Top

Published in:

01-04-2018 | Epidemiology

Dietary intake of soy and cruciferous vegetables and treatment-related symptoms in Chinese-American and non-Hispanic White breast cancer survivors

Authors: Sarah J. O. Nomura, Yi-Ting Hwang, Scarlett Lin Gomez, Teresa T. Fung, Shu-Lan Yeh, Chiranjeev Dash, Laura Allen, Serena Philips, Leena Hilakivi-Clarke, Yun-Ling Zheng, Judy Huei-yu Wang

Published in: Breast Cancer Research and Treatment | Issue 2/2018

Abstract

Purpose

This project was undertaken to examine the association between dietary intake of soy or cruciferous vegetables and breast cancer treatment-related symptoms among Chinese-American (CA) and Non-Hispanic White (NHW) breast cancer survivors.

Methods

This cross-sectional study included 192 CA and 173 NHW female breast cancer survivors (stages 0–III, diagnosed between 2006 and 2012) recruited from two California cancer registries, who had completed primary treatment. Patient-reported data on treatment-related symptoms and potential covariates were collected via telephone interviews. Dietary data were ascertained by mailed questionnaires. The outcomes evaluated were menopausal symptoms (hot flashes, night sweats, vaginal dryness, vaginal discharge), joint problems, fatigue, hair thinning/loss, and memory problems. Associations between soy and cruciferous vegetables and symptoms were assessed using logistic regression. Analyses were further stratified by race/ethnicity and endocrine therapy usage (non-user, tamoxifen, aromatase inhibitors).

Results

Soy food and cruciferous vegetable intake ranged from no intake to 431 and 865 g/day, respectively, and was higher in CA survivors. Higher soy food intake was associated with lower odds of menopausal symptoms (≥ 24.0 vs. 0 g/day, OR 0.51, 95% CI 0.25, 1.03), and fatigue (≥ 24.0 vs. 0 g/day, OR 0.43, 95% CI 0.22, 0.84). However, when stratified by race/ethnicity, associations were statistically significant in NHW survivors only. Compared with low intake, higher cruciferous vegetable intake was associated with lower odds of experiencing menopausal symptoms (≥ 70.8 vs. < 33.0 g/day, OR 0.50, 95% CI 0.25, 0.97) in the overall population.

Conclusions

In this population of breast cancer survivors, higher soy and cruciferous vegetable intake was associated with less treatment-related menopausal symptoms and fatigue.

Available only for authorised users

Ganz PA (2006) Monitoring the physical health of cancer survivors: a survivorship-focused medical history. J Clin Oncol 24(32):5105–5111. https://doi.org/10.1200/JCO.2006.06.0541 CrossRefPubMed

U.S. National Cancer Institute (2017) NCI Dictionary of Cancer Terms. https://www.cancer.gov/publications/dictionaries/cancer-terms?cdrid=390292. Accessed 17 Aug 2017

Cusack L, Brennan M, Baber R, Boyle F (2013) Menopausal symptoms in breast cancer survivors: management update. Br J Gen Pract 63(606):51–52. https://doi.org/10.3399/bjgp13X660977 CrossRefPubMedPubMedCentral

Harris PF, Remington PL, Trentham-Dietz A, Allen CI, Newcomb PA (2002) Prevalence and treatment of menopausal symptoms among breast cancer survivors. J Pain Symptom Manag 23(6):501–509. https://doi.org/10.1016/S0885-3924(02)00395-0 CrossRef

Jim HS, Phillips KM, Chait S, Faul LA, Popa MA, Lee YH, Hussin MG, Jacobsen PB, Small BJ (2012) Meta-analysis of cognitive functioning in breast cancer survivors previously treated with standard-dose chemotherapy. J Clin Oncol 30(29):3578–3587. https://doi.org/10.1200/JCO.2011.39.5640 CrossRefPubMedPubMedCentral

Gallicchio L, Calhoun C, Helzlsouer KJ (2013) Aromatase inhibitor therapy and hair loss among breast cancer survivors. Breast Cancer Res Treat 142(2):435–443. https://doi.org/10.1007/s10549-013-2744-2 CrossRefPubMed

Kenyon M, Mayer DK, Owens AK (2014) Late and long-term effects of breast cancer treatment and surveillance management for the general practitioner. J Obstet Gynecol Neonatal Nurs 43(3):382–398. https://doi.org/10.1111/1552-6909.12300 CrossRefPubMed

Runowicz CD, Leach CR, Henry NL, Henry KS, Mackey HT, Cowens-Alvarado RL, Cannady RS, Pratt-Chapman ML, Edge SB, Jacobs LA, Hurria A, Marks LB, LaMonte SJ, Warner E, Lyman GH, Ganz PA (2016) American Cancer Society/American Society of clinical oncology breast cancer survivorship care guideline. J Clin Oncol 34(6):611–635. https://doi.org/10.1200/JCO.2015.64.3809 CrossRefPubMed

Syrowatka A, Motulsky A, Kurteva S, Hanley JA, Dixon WG, Meguerditchian AN, Tamblyn R (2017) Predictors of distress in female breast cancer survivors: a systematic review. Breast Cancer Res Treat. https://doi.org/10.1007/s10549-017-4290-9 PubMedPubMedCentral

10.

