6 whereas no changes were observed in the control group. No statistical comparison between ipriﬂavone and control groups was reported for this marker of bone resorption. In a large prospective, randomised, double-blind, placebo-controlled trial including 474 postmenopausal Cau- casian women aged 45 to 75 years with osteopenia or osteoporosis Alexandersen et al. [62] randomly assigned subjects to receive either ipriﬂavone (200 mg 3 times per day, n = 234) or placebo (n = 240) for three years in addition to 500 mg/d of calcium. Based on an intention- to-treat analysis, the annual percent change from baseline in BMD at the lumbar spine or at any of the other sites measured did not diﬀer signiﬁcantly between the ipriﬂavone and the placebo groups after 36 months of treatment. The response of biochemical markers of bone turnover did not diﬀer between groups. The number of women with new vertebral fractures was not diﬀerent between the intervention and control groups after three years of follow-up. Although four small intervention studies suggest a role of ipriﬂavone in attenuating the loss of BMD at the lumbar spine in postmenopausal women by decreasing bone resorption, the largest RCT with the highest number of subjects and the longest followup indicates that ipriﬂavone does not prevent bone loss or aﬀect biochemical markers of bone turnover in postmenopausal women. Furthermore, a cause and eﬀect relationship has not been established between the consumption of ipriﬂavone and maintenance of bone mineral density in postmenopausal women. 6. Concluding Remarks Diet and nutrition contribute to the diﬀerent rates of cancer and other diseases throughout the world. Diets rich in plant- derived products may supply a variety of phytoestrogens capable of producing a range of pharmacological eﬀects in the human body. As people live longer, women are spending more of their lives in menopause, aﬀected by a variety of estrogen-related conditions such as osteoporosis, cognitive decline and cardiovascular diseases. Soy protein has a modest beneﬁcial eﬀect on bone. However, after the analyses of existing literature it should be stated that it is too early to state whether soy protein or its isoﬂavones can be substituted for estrogen in preventing the bone loss induced by ovarian hormone deﬁciency. More studies need to be conducted to ﬁnd out whether: (1) isoﬂavones independent of soy protein can prevent ovarian hormone deﬁciency-associated bone loss; (2) consumption of soy containing food or intake of isoﬂavones on a daily basis is necessary to observe the expected beneﬁcial eﬀects on bone or simply intermittent use will produce the same results; (3) the eﬀect of soy protein or its isoﬂavones on bone is transi- tory; (4) the combination of soy isoﬂavones and lower doses of estrogens can prevent postmenopausal bone mineral loss and at the same time lower the estrogen-associated risks. It is essential that future studies be performed with standardized and structurally characterized mixtures of compounds or with isolated phytoestrogens. Also more research is needed to determine the eﬃcacy of ipriﬂavone in inhibiting the Journal of Osteoporosis decrease in BMD and it is too early to recommend it as supplement for patients with osteoporosis. 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