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Li H, Zeng Y, Zi J, Hu Y, Ma G, Wang X, Shan S, Cheng G, Xiong J. Dietary Flavonoids Consumption and Health: An Umbrella Review. Mol Nutr Food Res 2024; 68:e2300727. [PMID: 38813726 DOI: 10.1002/mnfr.202300727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 05/07/2024] [Indexed: 05/31/2024]
Abstract
SCOPE The current evidence between dietary flavonoids consumption and multiple health outcomes is inadequate and inconclusive. To summarize and evaluate the evidence for dietary flavonoids consumption and multiple health outcomes, an umbrella review of meta-analyses and systematic reviews is conducted. METHODS AND RESULTS PubMed, Ovid-EMBASE, and the Cochrane Database of Systematic Reviews are searched up to January 2024. The study includes a total of 32 articles containing 24 unique health outcomes in this umbrella review. Meta-analyses are recalculated by using a random effects model. Separate analyses are performed based on the kind of different flavonoid subclasses. The study finds some unique associations such as flavonol and gastric cancer, isoflavone and uterine fibroids and endometrial cancer, total flavonoids consumption and lung cancer, ovarian cancer, and prostate cancer. Overall, the study confirms the negative associations between dietary flavonoids consumption and type 2 diabetes mellitus, cardiovascular diseases, breast cancer, colorectal cancer, lung cancer, and mortality, while positive associations are observed for prostate cancer and uterine fibroids. CONCLUSION Although dietary flavonoids are significantly associated with many outcomes, firm generalizable conclusions about their beneficial or harmful effects cannot be drawn because of the low certainty of evidence for most of outcomes. More well-designed primary studies are needed.
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Affiliation(s)
- Haoqi Li
- Healthy Food Evaluation Research Center, Department of Occupational and Environmental Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, China
| | - Yaxian Zeng
- Healthy Food Evaluation Research Center, Department of Occupational and Environmental Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, China
| | - Jing Zi
- Healthy Food Evaluation Research Center, Department of Occupational and Environmental Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, China
| | - Yifan Hu
- Healthy Food Evaluation Research Center, Department of Occupational and Environmental Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, China
| | - Guochen Ma
- Healthy Food Evaluation Research Center, Department of Occupational and Environmental Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, China
| | - Xiaoyu Wang
- Laboratory of Molecular Translational Medicine, Center for Translational Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, 610041, China
| | - Shufang Shan
- Laboratory of Molecular Translational Medicine, Center for Translational Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, 610041, China
| | - Guo Cheng
- Laboratory of Molecular Translational Medicine, Center for Translational Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, 610041, China
- Food Safety Monitoring and Risk Assessment Key Laboratory of Sichuan Province, Chengdu, 610041, China
| | - Jingyuan Xiong
- Healthy Food Evaluation Research Center, Department of Occupational and Environmental Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, China
- Food Safety Monitoring and Risk Assessment Key Laboratory of Sichuan Province, Chengdu, 610041, China
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Lu LJW, Chen NW, Nayeem F, Nagamani M, Anderson KE. Soy isoflavones interact with calcium and contribute to blood pressure homeostasis in women: a randomized, double-blind, placebo controlled trial. Eur J Nutr 2020; 59:2369-2381. [PMID: 31535213 PMCID: PMC7416691 DOI: 10.1007/s00394-019-02085-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 08/28/2019] [Indexed: 01/31/2023]
Abstract
BACKGROUND Estrogens and calcium regulate vascular health but caused adverse cardiovascular events in randomized trials. OBJECTIVES Whether phytoestrogenic soy isoflavones modulate the physiological effects of calcium on blood pressure was explored. DESIGN A double-blind, randomized study assigned 99 premenopausal women to 136.6 mg isoflavones (as aglycone equivalents) and 98 to placebo for 5 days per week for up to 2 years. Blood pressure, serum calcium and urinary excretion of daidzein (DE) and genistein (GE) were measured repeatedly before and during treatment. RESULTS Isoflavones did not affect blood pressure per intake dose assignment (i.e. intention-to-treat, n = 197), but significantly affected blood pressure per measured urinary excretion of isoflavones (i.e. per protocol analysis, n = 166). Isoflavones inversely moderated calcium effects on systolic blood pressure (SBP) (interaction term β-estimates: - 3.1 for DE, - 12.86 for GE, all P < 0.05), and decreased diastolic blood pressure (DBP) (β-estimates: - 0.84 for DE, - 2.82 for GE, all P < 0.05) after controlling for calcium. The net intervention effects between the maximum and no isoflavone excretion were - 17.7 and + 13.8 mmHg changes of SBP, respectively, at serum calcium of 10.61 and 8.0 mg/dL, and about 2.6 mmHg decrease of DBP. CONCLUSIONS Moderation by isoflavones of the physiological effect of calcium tends to normalize SBP, and this effect is most significant when calcium concentrations are at the upper and lower limits of the physiological norm. Isoflavones decrease DBP independent of calcium levels. Further studies are needed to assess the impact of this novel micronutrient effect on blood pressure homeostasis and cardiovascular health. TRIAL REGISTRATION www.clinicaltrials.gov identifier: NCT00204490.
