Traditional Asian fermented soy food products are associated with reduced cardiovascular disease risk in prospective studies, but few randomized controlled trials have been conducted in at-risk populations. The aim of this study was to investigate the effect of a commercial non-probiotic fermented soy product on blood lipids in adults with cardiovascular risk biomarkers. In a randomized, crossover, intervention study, 27 men and women (aged 29–75 y) exhibiting at least two risk factors, consumed two packets (12.5 g each) daily of a fermented powdered soy product, or an isoenergic control powder made from germinated brown rice for 12 weeks each. The consumption of the fermented soy product resulted in a significantly greater mean change from baseline (compared to the germinated rice, all p < 0.05) in total cholesterol of −0.23 mmol/L (CI: −0.40, −0.06) compared with 0.14 mmol/L (CI: −0.03, 0.31), respectively; and low density lipoprotein (LDL) cholesterol −0.18 mmol/L (CI: −0.32, −0.04) compared with 0.04 mmol/L (CI: −0.01, 0.018) respectively. This was accompanied by an increase in high density lipoprotein (HDL) cholesterol in the germinated rice group, a decrease in apolipoprotein B (ApoB) in the fermented soy group, and a between-treatment effect in apolipoprotein A1 (ApoA1); however, the ratio of the LDL:HDL and of Apo B:ApoA1 did not differ between the groups. The ratio of total cholesterol:LDL decreased in men in the fermented soy group (p < 0.001). Twenty-four-hour urine collection at the end of each treatment period resulted in an increased excretion expressed as a ratio in μmol/d between treatments of 10.93 (CI: 5.07, 23.54) for daidzein; 1.24 (CI: 1.14, 4.43) for genistein; and, 8.48 (CI: 4.28, 16.80) for glycitein, all p < 0.05. The fermented soy powder consumed by participants in this study without implementing other changes in their typical diets, decreased the total and LDL cholesterol, and may serve as a dietary strategy to manage blood lipids. The trial was registered at ClinicalTrials.gov as NCT03429920.

Background/Objectives: Soy foods and isoflavones are inversely associated with cognitive decline; however, randomized controlled trials (RCTs) show mixed results. Fermented soy contains bioactive compounds not found in unfermented soybeans, such as peptides and aglycone isoflavones, which may support cognition by reducing neuroinflammation and oxidative stress. Fermented soy RCTs on older adults with mild cognitive impairment show cognitive benefits; however, the effects of fermented soy on cognitively healthy older adults are not known. Methods: We investigated the effects of a non-probiotic fermented soy powder, added to the usual diet, compared to a placebo matched for energy on global cognition, memory, verbal fluency, processing speed, and executive function in a 12-week RCT on 61 adults aged 65 years and older (74 ± 5 y; 47 completers). Results: The fermented soy group showed significant improvement (p = 0.041) in memory scores (1.81%, 95% CI: −2.10, 5.72) vs. placebo (1.16%, 95% CI: −3.64, 5.97) using analysis of variance, adjusted for sex and baseline scores. Post hoc analyses on women 70 years and older (n = 29) found significant improvement in global cognition (p = 0.028) and memory (p = 0.049) in the fermented soy group. Global cognition mean change adjusted for baseline scores was 2.86% (95% CI: 1.52, 4.21) for fermented soy and 0.06% (95% CI: −1.43, 1.55) for placebo. Memory mean change adjusted for baseline scores was 8.47% (95% CI: 5.05, 11.89) in the fermented soy group, compared to 2.05% (95% CI: −1.75, 5.84) for placebo. Conclusions: These outcomes suggest that fermented soy has the potential to slow age-related cognitive decline, especially memory for women 70 and older. Further research to confirm these findings in older women, and in males and other age categories is warranted.

Among all tree nuts, walnuts contain the highest total polyphenols by weight. This secondary data analysis examined the effect of daily walnut supplementation on the total dietary polyphenols and subclasses and the urinary excretion of total polyphenols in a free-living elderly population. In this 2-year prospective, randomized intervention trial (ID NCT01634841), the dietary polyphenol intake of participants who added walnuts daily to their diets at 15% of daily energy were compared to those in the control group that consumed a walnut-free diet. Dietary polyphenols and subclasses were estimated from 24 h dietary recalls. Phenolic estimates were derived from Phenol-Explorer database version 3.6. Participants in the walnut group compared to the control group had a higher intake of total polyphenols, flavonoids, flavanols, and phenolic acids in mg/d (IQR): 2480 (1955, 3145) vs. 1897 (1369, 2496); 56 (42,84) vs. 29 (15, 54); 174 (90, 298) vs. 140 (61, 277); and 368 (246, 569) vs. 242 (89, 398), respectively. There was a significant inverse association between dietary flavonoid intake and urine polyphenol excretion; less urinary excretion may imply that some of the polyphenols were eliminated via the gut. Nuts had a significant contribution to the total polyphenols in the diet, suggesting that a single food like walnuts added to habitual diet can increase the polyphenol intake in a Western population.