Accession information: DOI: 10.1017/S1462399403005264; Vol. 5; ?? September 2003 ©2003 Cambridge University Press http://www.expertreviews.org/ Molecular mechanisms by which dietary isoflavones potentially prevent atherosclerosis 1 expert reviews in molecular medicine Molecular mechanisms by which dietary isoflavones potentially prevent atherosclerosis Aedin Cassidy, Sonia de Pascual Teresa and Gerald Rimbach Aedin Cassidy (corresponding author) Visiting Academic, Hugh Sinclair Human Nutrition Unit, School of Food Biosciences, University of Reading, Whiteknights, Reading, RG6 6AP, UK. Tel/Fax: +44 (0)1234 870498; E-mail: cassidyaedin@hotmail.com Sonia de Pascual Teresa Postdoctoral Scientist, Department of Plant Food Science and Technology, Instituto del Frio, Consejo Superior de Investigaciones Cientificas, Jose Antonio Novais 10, E-28040 Madrid, Spain. Tel: +34 91 549 23 00; Fax: +34 91 549 36 27; E-mail: soniapt@if.csic.es Gerald Rimbach Lecturer, Hugh Sinclair Human Nutrition Unit, School of Food Biosciences, University of Reading, Whiteknights, Reading, RG6 6AP, UK. Tel: +44 (0)118 931 6463; Fax: 0118 931 0080; E-mail: g.h.rimbach@reading.ac.uk Dietary isoflavones are currently receiving much attention because of their potential role in preventing coronary artery disease and other chronic diseases. Accumulating evidence from cell culture and laboratory animal experiments indicates that isoflavones have the potential to prevent or delay atherogenesis. Suggested mechanisms of action include: a reduction in low-density lipoprotein (LDL) cholesterol and a potential reduction in the susceptibility of the LDL particle to oxidation; (2) an improvement in vascular reactivity; (3) an inhibition of pro-inflammatory cytokines, cell adhesion proteins and nitric oxide (NO) production; and (4) an inhibition of platelet aggregation. These mechanisms are consistent with the epidemiological evidence that a high consumption of isoflavone-rich soy products is associated with a reduced incidence of coronary artery disease. Biological effects of isoflavones are dependent on many factors, including dose consumed, duration of use, protein-binding affinity, and an individual’s metabolism or intrinsic oestrogenic state. Further clinical studies are necessary to determine the potential health effects of isoflavones in specific population groups as we currently know little about age-related differences in exposure to these compounds and there are few guidelines on optimal dose for cardiovascular health benefits.