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Samimisedeh P, Afshar EJ, Ejtahed HS, Qorbani M. The impact of vegetarian diet on sperm quality, sex hormone levels and fertility: a systematic review and meta-analysis. J Hum Nutr Diet 2024; 37:57-78. [PMID: 37581238 DOI: 10.1111/jhn.13230] [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: 05/20/2023] [Accepted: 08/09/2023] [Indexed: 08/16/2023]
Abstract
BACKGROUND An increasing number of people have adhered to a vegetarian diet for several years. Nowadays, the favourable effect of this dietary pattern on metabolic diseases is well established, but its impact on fertility and reproductive health as a serious health concern is not clear yet. Therefore, we aim to summarise existing evidence regarding the possible association between a vegetarian diet and fertility as measured by key indicators such as sperm quality and sex hormone levels. METHODS We systematically searched online databases, including PubMed, ISI, Scopus and Google Scholar, up to 1 December 2022 using relevant keywords. We included observational studies that compared semen quality, sex hormone levels and infertility in people who adhered to a vegetarian diet versus an omnivore diet. Heterogeneity between studies was assessed using I2 and Q tests. Standardised mean differences (SMD) using a random/fixed model were calculated to assess outcomes between vegetarians and omnivores in included articles. RESULTS Finally, out of 972 documents that were retrieved, 20 articles met our inclusion criteria, and 16 were eligible for quantitative synthesis. Results of meta-analyses showed that there were no significant differences between vegetarians and omnivores in terms of semen quality parameters, including total sperm count, total and progressive sperm motility, sperm morphology and sperm concentration. Seven studies on female sex hormone profiles were eligible for meta-analysis. The only significant difference was the lower level of plasma oestrone in vegetarians (pooled SMD: -0.56; 95% confidence interval [CI]: -1.08, -0.05; p-value = 0.03) compared to omnivores. Furthermore, our meta-analysis revealed significantly higher sex-hormone-binding globulin levels in vegetarian men than in omnivores (pooled SMD: 0.52; 95% CI: 0.18, 0.86; p-value = 0.002). CONCLUSION Despite the numerous health benefits of a vegetarian diet, our review suggested that there were no conclusive positive or negative associations between vegetarian diet and semen quality, sex hormone levels and infertility. Further studies are recommended to better understand vegetarian dietary pattern effect on infertility and reproductive health.
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Affiliation(s)
- Parham Samimisedeh
- Cardiovascular Research Center, Alborz University of Medical Sciences, Alborz, Iran
| | - Elmira Jafari Afshar
- Cardiovascular Research Center, Alborz University of Medical Sciences, Alborz, Iran
| | - Hanieh-Sadat Ejtahed
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mostafa Qorbani
- Non-Communicable Diseases Research Center, Department of Epidemiology and Public Health, Alborz University of Medical Sciences, Karaj, Iran
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Dušková M. The Effects of Different Types of Diets on Steroid Hormone Concentrations. Physiol Res 2023; 72:S323-S337. [PMID: 38116769 DOI: 10.33549/physiolres.935209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024] Open
Abstract
The great popularity of various diets in recent years has led us to reflect on their suitability for our health. The aim of this communication is to review current knowledge on the influence of the most well-known diets on the concentrations of the main steroids and to consider possible mechanisms. The influence of diet on hormone concentrations is expected, but the literature data on this topic are inconsistent and yield conflicting results. The main problem in evaluating these influences is the change in weight that a change in diet induces. This effect needs to be filtered out in order to discover interesting associations between diet and steroid hormones. This is illustrated by the example of the effects of ketogenic diets on testosterone levels in men, where the direct effect of the diet is to reduce testosterone levels, but a number of papers have described increases that are due to diet-related weight loss and the modification of obesity-induced changes. A second major driver is the change in circadian rhythm, and it is necessary to assess hormonal changes induced by changing the time of day of the diet. Such shifts within the circadian rhythm rather than due to a particular type of diet itself are documented by changes in the circadian rhythm of cortisol.
