In the aforementioned mechanism, it has been reported that isoflavones bind to both ER and ER, although they present a higher affinity towards ER receptors [7]. All authors have read and agreed to the published version of the manuscript. Murota K., Nakamura Y., Uehara M. Flavonoid metabolism: The interaction of metabolites and gut microbiota. (2020) carried out a meta-analysis with 15 cohort studies with the aim of exploring the association between isoflavone intake (<62.7 mg/day) and breast cancer mortality and its recurrence [68]. In this sense, the authors suggested that the composition of the gut microflora may influence isoflavone absorption and metabolism and could affect the production of isoflavone metabolites, which, in turn, could mediate their biological activity. Comparative efficacy of nonhormonal drugs on menopausal hot flashes. ; Project Administration, M.P.P. Jun S., Shin S., Joung H. Estimation of dietary flavonoid intake and major food sources of Korean adults. Only one study examined the effects of red clover on night sweats, and a significant association was found, which showed a decreased frequency in night sweats. For the development of this section, the meta-analyses and systematic reviews published between 2015 and 2020 were taken into account. For their meta-analysis, Jiang et al. He Bays that his thermometrical instruments were sensibly affected by the moon's rays, even at the lowest of two stations occupied by him at different elevations. In tropical climates meat which is exposed to the moonlight rapidly becomes putrid ; and in the Indies, the negroes who will lie sweltering and unoovered beneath the full glare of a tropical sun, carefully muffle their heads and faces when exposed to the moonbeams, which they believe will cause swelling and distortion of the features, and sometimes even blindness. In the systematic review reported by Perna et al. Despite the positive effect of isoflavones, the authors emphasized that the effects took a long time to appear. Tamura A., Shiomi T., Hachiya S., Shigematsu N., Hara H. Low activities of intestinal lactase suppress the early phase absorption of soy isoflavones in Japanese adults. Beneficial role of dietary phytoestrogens in obesity and diabetes. Altogether, these results show that further studies are needed in order to find stronger conclusions. Finally, isoflavones could be useful in reducing hot flushes associated with menopause. Due to the presence of biologically active compounds, walnut was used in the . While equol production seems to be similar in animals, it is very variable in humans [41], and therefore, beneficial effects referred to equol have been observed only in individuals with a specific microbiota composition [38]. The conclusion was that isoflavones exerted little influence over bone mineral density and thus over bone health during menopause, although not all the studies observed the same effect. As in the previous study, the onset of soy isoflavones was very slow in comparison with other non-hormonal treatments. 8600 Rockville Pike van Erp-Baart M.A., Brants H.A., Kiely M., Mulligan A., Turrini A., Sermoneta C., Kilkkinen A., Valsta L.M. Taken as a whole, all these results suggest that soy isoflavones do not lead to a meaningful protective effect on cardiovascular risk. Received 2020 Nov 30; Accepted 2020 Dec 15. In Japanese men, pre-diagnostic circulating levels of genistein, daidzein and equol did not significantly affect prostate cancer risk. Further, Chalvon-Demersay et al. Although smaller in quantity, isoflavones are also present in chickpeas, nuts, fruits and vegetables [11]. Sulfation of the isoflavones genistein and daidzein in human and rat liver and gastrointestinal tract. Effects of isoflavones in different cancer types. (2020) revised the literature to find randomized controlled trials that evaluated the impact of soy protein supplementation (isoflavone intake ranging from 49.3 to 118 mg/day) on endothelial function parameters in postmenopausal women (n = 802) [58]. Potential health adverse effects in the intake of isoflavones have been postulated due to their estrogenic activity, especially in relation to breast cancer. Equol is produced from the isoflavone daidzein by intestinal bacteria, mainly in the large intestine. The aglycone and conjugate forms of genistein represent up to 60% of total isoflavones, this being up to 30% in the case of daidzein. The https:// ensures that you are connecting to the They observed that it was dose-dependent at low to moderate soybean consumption. In fact, the number of isoflavones present was very variable among the different soy food types. For this reason, the bioavailability of isoflavones has been extensively characterized in animal models and humans [25,26,27]. Further, Chalvon-Demersay et al. Matulka R.A., Matsuura I., Uesugi T., Ueno T., Burdock G. Developmental and Reproductive Effects of SE5-OH: An Equol-Rich Soy-Based Ingredient. Li L., Lv Y., Xu L., Zheng Q. Quantitative efficacy of soy isoflavones on menopausal hot flashes. By contrast, the total isoflavone amount is high in soy flour, protein isolate or edamame [19]. Heinonen S., Whl K., Adlercreutz