Volume 10 Supplement 2

Breast Cancer Research 2008

Open Access

Food choice and phytoestrogen consumption in women previously treated for postmenopausal breast cancer

  • BM Parry1,
  • JM Lawrence2,
  • L Storey3,
  • JE Brown4,
  • DB Clarke5,
  • M Raats3,
  • SM Horton1,
  • JM Stilwell1 and
  • RM Rainsbury1
Breast Cancer Research200810(Suppl 2):P92

https://doi.org/10.1186/bcr1976

Published: 13 May 2008

Background

Phytoestrogens are plant-derived, bioactive substances with a chemical structure similar to that of 17β-oestradiol. Women previously treated for breast cancer may increase their phytoestrogen intake to avoid conventional hormone replacement therapy or because of a belief that they may help avoid recurrence [1, 2]. There is no recommended daily intake and there are some concerns about phytoestrogen safety in this group, although the evidence is conflicting and more research is needed [3, 4].

Methods

Three hundred and sixteen women each completed a 4-day food and drink diary (14 of whom also completed a 7-day weighed intake diary 6 weeks previously). The 55 most recently recruited women collected their urine for 24 hours whilst completing their diaries and were interviewed by telephone regarding their food choices since diagnosis.

Results

A new dietary analysis database was created using peer-reviewed published data and analysing 34 additional foods and beverages for which there were no published results. The urinanalysis results contributed validation data. A summary of the dietary intake data is shown in Table 1. There was a lack of primary analytical data on the phytoestrogen profile of many foods and beverages routinely consumed by this study population. However, food frequency data from the highest quartile show the important contribution of nonsoya foods to high intakes (Table 2). Telephone interviews were completed by 39 subjects. For most women, having breast cancer had not changed their diet. Health concerns unrelated to cancer, the needs of other family members, cooking on a budget and physical appearance all seemed more important than the impact of the cancer diagnosis.
Table 1

Summary of intake data by receptor status and antioestrogenic drug prescription

Total phytoestrogen intake (μg/1,000 kcal) (n = 316)

n

First quartile

Second quartile

Third quartile

Fourth quartile

  

Receptor status

     

Mean

8,388

   ER-negative

42

11 (14%)

11 (14%)

13 (16%)

7 (9%)

Range

126 to 77,703

   ER-positive

182

40 (51%)

42 (53%)

48 (61%)

52 (66%)

Quartile ranges

 

   Not available

92

28 (35%)

26 (33%)

18 (23%)

20 (25%)

   First quartile

<3,817

Antioestrogenic drugs

     

   Second quartile

3,817 to 6,798

   No prescription

109

30 (38%)

30 (38%)

25(32%)

24 (30%)

   Third quartile

6,799 to 10,255

   Tamoxifen or arimidexa

200

47 (59%)

47 (59%)

52 (65%)

54 (68%)

   Fourth quartile

>10,255

   Other/missing

7

2 (3%)

2 (3%)

2 (3%)

1 (2%)

aAstraZeneca, London, UK.

Table 2

Main food sources of phytoestrogens

From highest quartile

Daidzein

Genistein

Glycitein

Formononetina

Biochanin Aa

Coumestrola

Matairesinola

Secoisolariciresinola

Main food group source

Cereal foods

Cereal foods

Soya products

Fruit, vegetables

Legumes, blackcurrants

Fruit, vegetables

Tea (black leaves), cereal foods

Tea (black leaves), fruit, vegetables

aLimited data available on content in some foods.

Discussion

Variation in phytoestrogen intakes and metabolite excretion reflect food preferences, dietary analysis database limitations and likely variations in existing knowledge combined with a lack of routine access to dietary information. In the absence of definitive advice, more immediate health and social concerns influence food choice rather than past breast cancer diagnosis.

Conclusion

No data previously existed on intake in this potentially vulnerable group and these data will help evaluate the health implications related to such phytoestrogen consumption patterns.

Declarations

Acknowledgements

Funded by the Food Standards Agency, UK.

Authors’ Affiliations

(1)
WINS Research Team, Winchester and Andover Breast Unit, Winchester and Eastleigh Healthcare NHS Trust
(2)
European Institute of Health and Medical Sciences, University of Surrey
(3)
Food, Consumer Behaviour and Health Research Centre, University of Surrey
(4)
Division of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey
(5)
Central Science Laboratory

References

  1. Adlercreutz H: Phytoestrogens and breast cancer. J Steroid Biochem Mol Biol. 2002, 83: 113-118. 10.1016/S0960-0760(02)00273-X.View ArticlePubMedGoogle Scholar
  2. Mills E, Ernst E, et al: Health food store recommendations: implications for breast cancer patients. Breast Cancer Res. 2003, 5: R170-R174. 10.1186/bcr636.View ArticlePubMedPubMed CentralGoogle Scholar
  3. De Lemos M: Safety issues of soy phytoestrogens in breast cancer patients. J Clin Oncol. 2002, 20: 3040-3041.PubMedGoogle Scholar
  4. Committee on Toxicology of Chemicals in Food, Consumer Products and the Environment: Phytoestrogens and Health. 2003, London: Food Standards AgencyGoogle Scholar

Copyright

© BioMed Central Ltd 2008

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