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Messina MJ, Messina V, Nagata C. Perspective: Observational Studies Involving Low-Soy Intake Populations Have Limited Ability for Providing Insight into the Health Effects of Soybean Isoflavones. Adv Nutr 2024; 15:100210. [PMID: 38484974 PMCID: PMC10992291 DOI: 10.1016/j.advnut.2024.100210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 02/28/2024] [Accepted: 03/11/2024] [Indexed: 04/01/2024] Open
Abstract
Isoflavones are naturally occurring plant compounds found in uniquely high amounts in soybeans and foods made from this legume. These soybean constituents have been proposed to exert several health benefits and as such they have been the subject of an enormous amount of research. This research includes randomized controlled trials (RCTs) and epidemiologic investigations. Although statistically significant associations between isoflavone intake and a wide range of health outcomes have been identified in cohorts involving low-isoflavone intake populations, we suggest that these associations are unlikely to have a causal basis because exposure is too low for isoflavones to exert physiologic effects. In cohorts involving predominantly non-Asian, non-vegetarian populations, the highest isoflavone intake category is typically ≤3 mg/d, an amount of isoflavones provided by ∼30 mL (2 tablespoons) of soymilk made from whole soybeans. In comparison, mean isoflavone intake in the upper intake categories in observational studies involving high-isoflavone intake populations is typically ≥50 mg/d. In RCTs, intervention doses of isoflavones typically range between 40 and 100 mg/d. Health professionals advising patients and clients about soy food and isoflavone intake need to be aware of the limitations of epidemiologic research involving low-isoflavone intake populations. Intake recommendations are best based on the results of RCTs using clinically relevant doses of isoflavones and epidemiologic studies involving populations for whom soy foods are a habitual part of the diet.
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Affiliation(s)
- Mark J Messina
- Soy Nutrition Institute Global, Jefferson City, MO, United States.
| | | | - Chisato Nagata
- Department of Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
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Yaghjyan L, Mai V, Wang X, Ukhanova M, Tagliamonte M, Martinez YC, Rich SN, Egan KM. Gut microbiome, body weight, and mammographic breast density in healthy postmenopausal women. Cancer Causes Control 2021; 32:681-692. [PMID: 33772705 DOI: 10.1007/s10552-021-01420-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 03/16/2021] [Indexed: 12/17/2022]
Abstract
PURPOSE We examined gut microbiome (GM) profiles in relation to mammographic breast density (BD) and body mass index (BMI) in healthy postmenopausal women. METHODS Eligible women were postmenopausal, had a BMI ≤ 35 kg/m2, and had not recently taken oral/IV antibiotics. All women provided a fecal sample and information on breast cancer risk factors. Mammographic BD was classified with the American College of Radiology's BI-RADS BD classification system. Bacterial DNA was isolated from fecal samples and the V1-V2 hypervariable regions of 16S rRNA were sequenced on the Illumina MiSeq platform. We examined associations of GM with indices of within-sample (alpha) diversity and the ratio of the two main phyla (Firmicutes and Bacteroidetes; F/B ratio) with BD and BMI. RESULTS Among 69 women with BD data, 39 had low BD (BI-RADS I/II) and 30 had high BD (BI-RADS III/IV). BMI was inversely associated with BD (mean BMI = 23.8 and 28.0 in women with high and low BD, respectively, p = 1.07 × 10-5). Similar levels of GM diversity were found across weight groups according to Shannon (p = 0.83); Inverse Simpson (p = 0.97); and Chao1 (p = 0.31) indices. F/B ratio and microbiota diversity were suggestively greater in women with high vs. low BD (p = 0.35, 0.14, 0.15, and 0.17 for F/B ratio, Shannon, Inverse Simpson and Chao1, respectively). CONCLUSION Suggestive differences observed in women with high and low BD with respect to GM alpha diversity and prevalence of specific GM taxa need to be confirmed in larger studies.
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Affiliation(s)
- Lusine Yaghjyan
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL, USA
| | - Volker Mai
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL, USA.,Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA
| | | | - Maria Ukhanova
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA
| | | | | | - Shannan N Rich
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL, USA
| | - Kathleen M Egan
- H. Lee Moffitt Cancer Center, Tampa, FL, USA. .,Moffitt Cancer Center and Research Institute, 12902 USF Magnolia Drive, Tampa, FL, 33612, USA.