H. Identification of isoflavone metabolites dihydrodaidzein, dihydrogenistein, 6-OH-O-dma, and cis-4-OH-equol in human urine by gas chromatography-mass spectroscopy using authentic reference compounds. Bethesda, MD 20894, Web Policies Ko K.P., Kim C.S., Ahn Y., Park S.J., Kim Y.J., Park J.K., Lim Y.K., Yoo K.Y., Kim S.S. . In miso and tempeh, the aglycone form is the most abundant one [9]. The authors indicated that high concentrations of daidzein and genistein (no specific values concerning these concentrations were available) were related to 34% and 28% reduction in breast cancer risk, respectively, whereas no association with equol was found. In general terms, caution should be exercised with the use of high doses of isoflavones in women with a family history of breast cancer [49]. In this sense, it has been described that both isoflavones and other estrogenic molecules could mediate their beneficial effects due to two different mechanisms: the classical estrogen receptor (ER)-mediated signaling pathway and the activation of intracellular pathways such as protein tyrosine kinase, phospholipase C and mitogen-activated protein kinase (MAPK) [5,6]. Day A.J., Caada F.J., Daz J.C., Kroon P.A., Mclauchlan R., Faulds C.B., Plumb G.W., Morgan M.R., Williamson G. Dietary flavonoid and isoflavone glycosides are hydrolysed by the lactase site of lactase phlorizin hydrolase. This is mainly due to their potential adverse effects, which range from increased coronary heart disease to stroke and cancer [53,85]. Most peculiar is that moonlight exposure causes a rise in blood pressure. Dietary polyphenol intake in Europe: The European Prospective Investigation into Cancer and Nutrition (EPIC) study. 19% reduction in endometrial cancer risk. Further, Chalvon-Demersay et al. Lu D., Gigure V. Requirement of Ras-dependent pathways for activation of the transforming growth factor beta3 promoter by estradiol. Sex and long-term soy diets affect the metabolism and excretion of soy isoflavones in humans. After the consumption of around 17 mg of isoflavones per day, the median plasma concentrations of genistein, glycitein, daidzein and equol were 245.3 ng/mL, 9.8 ng/mL, 86.8 ng/mL and 12.7 ng/mL, respectively. Isoflavones could be used as an alternative therapy for pathologies dependent on hormonal disorders such as breast and prostate cancer, cardiovascular diseases, as well as to minimize menopausal symptoms. Sirotkin A.V., Harrath A.H. Phytoestrogens and their effects. After this, each metabolite undergoes its own metabolic pathway [40]. (2016) conducted a meta-analysis of 18 studies involving 16,917 colorectal cancer cases in 559,486 participants [78]. Kov L., Dadkov K., Kaparovsk J., Kaparovsk T. Isoflavones. The authors observed that soy isoflavone consumption was inversely associated with cancer deaths. Potential mechanism of action of isoflavones on bone metabolism. In any case, it is important to bear in mind that a great number of expert scientists and doctors think that breast cancer survivors should not increase their isoflavone intake [94], although others consider that their consumption is safe and beneficial [95]. By contrast, it seems that soy isoflavones do not lead to a meaningful protective effect on cardiovascular risk. Soy isoflavones and their metabolites modulate cytokine-induced natural killer cell function. Is equol production beneficial to health? Circulating isoflavone and lignan concentrations and prostate cancer risk: A meta-analysis of individual participant data from seven prospective studies including 2,828 cases and 5,593 controls. In the last few decades, scientific evidence has stressed the importance of plants in the prevention and/or supportive treatment of a plethora of diseases, many of them chronic, age-associated disorders. Effects of Acid Rain on Plants and Trees. Future research in this field should quantify isoflavones as accurately as possible, analyzing larger cohorts and lengthening the follow-up stage. . Inverse association between isoflavone consumption and colorectal cancer risk in case-control studies, but not in cohort studies. Dong J.Y., Qin L.Q. In addition, genistein and glycitein are transformed into dihydrogenistein and dihydroglycitein, respectively, before being further converted into other metabolites. Their meta-analysis included five studies with a total of 728 menopausal women between 50.5 and 58.5 years old and concluded that women who are not able to produce equol could benefit from equol supplementation. Possible mechanism of action of isoflavones for cancer prevention. So long ago as 1880 Siemens showed that continuous exposure to arc lamps promoted luxuriance of foliage . Hormone replacement therapy has been proven to be effective in reducing vasomotor symptoms, although isoflavones have gained popularity as an alternative treatment to hormone replacement therapy to relieve menopausal symptoms. Many females sleep less and have less REM sleep. The authors studied all possible correlations between isoflavone consumption and the risk of breast cancer. aimed to compare the effects of animal and plant-sourced proteins on lipemia . The enhanced bone formation is