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Affiliation(s)
- Lee-Jane W Lu
- Department of Preventive Medicine and Community Health, The University of Texas Medical Branch, 700 Harborside Dr., Galveston, TX, 77555-1109, USA.
| | - Nai-Wei Chen
- Department of Preventive Medicine and Community Health, The University of Texas Medical Branch, 700 Harborside Dr., Galveston, TX, 77555-1109, USA
| | - Fatima Nayeem
- Department of Preventive Medicine and Community Health, The University of Texas Medical Branch, 700 Harborside Dr., Galveston, TX, 77555-1109, USA
| | - Manubai Nagamani
- Department of Obstetrics and Gynecology, The University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77555, USA
- Houston Bay Area Fertility Center, Webster, TX, 77598, USA
| | - Karl E Anderson
- Department of Preventive Medicine and Community Health, The University of Texas Medical Branch, 700 Harborside Dr., Galveston, TX, 77555-1109, USA.
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Abstract
Soybeans are among the most popular foods worldwide, and intake of soy-containing foods has been associated with many health benefits in part because of it structure similar to estrogen. Epidemiologic studies have demonstrated that soy consumption improves serum profiles of hypercholesterolemic patients. Several studies have also indicated an inverse relationship between the consumption of soy isoflavones and the incidence of cardiovascular diseases (CVD). Soy is a rich dietary source of isoflavones. The main soy isoflavones are daidzein and genistein; equol, another isoflavone and a major intestinal bacterial metabolite of daidzein, is generated by enterobacterial effects. Many isoflavones have antioxidative effects and anti-inflammatory actions, as well as induce nitric oxide production to maintain a healthy endothelium and prevent endothelial cell dysfunction. These effects may limit the development of atherosclerosis and CVD and restore healthy endothelial function in altered endothelia. Although the evidence supporting the benefits of soy isoflavones in CVD prevention continues to increase, the association between soy isoflavones and disease is not fully understood. This review summarized recent progress in identifying the preventive mechanisms of action of dietary soybean isoflavones on vascular endothelial cells. Furthermore, it describes the beneficial roles that these isoflavones may have on endothelial dysfunction-related atherosclerosis.
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Nayeem F, Chen NW, Nagamani M, Anderson KE, Lu LJW. Daidzein and genistein have differential effects in decreasing whole body bone mineral density but had no effect on hip and spine density in premenopausal women: A 2-year randomized, double-blind, placebo-controlled study. Nutr Res 2019; 68:70-81. [PMID: 31421395 DOI: 10.1016/j.nutres.2019.06.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 06/12/2019] [Accepted: 06/26/2019] [Indexed: 12/22/2022]
Abstract
Soy isoflavones are potentially beneficial phytoestrogens, but their tissue-selective effects in women are poorly understood. We tested the hypothesis that soy isoflavones affect bone mineral density (BMD), which may be influenced by individual differences in isoflavone metabolism and serum calcium levels. Ninety-nine healthy premenopausal women were randomized to isoflavones (136.6 mg aglycone equivalence) and 98 to placebo for 5 days per week for up to 2 years. BMD, serum calcium, and urinary excretion of daidzein and genistein were measured before and during treatment. In 129 adherent subjects, we found that isoflavone exposure, determined by urinary excretion levels, but not by dose assignment, interacted with serum calcium in affecting whole body BMD, but not hip and spine BMD. The regression coefficient was -0.042 for genistein excretion (GE) and 0.091 for the interaction between GE and serum calcium (all P < .05). Daidzein excretion had similar but marginal effect. Genistein significantly decreased whole body BMD only at low normal serum calcium levels but increased whole body BMD at higher serum calcium levels. Comparing maximum to minimum GE, mean changes in whole body BMD were +0.033 and -0.113 g/cm2 at serum calcium levels of 10 and 8.15 mg/dL, respectively. These associations were not evident by intention-to-treat analysis, which could not model for inter-individual differences in isoflavone metabolism. In summary, soy isoflavones decrease whole body BMD only when serum calcium is low. Isoflavones are dietary substances that may influence calcium homeostasis by releasing calcium from bone while sparing the common fracture risk sites hip and spine.
