Dietary Intake of Phytoestrogens Is Associated with a Favorable Metabolic Cardiovascular Risk Profile in Postmenopausal U.S. Women: The Framingham Study

Kleijn, Miriam J.J. de; Schouw, Yvonne T. van der; Wilson, Peter W.F.; Grobbee, Diederick E.; Jacques, Paul F.

doi:10.1093/jn/132.2.276

Cited by 199 publications

(128 citation statements)

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“…Two studies in Asian populations did find a positive effect of phytoestrogen intake on total cholesterol and LDL but the levels of intake are several fold higher in the Asian population as compared to western populations. In western postmenopausal women some positive effects of dietary phytoestrogens on plasma lipids were reported [28]. Our results are not consistent with these findings, but confounding by unmeasured factors could have caused the discrepancy.…”

Section: Discussioncontrasting

confidence: 96%

Dietary phytoestrogens and plasma lipids in Dutch postmenopausal women; a cross-sectional study

et al. 2005

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Objective: Isoflavone supplementation in high doses is associated with plasma lipid, glucose and insulin levels. Little is known about the effects of intake within the range of western diets on these endpoints. Design: We conducted a population-based cross-sectional study in 301 women aged 60-75 years. Methods: Dietary isoflavone and lignan intake was assessed with a food frequency questionnaire covering habitual diet during the year preceding enrolment. The outcome measures were total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides, Lp(a), fasting glucose and insulin levels. Data were analysed using linear regression and logistic regression models. In the analyses we adjusted for a wide range of potential confounders. Results: High intake of isoflavones was associated with lower Lp(a) levels (tertile three versus tertile one: odds ratio 0.36, 95% CI 0.16; 0.80). No relation was found between blood levels and the other plasma lipids, glucose or insulin was found. Conclusion: The results of this study suggest that an effect of dietary phytoestrogen intake at low levels on plasma lipid levels is of limited magnitude. It is premature to advise postmenopausal women with low phytoestrogen intake to change their diet towards a phytoestrogen rich diet with the sole aim to prevent cardiovascular disease.

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Section: Discussioncontrasting

confidence: 96%

Dietary phytoestrogens and plasma lipids in Dutch postmenopausal women; a cross-sectional study

et al. 2005

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“…Epidemiological studies (19,20) have indicated that there is no significant association between the standard western dietary intake of isoflavones (0.369 -0.770 mg/day) and the reduction of cardiovascular events or lipid levels in different cohorts of postmenopausal women over prolonged periods of time (4 -6 years). Our subjects received Ͼ150 times this amount, yet no significant changes were observed over a 3-month period.…”

Section: Discussionmentioning

confidence: 99%

Effects of Isoflavone Dietary Supplementation on Cardiovascular Risk Factors in Type 2 Diabetes

et al. 2007

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A diet supplemented with soy protein and isoflavones has been shown to reduce cardiovascular risk factors in postmenopausal women with type 2 diabetes. However, it remains unclear which component is responsible for these effects. Our aim was to determine whether the addition of isoflavones alone modifies cardiovascular disease risk markers in this group of patients. Cardiovascular disease (CVD) is the leading cause of mortality in women in developed countries (1), and women with diabetes are four times more likely to die from CVD than men (2). Among other factors, postmenopausal estrogen depletion, greater insulin resistance, and dyslipidemia (3,4) may contribute to high risk of accelerated CVD.Modification of lifestyle is important to reduce CVD risk factors and delay progression of type 2 diabetes-associated complications. In particular, the addition of oral supplements, such as soy products, as part of a healthy diet has attracted recent interest because of their beneficial effects on lipid profiles (5-10). However, scant information is available on the effects of soy in individuals with type 2 diabetes (11-13), who are at higher risk due to hyperlipidemia, lower HDL levels, and abnormalities in LDL/lipoprotein composition (14). It also remains unclear whether a beneficial effect can be attributed to the soy protein or isoflavones.We have shown that soy protein combined with isoflavones can improve glycemic control, insulin resistance, and lipids in patients with type 2 diabetes (11). Therefore, our aim was to determine if this effect was due to the isoflavone component alone. RESEARCH DESIGN ANDMETHODS -This was a randomized, double-blind, placebo-controlled, crossover study with a 4-week washout period separating the placebo and active phases (12 weeks each). Subjects provided informed consent. Randomization was performed using a random number generator. Thirty-two Caucasian, postmenopausal women with diet-controlled type 2 diabetes (according to World Health Organization criteria) (15) and amenorrhoa (for Ͼ1 year) were recruited. Exclusion criteria were breast/uterine cancer; uncontrolled hypothyroidism; and treatment with oral hypoglycemic agents, insulin, estrogens, or statins initiated Ͻ4 months before the trial.Baseline characteristics are included in Table 1. Six subjects withdrew from the study: one required a cholecystectomy and one a coronary angioplasty, one had an acute attack of polymyalgia rheumatica requiring steroids, and three were unable to comply with study requirements. InterventionThe soy preparation (Essential Nutrition) contained 132 mg isoflavones (53% genistein, 37% daidzein, and 10% glycitein). It was devoid of soluble fiber. The placebo was an identical tablet of microcrystalline cellulose. Compliance was monitored by counting returned medication. Study measurementsVenous blood samples were collected at each visit after a 12-h overnight fast. A1C, glucose, and lipid levels were measured using standard methods. LDL cholesterol was calculated using the Friedewald equation and insulin...