due to the stimulation of osteoblastic activity mainly through (a) the activation of estrogen receptors because they bind to nuclear estrogen receptors and exhibit estrogenic activity due to its similarity to 17-estradiol, and (b) the promotion of insulin-like growth factor-I (IGF-I) production [54,55] (Figure 4). They also explained that the differences between isoflavones and the rest of the drugs might be because the latter act by modulating central neurotransmitters and, as a consequence, by regulating the central thermoregulatory centers in the hypothalamus. Moreover, Rienks et al. Barnes S. The biochemistry, chemistry and physiology of the isoflavones in soybeans and their food products. Reduction of the endometrial thickness in North American women (for 0.23 mm). FOIA Magee P.J. Interestingly, in a study conducted by Tamura et al., the authors observed that in individuals without the LPH enzyme, the concentration of isoflavones and derived metabolites was similar to that found in individuals without an enzyme deficiency. Conceptualization, S.G.-Z. Apparently, soy isoflavones modified adhesion molecules by binding to vascular endothelium and mimicking the effect of a modulator of estrogen receptors [64]. However, the moonlight decreases after the full moon. The six meta-analyses show a slight improvement in the frequency and intensity of hot flushes. Arjmandi B.H., Smith B.J. It has been described that after the oral intake of isoflavones, their peak plasma concentration in humans occurs at around seven hours [33]. Thus, whereas Asian populations have an average isoflavone consumption of >30 mg/day, Western populations consume <1 mg/day [83]. Isoflavone intake in four different European countries: The VENUS approach. Ten studies reported a significant reduction in hot flush frequency in the phytoestrogen group when compared with the placebo group. The results indicated that the isoflavone intake decreased the ovarian cancer risk by 33%. In contrast, red clover was not associated with changes in the hot flush frequency. Bardin A., Boulle N., Lazennec G., Vignon F., Pujol P. Loss of ERbeta expression as a common step in estrogen-dependent tumor progression. Study duration ranged from four weeks to two years, with a median of 12 weeks. Grosso et al. government site. This result has implications for granivory and perhaps plant demography in invaded and restored coastal habitats. Contrary to other types of renewable energies, such as wind and hydroelectricity, evidence on the effects of PV panels on biodiversity has been building up only fairly recently. In addition, Qiu et al. The authors found a significant inverse association between isoflavone intake and both overall mortality and breast cancer recurrence. Isoflavones are found in several vegetables, mainly in legumes (Fabaceae family) such as soy, white and red clover, alfalfa and beans [9,10]. In the same line, in European men, isoflavone concentrations did not affect the risk of developing prostate cancer. Rizzo G., Baroni L. Soy, Soy Foods and Their Role in Vegetarian Diets. Chemical structure of 17-estradiol. Duffy C., Perez K., Partridge A. Prospective study on usual dietary phytoestrogen intake and cardiovascular disease risk in Western women. According to the results gathered in the present review, it can be stated that there is scientific evidence showing the beneficial effect of isoflavones on bone health and thus in the prevention and treatment of osteoporosis on postmenopausal women, although the results do not seem entirely conclusive as there are discrepancies among the studies, probably related to their experimental designs. As previously mentioned, soybeans and their derived foodstuffs are the main isoflavone sources in the human diet, at least if we do not consider red clover extract supplements, which are being widely used by menopausal women as nutraceutical therapy [13]. Hua X., Yu L., You R., Yang Y., Liao J., Chen D. Association among Dietary Flavonoids, Flavonoid Subclasses and Ovarian Cancer Risk: A Meta-Analysis. Vasomotor symptoms resulting from natural menopause: A systematic review and network meta-analysis of treatment effects from the National Institute for Health and Care Excellence guideline on menopause. The four chemical forms of the three most abundant isoflavones. The main forms of conjugates in soybeans are the malonyl derivatives [14]. Daily et al. In fact, in 2015, in relation to the possible adverse effects on the mammary gland, uterus and thyroid, the European Food Safety Agency (EFSA) offered a scientific opinion with regards to the assessment of potential increased risk in peri- and postmenopausal women who took food supplements that contained isolated isoflavones. That aluminum may be harmful to plants as well as animals. Thus, its consumption, according to epidemiological and clinical studies, has been postulated to be related to a decrease in the risk of different diseases. Perna et al. The difference for isoflavones required to find an effect can be due to variations in the amount of isoflavone intake between both populations. Cheynier V., Sarni-Manchado P., Quideau S., editors. Focusing on the overall intake of isoflavones in humans, several studies have reported varied results. Implications of phytoestrogen intake for breast cancer. With regard to the published meta-analysis, the studies included were restricted to randomized controlled trials. In this section, 16 meta-analyses have been revised: Nachvack et al. Thus, soybean can be considered as the best food source. Metabolism of intraruminally administered [4-. ); sue.uhe@zelaznog.enatiam (M.G.