen; Lene F. Andersen; Jiri Ruprich; Willem De Keizer; Inge Huybrechts; Lionel Lafay; Maria S. de Magistris; Fulvio Ricceri; Rosario Tumino; Vittorio Krogh; H. Bas Bueno-de-Mesquita; Joline W. J. Beulens; Marie-Christine Boutron-Ruault; Androniki Naska; Francesca L. Crowe; Heiner Boeing; Alison McTaggart; Rudolf Kaaks; Pieter van’t Veer; Nadia Slimani (997-1010).
We investigated whether group-level bias of a 24-h recall estimate of protein and potassium intake, as compared to biomarkers, varied across European centers and whether this was influenced by characteristics of individuals or centers.The combined data from EFCOVAL and EPIC studies included 14 centers from 9 countries (n = 1,841). Dietary data were collected using a computerized 24-h recall (EPIC-Soft). Nitrogen and potassium in 24-h urine collections were used as reference method. Multilevel linear regression analysis was performed, including individual-level (e.g., BMI) and center-level (e.g., food pattern index) variables.For protein intake, no between-center variation in bias was observed in men while it was 5.7% in women. For potassium intake, the between-center variation in bias was 8.9% in men and null in women. BMI was an important factor influencing the biases across centers (p < 0.01 in all analyses). In addition, mode of administration (p = 0.06 in women) and day of the week (p = 0.03 in men and p = 0.06 in women) may have influenced the bias in protein intake across centers. After inclusion of these individual variables, between-center variation in bias in protein intake disappeared for women, whereas for potassium, it increased slightly in men (to 9.5%). Center-level variables did not influence the results.The results suggest that group-level bias in protein and potassium (for women) collected with 24-h recalls does not vary across centers and to a certain extent varies for potassium in men. BMI and study design aspects, rather than center-level characteristics, affected the biases across centers.
Keywords: Diet; Protein; Potassium; Biomarker; Validity; 24-h dietary recall; Multilevel

Silk and silkworm pupa peptides suppress adipogenesis in preadipocytes and fat accumulation in rats fed a high-fat diet by Sun Hee Lee; Dongsun Park; Goeun Yang; Dae-Kwon Bae; Yun-Hui Yang; Tae Kyun Kim; Dajeong Kim; Jangbeen Kyung; Sungho Yeon; Kyo Chul Koo; Jeong-Yong Lee; Seock-Yeon Hwang; Seong Soo Joo; Yun-Bae Kim (1011-1019).
The objective was to confirm the anti-obesity activity of a silk peptide (SP) and a silkworm pupa peptide (SPP) in rats fed a high-fat diet (HFD) and to elucidate their action mechanism(s) in a preadipocyte culture system.In an in vitro mechanistic study, the differentiation and maturation of 3T3-L1 preadipocytes were stimulated with insulin (5 μg/mL), and effects of SP and SPP on the adipogenesis of mature adipocytes were assessed. In an in vivo anti-obesity study, male C57BL/6 mice were fed an HFD containing SP or SPP (0.3, 1.0, or 3.0%) for 8 weeks, and blood and tissue parameters of obesity were analyzed.Hormonal stimulation of preadipocytes led to a 50–70% increase in adipogenesis. Polymerase chain reaction and Western blot analyses revealed increases in adipogenesis-specific genes (leptin and Acrp30) and proteins (peroxisome proliferator-activated receptor-γ and Acrp30). The hormone-induced adipogenesis and activated gene expression was substantially inhibited by treatment with SP and SPP (1–50 μg/mL). The HFD markedly increased body weight gain by increasing the weight of epididymal and mesenteric fat. Body and fat weights were significantly reduced by SP and SPP, in which decreases in the area of abdominal adipose tissue and the size of epididymal adipocytes were confirmed by magnetic resonance imaging and microscopic examination, respectively. Long-term HFD caused hepatic lipid accumulation and increased blood triglycerides and cholesterol, in addition to their regulatory factors Acrp30 and leptin. However, SP and SPP recovered the concentrations of Acrp30 and leptin, and attenuated steatosis.SP and SPP inhibit the differentiation of preadipocytes and adipogenesis by modulating signal transduction pathways and improve HFD-induced obesity by reducing lipid accumulation and the size of adipocytes.
Keywords: Silk peptide; Silkworm pupa peptide; Adipogenesis; Obesity; Hyperlipidemia; Steatosis