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VAHID DASTJERDI M, ESLAMI B, ALSADAT SHARIFI M, MOINI A, BAYANI L, MOHAMMAD KHANI H, ALIPOUR S. Effect of Soy Isoflavone on Hot Flushes, Endometrial Thickness, and Breast Clinical as well as Sonographic Features. IRANIAN JOURNAL OF PUBLIC HEALTH 2018; 47:382-389. [PMID: 29845026 PMCID: PMC5971175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Phytoestrogens treatment to relieve hot flushes in menopausal women was considered recently. However, the actual effectiveness and safety are not clear. METHODS Randomized clinical trial (IRCT#20100706004329N5) was performed in 204 patients who complained of hot flushes in Arash Women's Hospital, Tehran, Iran from 2013-2015. The first group received 50 mg isoflavone (group A) once daily and the second group received placebo (group B) in the same regimen. Patients were evaluated for breast examination (BE) and breast sonography (BS) as well as vaginal sonography at initial presentation and at 6th and 12th week follow-ups. Patients were educated to record frequency and severity of hot flushes. RESULTS Group A experienced less hot flushes attack (6 vs 9 patients with 5< attacks in 6 wk (P= 0.05), 7 Vs 13 patients with 5< in 12 wk (P=0.01)) which was also less severe (8 vs 12 patients with severe symptoms in 6 wk (0.04) and 3 Vs 10 patients with severe symptoms in 12 wk (0.001). Isoflavone had no effect on neither breast density nor nodularity (in 6 wk, P=0.50 and 0.80, respectively and in 12 wk, P=0.32 and 0.43) and neither breast tenderness nor nipple discharge (in 6 wk, P=0.40 and 0.34 respectively and in 12 wk, P= 0.31 and 0.26). There were no significant differences in endometrial thickness in 6 and 12wk. CONCLUSION Effects of isoflavone on frequency and severity of hot flushes in perimenopausal women is observed. Some clinical and ultrasonographic benign non-significant changes of the breast and endometrium are noted after isoflavone intake.
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Affiliation(s)
- Marziyeh VAHID DASTJERDI
- Dept. of Obstetrics and Gynecology, Arash Women’s Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Bita ESLAMI
- Breast Disease Research Center (BDRC), Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam ALSADAT SHARIFI
- Dept. of Obstetrics and Gynecology, Arash Women’s Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ashraf MOINI
- Dept. of Obstetrics and Gynecology, Arash Women’s Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Leila BAYANI
- Dept. of Radiology, Arash Women’s Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hoda MOHAMMAD KHANI
- Dept. of Obstetrics and Gynecology, Vali-e-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Sadaf ALIPOUR
- Breast Disease Research Center (BDRC), Tehran University of Medical Sciences, Tehran, Iran, Dept. of Surgery, Arash Women’s Hospital, Tehran University of Medical Sciences, Tehran, Iran,Corresponding Author:
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Alipour S, Afshar S, Moini A, Dastjerdi MV, Saberi A, Bayani L, Eslami B, Hosseini L. Clinical and ultrasonographic changes of the breast after use of soy isoflavones. Asian Pac J Cancer Prev 2016; 13:6093-5. [PMID: 23464410 DOI: 10.7314/apjcp.2012.13.12.6093] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Phytoestrogens may be an alternative therapy in control of menopausal symptoms but their definite effects on breast tissue must be determined. Our study aimed to define the clinical and ultrasonographic changes of the breast after use of soy isoflavones in menopausal women. MATERIALS AND METHODS Menopausal women with hot flashes were randomly grouped as cases and controls and cases received soy isoflavones for 12 weeks. Breast examination (BE) and ultrasonography (US) were done at 0, 6 and 12 weeks. Tenderness and nodularity on BE were graded 1-4 by breast surgeons. RESULTS There were 30 women in the case and 26 in the control group. The mean age was 51.3 years and the mean age of menopause was 49.2 years. There was no change in the BE and US at 6 weeks in controls. In the case group, 10% had grade 1 tenderness and 13.3% grade 2 tenderness and grade 1 nodularity in BE accompanied with diffuse small cysts in US. At 12 weeks, there was no change in BE and US in the 2 groups. CONCLUSIONS There was no statistically significant difference in the BE of the 2 groups at 6 and 12 weeks (p value=0.36 and 0.41 for nodularity and tenderness respectively) and in the US results. Although the literature contains many facts concerning PEs and the breast, further prospective studies are needed to identify structural breast changes produced by PEs in order to identify the appropriate dosage and indications of use.