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Affiliation(s)
- M Dušková
- Institute of Endocrinology, Prague, Czech Republic
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3
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Deng X, Si J, Qu Y, Jie L, He Y, Wang C, Zhang Y. Vegetarian diet duration's influence on women's gut environment. GENES & NUTRITION 2021; 16:16. [PMID: 34600491 PMCID: PMC8487541 DOI: 10.1186/s12263-021-00697-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 09/13/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Nutrient composition of vegetarian diets is greatly different from that of omnivore diets, which may fundamentally influence the gut microbiota and fecal metabolites. The interactions between diet pattern and gut environment need further illustration. This study aims to compare the difference in the gut microbiota and fecal metabolites between vegetarian and omnivore female adults and explore associations between dietary choices/duration and gut environment changes. METHODS In this study, investigations on the fecal metabolome together with the gut microbiome were performed to describe potential interactions with quantitative functional annotation. In order to eliminate the differences brought by factors of gender and living environment, 80 female adults aged 20 to 48 were recruited in the universities in Beijing, China. Quantitative Insights Into Microbial Ecology (QIIME) analysis and Ingenuity Pathway Analysis (IPA) were applied to screen differential data between groups from gut microbiota and fecal metabolites. Furthermore, weighted gene correlation network analysis (WGCNA) was employed as the bioinformatics analysis tool for describing the correlations between gut microbiota and fecal metabolites. Moreover, participants were further subdivided by the vegetarian diet duration for analysis. RESULTS GPCR-mediated integration of enteroendocrine signaling was predicted to be one of the regulatory mechanisms of the vegetarian diet. Intriguingly, changes in the gut environment which occurred along with the vegetarian diet showed attenuated trend as the duration increased. A similar trend of returning to "baseline" after a 10-year vegetarian diet was detected in both gut microbiota and fecal metabolome. CONCLUSIONS The vegetarian diet is beneficial more than harmful to women. Gut microbiota play roles in the ability of the human body to adapt to external changes.
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Affiliation(s)
- Xinqi Deng
- School of Life Science, Beijing University of Chinese Medicine, Beijing, China
| | - Jiangtao Si
- Special Treatment Center, Wang Jing Hospital of Chinese Academy of Traditional Chinese Medicine, Beijing, China
| | - Yonglong Qu
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Li Jie
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Yuansong He
- Sichuan Vocational College of Nursing, Chengdu, China
| | - Chunguo Wang
- Beijing Research Institute of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China.
| | - Yuping Zhang
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China.
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Religiosity and spirituality and the intake of fruit, vegetable, and fat: a systematic review. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2013; 2013:146214. [PMID: 24319472 PMCID: PMC3844200 DOI: 10.1155/2013/146214] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Accepted: 09/02/2013] [Indexed: 11/18/2022]
Abstract
Objectives. To systematically review articles investigating the relationship between religion and spirituality (R/S) and fruit, vegetable, and fat intake. Methods. PubMed, CINAHL, and PsycInfo were searched for studies published in English prior to March 2013. The studies were divided into two categories: denominational studies and degree of R/S studies. The degree of R/S studies was further analyzed to (1) determine the categories of R/S measures and their relationship with fruit, vegetable, and fat intake, (2) evaluate the quality of the R/S measures and the research design, and (3) determine the categories of reported relationship. Results. Thirty-nine studies were identified. There were 14 denominational studies and 21 degree of R/S studies, and 4 studies were a combination of both. Only 20% of the studies reported validity and 52% reported reliability of the R/S measures used. All studies were cross-sectional, and only one attempted mediation analysis. Most studies showed a positive association with fruit and vegetable intake and a mixed association with fat intake. Conclusion. The positive association between R/S and fruit and vegetable intake may be one possible link between R/S and positive health outcome. However, the association with fat intake was mixed, and recommendations for future research are made.
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Aubertin-Leheudre M, Hämäläinen E, Adlercreutz H. Diets and hormonal levels in postmenopausal women with or without breast cancer. Nutr Cancer 2011; 63:514-24. [PMID: 21500098 DOI: 10.1080/01635581.2011.538487] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The role of diet in breast cancer (BC) risk is unclear. Fiber could reduce BC risk, through the enterohepatic circulation of estrogens. We examined the relationship between diet and sex hormones in postmenopausal women with or without BC. Thirty-one postmenopausal women (10 omnivores, 11 vegetarians, and 10 BC omnivores) were recruited. Dietary records (5 days) and hormone levels (3 days) were evaluated on 4 occasions over 1 yr. Vegetarians showed a lower fat/fiber ratio, a higher intake of total and cereal fiber (g/d)/body weight (kg), a significantly lower level of plasma estrone-sulfate, estradiol, free-estradiol, free-testosterone, and ring D oxygenated estrogens, and a significantly higher level of sex-hormone-binding-globulin than BC subjects. Fiber was consumed in slightly larger amounts by omnivores than by BC subjects. Omnivores had significantly lower plasma testosterone and estrone-sulfate but higher sex-hormone-binding-globulin than BC subjects. No difference was found for the urinary 16-oxygenated estrogens. However, the 2-MeO-E1/2-OH-E1 ratio was significantly lower in omnivores than in BC group. This ratio is positively associated with the fat/fiber ratio. In conclusion, testosterone may contribute to causing alterations in the levels of catechol estrogens and 16-oxygenated estrogens. The fat/fiber ratio appears to be useful in evaluating dietary effects on estrogen metabolism.