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Affiliation(s)
- Fatima Nayeem
- Department of Preventive Medicine and Community Health The University of Texas Medical Branch, Galveston, TX 77555.
| | - Nai-Wei Chen
- Department of Preventive Medicine and Community Health The University of Texas Medical Branch, Galveston, TX 77555.
| | - Manubai Nagamani
- Department of Obstetrics and Gynecology, The University of Texas Medical Branch, Galveston, TX 77555.
| | - Karl E Anderson
- Department of Preventive Medicine and Community Health The University of Texas Medical Branch, Galveston, TX 77555.
| | - Lee-Jane W Lu
- Department of Preventive Medicine and Community Health The University of Texas Medical Branch, Galveston, TX 77555.
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Godos J, Bergante S, Satriano A, Pluchinotta FR, Marranzano M. Dietary Phytoestrogen Intake is Inversely Associated with Hypertension in a Cohort of Adults Living in the Mediterranean Area. Molecules 2018; 23:molecules23020368. [PMID: 29425149 PMCID: PMC6017940 DOI: 10.3390/molecules23020368] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 02/05/2018] [Accepted: 02/06/2018] [Indexed: 02/08/2023] Open
Abstract
Background: Dietary polyphenols, including phytoestrogens are abundantly present in a balanced diet. Evidence for their role in preventing non-communicable diseases is emerging. Methods: We examined the association between estimated habitual intakes of dietary phytoestrogens and hypertension in a cohort study. The baseline data included 1936 men and women aged 18 years and older. Intakes of total phytoestrogens, isoflavones, and lignans were calculated from validated food frequency questionnaire. Data on the polyphenols content in foods were retrieved from the Phenol-Explorer database. Results: Individuals in the highest quartile of dietary phytoestrogens intake were less likely to be hypertensive (OR: 0.66, 95% CI: 0.44–0.98); moreover, the association showed a significant decreasing trend. Isoflavones and lignans were not associated with lower odds of hypertension; however, some individual compounds, such as biochanin A and pinoresinol showed an independent inverse association with hypertension. Conclusions: Dietary phytoestrogens are associated with lower likelihood of hypertension in adults living in the Mediterranean area. Future studies are needed to confirm the present findings (i.e., prospective cohort studies) and to better understand the mechanisms underlying such associations.
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Affiliation(s)
- Justyna Godos
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", University of Catania, 95125 Catania, Italy.
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy.
| | - Sonia Bergante
- IRCCS Policlinico San Donato, 20097 San Donato Milanese (MI), Italy.
| | - Angela Satriano
- IRCCS Policlinico San Donato, 20097 San Donato Milanese (MI), Italy.
| | | | - Marina Marranzano
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", University of Catania, 95125 Catania, Italy.
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Pallauf K, Giller K, Huebbe P, Rimbach G. Nutrition and healthy ageing: calorie restriction or polyphenol-rich "MediterrAsian" diet? OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2013; 2013:707421. [PMID: 24069505 PMCID: PMC3771427 DOI: 10.1155/2013/707421] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2013] [Accepted: 07/26/2013] [Indexed: 12/17/2022]
Abstract
Diet plays an important role in mammalian health and the prevention of chronic diseases such as cardiovascular disease (CVD). Incidence of CVD is low in many parts of Asia (e.g., Japan) and the Mediterranean area (e.g., Italy, Spain, Greece, and Turkey). The Asian and the Mediterranean diets are rich in fruit and vegetables, thereby providing high amounts of plant bioactives including polyphenols, glucosinolates, and antioxidant vitamins. Furthermore, oily fish which is rich in omega-3 fatty acids is an important part of the Asian (e.g., Japanese) and also of the Mediterranean diets. There are specific plant bioactives which predominantly occur in the Mediterranean (e.g., resveratrol from red wine, hydroxytyrosol, and oleuropein from olive oil) and in the Asian diets (e.g., isoflavones from soybean and epigallocatechin gallate from green tea). Interestingly, when compared to calorie restriction which has been repeatedly shown to increase healthspan, these polyphenols activate similar molecular targets such as Sirt1. We suggest that a so-called "MediterrAsian" diet combining sirtuin-activating foods (= sirtfoods) of the Asian as well as Mediterranean diet may be a promising dietary strategy in preventing chronic diseases, thereby ensuring health and healthy ageing. Future (human) studies are needed which take the concept suggested here of the MediterrAsian diet into account.
