Effects of prune consumption on the ratio of 2-hydroxyestrone to 16alpha-hydroxyestrone

A randomized, double-blind, placebo-controlled, cross-over trial to evaluate the effect of EstroSense® on 2-hydroxyestrone:16α-hydroxyestrone ratio in premenopausal women

OBJECTIVES

Some estrogen metabolites are associated with increased breast cancer risk, while others are protective. Research efforts have focused on modifiable factors, including bioactive compounds found in food or supplements, promoting estrogen profiles with anti-cancer properties. EstroSense^® is a nutraceutical product with bioactive compounds, including Indole-3-carbinol and green-tea catechins, which may favourably affect estrogen profiles. This study was conducted to determine if EstroSense use, compared to placebo, promotes a higher urinary 2-hydroxyestrone:16α-hydroxyestrone ratio (2-OHE₁:16α-OHE₁), a biomarker associated with a lowered risk of breast cancer.

METHODS

A total of 148 premenopausal women were recruited from British Columbia, Canada to participate in a randomized, double-blind, cross-over, multicentre, placebo-controlled study in which women were randomized to a treatment sequence that consisted of either EstroSense^®, followed by placebo or vice-versa. The women were instructed to consume three capsules per day of EstroSense^® or the placebo for three menstrual cycles (∼12 weeks). The primary outcome was the measurement of 2-OHE1:16α-OHE1 in casual samples at baseline and after each treatment phase.

RESULTS

After 12 weeks of intervention, the mean (95% CI) urinary 2-OHE₁:16α-OHE₁ was 4.55 (2.69, 6.42) (p<0.001) higher following EstroSense than placebo adjusted for baseline values.

CONCLUSIONS

EstroSense use led to markedly higher urinary 2-OHE1:16α-OHE1 than the placebo, a biomarker associated with a lower risk of breast cancer.

REGISTRATION

http://clinicaltrials.gov (NCT02385916).

Cancer protective effects of plums: A systematic review

Plums is one of the most cultivated stone fruits due to its fast growing popularity. It has various traditionally recognized health benefits. There are two main commercial types of plums: the European plum (Prunus domestica) and the Japanese plum (Prunus salicina), each having many varieties. Researchers are gathering further evidence of pharmacological effects for plums by scientifically studying its anti-inflammatory, antioxidant properties. A systematic review analysing the literature related to the effects of plums on prevention and treatment of cancer is warranted. This is the first review examining the cancer-related effects of plums. Antioxidation properties of the active constituents of plum were also compared. Scopus, Google Scholar, PubMed, Medxriv and Cochrane Library databases, from their date of inception until July 2021 were utilized. The risk of bias was assessed using CONSORT checklist. A total of 6639 studies were screened and eventually only 54 studies were included. Full-text review of included studies revealed that plum extracts were rich in antioxidants. Overall, most of the studies that fulfilled the eligibility criteria were in vitro and a few clinical studies involving in vivo work. Therefore, it would be beneficial to perform more studies on animals or humans, to confirm that the result obtained from these in vitro studies are able to be extrapolated in a wider range of applications. Further clinical and in vivo studies are warranted to validate plums as a functional food for treatment and prevention of cancer.

A Systematic Review on the Health Effects of Plums (Prunus domestica and Prunus salicina)

In recent times, plums have been described as foods with health-promoting properties. Research on the health effects of plum continue to show promising results on its antiinflammatory, antioxidant and memory-improving characteristics. The increased interest in plum research has been attributed to its high phenolic content, mostly the anthocyanins, which are known to be natural antioxidants. A systematic review of literature was carried out to summarize the available evidence on the impact of plums (Prunus species; domestica and salicina) on disease risk factors and health outcomes. A number of databases were searched according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for relevant studies on plum health effects in vitro, animal studies and clinical trials. A total of 73 relevant peer-reviewed journal articles were included in this review. The level of evidence remains low. Of the 25 human studies, 6 were confirmatory studies of moderate quality, while 19 were exploratory. Plums have been shown to possess antioxidant and antiallergic properties, and consumption is associated with improved cognitive function, bone health parameters and cardiovascular risk factors. Most of the human trials used the dried version of plums rather than fresh fruit, thus limiting translation to dietary messages of the positioning of plums in a healthy diet. Evidence on the health effect of plums has not been extensively studied, and the available evidence needs further confirmation. Copyright © 2016 John Wiley & Sons, Ltd.

