IsoflavonoidsandBreastCancerRisk.pptVIP

Isoflavonoids and Breast Cancer Risk Michelle D. Holmes, MD, DrPH Learning Objectives To understand the structure and food sources of isoflavonoids To understand the different types of research studies supporting an isoflavonoid-breast cancer link To understand recommendations for soy intake for average risk women and also for women with a personal or family history of breast cancer Performance Objectives Students should be able to evaluate new research findings on isoflavonoids and breast cancer in light of the previous evidence Be able to make recommendations on soy intake for average risk and high risk women based on the weight of present research evidence Interests I was trained as a primary care physician and have always had a strong interest in public health. I have always been interested in the impact of diet, exercise, and other lifestyle factors on chronic disease. I became an epidemiologist in mid career. My research focus is diet and cancer. Overview Structure, food sources of isoflavonoids Different types of studies supporting a isoflavonoid-breast cancer link international in vitro and animal case-control and cohort trials Recommendations Structure and Food Sources Flavonoids are plant-derived polyphenols Isoflavonoid subgroup weakly estrogenic examples: genistein, daidzein, equol Intake 1 gram soybeans ? 2 mg isoflavonoids Typical daily intake: Asian countries ? 50-100 mg Western countries ? 1 mg International Data Asian countries: high soy intake and lower breast cancer rates Japanese migrants assume host country rates of breast cancer Western diet: minimal soy Vegetarians in the US have lower cancer rates Estrogenic Effects Weakly estrogenic 1/1000th -1/100,000th the strength of estradiol Produce estrogenic responses in mice May be antagonistic by competing for estrogen receptors In vitro studies of Genistein Inhibits Tyrosine Kinase (important for cell prolife