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Affiliation(s)
- Kathrin Pallauf
- Institute of Human Nutrition and Food Science, Christian-Albrechts University of Kiel, Hermann-Rodewald-Straße 6, 24118 Kiel, Germany
| | - Katrin Giller
- Institute of Human Nutrition and Food Science, Christian-Albrechts University of Kiel, Hermann-Rodewald-Straße 6, 24118 Kiel, Germany
| | - Patricia Huebbe
- Institute of Human Nutrition and Food Science, Christian-Albrechts University of Kiel, Hermann-Rodewald-Straße 6, 24118 Kiel, Germany
| | - Gerald Rimbach
- Institute of Human Nutrition and Food Science, Christian-Albrechts University of Kiel, Hermann-Rodewald-Straße 6, 24118 Kiel, Germany
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7
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Beavers DP, Beavers KM, Miller M, Stamey J, Messina MJ. Exposure to isoflavone-containing soy products and endothelial function: a Bayesian meta-analysis of randomized controlled trials. Nutr Metab Cardiovasc Dis 2012; 22:182-191. [PMID: 20709515 DOI: 10.1016/j.numecd.2010.05.007] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2010] [Revised: 05/20/2010] [Accepted: 05/24/2010] [Indexed: 02/05/2023]
Abstract
BACKGROUND AND AIMS To determine whether and to what degree exposure to isoflavone-containing soy products affects EF. Endothelial dysfunction has been identified as an independent coronary heart disease risk factor and a strong predictor of long-term cardiovascular morbidity and mortality. Data on the effects of exposure to isoflavone-containing soy products on EF are conflicting. METHODS AND RESULTS A comprehensive literature search was conducted using the PUBMED database (National Library of Medicine, Bethesda, MD) inclusively through August 21, 2009 on RCTs using the keywords: soy, isoflavone, phytoestrogen, EF, flow mediated vasodilation, and FMD. A Bayesian meta-analysis was conducted to provide a comprehensive account of the effect of isoflavone-containing soy products on EF, as measured by FMD. A total of 17 RCTs were selected as having sufficient data for study inclusion. The overall mean absolute change in FMD (95% Bayesian CI) for isoflavone-containing soy product interventions was 1.15% (-0.52, 2.75). When the effects of separate interventions were considered, the treatment effect for isolated isoflavones was 1.98% (0.07, 3.97) compared to 0.72% (-1.39, 2.90) for isoflavone-containing soy protein. The models were not improved when considering study-specific effects such as cuff measurement location, prescribed dietary modification, and impaired baseline FMD. CONCLUSIONS Cumulative evidence from the RCTs included in this meta-analysis indicates that exposure to soy isoflavones can modestly, but significantly, improve EF as measured by FMD. Therefore, exposure to isoflavone supplements may beneficially influence vascular health.