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Affiliation(s)
- Mylène Aubertin-Leheudre
- Folkhälsan Research Center, Institute for Preventive Medicine, Nutrition and Cancer, and Division of Clinical Chemistry, University of Helsinki, Helsinki, Finland.
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6
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Adlercreutz H. Western diet and Western diseases: Some hormonal and biochemical mechanisms and associations. Scandinavian Journal of Clinical and Laboratory Investigation 2011. [DOI: 10.1080/00365519009085798] [Citation(s) in RCA: 163] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Yeh M, Moysich KB, Jayaprakash V, Rodabaugh KJ, Graham S, Brasure JR, McCann SE. Higher intakes of vegetables and vegetable-related nutrients are associated with lower endometrial cancer risks. J Nutr 2009; 139:317-22. [PMID: 19074206 DOI: 10.3945/jn.108.099960] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
A limited number of studies have investigated diet in association with endometrial cancer (EC). We examined the association between intakes of selected food groups and nutrients with EC risk among 541 women with histologically confirmed EC and 541 women with an intact uterus and noncancer diagnoses seen at Roswell Park Cancer Institute between 1982 and 1998. Self-reported dietary and other epidemiologic data were collected by questionnaire. Unconditional logistic regression was used to estimate odds ratios (OR) and 95% CI, adjusting for age, BMI, hormone replacement therapy use, cigarette smoking, lifetime duration of menstruation, and total energy intake. We observed significant inverse associations for women in the highest vs. lowest quartiles of intake of total vegetables (OR, 0.51; 95% CI, 0.34-0.75), vitamin E (OR, 0.44; 95% CI, 0.27-0.70), dietary fiber (OR, 0.60; 95% CI, 0.39-0.94), beta-carotene (OR, 0.55; 95% CI, 0.37-0.82), lutein (OR, 0.52; 95% CI, 0.34-0.78), and folate (OR, 0.57; 95% CI, 0.36-0.91). Our results support that vegetables and related nutrients are associated with decreased risk of EC.
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Affiliation(s)
- Michael Yeh
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY 14263, USA
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8
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McCann SE, Freudenheim JL, Marshall JR, Graham S. Risk of human ovarian cancer is related to dietary intake of selected nutrients, phytochemicals and food groups. J Nutr 2003; 133:1937-42. [PMID: 12771342 DOI: 10.1093/jn/133.6.1937] [Citation(s) in RCA: 167] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Intakes of specific nutrients and food groups have been shown previously to be related to ovarian cancer risk, but no studies, to our knowledge, have emphasized the effect of phytochemical intakes on this cancer. We conducted a case-control study of diet and ovarian cancer in western New York involving 124 primary, histologically confirmed ovarian cancer cases and 696 population-based controls, frequency matched to cases on age and county of residence. Diet was assessed with a detailed food-frequency questionnaire. Nutrient and phytochemical intakes were calculated from published food composition data. The odds ratios (OR) and 95% CI for risk of ovarian cancer with each nutrient, phytochemical and food group were estimated with unconditional logistic regression adjusting for age, education, total months menstruating, difficulty becoming pregnant, oral contraceptive use, menopausal status and energy intake. Compared with women in the lowest quintile of intake, reduced risks were observed for women in the highest quintile of intake of dietary fiber (OR 0.43, 95% CI, 0.20-0.94), total carotenoids (OR 0.33, 95% CI, 0.16-0.68), stigmasterol (OR 0.42, 95% CI, 0.20-0.87), total lignans (OR 0.43, 95% CI, 0.21-0.85), vegetables (OR 0.47, 95% CI, 0.23-0.97) and poultry (OR 0.45, 95% CI, 0.22-0.92). These results support a protective effect on ovarian cancer of phytoestrogen intakes, and our results support the hypothesis that a plant-based diet may be important in reducing risks of hormone-related neoplasms.
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Affiliation(s)
- Susan E McCann
- Department of Social and Preventive Medicine, University at Buffalo, Buffalo, NY 14214, USA.