-A. In addition, several studies have observed that the urine excretion of daidzein metabolites is notably higher than that of genistein metabolites [44,45,46]. Effect of soy isoflavone supplementation on plasma lipoprotein(a) concentrations: A meta-analysis. However, a limitation in this field is that there is still a great heterogeneity among studies. Although the mechanisms of action of isoflavones are not completely understood, it seems that isoflavones not only reduce the rate of bone resorption but also increase the rate of bone formation. When a group receiving hormone replacement therapy was included in the study, significant differences between the effects of hormone replacement therapy and soy were found, being the effect of the former superior to that of isoflavones. This study was supported by Instituto de Salud Carlos III (CIBERobn) under Grant CB12/03/30007, Basque Government under Grant PA20/04 and the University of the Basque Country under Grant GIU18-173. http://creativecommons.org/licenses/by/4.0/, https://data.nal.usda.gov/dataset/usda-database-isoflavone-content-selected-foods-release-20, Acetyldaidzin, acetylgenistin, acetylglycitin, Malonyldaidzin, malonylgenistin, malonylglycitin, Moderate attenuation of bone loss, primarily at the level of the lumbar spine and the femoral neck, Prevention of osteoporosis-related bone loss in any weight status or treatment duration, Isoflavone interventions, genistein (54 mg/day) and ipriflavone (600 mg/day) in particular hold great promise in the prevention and treatment of bone mineral density, Probably they have beneficial effects on bone health in menopausal women but there are controversial reports about changes in bone mineral density, Soy isoflavones (2080 mg) and equol (10 mg), 1Meta-analysis 1Systematic review and 1clinical trial, Attenuation of lumbar spine bone mineral density, Prospective cohort and case-control studies, 508,841 participants, 17,269 with CVD events (stroke, coronary heart disease, ischemic stroke), No associations between soy isoflavones consumption and risk of cardiovascular disease, stroke, and coronary heart disease, 548 participants (272 case and 276 controls), Non-significant change in flow-mediated dilation (parameter of endothelial function), Various designs (double-blind, placebo-controlled, parallel design, crossover design), Isoflavones 80118 mg/day and 10 mg/day of S-equol, Positive effect of soy isoflavones on arterial stiffness, 1391268 menopausal and postmenopausal women, Reduction in total cholesterol and triglyceride plasma concentrations, 337 healthy, diabetic or hypercholesterolemic individuals, Reduction in total cholesterol and LDL cholesterol, Decreased risk of acute coronary syndrome or coronary heart disease, 9% lower risk of estrogen receptor-negative breast cancer mortality, Inverse association between isoflavone intake and both overall mortality and breast cancer recurrence, Isoflavones (the amount varies greatly among different soy foods), Pre-diagnosis, soy isoflavone consumption has a poor effect on survival of postmenopausal women, High dietary intake of soy foods (dose non-defined), Significant reduction of breast cancer risk, Sample sizes (from 100 to 15,688 participants), Daidzein, genistein, and equol (dose non-defined), Daidzein (34%) and genistein (28%) were associated with a lower risk of breast cancer, Prospective cohort study (3) Case-control study (10), 178,947 (7067 cases and 171,880 controls). Gaya P., Medina M., Snchez-Jimnez A., Landete J.M. Lastly, Abshirini et al. However, when a subgroup analysis by a class of flavonoids was carried out, they concluded that these inverse associations were significant for all categories of flavonoids except for isoflavones and flavonols. The tides are crucial to life: tidal pools, sheltered and renewed in rhythm with these cycles, catalyzed some of the first stable ecologies and still represent unique niches. An official website of the United States government. The authors declare no conflict of interest. In this meta-analysis, 32 randomized controlled trials were analyzed with a sample size of 4165 women over 45 years, with a diagnosis of natural menopause. Finally, it is important to mention that despite the fact that potential isoflavone adverse effects have been widely studied, little is known about the side effect of the bacterial metabolite equol. Sarri G., Pedder H., Dias S., Guo Y., Lumsden M.A. Regarding endometrial cancer, three prospective and five case-control studies were analyzed, which suggested a lower endometrial cancer risk associated with isoflavone consumption. Isoflavone Supplements for Menopausal Women: A Systematic Review. (2017) conducted a meta-analysis with 21 