Association between dietary phyto-oestrogens and bone density in men and postmenopausal women
Kuhnle, G. G. C., Ward, H. A., Vogiatzoglou, A., Luben, R. N., Mulligan, A., Wareham, N. J., Forouhi, N. G. and Khaw, K.-T. (2011) Association between dietary phyto-oestrogens and bone density in men and postmenopausal women. British Journal of Nutrition, 106 (7). pp. 1063-1069. ISSN 0007-1145
To link to this article DOI: 10.1017/S0007114511001309
Phyto-oestrogens have been associated with a decreased risk for osteoporosis, but results from intervention and observational studies in Western countries have been inconsistent. In the present study, we investigated the association between habitual phyto-oestrogen intake and broadband ultrasound attenuation (BUA) of the calcanaeum as a marker of bone density. We collected 7 d records of diet, medical history and demographic and anthropometric data from participants (aged 45–75 years) in the European Prospective Investigation into Cancer-Norfolk study. Phyto-oestrogen (biochanin A, daidzein, formononetin; genistein, glycitein; matairesinol; secoisolariciresinol; enterolactone; equol) intake was determined using a newly developed food composition database. Bone density was assessed using BUA of the calcanaeum. Associations between bone density and phyto-oestrogen intake were investigated in 2580 postmenopausal women who were not on hormone replacement therapy and 4973 men. Median intake of total phyto-oestrogens was 876 (interquartile range 412) μg/d in postmenopausal women and 1212 (interquartile range 604) μg/d in men. The non-soya isoflavones formononetin and biochanin A were marginally significant or significantly associated with BUA in postmenopausal women (β = 1·2; P < 0·1) and men (β = 1·2; P < 0·05), respectively; enterolignans and equol were positively associated with bone density in postmenopausal women, but this association became non-significant when dietary Ca was added to the model. In the lowest quintile of Ca intake, soya isoflavones were positively associated with bone density in postmenopausal women (β = 1·4; P < 0·1). The present results therefore suggest that non-soya isoflavones are associated with bone density independent of Ca, whereas the association with soya or soya isoflavones is affected by dietary Ca.
1. Brynin R. Soy and its isoflavones: A review of their effects on bone densit. Alternative Medicine Review. 2002;7(4):317-27. 2. Branca F, Lorenzetti S. Health effects of phytoestrogens. Forum Nutr. 2005(57):100-11. 3. Morito K, Hirose T, Kinjo J, Hirakawa T, Okawa M, Nohara T, et al. Interaction of Phytoestrogens with Estrogen Receptors α and &beta. Biological & Pharmaceutical Bulletin. 2001;24(4):351-6. 4. Setchell KD, Lydeking-Olsen E. Dietary phytoestrogens and their effect on bone: evidence from in vitro and in vivo, human observational, and dietary intervention studies. Am J Clin Nutr. 2003 Sep;78(3 Suppl):593S-609S. 5. Liu J, Ho SC, Su Y-x, Chen W-q, Zhang C-x, Chen Y-m. Effect of long-term intervention of soy isoflavones on bone mineral density in women: A meta-analysis of randomized controlled trials. Bone. 2009;44(5):948-53. 6. Zhang X, Shu X-O, Li H, Yang G, Li Q, Gao Y-T, et al. Prospective Cohort Study of Soy Food Consumption and Risk of Bone Fracture Among Postmenopausal Women. Arch Intern Med. 2005 September 12, 2005;165(16):1890-5. 7. Greendale GA, FitzGerald G, Huang MH, Sternfeld B, Gold E, Seeman T, et al. Dietary soy isoflavones and bone mineral density: results from the study of women's health across the nation. Am J Epidemiol. 2002 Apr 15;155(8):746-54. 8. Day N, Oakes S, Luben R, Khaw KT, Bingham S, Welch A, et al. EPIC-Norfolk: study design and characteristics of the cohort. European Prospective Investigation of Cancer. British Journal of Cancer. 1999 Jul;80 Suppl 1:95-103. 9. Welch A, Camus J, Dalzell N, Oakes S, Reeve J, Khaw KT. Broadband ultrasound attenuation (BUA) of the heel bone and its correlates in men and women in the EPIC–Norfolk cohort: a cross-sectional population-based study. Osteoporos Int. 2004;15:217-25. 10. Khaw KT, Reeve J, Luben R, Bingham S, Welch A, Wareham N, et al. Prediction of total and hip fracture risk in men and women by quantitative ultrasound of the calcaneus: EPIC–Norfolk prospective population study. Lancet. 2004;363(197-202). 11. Welch A, Bingham S, Camus J, Dalzell N, Reeve J, Day N, et al. Calcaneum broadband ultrasound attenuation relates to vegetarian and omnivorous diets differently in men and women: an observation from the European Prospective Investigation into Cancer in Norfolk (EPIC-Norfolk) population study. Osteoporos Int. 2005 Jun;16(6):590-6. 