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Phyto-oestrogens: A potential role in the prevention of CHD?

Published online by Cambridge University Press:  28 February 2007

Aedin Cassidy  and
Bruce Griffin
Aedin Cassidy*
Affiliation:
Centre for Nutrition and Food Safety, University of Surrey, Guildford, GU2 5XH, UK
Bruce Griffin*
Affiliation:
Centre for Nutrition and Food Safety, University of Surrey, Guildford, GU2 5XH, UK
*
Corresponding author: Dr Aedin Cassidy, fax +44 (0)1483 259341, email a.cassidy@surrey.ac.uk
Corresponding author: Dr Aedin Cassidy, fax +44 (0)1483 259341, email a.cassidy@surrey.ac.uk
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Abstract

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CHD is a major cause of morbidity and mortality in women. The incidence of CHD in premenopausal women is low but increases substantially after the menopause, and this difference suggests that endogenous oestrogens are cardioprotective. Observational prospective studies have consistently shown that exogenous oestrogens also lower CHD risk. The biological mechanisms by which endogenous and exogenous oestrogens exert their protective effect are multifactorial, affecting lipids, carbohydrate metabolism, body fat distribution and blood pressure. The prevention of CHD with oestrogen therapy is therefore aimed both at correction of the traditional risk factors and at direct control of vessel structure and function. The wide international variation in rates of CHD together with the lower mortality in sub-groups of the population suggests that a considerable proportion of CHD may be prevented by dietary modification. Since phyto-oestrogens are structually similar to oestrogen, they have the potential to mimic its effects in vivo. The hypocholesterolaemic effects of soyabean protein (rich in phyto-oestrogen precursors) are well established, but the underlying mechanism and atherogenic potential of these changes are unknown. One isoflavone, genistein, has been shown in vitro to exert effects which may slow the development of atherosclerotic disease. However, further studies are required to determine the dose-related changes induced by phyto-oestrogens on serum lipoproteins, haemostasis and vascular function.

Keywords

Phyto-oestrogensOestrogensLignansSoyabeanCHD
Type
Micronutrient Group Symposium on ‘Dietary determinants of lipoprotein-mediated cardiovascular risk’
Information
Proceedings of the Nutrition Society , Volume 58 , Issue 1 , February 1999 , pp. 193 - 199
Copyright
Copyright © The Nutrition Society 1999

References

Anderson, JW, Johnstone, BM & Cook-Newell, ME (1995) Meta-analysis of the effects of soy protein intake on serum lipids. New England Journal of Medicine 333, 272–286.CrossRefGoogle ScholarPubMed
Anthony, MS, Clarkson, TB, Hughes, CL Jr, Morgan, TM & Burke, GL (1996) Soybean isoflavones improve cardiovascular risk factors without affecting the reproductive system of peripubertal rhesus monkeys. Journal of Nutrition 126, 43–50.CrossRefGoogle ScholarPubMed
Arjmandi, BH, Khan, DA, Juma, SS & Svanborg, A (1997) The ovarian hormone deficiency induced hypercholesterolemia is reversed by soy protein and the synthetic isoflavone, ipriflavone. Nutrition Research 17, 885–894.CrossRefGoogle Scholar
Austin, MA (1988) Epidemiologic associations between hypertriglyceridemia and coronary heart disease. Seminars in Thrombosis and Hemostasis 14, 137–142.CrossRefGoogle ScholarPubMed
