BACKGROUND: Dietary intake of soy protein with isoflavones may be associated with reductions in serum cholesterol.

OBJECTIVES: To compare the effects of a water-washed soy protein concentrate with a milk-protein based control on blood lipid levels in hyperlipidemic men and women.

METHODS: A randomized, double-blind, controlled clinical trial including 159 subjects. After a 3-week run-in period during which all subjects consumed a milk protein-based supplement, participants were randomized into one of two groups: a control group (continued milk protein) and an intervention group (soy protein) for a five-week period. Fasting venous blood draws for lipid measurement were obtained at baseline, towards the end of the run-in period and at the end of the intervention. Blood isoflavone concentrations were measured at the end of the study.

RESULTS: Blood lipid levels were not significantly different between groups at any point in time; and there were no significant associations between blood isoflavones and lipid levels. Significant decreases in total cholesterol (19 mg/dL), and LDL-cholesterol (11 mg/dL), were observed during the run-in period, with no further decreases in lipids during the intervention period in either group.

CONCLUSIONS: These results do not support the hypothesis that water-washed soy protein has an effect on blood lipids. Several hypotheses are discussed, highlighting the selective nature of the effect of soy consumption in the population. The cholesterol-lowering effect during the run-in period may be explained by the "regression to the mean effect" and by other factors related to study participation, mainly nutrient displacement induced by the protein supplement.