Dried plums and their products: composition and health effects--an updated review

This paper describes composition of dried plums and their products (prune juice and dried plum powder) with special attention to possibly bioactive compounds. Dried plums contain significant amounts of sorbitol, quinic acid, chlorogenic acids, vitamin K1, boron, copper, and potassium. Synergistic action of these and other compounds, which are also present in dried plums in less conspicuous amounts, may have beneficial health effects when dried plums are regularly consumed. Snacking on dried plums may increase satiety and reduce the subsequent intake of food, helping to control obesity, diabetes, and related cardiovascular diseases. Despite their sweet taste, dried plums do not cause large postprandial rise in blood glucose and insulin. Direct effects in the gastrointestinal tract include prevention of constipation and possibly colon cancer. The characteristic phenolic compounds and their metabolites may also act as antibacterial agents in both gastrointestinal and urinary tracts. The indirect salutary effects on bone turnover are supported by numerous laboratory studies with animals and cell cultures. Further investigation of phenolic compounds in dried plums, particularly of high molecular weight polymers, their metabolism and biological actions, alone and in synergy with other dried plum constituents, is necessary to elucidate the observed health effects and to indicate other benefits.

Comparison of Dried Plum Puree, Rosemary Extract, and BHA/BHT as Antioxidants in Irradiated Ground Beef Patties

Fresh ground beef patties with (1) no antioxidant (control), (2) 0.02% butylated hydroxyanisole/butylated hydroxytoluene (BHA/BHT), (3) 3% dried plum puree, or (4) 0.25% rosemary extract were aerobically packaged, irradiated at target doses of 0, 1.5, or 2.0 kGy (1.7 and 2.3 kGy actual doses), and stored at 4°C. The samples were evaluated for lipid oxidation on 0, 3, 7, 14, 21, and 28 days of storage after irradiation. When compared to the control, all antioxidant treatments were effective in retarding (P < 0.05) irradiation-induced lipid oxidation during storage as determined by 2-thiobarbituric acid reactive substances (TBARs) values. Rosemary extracts had the same antioxidant effect (P > 0.05) as BHA/BHT in irradiated and nonirradiated beef patties, followed by the dried plum puree treatment. Irradiation increased TBARs values, but no differences were noted in oxidation between irradiation dose levels.

Estrogenic Effect of Yam Ingestion in Healthy Postmenopausal Women

OBJECTIVE

Yam (Dioscorea) has been used to treat menopausal symptom folklorically. This study was to investigate the effects of yam ingestion on lipids, antioxidant status, and sex hormones in postmenopausal women.

METHODS

Twenty-four apparently healthy postmenopausal women were recruited to replace their staple food (rice for the most part) with 390 g of yam (Dioscorea alata) in 2 of 3 meals per day for 30 days and 22 completed the study. Fasting blood and first morning urine samples were collected before and after yam intervention for the analyses of blood lipids, sex hormones, urinary estrogen metabolites and oxidant stress biomarker. The design was a one arm, pre-post study. A similar study of postmenopausal women (n = 19) fed 240 g of sweet potato for 41 days was included as a control study. Serum levels of estrone, estradiol and SHBG were analyzed for this control group.

RESULTS

After yam ingestion, there were significant increases in serum concentrations of estrone (26%), sex hormone binding globulin (SHBG) (9.5%), and near significant increase in estradiol (27%). No significant changes were observed in serum concentrations of dehydroepiandrosterone sulfate, androstenedione, testosterone, follicular stimulating hormone, and luteinizing hormone. Free androgen index estimated from the ratio of serum concentrations of total testosterone to SHBG decreased. Urinary concentrations of the genotoxic metabolite of estrogen, 16alpha-hydroxyestrone decreased significantly by 37%. Plasma cholesterol concentration decreased significantly by 5.9%. Lag time of low-density lipoprotein oxidation prolonged significantly by 5.8% and urinary isoprostane levels decreased significantly by 42%. For the control subjects fed with sweet potato, all three hormone parameters measured were not changed after intervention.