Baird, DD, Umbach, DM, Lansdell, L, Hughes, CL, Setchell, KDR, Weinberg, CR, Haney, AF, Wilcox, AJ & McLachlan, JA (1995) Dietary intervention study to assess estrogenicity of dietary soy among postmenopausal women. Journal of Clinical Endocrinology and Metabolism 80, 1685–1690.Google ScholarPubMed
Barrett-Connor, E (1991) Postmenopausal women and prevention bias. Annals of Internal Medicine 115, 455–456.CrossRefGoogle Scholar
Beresford, SAA, Weiss, NS, Voigt, LF & McKnight, B (1997) Risk of endometrial cancer in relation to use of oestrogen combined with cyclic progestagen therapy in postmenopausal women. Lancet 349, 458–461.CrossRefGoogle ScholarPubMed
Bergmann, S, Siegert, G, Wahrburg, U, Schulte, H, Assmann, G & Jaross, W (1997) Influence of menopause and lifestyle factors on high density lipoproteins in middle-aged women. Menopause 4, 52–61.Google Scholar
Bruschi, F, Meschia, M, Soma, M, Perotti, D, Paoletti, R & Crosignani, PG (1996) Lipoprotein (a) and other lipids after oophorectomy and estrogen replacement therapy. Obstetrics and Gynaecology 88, 950–954.CrossRefGoogle ScholarPubMed
Campos, H, McNamara, JR, Wilson, PW, Ordovas, JM & Schaefer, EJ (1988) Differences in low density lipoprotein subfractions and apolipoproteins in premenopausal and postmenopausal women. Journal of Clinical Endocrinology and Metabolism 67, 30–35.CrossRefGoogle ScholarPubMed
Carroll, KK (1991) Review of clinical studies on cholesterol lowering responses to soy protein. Journal of the American Dietetic Association 91, 8320–8327.CrossRefGoogle ScholarPubMed
Cassidy, A (1997) Risks and benefits of phytoestrogen-rich diets. In Hormonally Active Agents in Food, pp. 91–117 [Eisenbrand, G, Daniel, H, Dayan, AD, Elias, PS, Grunow, W, Kemper, FH, Loser, E, Metzler, M and Schlatter, J, editors]. Weinheim, Germany: Wiley–VCH.Google Scholar
Cassidy, A, Bingham, S & Setchell, K (1994) Biological effects of isoflavones present in soy in premenopausal women: Implications for the prevention of breast cancer. American Journal of Clinical Nutrition 60, 333–340.CrossRefGoogle Scholar
Cassidy, A, Bingham, S & Setchell, K (1995) Biological effects of isoflavones in young women: importance of the chemical composition of soyabean products. British Journal of Nutrition 74, 587–601.CrossRefGoogle ScholarPubMed
Cassidy, A, Faughnan, M, Hughes, R, Cathcart, A, Fraser, C, Setchell, K & Bingham, S (1998) Hormonal effects of phytoestrogens in postmenopausal women and elderly men. American Journal of Clinical Nutrition (In the Press).Google Scholar
Castelli, WP (1986) The triglyceride issue: a view from Framingham. American Heart Journal 112, 432–437.CrossRefGoogle ScholarPubMed
Cohn, JS, McNamara, JR, Cohn, SD, Ordovas, JM & Schaefer, EJ (1988) Postprandial plasma lipoprotein changes in human subjects of different ages. Journal of Lipid Research 29, 469–479.CrossRefGoogle ScholarPubMed
Col, NF, Eckman, MH, Karas, RH, Pauker, SG, Goldberg, RJ, Ross, EM, Orr, RK & Wong, JB (1997) Patient-specific decisions about HRT in postmenopausal women. Journal of the American Medical Association 277, 1140–1147.CrossRefGoogle Scholar
Colditz, GA, Hankinson, SE, Hunter, DJ, Willett, WC, Manson, JE & Stampfer, MJ (1995) The use of estrogens and progestins and the risk of breast cancer in postmenopausal women. New England Journal of Medicine 332, 1589–1593.CrossRefGoogle ScholarPubMed
Farhat, MY, Lavigne, MC & Ramwell, PW (1996) The vascular protective effects of estrogen. FASEB Journal 10, 615–624.CrossRefGoogle ScholarPubMed
Fotsis, T, Peper, M, Adlercreutz, H, Fleischmann, G, Hase, T, Montesano, R & Schweigerer, L (1993) Genistein, a dietary derived inhibitor of angiogenesis. Proceedings of the National Academy of Sciences USA 90, 2690–2694.CrossRefGoogle ScholarPubMed