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9
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Kamath SK, Murillo G, Chatterton RT, Hussain EA, Amin D, Mortillaro E, Peterson CT, Alekel DL. Breast cancer risk factors in two distinct ethnic groups: Indian and Pakistani vs. American premenopausal women. Nutr Cancer 2001; 35:16-26. [PMID: 10624702 DOI: 10.1207/s1532791416-26] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Asian Indians from the Indian subcontinent have low rates of breast cancer, but studies on breast cancer risk factors in Indian and Pakistani women living in the United States are lacking. This study contrasted breast cancer risk factors [serum total 17 beta-estradiol (E2), sex hormone-binding globulin-bound E2, available E2, estrone (E1), and dehydroepiandrosterone sulfate, reproductive history, family history of cancer, body composition/size, dietary intake, physical activity, and excretion of isoflavones] between two distinct ethnic groups of premenopausal women residing in the United States. We also determined the contribution of these and other factors to the variability of each sex hormone. Distributions of values for serum total E2, available E2, and sex hormone-binding globulin-bound E2 (%) were greater (p < 0.005) in American (n = 47) than in Indian and Pakistani (n = 47) women. Multiple regression analysis indicated that 26% of the variability (p < or = 0.0001) in serum E2 was accounted for by the ratio of total cholesterol to high-density-lipoprotein cholesterol, length of time in the United States, and saturated fat intake, whereas less (17%) variability was accounted for by available E2 (representing free E2 + albumin-bound E2), contributed by the ratio of total cholesterol to high-density-lipoprotein cholesterol and saturated fat intake. Five variables accounted for 31% of the variability (p < or = 0.0001) in E1. The major finding of this study was that circulating sex hormone concentrations were determined more by environmental factors than by ethnicity, which was not a significant contributor to any of the serum hormones.
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Affiliation(s)
- S K Kamath
- College of Health and Human Development Sciences, Chicago, IL, USA
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10
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Horner NK, Lampe JW. Potential mechanisms of diet therapy for fibrocystic breast conditions show inadequate evidence of effectiveness. JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION 2000; 100:1368-80. [PMID: 11103660 DOI: 10.1016/s0002-8223(00)00383-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Fibrocystic breast conditions, formerly referred to as fibrocystic breast disease, affect about half of all women and typically present as any combination of breast nodularity, swelling, and pain. We reviewed the literature to evaluate evidence supporting nutrition interventions commonly recommended for fibrocystic breast conditions by health care providers. Randomized, controlled studies of the effectiveness of caffeine restriction fail to support any benefit in fibrocystic breast conditions. Similarly, evidence supporting evening primrose oil, vitamin E, or pyridoxine as treatments for the discomforts of fibrocystic breast conditions is insufficient to draw conclusions about effectiveness. Dietary alterations that influence the intermediate markers for fibrocystic breast conditions include low-fat (15% to 20% energy), high-fiber (30 g/day), and soy isoflavone regimens. However, our findings provide no solid evidence for secondary prevention or treatment of fibrocystic breast conditions through a dietary approach. Health care providers should limit recommendations to proven diet therapies supported by randomized, placebo-controlled trials, given the instability inherent in fibrocystic breast conditions and the near 20% placebo effect associated with intervention. Because excessive estrogen or altered sensitivity to estrogen is the dominant theory of etiology, interventions that may modulate endogenous steroid hormones warrant further investigation as potential treatments for symptomatic fibrocystic breast conditions.
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Affiliation(s)
- N K Horner
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA 98109-1024, USA
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11
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Abstract
Intestinal transit has a substantial influence on the enterohepatic circulation of bile acids and steroid hormones, on colonic pH, and on short chain fatty acid concentrations in the distal colon. Slow transit is likely to favor disease processes that are related to over-efficient enterohepatic recirculation and to lack of short chain fatty acid in the distal colon. These include gallstones, large bowel cancer, and possibly breast cancer. The best-documented influence of slow colonic transit is on bile acid metabolism. Slowing colonic transit increases deoxycholate and raises cholesterol saturation of bile, making gallstone formation more likely. In this review, we also examine the evidence that slow colonic transit may be important in the etiology of large bowel and breast cancer. There is a lack of data pertaining to the relationship between colonic transit and diseases such as colon and breast cancer. Should slow colonic transit prove to be a significant factor in the etiology of such diseases, then the health of the population might benefit from dietary and lifestyle changes that speed up intestinal transit.