CONCLUSION

Although the exact mechanism is not clear, replacing two thirds of staple food with yam for 30 days improves the status of sex hormones, lipids, and antioxidants. These effects might reduce the risk of breast cancer and cardiovascular diseases in postmenopausal women.

Serum steroid hormones, sex hormone-binding globulin concentrations, and urinary hydroxylated estrogen metabolites in post-menopausal women in relation to daidzein-metabolizing phenotypes

Equol and O-desmethylangolensin (O-DMA) are products of bacterial metabolism of daidzein, an isoflavone in soybeans; thus, the presence or absence of equol and/or O-DMA in urine is a marker of particular intestinal bacteria profiles. Plasma hormone concentrations may be lower in pre-menopausal women who harbor the bacteria capable of producing equol (equol producers) compared to women who do not (equol non-producers). We evaluated concentrations of serum hormones, sex hormone-binding globulin (SHBG), and urinary 2-hydroxyestrone (2-OH E(1)) and 16alpha-hydroxyestrone (16alpha-OH E(1)) in relation to equol-producer and O-DMA-producer phenotypes in 89 post-menopausal women. Follicle stimulating hormone (FSH) was 23% greater in O-DMA-producers compared to non-producers (P = 0.04). No significant differences in serum estrogens, androgens, metabolic hormones, or SHBG were observed in relation to either daidzein-metabolizing phenotype. Compared with non-producers within each phenotype, age-adjusted 2-OH E(1):16alpha-OH E(1) was 27% greater (P = 0.06) in equol-producers and 9% greater (P > 0.10) in O-DMA-producers, and 2-OH E(1) concentrations were 24% greater in equol producers (P = 0.07) and 42% greater in O-DMA producers (P = 0.02). No significant differences in 16alpha-OH E(1) were observed in relation to either phenotype. These results suggest that interindividual variability in intestinal bacteria may be related to differences in products of hormone metabolism in post-menopausal women.

Metabolic and endocrine effects of a polyunsaturated fatty acid-rich diet in polycystic ovary syndrome

Effects of a polyunsaturated fatty acid (PUFA)-rich diet were investigated in 17 polycystic ovary syndrome (PCOS) patients. After a 3-month habitual diet period, dietary fats were partly replaced with PUFAs for another 3 months. The PUFA-rich diet increased plasma linoleic acid from 28.36 +/- 1.00% to 33.76 +/- 1.08% (P < 0.002) and alpha-linolenic acid from 0.52 +/- 0.03% to 1.06 +/- 0.10% (P < 0.0001). Fasting glucose increased from 76 +/- 3 to 95 +/- 3 mg/dl (4.2 +/- 0.2 to 5.30.2 mmol/liter; P < 0.0001), and the area under the curve for glucose during oral glucose tolerance test increased from 421 +/- 34 to 503 +/- 31 mg/dl (23.4 +/- 1.9 to 27.9 +/- 1.7 mmol/liter; P < 0.001). Plasma insulin did not change either at fasting or during oral glucose tolerance test. Fasting plasma free fatty acids decreased from 0.596 +/- 0.048 to 0.445 +/- 0.058 mg/dl (P = 0.037), and ketone bodies decreased from 9.14 +/- 1.57 to 3.63 +/- 0.62 mg/dl (895 +/- 154 to 356 +/- 61 micromol/liter; P < 0.003). Plasma 15-deoxyprostaglandin J(2) tended to decrease (from 239 +/- 65 to 171 +/- 60 ng/ml; P = 0.053). Plasma testosterone, free testosterone, SHBG, dehydroepiandrosterone sulfate, LH, FSH, and urinary estrogen conjugates did not change. Urinary pregnanediol 3-glucuronide increased from 18.6 +/- 2.2 to 31.0 +/- 5.7 micro g/mg creatinine (P = 0.038). In conclusion, increased dietary PUFA intake can exert significant metabolic and endocrine effects in women with PCOS.