Gaziano, JM, Manson, JE, Branch, LG, Colditz, GA, Willett, WC & Buring, JE (1995) A prospective study of consumption of carotenoids in fruits and vegetables and decreased cardiovascular mortality in the elderly. Annals of Epidemiology 5, 255–260.CrossRefGoogle ScholarPubMed
Gerhard, M & Ganz, P (1995) How do we explain the clinical benefits of oestrogen? Circulation 92, 5–8.CrossRefGoogle Scholar
Griffin, BA (1999) Lipoprotein atherogenicity: an overview of current mechanisms. Proceedings of the Nutrition Society 58, 163–169.CrossRefGoogle ScholarPubMed
Gooderham, MJ, Adlercreutz, HA, Ojala, ST, Wahala, K & Holub, BJ (1996) A soy protein isolate rich in genistein and daidzein and its effects on plasma isoflavone concentrations, platelet aggregation, blood lipids and fatty acid composition of plasma phospholipids in normal men. Journal of Nutrition 126, 2000–2006.Google Scholar
Grodstein, F, Stampfer, MJ, Manson, JE, Colditz, GA, Willett, WC, Rosner, B, Speizer, FE & Hennekens, CH (1996) Postmenopausal estrogen and progestin use and the risk of cardiovascular disease. New England Journal of Medicine 335, 453–461.CrossRefGoogle ScholarPubMed
Hertog, MGL, Feskens, EJM, Hollman, PCH, Katan, MB & Kromhout, D (1993) Dietary antioxidant flavonoids and risk of coronary heart disease: the Zutphen Elderly Study. Lancet 342, 1007–1111.CrossRefGoogle ScholarPubMed
Hodgson, JM, Puddey, IB, Beilin, LJ, Mori, TA & Croft, KD (1998) Supplementation with isoflavonoid phytoestrogens does not alter serum lipid concentrations: a randomized controlled trial in humans. Journal of Nutrition 128, 728–732.CrossRefGoogle Scholar
Hokanson, J & Austin, MA (1996) Plasma triglyceride level is a risk factor for cardiovascular disease independent of HDL cholesterol: a meta-analysis of population-based prospective studies. Journal of Cardiovascular Risk 3, 213–219.CrossRefGoogle ScholarPubMed
Honore, EK, Williams, JK, Anthony, MS & Clarkson, TB (1997) Soy isoflavones enhance coronary vascular reactivity in atherosclerotic female macaques. Fertility and Sterility 67, 148–154.CrossRefGoogle ScholarPubMed
Iafrati, MD, Karas, RH, Aronovitz, M, Kim, S, Sullivan, TR, Lubahn, DB, O'Donnell, TF, Korach, KS & Mendelsohn, ME (1997) Estrogen inhibits the vascular injury response in estrogen receptor a-deficient mice. Nature Medicine 3, 545–548.CrossRefGoogle Scholar
Isles, CG, Hole, DJ, Hawthorne, VM & Lever, AF (1992) Relation between coronary risk and coronary mortality in women of the Renfrew and Paisley survey: comparison with men. Lancet 339, 702–706.CrossRefGoogle ScholarPubMed
Jaggers, DC, Collins, WP & Milligan, SR (1996) Potent inhibitory effects of steroids in an in vitro model of angiogenesis. Journal of Endocrinology 150, 457–464.CrossRefGoogle Scholar
Key, TJA, Thorogood, M, Appleby, PN & Burr, ML (1996) Dietary habits and mortality in 11000 vegetarians and health conscious people: results of a 17 year follow up. British Medical Journal 313, 775–779.CrossRefGoogle Scholar
Kim-Schulze, S, McGrowan, A, Hubchak, SC, Cid, MC, Martin, MB, Kleinman, HK, Greene, GL & Schnaper, HW (1996) Expression of an estrogen receptor by human coronary artery and umbilical vein endothelial cells. Circulation 94, 1402–1407.CrossRefGoogle ScholarPubMed
Knopp, RH (1991) Estrogen replacement therapy for reduction of cardiovascular risk in women. Current Opinion in Lipidology 2, 240–247.CrossRefGoogle Scholar
Kuiper, GGJM, Carlsson, B, Grandien, K, Enmark, E, Haggblad, J, Nilsson, S & Gustaffson, JA (1997) Comparison of the ligand binding specificity and transcript tissue distribution of estrogen receptors alpha and beta. Endocrinology 138, 863–870.CrossRefGoogle ScholarPubMed