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Affiliation(s)
- S J Lewis
- University Department of Medicine, University Hospital of Wales, Cardiff
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12
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Thomas HV, Davey GK, Key TJ. Oestradiol and sex hormone-binding globulin in premenopausal and post-menopausal meat-eaters, vegetarians and vegans. Br J Cancer 1999; 80:1470-5. [PMID: 10424753 PMCID: PMC2363084 DOI: 10.1038/sj.bjc.6690546] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Endogenous oestradiol is strongly associated with breast cancer risk but its determinants are poorly understood. To test the hypothesis that vegetarians have lower plasma oestradiol and higher sex hormone-binding globulin (SHBG) than meat-eaters we assayed samples from 640 premenopausal women (153 meat-eaters, 382 vegetarians, 105 vegans) and 457 post-menopausal women (223 meat-eaters, 196 vegetarians, 38 vegans). Vegetarians and vegans had lower mean body mass indices (BMI) and lower plasma cholesterol concentrations than meat-eaters, but there were no statistically significant differences between meat-eaters, vegetarians and vegans in pre- or post-menopausal plasma concentrations of oestradiol or SHBG. Before adjusting for BMI there were small differences in the direction expected, with the vegetarians and vegans having higher SHBG and lower oestradiol (more noticeable amongst post-menopausal women) than the meat-eaters. These small differences were essentially eliminated by adjusting for BMI. Thus this study implies that the relatively low BMI of vegetarians and vegans does cause small changes in SHBG and in post-menopausal oestradiol, but that the composition of vegetarian diets may not have any additional effects on these hormones.
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Affiliation(s)
- H V Thomas
- Imperial Cancer Research Fund Cancer Epidemiology Unit, Radcliffe Infirmary, Oxford, UK
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13
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Wynder EL, Cohen LA, Muscat JE, Winters B, Dwyer JT, Blackburn G. Breast cancer: weighing the evidence for a promoting role of dietary fat. J Natl Cancer Inst 1997; 89:766-75. [PMID: 9182974 DOI: 10.1093/jnci/89.11.766] [Citation(s) in RCA: 124] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
It has been hypothesized that a high-fat diet promotes the development of postmenopausal breast cancer. This contention is supported by data showing high international correlations between fat intake and breast cancer rates, modest positive associations with a high-fat diet in case-control studies, and animal model studies that have consistently demonstrated that dietary fat influences mammary cancer development at several stages in the carcinogenic process. A number of plausible biologic mechanisms have been suggested that may explain such promotional effects. In contrast, dietary fat intake is unrelated to the risk of breast cancer in cohort studies. The conflicting findings from cohort studies have created uncertainty regarding nutritional recommendations and breast cancer prevention. After reviewing key scientific findings that are relevant to this issue, the following conclusion is drawn: In the absence of data from dietary intervention trials, the weight of available evidence suggests that the type and amount of fat in the diet is related to postmenopausal breast cancer and that the inability to detect associations within populations (cohort studies) is because of measurement error and the relative homogeneity of diets measured. It is expected that the results from intervention trials will clarify this issue.
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Affiliation(s)
- E L Wynder
- American Health Foundation, New York, NY 10017, USA
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14
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Lewis SJ, Heaton KW, Oakey RE, McGarrigle HH. Lower serum oestrogen concentrations associated with faster intestinal transit. Br J Cancer 1997; 76:395-400. [PMID: 9252210 PMCID: PMC2224051 DOI: 10.1038/bjc.1997.397] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Increased fibre intake has been shown to reduce serum oestrogen concentrations. We hypothesized that fibre exerts this effect by decreasing the time available for reabsorption of oestrogens in the colon. We tested this in volunteers by measuring changes in serum oestrogen levels in response to manipulation of intestinal transit times with senna and loperamide, then comparing the results with changes caused by wheat bran. Forty healthy premenopausal volunteers were placed at random into one of three groups. The first group took senna for two menstrual cycles then, after a washout period, took wheat bran, again for two menstrual cycles. The second group did the reverse. The third group took loperamide for two menstrual cycles. At the beginning and end of each intervention a 4-day dietary record was kept and whole-gut transit time was measured; stools were taken for measurement of pH and beta-glucuronidase activity and blood for measurement of oestrone and oestradiol and their non-protein-bound fractions and of oestrone sulphate. Senna and loperamide caused the intended alterations in intestinal transit, whereas on wheat bran supplements there was a trend towards faster transit. Serum oestrone sulphate fell with wheat bran (mean intake 19.8 g day(-1)) and with senna; total- and non-protein-bound oestrone fell with senna. No significant changes in serum oestrogens were seen with loperamide. No significant changes were seen in faecal beta-glucuronidase activity. Stool pH changed only with senna, in which case it fell. In conclusion, speeding up intestinal transit can lower serum oestrogen concentrations.