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Affiliation(s)
- D P Beavers
- Department of Biostatistical Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, USA
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8
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Taku K, Lin N, Cai D, Hu J, Zhao X, Zhang Y, Wang P, Melby MK, Hooper L, Kurzer MS, Mizuno S, Ishimi Y, Watanabe S. Effects of soy isoflavone extract supplements on blood pressure in adult humans: systematic review and meta-analysis of randomized placebo-controlled trials. J Hypertens 2010; 28:1971-82. [PMID: 20577121 DOI: 10.1097/hjh.0b013e32833c6edb] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Reported effects of different soy products on blood pressure vary. This systematic review and meta-analysis was performed to clarify the effects of soy isoflavone extract supplements on systolic and diastolic blood pressure (SBP and DBP) in adult humans. METHODS PubMed, CENTRAL, ICHUSHI, and CNKI were searched in June 2009 for relevant randomized placebo-controlled trials. Study data and indicators of methodological validity were independently extracted by two authors using predefined data fields. Meta-analysis was carried out in Review Manager 5.0.22. RESULTS Searches identified 3740 articles, of which 14 randomized controlled trials (789 participants) were included. Daily ingestion of 25-375 mg soy isoflavones (aglycone equivalents) for 2-24 weeks significantly decreased SBP by 1.92 mmHg (95% confidence interval -3.45 to -0.39; P = 0.01) compared with placebo (heterogeneity P = 0.39, fixed effect model) in adults with normal blood pressure and prehypertension. The effect was not lost on sensitivity analysis. Subgroup analyses suggest greater effects in studies longer than 3 months, in Western populations, at lower doses, and in studies at lower risk of bias. Soy isoflavones did not affect DBP [-0.13 (95% confidence interval -1.03 to 0.78) mmHg, P = 0.78; heterogeneity P = 0.20, fixed effect model]. CONCLUSION Soy isoflavone extracts significantly decreased SBP but not DBP in adult humans, and no dose-response relationship was observed. Further studies are needed to address factors related to the observed effects of soy isoflavones on SBP and to verify the effect in hypertensive patients.
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Affiliation(s)
- Kyoko Taku
- Information Center, National Institute of Health and Nutrition, Tokyo, Japan.
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Hall WL, Formanuik NL, Harnpanich D, Cheung M, Talbot D, Chowienczyk PJ, Sanders TAB. A meal enriched with soy isoflavones increases nitric oxide-mediated vasodilation in healthy postmenopausal women. J Nutr 2008; 138:1288-92. [PMID: 18567749 DOI: 10.1093/jn/138.7.1288] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Evidence from infusion studies suggests that soy isoflavones influence nitric oxide-dependent vasorelaxation. It is uncertain whether orally consumed isoflavones have similar effects. Healthy postmenopausal women (n = 22) consumed 2 low-fat test meals in random order 1 wk apart, with 80 mg isoflavones (ISO) or without isoflavones (CON). Endothelium-dependent vasodilation, assessed by brachial artery flow-mediated dilatation (FMD), was measured in fasting subjects, and 4 and 6 h following the test meal, in addition to blood pressure and pulse wave analysis to derive the peripheral augmentation index (pAIx). Blood samples were taken after fasting, and 5 and 7 h following the test meal for serum isoflavone, plasma 8-isoprostane F(2alpha), nitric oxide metabolites (NOx), glucose, and triacylglycerol analysis. Serum genistein and daidzein concentrations (geometric mean, 95% CI) reached 1.49 (1.20-1.84) micromol/L and 0.95 (0.70-1.30) micromol/L, respectively, following ISO (7 h). FMD and plasma NOx concentrations were greater following ISO compared with CON, indicating better postprandial endothelial function. FMD values (%, mean +/- SD) were: CON, 5.49 +/- 2.32, 4.35 +/- 2.32, 4.40 +/- 2.26; ISO, 5.38 +/- 1.91, 5.08 +/- 1.74, 6.11 +/- 2.60, at baseline, 4 h, and 6 h, respectively (P < 0.01). Plasma NOx concentrations (micromol/L, mean +/- SD) were: CON, 20.0 +/- 5.1, 16.8 +/- 5.1, 23.1 +/- 6.0; ISO, 18.6 +/- 6.3, 19.5 +/- 5.1, 21.3 +/- 10.1, at baseline, 5 h, and 7 h, respectively (P < 0.005). Treatment did not affect pAIx, blood pressure, or plasma 8-isoprostane F(2alpha) concentrations. In conclusion, consuming an isoflavone-enriched low-fat meal acutely increases endothelium-dependent vasodilation in postmenopausal women. Regular consumption of soy isoflavones may protect against endothelial dysfunction.
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Affiliation(s)
- Wendy L Hall
- Nutritional Sciences Division, School of Biomedical and Health Sciences, King's College London, London SE1 9NH, UK.