Wen KY, Fang CY, Ma GX (2014) Breast cancer experience and survivorship among Asian Americans: a systematic review. J Cancer Surviv 8(1):94–107. https://doi.org/10.1007/s11764-013-0320-8 CrossRefPubMed

11.

Messina MJ, Loprinzi CL (2001) Soy for breast cancer survivors: a critical review of the literature. J Nutr 131(11):3095S–3108SCrossRefPubMed

12.

Setchell KDR, Cassidy A (1999) Dietary isoflavones: biological effects and relevance to human health. J Nutr 129(3):758CrossRef

13.

Jacobs A, Wegewitz U, Sommerfeld C, Grossklaus R, Lampen A (2009) Efficacy of isoflavones in relieving vasomotor menopausal symptoms - a systematic review. Mol Nutr Food Res 53(9):1084–1097. https://doi.org/10.1002/mnfr.200800552 CrossRefPubMed

14.

Kronenberg F, Fugh-Berman A (2002) Complementary and alternative medicine for menopausal symptoms: a review of randomized, controlled trials. Ann Intern Med 137(10):805–813CrossRefPubMed

15.

Messina M, Hughes C (2003) Efficacy of soyfoods and soybean isoflavone supplements for alleviating menopausal symptoms is positively related to initial hot flush frequency. J Med Food 6(1):1–11. https://doi.org/10.1089/109662003765184697 CrossRefPubMed

16.

Dorjgochoo T, Gu K, Zheng Y, Kallianpur A, Chen Z, Zheng W, Lu W, Shu XO (2011) Soy intake in association with menopausal symptoms during the first 6 and 36 months after breast cancer diagnosis. Breast Cancer Res Treat 130(3):879–889. https://doi.org/10.1007/s10549-010-1096-4 CrossRefPubMed

17.

Gold EB, Flatt SW, Pierce JP, Bardwell WA, Hajek RA, Newman VA, Rock CL, Stefanick ML (2006) Dietary factors and vasomotor symptoms in breast cancer survivors: the WHEL study. Menopause 13(3):423–433. https://doi.org/10.1097/01.gme.0000185754.85328.44 CrossRefPubMed

18.

MacGregor CA, Canney PA, Patterson G, McDonald R, Paul J (2005) A randomised double-blind controlled trial of oral soy supplements versus placebo for treatment of menopausal symptoms in patients with early breast cancer. Eur J Cancer 41(5):708–714. https://doi.org/10.1016/j.ejca.2005.01.005 CrossRefPubMed

19.

Nikander E, Kilkkinen A, Metsa-Heikkila M, Adlercreutz H, Pietinen P, Tiitinen A, Ylikorkala O (2003) A randomized placebo-controlled crossover trial with phytoestrogens in treatment of menopause in breast cancer patients. Obstet Gynecol 101(6):1213–1220PubMed

20.

Van Patten CL, Olivotto IA, Chambers GK, Gelmon KA, Hislop TG, Templeton E, Wattie A, Prior JC (2002) Effect of soy phytoestrogens on hot flashes in postmenopausal women with breast cancer: a randomized, controlled clinical trial. J Clin Oncol 20(6):1449–1455. https://doi.org/10.1200/JCO.2002.20.6.1449 CrossRefPubMed

21.

Keck AS, Finley JW (2004) Cruciferous vegetables: cancer protective mechanisms of glucosinolate hydrolysis products and selenium. Integr Cancer Ther 3:5–12CrossRefPubMed

22.

Fuentes F, Paredes-Gonzalez X, Kong AT (2015) Dietary glucosinolates sulforaphane, phenethyl isothiocyanate, indole-3-carbinol/3,3′-diindolylmethane: anti-oxidative stress/inflammation, Nrf2, epigenetics/epigenomics and in vivo cancer chemopreventive efficacy. Curr Pharmacol Rep 1(3):179–196. https://doi.org/10.1007/s40495-015-0017-y CrossRefPubMedPubMedCentral

23.

Higdon JV, Delage B, Williams DE, Dashwood RH (2007) Cruciferous vegetables and human cancer risk: epidemiologic evidence and mechanistic basis. Pharmacol Res 55(3):224–236. https://doi.org/10.1016/j.phrs.2007.01.009 CrossRefPubMedPubMedCentral

24.

Navarro SL, Schwarz Y, Song X, Wang CY, Chen C, Trudo SP, Kristal AR, Kratz M, Eaton DL, Lampe JW (2014) Cruciferous vegetables have variable effects on biomarkers of systemic inflammation in a randomized controlled trial in healthy young adults. J Nutr 144(11):1850–1857. https://doi.org/10.3945/jn.114.197434 CrossRefPubMedPubMedCentral

25.

Steinkellner H, Rabot S, Freywald C, Nobis E, Scharf G, Chabicovsky M, