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Department of Food Science and Nutrition, University of Minnesota, St. Paul, MN 55108;
* Division of Biostatistics, University of Minnesota, Minneapolis, MN 55407; and
Institute for Preventive Medicine, Nutrition, and Cancer, Folkhälsan research center and the Division of Clinical Chemistry, University of Helsinki, Finland 00014
2To whom correspondence should be addressed. E-mail: mkurzer{at}umn.edu.
Some epidemiologic studies reported an association between a low ratio of urinary 2-hydroxyestrogens (2-hydroxyestradiol + 2-hydroxyestrone) to 16
-hydroxyestrone (2:16OHE1) and increased breast cancer risk. Some studies show that soy consumption increases this ratio, and it is suggested that this effect may reduce breast cancer risk. We hypothesized that consumption of probiotic bacteria would alter fecal bacteria and enzymes involved in soy isoflavone metabolism, thereby increasing isoflavone bioavailability and enhancing the beneficial effects of soy on estrogen metabolism. Breast cancer survivors (n = 20) and controls (n = 20) were given 4 treatments for 6 wk each, separated by 2-wk washout periods, in a randomized, crossover design: soy protein (26.6 ± 4.5 g protein/d containing 44.4 ± 7.5 mg isoflavones/d); soy protein + probiotics (109 colony-forming units Lactobacillus acidophilus DDS®+1 & Bifidobacterium longum, 1530 mg fructooligosaccharide/d); milk protein (26.6 ± 4.5 g protein/d); and milk protein + probiotics. Survivors tended to have a lower baseline urine 2:16OHE1 ratio than controls (P = 0.10). In the group as a whole, soy consumption tended to increase urinary 2-hydroxyestrogens (P = 0.07) and 16
-hydroxyestrone (P = 0.11) but had no effect on the urinary 2:16OHE1 ratio. When subjects were divided into groups by plasma concentrations and urinary levels of the daidzein metabolite equol, soy increased urinary 2-hydroxyestrogens (P = 0.01) and the 2:16OHE1 ratio (P = 0.04) only in subjects with high plasma equol concentrations. None of these results were influenced by probiotic consumption. These results are consistent with studies that found lower urine 2:16OHE1 ratios in women with breast cancer and suggest that soy consumption increases this ratio only in women who are equol producers.
KEY WORDS: probiotics soy equol 2:16-hydroxyestrone ratio breast cancer
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