Kuiper, GGJM, Enmark, E, Peltohuikki, M, Nilsson, S & Gustaffson, JA (1996) Cloning of a novel estrogen receptor expressed in rat prostate and ovary. Proceedings of the National Academy of Sciences USA 93, 5925–5930.CrossRefGoogle ScholarPubMed
Kuller, LH, Gutai, JP, Meilahn, E, Matthewa, KA & Plantinga, P (1990) Relationship of endogenous sex steroid hormones to lipids and apoproteins in postmenopausal women. Atherosclerosis 10, 1058–1066.Google ScholarPubMed
Lock, M, Kaupfer, P & Gilbert, P (1988) Cultural construction of the menopause syndrome: the Japanese case. Maturitas 10, 317–322.CrossRefGoogle ScholarPubMed
Losordo, DW, Kearney, M, Kim, EA, Jekanowski, J & Isner, JM (1994) Variable expression of the estrogen receptor in normal and atherosclerotic coronary arteries in premenopausal women. Circulation 89, 1501–1510.CrossRefGoogle ScholarPubMed
McDonald, & Stewart, HJ (1991) Fatal myocardial infarction in the Scottish adjuvant tamoxifen trial. British Medical Journal 303, 435–437.CrossRefGoogle ScholarPubMed
Magness, RR & Rosenfield, CR (1989) Local and systemic oestradiol 17B: effects on uterine and systemic vasodilation. American Journal of Physiology 256, E536–E542.Google Scholar
Matthews, KA, Meilahn, E, Kuller, LH, Kelsey, SF, Caggiula, AW & Wing, RR (1989) Menopause and risk factors for coronary heart disease. New England Journal of Medicine 321, 641–646.CrossRefGoogle ScholarPubMed
Meade, TW & Berra, A (1992) Hormone replacement therapy and cardiovascular disease. British Medical Bulletin 48, 276–308.CrossRefGoogle ScholarPubMed
Meilahn, EN, Kuller, LH, Kiss, JE, Mathews, KA & Lewis, JH (1990) Change in coagulation parameters over one year in postmenopausal women. Circulation 84, 718.Google Scholar
Murkies, AL, Lombard, C, Strauss, BJG, Wilcox, G, Burger, HG & Morton, MS (1995) Dietary flour supplementation decreases postmenopausal hot flushes - effect of soy and wheat. Maturitas 21, 189–195.CrossRefGoogle ScholarPubMed
Nagata, C, Takatsuka, N, Kurisu, Y & Shimizu, H (1998) Decreased serum total cholesterol concentration is associated with high intakes of soy products in Japanese men and women. Journal of Nutrition 128, 209–213.CrossRefGoogle ScholarPubMed
Nestel, PJ, Yamashita, T, Sasahara, T, Pomeroy, S, Dart, A, Komesaroff, P, Owen, A & Abbey, M (1997) Soy isoflavones improve systemic arterial compliance but not plasma lipids in menopausal and perimenopausal women. Arteriosclerosis, Thrombosis and Vascular Biology 17, 3392–3398.CrossRefGoogle Scholar
Pandey, DK, Shekelle, R, Selwyn, BJ, Tangney, C & Stamler, J (1995) Dietary vitamin C and β-carotene and risk of death in middle-aged men. The Western Electric study. American Journal of Epidemiology 142, 1269–1278.CrossRefGoogle ScholarPubMed
RuizLarrea, MB, Mohan, AR, Paganga, G, Miller, NJ, Bolwell, GP & Rice-Evans, CA (1997) Antioxidant activity of phytoestrogenic isoflavones. Free Radical Research 26, 63–70.CrossRefGoogle ScholarPubMed
Sargeant, P, Farndale, RW & Sage, SO (1993) The tyrosine kinase inhibitors methyl 2, 5-dihydroxycinnimate and genistein reduce thrombin-evoked tyrosine phosphorylation and Ca2+ entry in human platelets. FEBS Letters 315, 242–246.CrossRefGoogle Scholar
Setchell, KDR & Adlercreutz, H (1988) Mammalian lignans and phyto-oestrogens. Recent studies on their formation, metabolism and biological role in health and disease. In Role of the Gut Flora in Toxicity and Cancer, pp. 315–345 [Rowland, IR, editor]. London: Academic Press.CrossRefGoogle Scholar