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Hooper L, Kroon PA, Rimm EB, Cohn JS, Harvey I, Le Cornu KA, Ryder JJ, Hall WL, Cassidy A. Flavonoids, flavonoid-rich foods, and cardiovascular risk: a meta-analysis of randomized controlled trials. Am J Clin Nutr 2008; 88:38-50. [PMID: 18614722 DOI: 10.1093/ajcn/88.1.38] [Citation(s) in RCA: 708] [Impact Index Per Article: 44.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND The beneficial effects of flavonoid consumption on cardiovascular risk are supported by mechanistic and epidemiologic evidence. OBJECTIVE We aimed to systematically review the effectiveness of different flavonoid subclasses and flavonoid-rich food sources on cardiovascular disease (CVD) and risk factors--ie, lipoproteins, blood pressure, and flow-mediated dilatation (FMD). DESIGN Methods included a structured search strategy on MEDLINE, EMBASE, and Cochrane databases; formal inclusion or exclusion, data extraction, and validity assessment; and meta-analysis. RESULTS One hundred thirty-three trials were included. No randomized controlled trial studied effects on CVD morbidity or mortality. Significant heterogeneity confirmed differential effects between flavonoid subclasses and foods. Chocolate increased FMD after acute (3.99%; 95% CI: 2.86, 5.12; 6 studies) and chronic (1.45%; 0.62, 2.28; 2 studies) intake and reduced systolic (-5.88 mm Hg; -9.55, -2.21; 5 studies) and diastolic (-3.30 mm Hg; -5.77, -0.83; 4 studies) blood pressure. Soy protein isolate (but not other soy products or components) significantly reduced diastolic blood pressure (-1.99 mm Hg; -2.86, -1.12; 9 studies) and LDL cholesterol (-0.19 mmol/L; -0.24, -0.14; 39 studies). Acute black tea consumption increased systolic (5.69 mm Hg; 1.52, 9.86; 4 studies) and diastolic (2.56 mm Hg; 1.03, 4.10; 4 studies) blood pressure. Green tea reduced LDL (-0.23 mmol/L; -0.34, -0.12; 4 studies). For many of the other flavonoids, there was insufficient evidence to draw conclusions about efficacy. CONCLUSIONS To date, the effects of flavonoids from soy and cocoa have been the main focus of attention. Future studies should focus on other commonly consumed subclasses (eg, anthocyanins and flavanones), examine dose-response effects, and be of long enough duration to allow assessment of clinically relevant endpoints.
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Affiliation(s)
- Lee Hooper
- School of Medicine, Health Policy and Practice, University of East Anglia, Norwich, United Kingdom.
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Gao J, Xu Y, Yang Y, Yang Y, Zheng Z, Jiang W, Hong B, Yan X, Si S. Identification of Upregulators of Human ATP-Binding Cassette Transporter A1 via High-Throughput Screening of a Synthetic and Natural Compound Library. ACTA ACUST UNITED AC 2008; 13:648-56. [DOI: 10.1177/1087057108320545] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The ATP-binding cassette transporter A1 (ABCA1) is a membrane transporter that directly contributes to high-density lipoprotein (HDL) biogenesis by mediating the cellular efflux of cholesterol and phospholipids to lipid-poor apolipoprotein A-I. Therefore, identification of a novel upregulator of ABCA1 would be beneficial for atherosclerosis prevention and/or therapy because of its pivotal role in cholesterol homeostasis and HDL metabolism. In this study, a high-throughput assay method for ABCA1 upregulators was developed and used for screening a synthetic and natural compound library. The cell-based high-throughput screen is conducted in a 96-well format using the human hepatoma HepG2 cells stably transfected with ABCA1 promoter-luciferase construct and calibrated with reference ABCA1 upregulators (oxysterols, 9-cis-retinoic acid, thiazolidinediones, cyclic adenosine monophosphate, verapamil, fenofibrate, and oncostatin M). Among 2600 compounds, 4 microbial compounds (pyrromycin, aclarubicin, daidzein, and pratensein) were picked up as hits by the high-throughput screening assay, and those compounds were further identified as upregulators of ABCA1 expression by real-time quantitative reverse transcription-polymerase chain reaction and Western blot analysis. ( Journal of Biomolecular Screening 2008:648-656)
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Affiliation(s)
- Jie Gao
- Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yanni Xu
- Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yuan Yang
- Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yi Yang
- Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Zhihui Zheng
- Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Wei Jiang
- Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Bin Hong
- Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xuguang Yan
- Department of Chemistry, Oregon State University, Corvallis
| | - Shuyi Si
- Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China,
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Urpi-Sarda M, Morand C, Besson C, Kraft G, Viala D, Scalbert A, Besle JM, Manach C. Tissue distribution of isoflavones in ewes after consumption of red clover silage. Arch Biochem Biophys 2008; 476:205-10. [PMID: 18513488 DOI: 10.1016/j.abb.2008.05.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2008] [Revised: 05/01/2008] [Accepted: 05/05/2008] [Indexed: 11/30/2022]
Abstract
When discovered in the 50's, isoflavones were suspected to provoke infertility syndrome in sheep grazing on clover. Many others effects of these phytoestrogens have been documented afterwards. To determine the distribution of isoflavone metabolites in ewe tissues and look for a link with their physiological impact, two ewes were fed a diet containing 50% red clover silage (variety Pawera) for one month with a daily intake of 157.6 mg/kg bw of total isoflavones. Only aglycones were fed due to the fermentation stage of the silage. At the sacrifice, isoflavone metabolites and aglycones were analyzed in blood, liver, kidney, lung, heart, muscle, ovaries, uterus, mammary glands, suprarenal glands, thymus, aorta, thyroid, pituitary gland, cerebellum, olfactory lobes, and brain hemispheres using HPLC-Coularray and LC-MS-MS. The major compounds recovered in tissues were equol and daidzein, present as glucuronides. Kidney concentrations were 10-fold higher than in other tissues. Penetration in brain was very limited. Reproductive organs contained higher concentrations of isoflavones than heart, muscle, or thymus. Distribution of isoflavones in ewe tissues is unequal and may reflect specific impact in some target tissues.
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Affiliation(s)
- Mireia Urpi-Sarda
- Nutrition and Food Science Department, XaRTA, Pharmacy Faculty, University of Barcelona, 08028 Barcelona, Spain
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Franke AA, Halm BM, Custer LJ, Tatsumura Y, Hebshi S. Isoflavones in breastfed infants after mothers consume soy. THE AMERICAN JOURNAL OF CLINICAL NUTRITION 2006; 84:406-13. [PMID: 16895891 DOI: 10.1093/ajcn/84.1.406] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND The bioavailability of isoflavones in children after soy exposure is uncertain. OBJECTIVE We aimed to compare isoflavone patterns in infants exposed to isoflavone-containing breast milk (BF), in tofu-fed (TF) infants, and in mothers consuming a soy beverage. DESIGN Eighteen nursing mothers who were not feeding soy foods to their infants consumed one daily serving of a soy protein beverage for 2-4 d and collected their own milk and urine and infant urine. Plasma was collected from infants if venous blood draws were ordered by pediatricians. Blood and urine were collected from additional children after they consumed tofu. Isoflavones were measured by liquid chromatography-mass spectrometry. RESULTS In 7 subjects, isoflavone values increased significantly from baseline after mothers ate soy: in maternal urine (x +/- SEM) from 18.4 +/- 13.0 to 135.1 +/- 26.0 nmol/mg creatinine, in breast milk from 5.1 +/- 2.2 to 70.7 +/- 19.2 nmol/L, and in infant urine from 29.8 +/- 11.6 to 111.6 +/- 18.9 nmol/mg creatinine. The mean isoflavone concentration in plasma obtained from 11 BF infants was 19.7 +/- 13.2 nmol/L. TF infants had much higher mean isoflavone values (urine, 229 +/- 129 nmol/mg creatinine; plasma, 1049 +/- 403 nmol/L). Statistically significant correlations were observed between the types of fluids investigated within mothers, between mothers and infants, and within infants. Urinary isoflavone excretion per hour adjusted for dose per body weight was 81% lower for BF infants and 24% higher for TF infants than for their mothers after eating soy. CONCLUSIONS More isoflavones appear in children than in adults after adjustment for isoflavone intake. Systemic isoflavone exposure in infants can be determined by urinary analysis.