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Affiliation(s)
- S J Lewis
- University Department of Medicine, Bristol Royal Infirmary, UK
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15
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Abstract
Epidemiologic evidence on the relation between nutrition and endometrial cancer (EC) is reviewed. Obesity is an important determinant of EC, probably because of its effect on the hormonal milieu of both pre- and postmenopausal women. However, epidemiologic studies of body fat distribution and EC are inconsistent, as are the data pertaining to the relation between body fat distribution and sex hormones. Randomized and observational studies of diet and sex hormones indicate that low fat diets may be associated weakly with decreased estrogen levels, and thus a lowering of EC risk. Only ecologic and case-control studies of diet and EC have been reported. These findings as well as the methodologic limitations of these study designs are discussed. Both types of studies implicate fat as a potential risk factor, while the case-control studies suggest that carotene may lower risk of EC. Epidemiologic studies of alcohol and EC also are inconsistent, but generally indicate no association, or a weak protective effect. The role of diet in the etiology of EC is unresolved. The conduct of cohort and intervention studies, which can avoid many of the methodologic shortcomings of ecologic and case-control studies, would improve our understanding of diet and EC.
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Affiliation(s)
- H A Hill
- Department of Epidemiology, Rollins School of Public Health of Emory University, Atlanta, Georgia 30322, USA
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Goldin BR, Woods MN, Spiegelman DL, Longcope C, Morrill-LaBrode A, Dwyer JT, Gualtieri LJ, Hertzmark E, Gorbach SL. The effect of dietary fat and fiber on serum estrogen concentrations in premenopausal women under controlled dietary conditions. Cancer 1994; 74:1125-31. [PMID: 8039147 DOI: 10.1002/1097-0142(19940801)74:3+<1125::aid-cncr2820741521>3.0.co;2-5] [Citation(s) in RCA: 102] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The effect of dietary fiber and fat on serum sex hormones was studied in premenopausal women. After an initial control period during which the diet was high in fat (40% of calories as fat) and low in fiber (12 g/day), the amounts of fat and fiber were varied in the setting of a metabolic kitchen and carefully monitored meals. Forty-eight women completed 58 protocols. When the diet was changed to low-fat (20-25% calories as fat) and high fiber (40 g/day), there were significant decreases in serum concentrations of estrone, estrone sulfate, testosterone, androstenedione, and sex hormone binding globulin (SHBG) and near significant decreases in estradiol and free estradiol. When independent effects were examined, high fiber alone caused a decrease in estradiol and SHBG, whereas fat and fiber caused the observed decrease in estrone sulfate. Dietary fat independently influenced the serum concentration of androstenedione. Increased dietary fiber caused a lengthening of the menstrual cycle by 0.72 day and a lengthening of the follicular phase by 0.85 day.
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Affiliation(s)
- B R Goldin
- Department of Community Health, Tufts University School of Medicine, Medford, MA 02111
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17
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Abstract
In a case-control study of 451 women with breast cancer and 451 population-based controls from metropolitan Adelaide, Australia, the risk of breast cancer was studied in relation to intake of dietary fiber and various fiber components. Intakes were estimated by means of a self-administered quantitative food-frequency questionnaire, and risks of breast cancer were estimated for each quintile of fiber density (intake/megaJoule of total energy intake) relative to an arbitrarily assigned risk of unity for women in the lowest quintile of fiber density. There were highly significant reductions in relative risk associated with increasing intake of a number of components of total dietary fiber. In women with the highest 20% estimated dietary densities of total non-starch polysaccharides (NSP), the relative risk of breast cancer was 0.46, and a test for trend across the quintiles was significant at p < 0.001. Separate risk estimations for various fiber components defined by the Englyst method of analysis revealed highest risk reductions associated with high densities of mannose from insoluble NSP and of glucose from soluble NSP. For many fiber components the point estimates of relative risk were quite similar both for pre- and for post-menopausal women, although results for the latter (who comprised over two thirds of all cases) were statistically more significant. The study provides strong support for recent conjecture that foods rich in dietary fiber may be protective against breast cancer.
