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PLANT OESTROGENS: AN ESSENTIAL GUIDE

Plant oestrogens (also called phytoestrogens) are very similar in their makeup to human oestrogen. If eaten regularly, and in sufficient quantities, they start to have mild oestrogenic effects – which is potentially useful as a woman’s oestrogen levels decline. For some women, these effects could be sufficient to help relieve menopausal symptoms, particularly hot flushes.

This article was included in issue 71 (winter 2016/2017) of The Menopause Exchange newsletter.

The interest in plant oestrogens developed because women living in Asia, where foods rich in plant oestrogens (such as soya and tofu) are eaten daily, have few hot flushes compared to women in western populations. However, the intake of plant oestrogens in a typical British diet is low, so an active selection of foods rich in plant oestrogens is required if beneficial effects are to be gained.

Do plant oestrogens help?
Individual studies only tell one part of a story. One way that researchers use to find out if things really work is to pull together the results from a large number of these studies and see what they can find out. The results of this type of large review were published earlier last year and showed that plant oestrogens have a modest effect in helping to cut the number of hot flushes and reduce any vaginal dryness, but had limited effects on night sweats.

Which foods do I choose?
Plant oestrogens are found at low levels in a range of plants, including wholegrain, peas and beans. The food contributing most to UK plant oestrogen intake in the UK is reported to be bread, mainly due to the use of soya in the recipes, and its widespread consumption. But if trying to boost your intake, the richest sources are soya beans and foods made from these, such as tofu, soya milks, soya yoghurts or desserts, and also linseeds. Some foods, such as breads or muesli cereals, combine soya and linseed as key ingredients, making them a great source of plant oestrogens as well.

Do supplements work?
This is difficult to answer, as it depends on which plant the oestrogens come from and the concentration of the supplement’s active ingredients. However, in 2012, a review of plant oestrogens from soya beans (called isoflavones) found that taking these for at least six to 12 months cut down both the number and the severity of hot flushes. Supplements containing more than 18mg of a specific plant oestrogen called genistein were far more effective compared to those with lower doses, so if you’re choosing the supplement route check what’s contained in the brand that you’re taking.

Should I change my diet?
Hot flushes are (sadly) not usually a short-term symptom. Research from the US suggests that hot flushes persist on average for 10 years. So it’s important to include plant oestrogen-rich foods as an integral part of your healthy balanced diet. The good news is that foods with a higher content of plant oestrogens also usually contain other beneficial nutrients, such as soya protein (useful to help control cholesterol), dietary fibre and a range of minerals. Increasing your intake of these plant foods could therefore hold other health benefits as well.
If you’re troubled with hot flushes, modifying your diet, alongside other lifestyle approaches, is worth a try. But be patient and give it time. Consuming plant oestrogens several times each day appears to have the best effect, so it’s worth experimenting with different ways to include these in your diet. If you find soya milk in tea isn’t to your taste, persevere and try it in other ways, as you may find a soya milk cappuccino or custard is fine. If you usually eat wholemeal bread, a switch to a soya and linseed loaf may be acceptable to you, while white bread lovers may take longer to adapt.

Boost your intake

Here are some ways to incorporate more plant oestrogens into your diet:

  • Breakfast on cereal with calcium fortified soya milk and opt for breads made with soya and linseeds
  • Replace yoghurt and ice cream with soya yoghurt or desserts
  • Try hot chocolate or cappuccino made with soya milk
  • Drink a fruit smoothie made with fresh fruit and soya milk
  • Snack on dry roast spiced soya beans (soya nuts) and seed mix
  • Make a mixed bean salad with soya beans and other mixed beans
  • Try edamame beans (green soya beans) instead of sugar snap peas or mange tout.
  • Marinade tofu & use it in a stir fry
  • Replace all or part of mince in dishes with soya mince.
  • Look out for recipe books and websites to give you some more ideas.

Other considerations
Concern has been raised in the past about the consumption of plant oestrogens by women at risk/or suffering from cancers sensitive to oestrogen, e.g. breast cancer. Extensive investigation has put these fears to rest, and women in the UK are in fact recommended to increase their intake of plant oestrogens as part of a lifestyle to reduce their breast cancer risk. But if this affects you, and you have any concerns, speak to your doctor before changing your diet, especially plant oestrogen intake.
Soya, and products made from soya beans such as milk and yoghurts, are low in calcium. So a switch from cow’s milk products to soya products could result in a fall in your calcium intake. Calcium is essential for your bones and a low intake could increase your risk of osteoporosis. It’s therefore important to check for products that are fortified with calcium or to replace your intake with a calcium supplement (ask a pharmacist for advice).

Key points

  • Research suggests increasing plant oestrogens can help reduce hot flushes.
  • It can take two to three months to see any potential benefits.
  • The effects are greater for some women than others so try it and see if it works for you.
  • Consuming plant oestrogens two to three times daily has a greater effect than consuming your intake in a single dose.

About the author
Angie Jefferson is a registered dietitian who believes all women can make simple positive dietary changes that can help achieve great nutrition within a healthy lifestyle.

References:

[1] Clarke DB & Lloyd AS (2004) Dietary exposure estimates of isoflavones from the 1998 UK Total Diet Study. Food Additives and Contaminants 21 : 305–16

[2] Franco OH et al (2016) Use of Plant-Based Therapies and Menopausal Symptoms: A Systematic Review and Meta-analysis. JAMA 315: 2554-2563

[3]  Kuhnle G et al (2009) Phytoestrogen Content of Cereals and Cereal-Based Foods Consumed in the UK. Nutrition and Cancer 61: 302–309

[4] Taku K et al (2012) Extracted or synthesized soybean isoflavones reduce menopausal hot flash frequency and severity: systematic review and meta-analysis of randomized controlled trials. Menopause19: 776-790

[5] http://www.cancerresearchuk.org/about-cancer/type/breast-cancer/about/risks/diet-and-breast-cancer

[6] North American Menopause Society (2011) The role of soy isoflavones in menopausal health: report of The North American Menopause Society. Menopause 18: 732-53

[7] Crawford AL et al (2013) The impact of dose, frequency of administration, and equol production on efficacy of isoflavones for menopausal hot flashes: a pilot randomized trial. Menopause 20: 911–921

[8] Kaunitz AM et al (2015) Management of Menopausal Symptoms. Obstet Gynecol 126: 859–876

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