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Affiliation(s)
- Adrian A Franke
- Cancer Research Center of Hawaii, Natural Products and Cancer Biology Program, Honolulu, HI, USA
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Franke AA, Halm BM, Custer LJ, Tatsumura Y, Hebshi S. Isoflavones in breastfed infants after mothers consume soy. Am J Clin Nutr 2006. [DOI: 10.1093/ajcn/84.2.406] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Adrian A Franke
- From the Cancer Research Center of Hawaii, Natural Products and Cancer Biology Program, Honolulu (AAF, LJC, YT, and SH), and the Kapi′olani Medical Center for Women and Children, Honolulu, HI (BHH)
| | - Brunhild M Halm
- From the Cancer Research Center of Hawaii, Natural Products and Cancer Biology Program, Honolulu (AAF, LJC, YT, and SH), and the Kapi′olani Medical Center for Women and Children, Honolulu, HI (BHH)
| | - Laurie J Custer
- From the Cancer Research Center of Hawaii, Natural Products and Cancer Biology Program, Honolulu (AAF, LJC, YT, and SH), and the Kapi′olani Medical Center for Women and Children, Honolulu, HI (BHH)
| | - Yvonne Tatsumura
- From the Cancer Research Center of Hawaii, Natural Products and Cancer Biology Program, Honolulu (AAF, LJC, YT, and SH), and the Kapi′olani Medical Center for Women and Children, Honolulu, HI (BHH)
| | - Sandra Hebshi
- From the Cancer Research Center of Hawaii, Natural Products and Cancer Biology Program, Honolulu (AAF, LJC, YT, and SH), and the Kapi′olani Medical Center for Women and Children, Honolulu, HI (BHH)
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Hall WL, Vafeiadou K, Hallund J, Bugel S, Reimann M, Koebnick C, Zunft HJF, Ferrari M, Branca F, Dadd T, Talbot D, Powell J, Minihane AM, Cassidy A, Nilsson M, Dahlman-Wright K, Gustafsson JA, Williams CM. Soy-isoflavone-enriched foods and markers of lipid and glucose metabolism in postmenopausal women: interactions with genotype and equol production. Am J Clin Nutr 2006; 83:592-600. [PMID: 16522905 DOI: 10.1093/ajcn.83.3.592] [Citation(s) in RCA: 102] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The hypocholesterolemic effects of soy foods are well established, and it has been suggested that isoflavones are responsible for this effect. However, beneficial effects of isolated isoflavones on lipid biomarkers of cardiovascular disease risk have not yet been shown. OBJECTIVE The objective was to investigate the effects of isolated soy isoflavones on metabolic biomarkers of cardiovascular disease risk, including plasma total, HDL, and LDL cholesterol; triacylglycerols; lipoprotein(a); the percentage of small dense LDL; glucose; nonesterified fatty acids; insulin; and the homeostasis model assessment of insulin resistance. Differences with respect to single nucleotide polymorphisms in selected genes [ie, estrogen receptor alpha (XbaI and PvuII), estrogen receptor beta (AluI), and estrogen receptor beta(cx) (Tsp509I), endothelial nitric oxide synthase (Glu298Asp), apolipoprotein E (Apo E2, E3, and E4), cholesteryl ester transfer protein (TaqIB), and leptin receptor (Gln223Arg)] and with respect to equol production were investigated. DESIGN Healthy postmenopausal women (n = 117) participated in a randomized, double-blind, placebo-controlled, crossover dietary intervention trial. Isoflavone-enriched (genistein-to-daidzein ratio of 2:1; 50 mg/d) or placebo cereal bars were consumed for 8 wk, with a wash-out period of 8 wk before the crossover. RESULTS Isoflavones did not have a significant beneficial effect on plasma concentrations of lipids, glucose, or insulin. A significant difference between the responses of HDL cholesterol to isoflavones and to placebo was found with estrogen receptor beta(cx) Tsp509I genotype AA, but not GG or GA. CONCLUSIONS Isoflavone supplementation, when provided in the form and dose used in this study, had no effect on lipid or other metabolic biomarkers of cardiovascular disease risk in postmenopausal women but may increase HDL cholesterol in an estrogen receptor beta gene-polymorphic subgroup.
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Affiliation(s)
- Wendy L Hall
- Hugh Sinclair Unit of Human Nutrition, School of Food Biosciences, University of Reading, Reading, United Kingdom.
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Bender DA. Editorial: vitamins and hormones. Nutr Res Rev 2005; 18:173-4. [PMID: 19079902 DOI: 10.1079/nrr2005114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Affiliation(s)
- David A Bender
- Department of Biochemistry and Molecular Biology University College London Gower Street London WC1E 6BT UK
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