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Affiliation(s)
- P A Baghurst
- Division of Human Nutrition, Commonwealth Scientific Industrial Research Organization, Adelaide, Australia
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Goldin BR, Gorbach SL. Hormone studies and the diet and breast cancer connection. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 1994; 364:35-46. [PMID: 7725958 DOI: 10.1007/978-1-4615-2510-3_4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- B R Goldin
- Department of Community Health, Tufts University School of Medicine, Boston, Massachusetts, USA
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Ling WH, Laitinen M, Hänninen O. Shifting from conventional diet to an uncooked vegan diet reversibly alters serum lipid and apolipoprotein levels. Nutr Res 1992. [DOI: 10.1016/s0271-5317(05)80185-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Glaser JL, Brind JL, Vogelman JH, Eisner MJ, Dillbeck MC, Wallace RK, Chopra D, Orentreich N. Elevated serum dehydroepiandrosterone sulfate levels in practitioners of the Transcendental Meditation (TM) and TM-Sidhi programs. J Behav Med 1992; 15:327-41. [PMID: 1404349 DOI: 10.1007/bf00844726] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Serum dehydroepiandrosterone sulfate (DHEA-S) levels were measured in 270 men and 153 women who were experienced practitioners of the Transcendental Meditation (TM) and TM-Sidhi programs, mental techniques practiced twice daily, sitting quietly with the eyes closed. These were compared according to sex and 5-year age grouping to 799 male and 453 female nonmeditators. The mean DHEA-S levels in the TM group were higher in all 11 of the age groups measured in women and in 6 of 7 5-year age groups over 40 in men. There were no systematic differences in younger men. Simple regression using TM-group data revealed that this effect was independent of diet, body mass index, and exercise. The mean TM-group levels measured in all women and in the older men were generally comparable to those of nonmeditator groups 5 to 10 years younger. These findings suggest that some characteristics of TM practitioners are modifying the age-related deterioration in DHEA-S secretion by the adrenal cortex.
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Affiliation(s)
- J L Glaser
- Department of Physiological and Biological Sciences, Maharishi International University, Fairfield, Iowa 52556
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Abstract
It is a general opinion that the Western diet plays a significant role in increasing the risk of breast cancer in the Western World. Recently some likely mechanisms involved in increasing the risk have been disclosed. It has been found that a Western-type diet elevates plasma levels of sex hormones and decreases the sex hormone binding globulin concentration, increasing the availability of these steroids for peripheral tissues. The same diet results in low formation by intestinal bacteria of mammalian lignans and isoflavonoid phyotestrogens from plant precursors. These diphenolic compounds seem to affect hormone metabolism and production and cancer cell growth by many different mechanisms making them strong candidates for a role as cancer protective substances. The sex hormone pattern found in connection with a Western-type diet combined with low lignan and isoflavonoid excretion was found particularly in postmenopausal breast cancer patients and omnivores living in high-risk areas, and to a lesser degree in areas with less risk. However, the pattern observed was not entirely due to diet.
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Affiliation(s)
- H Adlercreutz
- Dept. of Clinical Chemistry, University of Helsinki, Meilahti Hospital, Finland
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22
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Dao TL, Hilf R. Dietary fat and breast cancer: a search for mechanisms. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 1992; 322:223-37. [PMID: 1442297 DOI: 10.1007/978-1-4684-7953-9_17] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- T L Dao
- Roswell Park Memorial Institute, Buffalo, New York
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Affiliation(s)
- H Adlercreutz
- Department of Clinical Chemistry, University of Helsinki, Meilahti Hospital, Finland
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Williams CM, Maunder K, Theale D. The effect of a low-fat diet on luteal-phase prolactin and oestradiol concentrations and erythrocyte phospholipids in normal premenopausal women. Br J Nutr 1989; 61:651-61. [PMID: 2758018 DOI: 10.1079/bjn19890152] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
1. Fifteen normal premenopausal women followed a low-fat diet for a period of 2 months. 2. Daily fat intake was reduced from 81 g on their customary diet to 36 g on the low-fat diet. A significant reduction in total energy intake and an increase in the dietary polyunsaturated fat: saturated fat ratio was also observed. There was a significant decline in body-weight, percentage body fat and total serum cholesterol, but no significant change in high-density-lipoprotein-cholesterol. 3. Luteal-phase prolactin concentrations were not altered, but there was a significant decline in oestradiol concentrations on the low-fat diet. The proportion of erythrocyte inositol-phospholipid was increased on the low-fat diet and there was a significant increase in the 20:4 omega 6 (arachidonate) content of inositol-phospholipids. No significant changes in the content or fatty acid compositions of other phospholipid fractions were observed. 4. Further investigation of the effect of level and type of dietary fat on the content and fatty acid composition of membrane inositol-phospholipids are required. Long-term studies investigating the response of both prolactin and oestradiol to dietary fat reduction are also warranted.
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Affiliation(s)
- C M Williams
- Department of Biochemistry, University of Surrey, Guildford
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Abstract
The occurrence of multiple primary cancers may reflect common etiologic factors. We investigated the extent to which the diet and cancer hypothesis was supported by data from the Surveillance, Epidemiology, and End Results (SEER) Program on multiple primary associations. Cancers of the colon/rectum and prostate in men, and those of the breast, colon/rectum, and uterine corpus in women, were hypothesized a priori to be diet-related cancers. Of the eight multiple primary associations among diet-related cancers that were possible in men and women, relative risks (RR) of a second diet-related primary cancer developing after a first diet-related primary ranged from 1.06 to 1.43. The lower bound of the 99% confidence intervals (CI) for five of these associations exceeded 1.00, and fell between 0.95 and 0.99 for the other three associations. The observed multiple primary associations were compatible with the existence of common etiologic dietary elements. However, hormonal, immunologic, and medical care factors shared by these malignancies must be considered as alternative explanations for these findings.
