Menopause

Question 1

What are phytoestrogens

Answer 1

Naturally occurring chemical compounds found in plants
Antifungal agent
Structured similarly to mammalian oestrogen

Question 2

Phytoestrogen structure

Answer 2

Phenol rings
Hydroxyl group
Distance between two structures
May exert oestrogenic properties

Question 3

Phytoestrogens Definition

Answer 3

Any plant substance or metabolite that induces biological responses in vertebrates and can mimic or modulate the action of endogenous oestrogen usually by binding to oestrogen receptors

Question 4

Phytoestrogens sub-group

Answer 4

Flavonoids

Non-flavonoids

Question 5

Flavonoids sub-group

Answer 5

Isoflavones
Coumestans
Prenyl flavonoids

Question 6

Isoflavones

Answer 6

Richest source is soyabean
Legumes
Lentils
Chickpeas

Question 7

Coumestans

Answer 7

Similar physical and chemical properties to isoflavones
Less well studied
Coumestrol – most common coumestan found in food
Young sprouting legumes
Clover
Alfalfa sprouts

Question 8

Prenylated Flavonoids

Answer 8

Structural similarity to isoflavones
Prenyl group rather than hydroxyl group
Found in high concentration in some beers
Hops

Question 9

Lignans

Answer 9

Flaxseed is most concentrated source of lignans – rarely consumes
Common consumption through cereal and whole grain products
o Rye
o Barley
o Wheat
Other sources – Sesame, fruits and veg

Question 10

What determines Phytoestrogen Concentration

Answer 10

Natural Variation
Influenced by:
Genetics
Crop year
Environment
Harvesting and Processing

Question 11

Consumers of Phytoestrogens

Answer 11

Vegetarians and Vegans (Isoflavones and lignin’s)

Japanese/Chinese (isoflavones)

Soy based food consumers (isoflavones)

Phytoestrogen dietary supplement consumers

Question 12

Cancer

Answer 12

• Multi-factorial – genetics, lifestyle, diet
• Hormone dependent – Breast, prostate, female reproductive tract
• Lower in Asia
• Support of migrant studies

Question 13

Bioavailability Definition

Answer 13

The fraction of ingested nutrient utilized for normal physiological function

Question 14

Non-nutrients definition

Answer 14

Effectiveness of a chemical in eliciting response in a target tissue

Question 15

Menopause

Answer 15

Ovarian failure
51+
Peri-menopausal - 1-5yrs
Irregular periods
Hot flushes
Fatigue
Body changes
Headaches
Memory problems
Joint and muscle stiffness
Bladder weakness
Psychological changes
Vaginal dryness

Question 16

Menopause south east asia

Answer 16

Report few and differing symptoms to western world

Thought it might be due to diet difference

Question 17

Cardiovascular disease and Menopause

Answer 17

Major cause of morbidity
Risk increases after menopause
Idea oestrogen is protective
Hormone supplementation helps reduce risk in women

Question 18

Hormone supplementation and Cardiovascular disease

Answer 18

Oestrogen decrease atherosclerosis
Improve lipid profile
Enhanced vascular reactivity
However,

Heart and Estrogen/Progestin intervention trial

• increased early CVD
• Hypertriglyceridemia
• Hypercoagulable state

Question 19

South east Asia and Cardiovascular disease

Answer 19

CHD mortality rates lower in Eastern Population
Beaglehole (1990)

Could phytoestrogens play a role?

Question 20

Osteoporosis

Answer 20

Disease characterised by bone mass loss and microarchitectural deterioration of bone

Question 21

Bone remodelling

Answer 21

Continuous process
Renewal of bone - deuteriation, Redistributing of matrix where there is stress
Bone formation occurring after bone resorption

Must be tightly controlled
Controlled by hormones and growth factors

Question 22

Oestrogen

Answer 22

Critical importance of oestrogen - prevent bone resorption and promote increased bone density
Menopause - significant reduction in circulating levels

Question 23

Hip fractures in japan

Answer 23

Lower levels in post-menopause women

Eat more soy

220 per 100/000 in oxford
90 in japan

Question 24

Could phytoestrogens offer a solution to bone mass loss post-menopause

Answer 24

Current use HRT but that increase chance of breast cancer

Phytoestrogen mimic oestrogen to inhibit bone resorption and may stimulate bone formation
May absorb more calcium

Question 25

Phytoestrogen and calcium

Answer 25

High animal protein intake increases calcium loss via urine | Replacing animal with soy reduce this loss

Question 26

Research study Methods

Answer 26

* Can animal studies be considered representative of humans * Are phytoestrogens consumed from diet or supplements * Quantity consumed * Length of consumption * Double blind? * Can people remember their historical dietary consumption * How much influence does historical dietary consumption * Objective or subjective improvement * How long does the effect last * In cross-over studies, is there a wash-out period

Question 27

Observation in humans and synthetic oestrogen

Answer 27

Diethylstilboestrol Drug to prevent miscarriage used in 1940s Abnormal reproductive development during puberty Vaginal adenocarcinoma

Question 28

What are the critical periods of sexual development and reproduction

Answer 28

``` Embryo Foetus Neonatal period Puberty Adulthood ```

Question 29

Human and Animal studies on phytoestrogens

Answer 29

Effect of phytoestrogen on reproduction or sexual development unethical in humans Use animal but: -reproductive and sexual development different -Route of administration -Exposure per kg

Question 30

Foetal exposure to phytoestrogens

Answer 30

Lower birth weight and delayed sexual maturation in rats when mother exposed to genistein Female offspring of mice exposed to genistein had early mammary gland development Perinatal exposure - irregular oestrogen cycle in rat but irregularity found similar in normal rats and so found to not impact

Question 31

Weaning exposure to phytoestrogen

Answer 31

Advanced puberty | Longer oestrogen cycles and abnormalities in reproductive tissue in female mice but did bot effect fertility

Question 32

Human studies and phytoestrogen

Answer 32

• More abnormal menstrual cycle for those working with hops • Increased rate of male hypospadias in vegetarian mothers • Longer and more painful periods for those who fed soy as a child • Consumption of soy infant formula associated with premature thelarche • However, males supplemented with isoflavones showed no difference in sex hormone concentration or semen quality • Infants – greater risk to infants fed on soy-based infant formula o Asian countries - <1mg/kg body weight o 4 month infant exclusive fed soya formula - <5mg/kg body weight

Question 33

Menopause and Cardiovascular disease

Answer 33

Oestrogen increases storage of peripheral fat Post menopause less oestrogen so more fat around organs Muscle mass decrease Lower BMR Blood pressure with age

Question 34

UCLP

Answer 34

Step 1 - mindset Step 2 - Healthy swap Step 3 - Introduce 4 UCLP foods a day