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Articles: Herbert Marini, Letteria Minutoli, Francesca Polito, Alessandra Bitto, Domenica Altavilla, Marco Atteritano, Agostino Gaudio, Susanna Mazzaferro, Alessia Frisina, Nicola Frisina, Carla Lubrano, Michele Bonaiuto, Rosario D'Anna, Maria Letizia Cannata, Francesco Corrado, Elena Bianca Adamo, Steven Wilson, and Francesco Squadrito Effects of the Phytoestrogen Genistein on Bone Metabolism in Osteopenic Postmenopausal Women: A Randomized Trial Ann Intern Med 2007; 146: 839-847 [Abstract] [Full text] [PDF]

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Geographic Differences in Dietary Influences May Play a Bigger Issue in Postmenopausal Women

An T. Tran, Daniel D. Arkfeld, M.D., Jeffrey B. Canceko MD, David Patterson   (20 July 2007)

Geographic Differences in Dietary Influences May Play a Bigger Issue in Postmenopausal Women 20 July 2007
An T. Tran, MD candidate Howard University College of Medicine, Daniel D. Arkfeld, M.D., Jeffrey B. Canceko MD, David Patterson Send rapid response to journal: Re: Geographic Differences in Dietary Influences May Play a Bigger Issue in Postmenopausal Women trieuan{at}yahoo.com An T. Tran, et al.	It is with great interest that we reviewed the article "Effects of the Phytoestrogen Genistein on Bone Metabolism in Osteopenic Postmenopausal Women " by Marini et al. The result on Genistein is very promising, however, there are several concerns we would like to address. Firstly, it would be of great benefit if this study is done in a more diverse setting not just limited to 3 university medical centers in Italy. A confounding variable is if the Mediterranean diet, which is high in green vegetables and goat cheese (a good source of calcium and iron) contributes to the result. One would wonder if the result is the same if the study is done in the United States where the diet composition is different and the population more diverse. Secondly, the patient sample chosen is by the study did not mention the activity levels of the participants. One would expect that the more active and fit the patient, the healthier the bone and therefore it would be vital to control for activity levels. Thirdly, further studies on the long term effect of Genistein would be important to examine the safety of this medicine beyond 2 years. Previous studies have shown that high estrogen post an increase risk in breast/ovarian/endometrial cancer, blood clots, cardiovascular and other complications. Therefore, these side effects must be address future studies. Also, the incident of bone fractures are most critical in the evaluation of the utility of Genistein as mentioned in the article. Despite these issues, the risk/benefit ratio of Genistein may warrant further studies and use in the postmenopausal population.