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Affiliation(s)
- A Schatzkin
- Cancer Prevention Studies Branch, National Cancer Institute, Bethesda, MD 20892
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Schwartz SM, Wilson ME, Walker ML, Collins DC. Dietary influences on growth and sexual maturation in premenarchial rhesus monkeys. Horm Behav 1988; 22:231-51. [PMID: 3294160 DOI: 10.1016/0018-506x(88)90069-4] [Citation(s) in RCA: 50] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The effect of a high-fat diet on growth, sexual maturation, and developmental changes in serum levels of estradiol (E2), growth hormone (GH), somatomedin-C (Sm-C), and insulin were examined in outdoor-housed premenarchial rhesus monkeys. From 16 to 32 months of age, females were fed either a high-fat diet (HFD, N = 5) with 31% calories from fat or a control diet (commercial laboratory chow, N = 10) with 12% of the calories from fat. Maintenance on a HFD did not accelerate physical growth, as all animals exhibited similar increments in body weight, crown-rump length, and weight/height ratios. In contrast, the HFD group exhibited an earlier onset of perineal swelling and menarche despite lower body weights during that time. Moreover, 80% of the HFD animals exhibited an early first ovulation (31-32 months of age) compared with 40% of control animals. These reproductive changes were associated with significant differences in the endocrine profiles of HFD animals. Fasting serum levels of insulin were significantly elevated within 2 months of diet treatment and remained elevated throughout the study period. Levels of Sm-C were elevated relative to those of controls after 3 months of diet treatment, but not thereafter. Serum GH increased after 6 months on the HFD and, overall, concentrations were higher in HFD animals. A significant rise in E2 was observed after only 45 days on the HFD treatment. These concentrations did not differ from 18 to 21 months of age but again were elevated at 27 months in the HFD females. Since these endocrine and physical changes associated with reproductive physiology occurred in the absence of enhanced growth, these data suggest that a high-fat diet may influence the rate of sexual maturation through changes in certain metabolic factors which may act on the developing neuroendocrine system.
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Affiliation(s)
- S M Schwartz
- Yerkes Regional Primate Research Center, Emory University, Atlanta, Georgia 30322
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Hughes RE. Dietary fibre. Lancet 1987; 2:581. [PMID: 2887883 DOI: 10.1016/s0140-6736(87)92979-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Abstract
Urinary and fecal excretion and plasma levels of estrogens were measured in pre- and postmenopausal women eating different diets. When premenopausal U.S. women eating a "Western diet," comprising high fat (40% of calories) and low fiber, were compared with age-matched vegetarians eating a moderate-fat (30%), high-fiber diet, it was found that the vegetarians excreted threefold more estrogen in their feces, had lower urinary excretion, and had 15-20% lower plasma estrogen levels. When U.S. pre- and postmenopausal women eating a Western diet were compared with recent Asian immigrants eating a very low-fat diet (20-25% of calories), similar results were obtained except that plasma estrogen levels were 30% lower among Orientals compared with those among Western omnivore women. Correlation analysis of dietary components and plasma estrogen showed that plasma estrogen was positively associated with fat and was negatively associated with fiber. The results indicate that diet can alter the route of excretion of estrogen by influencing the enterohepatic circulation and that this, in turn, influences plasma estrogen levels.
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Abstract
The in vitro binding of estrone, estradiol-17 beta, estriol, testosterone, dihydrotestosterone, and estrone-3-glucuronide by wheat, oat, and corn brans, oat hulls, cellulose, lignin, and cholestyramine resin was measured. The extent of steroid sequestration was characteristic and reproducible for each hormone. Cholestyramine bound an average of 90% of all the steroids tested, whereas cellulose bound the least (12%). Of the other substances tested, each bound the following percentage of unconjugated hormones: lignin, 87%; wheat and oat brans, 45% each; corn bran 44%; and oat hulls, 32%. The conjugated steroid was less likely to bind than the unconjugated steroids. Lignin appeared to be an important component in the interaction with steroid hormones. The results support the hydrophobic nature of adsorption and suggest that the components of fiber in diet should be considered separately when evaluating in vivo metabolic effects.
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