Setchell, KDR, Borriello, SP, Hulme, P, Kirk, DN & Axelson, M (1984) Non-steroidal oestrogens of dietary origin: possible roles in hormone dependent disease. American Journal of Clinical Nutrition 40, 569–578.CrossRefGoogle ScholarPubMed
Shewmon, DA, Stock, JL, Rosen, CJ, Heinluoma, KM, Hogue, MM, Morrision, A, Doyle, EM, Ukena, T, Weale, V & Baker, S (1994) Tamoxifen and oestrogen lower circulating lipoprotein (a) concentrations in healthy postmenopausal women. Arteriosclerosis and Thrombosis 14, 1586–1593.CrossRefGoogle ScholarPubMed
Shutt, DA & Cox, RI (1972) Steroid and phytoestrogen binding to sheep uterine receptors in vitro. Journal of Endocrinology 52, 299–310.CrossRefGoogle Scholar
Sirtori, CR, Even, R & Lovati, MR (1993) Soyabean diet and plasma cholesterol: From therapy to molecular mechanisms. Annals of the New York Academy of Sciences 676, 188–201.CrossRefGoogle Scholar
Sirtori, CR, Gianazza, E, Manzoni, C, Lovati, MR & Murphy, PA (1997) Role of isoflavones in the cholesterol reduction by soy protein in the clinic. American Journal of Clinical Nutrition 65, 166–171.CrossRefGoogle ScholarPubMed
Soma, MR, Baetta, R & Crosignani, PG (1997) The menopause and lipid metabolism: strategies for cardiovascular disease prevention. Current Opinion in Lipidology 8, 229–235.CrossRefGoogle ScholarPubMed
Stampfer, MJ & Colditz, GA (1991) Estrogen replacement therapy and coronary heart disease: a quantitative assessment of the epidemiologic evidence. Preventive Medicine 20, 47–63.CrossRefGoogle ScholarPubMed
Stampfer, MJ, Colditz, GA, Willett, WC, Manson, JE, Rosner, B, Speizer, FE & Hennekens, CH (1991) Postmenopausal estrogen therapy and cardiovascular disease - 10 year follow-up from the nurses health study. New England Journal of Medicine 325, 756–762.CrossRefGoogle ScholarPubMed
Stefanick, ML, Legault, C, Tracy, RP, Howard, G, Kessler, CM, Lucas, DL & Bush, TL (1995) Distribution and correlates of plasma fibrinogen in middle-aged women. Initial findings of the Postmenopausal Estrogen/Progestin Interventions (PEPI) study. Arteriosclerosis, Thrombosis and Vascular Biology 15, 2085–2093.CrossRefGoogle ScholarPubMed
Stevenson, JC, Crook, D & Godsland, IF (1993) Effects of age and menopause on lipid metabolism in healthy women. Arteriosclerosis 98, 83–90.CrossRefGoogle Scholar
Sullivan, TR Jr, Karas, RH, Aronovitz, M, Faller, GT, Ziar, JP, Smith, JJ, O'Donnell, TF Jr & Mendelsohn, ME (1995) Estrogen inhibits the response-to-injury in a mouse carotid artery model. Journal of Clinical Investigation 96, 2482–2488.CrossRefGoogle Scholar
Walsh, BW, Kuller, LH, Wild, RA, Paul, S, Farmer, M, Lawrence, JB, Shah, AS & Anderson, PW (1998) Effects of Raloxifene on serum lipids and coagulation factors in healthy postmenopausal women. Journal of the American Medical Association 279, 1445–1451.CrossRefGoogle ScholarPubMed
Wilcox, G, Wahlqvist, ML, Burger, HG & Medley, G (1990) Oestrogen effects of plant derived foods in postmenopausal women. British Medical Journal 301, 905–906.CrossRefGoogle Scholar
Wilcox, JN & Blumenthal, BF (1995) Thrombotic mechanisms in atherosclerosis: Potential impact of soy protein. Journal of Nutrition 125, 631s–638s.Google Scholar
Williams, CM (1997) Cardiovascular risk factors in women. Proceedings of the Nutrition Society 56, 383–391.CrossRefGoogle ScholarPubMed
Williams, JK, Adams, MR, Herrington, DM & Clarkson, TB (1992) Short term administration of estrogen and vascular responses of atherosclerotic coronary arteries. Journal of the American College of Cardiology 20, 452–457CrossRefGoogle ScholarPubMed