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Affiliation(s)
- Sadaf Alipour
- Surgery Department, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran.
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Tseng M, Byrne C, Kurzer MS, Fang CY. Equol-producing status, isoflavone intake, and breast density in a sample of U.S. Chinese women. Cancer Epidemiol Biomarkers Prev 2013; 22:1975-83. [PMID: 24019393 DOI: 10.1158/1055-9965.epi-13-0593] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Differences in ability to metabolize daidzein to equol might help explain inconsistent findings about isoflavones and breast cancer. We examined equol-producing status in relation to breast density, a marker of breast cancer risk, and evaluated whether an association of isoflavone intake with breast density differs by equol-producing status in a sample of Chinese immigrant women. METHODS Participants were 224 women, ages 36 to 58 years, enrolled in a study on diet and breast density. All women completed dietary recall interviews, underwent a soy challenge to assess equol-producing status, and received a mammogram assessed for breast density using a computer-assisted method. RESULTS In our sample, 30% were classified as equol producers. In adjusted linear regression models, equol producers had significantly lower mean dense tissue area (32.8 vs. 37.7 cm(2), P = 0.03) and lower mean percent breast density (32% vs. 35%, P = 0.03) than nonproducers. Significant inverse associations of isoflavone intake with dense area and percent density were apparent, but only in equol producers (interaction P = 0.05 for both). CONCLUSIONS These results support the possibility that equol-producing status affects breast density and that effects of isoflavones on breast density depend on ability to metabolize daidzein to equol. IMPACT Although these findings warrant confirmation in a larger sample, they offer a possible explanation for the inconsistent findings about soy intake and breast density and possibly breast cancer risk as well. The findings further suggest the importance of identifying factors that influence equol-producing status and exploring appropriate targeting of interventions.
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Affiliation(s)
- Marilyn Tseng
- Authors' Affiliations: Kinesiology Department, California Polytechnic State University, San Luis Obispo, California; Department of Preventive Medicine and Biometrics, Uniformed Services University of the Health Sciences, Bethesda, Maryland; Department of Food Science and Nutrition, University of Minnesota, Saint Paul, Minnesota; and Cancer Prevention & Control Program, Fox Chase Cancer Center, Philadelphia, Pennsylvania
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Wang J, Trentham-Dietz A, Hemming JDC, Hedman CJ, Sprague BL. Serum factors and clinical characteristics associated with serum E-screen activity. Cancer Epidemiol Biomarkers Prev 2013; 22:962-71. [PMID: 23588007 DOI: 10.1158/1055-9965.epi-12-1117] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The E-Screen bioassay can measure the mitogenicity of human serum and thus may be useful as a biomarker in epidemiologic studies of breast cancer. While the assay's MCF-7 cells are known to proliferate in response to estrogen, the specific determinants of variation in E-Screen activity in human serum samples are poorly understood. We sought to identify serum molecules and patient characteristics associated with serum E-Screen activity among postmenopausal women. METHODS Postmenopausal women (N = 219) aged 55 to 70 years with no history of postmenopausal hormone use or breast cancer completed a questionnaire and provided a blood sample. Serum was analyzed for E-Screen activity and a variety of molecules including sex hormones, growth factors, and environmental chemicals. Stepwise selection procedures were used to identify correlates of E-Screen activity. RESULTS Serum samples from all women had detectable E-Screen activity, with a median estradiol equivalents value of 0.027 ng/mL and interquartile range of 0.018-0.036 ng/mL. In the final multivariable-adjusted model, serum E-Screen activity was positively associated with serum estradiol, estrone, insulin-like growth factor-binding protein (IGFBP)-3, and testosterone levels (all P < 0.05), as well as body mass index (P = 0.03). Serum E-Screen activity was lower among women with higher SHBG (P < 0.0001) and progesterone levels (P = 0.03). CONCLUSION Serum E-Screen activity varies according to levels of endogenous estrogens and other serum molecules. Obesity appears to confer additional serum mitogenicity beyond its impact on the measured hormones and growth factors. IMPACT By capturing mitogenicity due to a variety of patient and serum factors, the E-Screen may provide advantages for use as a biomarker in breast cancer studies.
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Affiliation(s)
- Jue Wang
- Department of Surgery, University of Vermont, Burlington, VT 05401, USA
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