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“…Whole grains contain higher amounts of fiber, vitamin E, magnesium, antioxidants and phytoestrogens (Slavin et al, 1997), the protective effects of which against chronic disease risk have been shown by previous studies (Stampfer et al, 1993;Ma et al, 1995;Anderson and Hanna, 1999;de Kleijn et al, 2002). Despite dietary recommendations to increased intake of whole grains, little research has been conducted on the physiologic effects of a diet high in whole grains, such that only one study, conducted in the Framingham Offspring Cohort, reported the association of whole-grain intake with the metabolic syndrome (McKeown et al, 2004).…”

Section: Introductionmentioning

confidence: 99%

Whole-grain consumption and the metabolic syndrome: a favorable association in Tehranian adults

2004

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Background: Although dietary guidelines recommend increased intake of grain products to prevent chronic diseases, epidemiologic data regarding whole-grain intake association with metabolic syndrome are sparse. Objective: To evaluate the relationship between whole-grain intakes, metabolic syndrome and metabolic risk factors in Tehranian adults. Design: Population-based cross-sectional study. Setting: Tehran, the capital of Iran. Subjects: A representative sample of 827 subjects (357 men and 470 women) aged 18-74 y. Methods: Usual dietary intake was assessed using a food frequency questionnaire. The procedure developed by Jacobs et al was used to classify grain products into whole and refined grains. Weight and height were measured according to standard protocols and body mass index was calculated. Fasting blood samples were taken for biochemical measurements and blood pressure was assessed according to standard methods. Hypertriglyceridemia, hypercholestrolemia, high LDL, low HDL and metabolic syndrome were defined according to ATP III guidelines and hypertension based on JNC VI. Diabetes was defined as fasting plasma glucose level of Z126 mg/dl or 2-h postchallenge blood glucose level of Z200 mg/dl. Subjects were categorized based on quartile cut-points of whole-and refined-grain intake. Results: Mean (7s.d.) consumptions of whole and refined grains were 93729 and 201757 g/day, respectively. Both men and women reported higher intakes of refined grain than of whole grains. Compared with subjects in the lower quartile category, those in the upper category of whole-grain intake had lower prevalence of metabolic risk factors. Conversely, those in the higher category of refined-grain intake had higher prevalence of metabolic risk factors, except for diabetes. After controlling for confounders, a significantly decreasing trend was observed for the risk of having hypertriglyceridemia (odds ratios among quartiles: 1.00, 0.89, 0.74, 0.61, respectively), hypertension (1.00, 0.99, 0.93, 0.84) and metabolic syndrome (1.00, 0.84, 0.76, 0.68). Higher consumption of refined grains was associated with higher odds of having hypercholestrolemia

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Dietary Intake of Phytoestrogens Is Associated with a Favorable Metabolic Cardiovascular Risk Profile in Postmenopausal U.S. Women: The Framingham Study

Cited by 199 publications

References 54 publications

Dietary phytoestrogens and plasma lipids in Dutch postmenopausal women; a cross-sectional study

Dietary phytoestrogens and plasma lipids in Dutch postmenopausal women; a cross-sectional study

Effects of Isoflavone Dietary Supplementation on Cardiovascular Risk Factors in Type 2 Diabetes

Whole-grain consumption and the metabolic syndrome: a favorable association in Tehranian adults

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