Prevalence of hypovitaminosis D and folate deficiency in healthy young female Austrian students in a health care profession by Stefan T. Kaehler; Holger Baumgartner; Martina Jeske; Markus Anliker; Harald Schennach; Peter Marschang; Anna Ratt; Anna C. Colvin; Jennifer Falk; Astrid Gasser; Julia Kirchebner; Christine Scherer; Anna E. Purtscher; Andrea Griesmacher; Jörg Striessnig (1021-1031).
We performed a single-day cross-sectional study to assess the prevalence of vitamin D deficiency as well as folate status in healthy young female volunteers well educated with respect to health information.We assessed dietary intake of vitamin D and calcium, serum concentrations of 25-OH-vitamin D3, folate, red blood cell folate and other dietary, laboratory, and lifestyle parameters in 215 young healthy women (age 18–30 years) on a single day at the end of the winter months. Primary aim was to investigate the prevalence of hypovitaminosis D. Folic acid status was a secondary study aim.Mean daily ingestion of vitamin D was 2.25 μg/day with a daily calcium intake of 749 mg/day. 6.9% had hypovitaminosis D (25-OH-vitamin D3 <30 nmol/L) and 89.3% were vitamin D insufficient (<75 nmol/L). Preplanned subpopulation comparison (lower vs. upper quartile) revealed a significant negative correlation (P = 0.048) between plasma PTH and 25-OH-vitamin D3 levels. Fifteen individuals (6.9%) were folic acid deficient (<140 ng/mL RBC folate). Only 9.3% reached RBC folate concentrations regarded as optimal for the prevention of fetal neural tube defects (>400 ng/mL).The prevalence of hypovitaminosis D in healthy young women trained in health care professions is low but 89.3% can be classified as vitamin D insufficient in spring. Folate status can also be considered not sufficient. Considering the emerging role of higher vitamin D plasma levels for many health conditions, a timely correction of vitamin D status in the general Austrian population appears appropriate.
Keywords: Vitamin D; Women; Diet; 25-(OH)-vitamin D; Hypovitaminosis D; Folic acid status; Calcium intake; Vitamin D intake

Soy intake and risk of type 2 diabetes mellitus in Chinese Singaporeans by Noel T. Mueller; Andrew O. Odegaard; Myron D. Gross; Woon-Puay Koh; Mimi C. Yu; Jian-Min Yuan; Mark A. Pereira (1033-1040).
To examine the association between soy products and their components, isoflavones and protein, and incident type 2 diabetes in a population with varied soy intake and high rates of diabetes.We used data from the Singapore Chinese Health Study, including 43,176 Chinese men and women aged 45–74 years, free of chronic disease at baseline (1993–1998) and followed through 2004. Intake of individual soy items, total unsweetened soy, and soy components was assessed by food-frequency questionnaire and examined with type 2 diabetes risk using Cox regression.During an average follow-up of 5.7 years, 2,252 of the 43,176 participants included in the current analyses developed diabetes. After adjustment for potential confounders and BMI, consumption of unsweetened soy was inversely associated with diabetes risk. Hazard ratios (HRs) and 95% CI for diabetes across unsweetened soy intake categories (none, 1–4/month, 1–2/week, 3–4/week, ≥5/week) were: 1 (referent), 0.81 (0.67–0.97), 0.76 (0.63–0.91), 0.76 (0.63–0.92), and 0.72 (0.59–0.89), respectively (P trend = 0.015). Conversely, in multivariate models, consuming sweetened soybean drink was positively associated with diabetes risk. HRs for diabetes across soybean drink intake categories (none, 1–3/month, 1/week, ≥2/week) were: 1 (referent), 1.07 (0.95–1.20), 1.12 (1.00–1.26), and 1.13 (1.00–1.28), respectively (P trend = 0.03). Furthermore, after full adjustment, including adjustment for sweetened soy items, we observed a marginally significant inverse association between isoflavone intake and diabetes (HR for the fifth compared to the first quintile: 0.76; 95% CI: 0.58–1.00; P trend = 0.08).The current findings support a protective role for unsweetened soy foods and isoflavones on risk of type 2 diabetes.
Keywords: Soy; Isoflavones; Type 2 diabetes; Chinese; Cohort study

Erratum to: Soy intake and risk of type 2 diabetes in Chinese Singaporeans by Noel T. Mueller; Andrew O. Odegaard; Myron D. Gross; Woon-Puay Koh; Mimi C. Yu; Jian-Min Yuan; Mark A. Pereira (1041-1041).