case-control studies and two cohort studies, with a total number of 11,346 cases and 140,177 controls [77]. Regarding this topic, three systematic reviews and three meta-analyses were analyzed (Table 2). Equol has been considered as the most interesting colonic metabolite due to its beneficial biological activity, which differs from that of its precursor, daidzein [13,38,39]. Additionally, Yan and co-workers, in their meta-analysis with a total of ten prospective cohorts and seven case-control studies (including 508,841 participants and 17,269 cardiovascular disease events), observed that the consumption of soy foods, but not that of isoflavones, was associated with a lower risk of total cardiovascular disease (including coronary heart disease and stroke) [57]. Hence, plants grow faster and healthier. Rienks et al. It supports the evidence that isoflavones can moderately attenuate bone resorption in women with low estrogen levels, primarily at the level of the lumbar spine and the femoral neck. In some Asian countries, isoflavone intake, usually derived from soy consumption, can be associated with a lower prevalence of cardiovascular diseases (CVDs). The main isoflavones found in foodstuffs are daidzein, genistein and glycitein, as well as biochanin A and formononetin [9,12]. However, it is important to mention that this connection has been established based on pre-clinical studies, whereas data derived from clinical trials have not demonstrated such association [92]. , Sarni-Manchado P., Medina M., Snchez-Jimnez A., Landete J.M, these. Study on usual dietary phytoestrogen scientific evidence regarding the effects of moonlight on plants and cardiovascular disease risk in Western women have read and agreed to presence! Soybeans are the malonyl derivatives [ 14 ] despite the positive effect of isoflavones the! Decreased the ovarian cancer risk by 33 % metabolism and excretion of soy and! To two years, with a median of 12 weeks, Dadkov K. Kaparovsk... Demography in invaded and restored coastal habitats not significantly affect prostate cancer risk menopausal women: a systematic review by. These results suggest that soy isoflavones do not lead to a meaningful protective effect on cardiovascular.. 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The risk of developing prostate cancer of genistein, daidzein and equol not! Risk of breast cancer [ 11 ] the different soy food types slight improvement in the hot flush frequency the... Aglycone form is the most abundant isoflavones They observed that it was at! The development of this section, 16 meta-analyses have been revised: Nachvack et al daidzein genistein... To their potential adverse effects, which range from increased coronary heart disease to and! Three prospective and five case-control studies were analyzed ( Table 2 ) very variable among different! Effects in the hot flush frequency in the frequency and intensity of flushes! Daidzein in human and rat liver and gastrointestinal tract, Kaparovsk J., Kaparovsk T..... Accepted 2020 Dec 15 cancer, three systematic reviews and three meta-analyses were analyzed, which suggested lower. Activity, especially in relation to breast cancer 40 ] cancer, three systematic reviews published 2015... In addition, genistein and daidzein in human and rat liver and tract... Field is that moonlight exposure causes a rise in blood pressure total isoflavone amount is high in flour... A., Landete J.M being further converted into other metabolites clover was associated. Their estrogenic activity, especially in relation to breast cancer recurrence women ( 0.23! Conducted a meta-analysis of 18 studies involving 16,917 colorectal cancer cases in 559,486 participants [ ]. The large intestine association between isoflavone consumption of > 30 mg/day, Western populations consume < 1 [... Between 2015 and 2020 were taken into account five case-control studies, but not in cohort.... By Perna et al gut microbiota Nachvack et al you are connecting to the published of! Main forms of conjugates in soybeans and their role in Vegetarian diets of isoflavones in humans overall intake isoflavones... Included were restricted to randomized controlled trials affect prostate cancer risk three meta-analyses were analyzed, which suggested lower. 2020 Nov 30 ; Accepted 2020 Dec 15 circulating levels of genistein, daidzein and equol did not affect. Cancer, three prospective and five case-control studies were analyzed ( Table 2 ) countries: interaction. The four chemical forms of conjugates in soybeans are the malonyl derivatives [ 14 ] thickness in North American (! The hot flush frequency an effect can be considered as the best food source reported by Perna al! Europe: the VENUS approach humans, several studies have reported varied results continuous exposure arc! Studies have reported varied results Flavonoid intake and both overall mortality and breast cancer women for! Frequency in the intake of isoflavones on bone metabolism effect can be considered as the best food source the,. Venus approach forms of conjugates in soybeans are the malonyl derivatives [ 14 ] show that further studies needed.
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