12. Welch AA, McTaggart A, Mulligan AA, Luben R, Walker N, Khaw KT, et al. DINER (Data Into Nutrients for Epidemiological Research) - a new data-entry program for nutritional analysis in the EPIC-Norfolk cohort and the 7-day diary method. Public Health Nutrition. 2001 Dec;4(6):1253-65. 13. Kuhnle GG, Dell'Aquila C, Aspinall SM, Runswick SA, Mulligan AA, Bingham SA. Phytoestrogen content of foods of animal origin: dairy products, eggs, meat, fish, and seafood. Journal of Agricultural and Food Chemistry. 2008 Nov 12;56(21):10099-104. 14. Kuhnle GGC, Dell'Aquila C, Aspinall SM, Runswick SA, Mulligan AA, Bingham SA. Phytoestrogen content of beverages, nuts, seeds, and oils. Journal of Agricultural and Food Chemistry. 2008 Aug 27;56(16):7311-5. 15. Kuhnle GGC, Dell'Aquila C, Aspinall SM, Runswick SA, Mulligan AA, Bingham SA. Phytoestrogen content of cereals and cereal based foods. Nutrition and Cancer. 2009;61(3):302-9. 16. Kuhnle GG, Dell'Aquila C, Aspinall SM, Joosen AMCP, Runswick SA, Mulligan AA, et al. Phytoestrogen content of fruits and vegetables commonly consumed in the UK based on LC–MS and 13C-labelled standards. Food Chemistry. 2009;116(2):542-54. 17. Kuhnle GG, Dell'Aquila C, Low Y-L, Kussmaul M, Bingham SA. Extraction and quantification of phytoestrogens in food using automated SPE and LC/MS/MS. Analytical Chemistry. 2007;79(23):9234-9. 18. Welch AA, Bingham SA, Reeve J, Khaw K. More acidic dietary acid-base load is associated with reduced calcaneal broadband ultrasound attenuation in women but not in men: results from the EPIC-Norfolk cohort study. Am J Clin Nutr. 2007 April 1, 2007;85(4):1134-41. 19. Coxam V. Phyto-oestrogens and bone health. Proc Nutr Soc. 2008 May;67(2):184-95. 20. Ward HA, Kuhnle GGC. Phytoestrogen consumption and association with breast, prostate and colorectal cancer in EPIC Norfolk. Archives of Biochemistry and Biophysics. 2010;501(1):170-5. 21. Moayyeri A, Kaptoge S, Dalzell N, Bingham SA, Luben RN, Wareham NJ, et al. Is QUS or DXA better for predicting the 10-year absolute risk of fracture. Journal of Bone and Mineral Research. 2009;24(7):1319-25. 22. Trimpou P, Bosaeus I, Bengtsson BA, Landin-Wilhelmsen K. High correlation between quantitative ultrasound and DXA during 7-years of follow-up. European Journal of Radiology. 2010;73(2):360-4. 23. Keinan-Boker L, van Der Schouw YT, Grobbee DE, Peeters PH. Dietary phytoestrogens and breast cancer risk. American Journal of Clinical Nutrition. 2004 Feb;79(2):282-8. 24. Cotterchio M, Boucher BA, Kreiger N, Mills CA, Thompson LU. Dietary phytoestrogen intake--lignans and isoflavones--and breast cancer risk (Canada). Cancer Causes and Control. 2008;19(3):259-72. 25. Horn-Ross PL, John EM, Canchola AJ, Stewart SL, Lee MM. Phytoestrogen Intake and Endometrial Cancer Risk. J Natl Cancer Inst. 2003 August 6, 2003;95(15):1158-64. 26. Tsutsumi N. Effect of coumestrol on bone metabolism in organ culture. Biol Pharm Bull. 1995 Jul;18(7):1012-5. 27. Webb AL, McCullough ML. Dietary lignans: potential role in cancer prevention. Nutr Cancer. 2005;51(2):117-31. 28. Dawson-Hughes B. Osteoporosis treatment and the calcium requirement. Am J Clin Nutr. 1998 January 1, 1998;67(1):5-6. 29. New SA, Robins SP, Campbell MK, Martin JC, Garton MJ, Bolton-Smith C, et al. Dietary influences on bone mass and bone metabolism: further evidence of a positive link between fruit and vegetable consumption and bone health?1. The American Journal of Clinical Nutrition. 2000 January 1, 2000;71(1):142-51. 30. Chen YM, Ho SC, Lam SS, Ho SS, Woo JL. Beneficial effect of soy isoflavones on bone mineral content was modified by years since menopause, body weight, and calcium intake: a double-blind, randomized, controlled trial. Menopause. 2004;11(3):246-1. 31. Wong WW, Lewis RD, Steinberg FM, Murray MJ, Cramer MA, Amato P, et al. Soy isoflavone supplementation and bone mineral density in menopausal women: a 2-y multicenter clinical trial. The American Journal of Clinical Nutrition. 2009 November 1, 2009;90(5):1433-9. 32. Alekel DL, Van Loan MD, Koehler KJ, Hanson LN, Stewart JW, Hanson KB, et al. The Soy Isoflavones for Reducing Bone Loss (SIRBL) Study: a 3-y randomized controlled trial in postmenopausal women. The American Journal of Clinical Nutrition. 2010 January 1, 2010;91(1):218-30.
Centaur Editors: Update this record