Phytoestrogen supplementation and body composition in postmenopausal women: A systematic review and meta-analysis of randomized controlled trials

Abstract

Phytoestrogen-based medications are commonly used by menopausal women, and especially by obese postmenopausal women, to relieve menopausal symptoms. Substitution of animal with soy protein is often used in weight loss regimens, yet the effect of phytoestrogens, the main constituent of soy foods, on body composition is not completely understood. We conducted a systematic review and meta-analysis to investigate the associations between phytoestrogen supplementation and body weight and the main parameters of body composition in postmenopausal women. A literature search was done using 5 electronic databases from inception to April 2018. Randomized controlled trials (RCTs) with postmenopausal women comparing phytoestrogen supplementation followed by usual diet and placebo were included in the present meta-analysis. From 5932 references, we identified 23 RCTs that met our inclusion criteria, with a total of 1880 postmenopausal women. No association was observed between phytoestrogen supplementation and body weight, body mass index, waist and hip circumference, total fat mass or percentage of body fat. However, the use of phytoestrogens supplementation was associated with a slight decrease in waist-hip ratio; the pooled mean difference was -0.01 cm (95%CI: -0.01 to -0.006). In subgroup analysis, we found a modest decrease in body weight with phytoestrogens supplementation compared with placebo in healthy postmenopausal women [pooled mean difference of changes -0.28 kg (95%CI: -0.52 to -0.04)] and in RCTs with a median number of participants of 66 or less [pooled mean difference of changes -0.49 kg (95%CI: -0.87 to -0.11)]. In contrast, phytoestrogen supplementation was associated with increased body weight in postmenopausal women with preexisting metabolic disorders (prediabetes, type 2 diabetes, prehypertension and hyperlipidemia) [pooled mean difference of changes: 0.78 kg (95%CI: 0.53-1.03)]. In addition, there were some indications that some types of phytoestrogens, such as daidzein, but not soy products or isoflavone mix, could lead to modest adverse changes in body composition in menopausal women. Therefore, future studies should investigate the potential adverse effects of phytoestrogen supplementation on body composition among postmenopausal women.

Effect of CIMicifuga racemosa on metaBOLIC parameters in women with menopausal symptoms: a retrospective observational study (CIMBOLIC)

“…Therefore, herbal medicinal products such as Black cohosh or phytoestrogen supplements have gained much attention in recent years. Just recently, a systematic review and meta-analysis reported a decrease in body weight with phytoestrogen supplementation in healthy postmenopausal women, but body weight gain in postmenopausal women with preexisting metabolic disorders [24]. In the present study, we did not observe a negative impact of Ze 450 on body weight gain and metabolic parameters in any subgroup.…”

Targeting Abdominal Obesity and Its Complications with Dietary Phytoestrogens

“…The overall analysis revealed an association between phytoestrogen supplementation and a decrease in the WHR that corresponded to a lower cumulation of visceral fat. In contrast, no significant changes in body weight, BMI, waist and hip circumference, total fat mass, or percentage of body fat were observed [106]. However, in a subgroup that only included healthy individuals who were on isoflavone mix, a modest decrease in body weight after the intervention was found.…”

“…For instance, isoflavone mixture supplements have been found to significantly decrease body weight in healthy postmenopausal women. In contrast, the administration of isoflavones rich in daidzein was found to be associated with an increased body weight in women suffering from metabolic disorders [105,106]. Moreover, it should be remembered that the effectiveness of phytoestrogen supplementation depends on the intestinal microflora composition that is responsible for their transformation into active metabolites [107].…”

“…However, it was found to improve insulin secretion and HOMA-IR [137]. The impact of phytoestrogen supplementation on glucose and insulin status was also assessed in the mentioned-above meta-analysis [106]. Phytoestrogen intake was associated with lower fasting glucose levels independently of weight, and the effect was more pronounced in a low-dose (< 100mg/d) but longer (≥ 6 months) treatment.…”

Gewichtsänderung als unerwünschte Arzneimittelwirkung

“…Kompliziert wird die Situation auch durch die Vielzahl verschiedener hormoneller Kontrazeptionsmethoden und Arzneimittel sowie durch die Altersspanne der Anwenderinnen, die in einer für Gewichtszunahme vulnerablen Lebensphase beginnen und sich bis weit ins mittlere Lebensalter fortsetzen kann. Aber egal, ob lokal wirksame Hormonfreisetzung von Gestagenen oder Depotanwendung oder kombinierte hormonelle Kontrazeption oder auch die Hormonersatztherapie im höheren Lebensalter, keine der verfügbaren Studien und systematischen Reviews berichten über signifikante Gewichtszunahmen bei den hormonanwendenden Frauen im Vergleich zu Frauen ohne Hormonanwendung [31][32][33][34][35]. Es ist dennoch sicher richtig, das Thema Gewichtszunahme im Aufklärungsgespräch und im weiteren Verlauf der Hormonanwendung zu adressieren und das Gewicht zu kontrollieren.…”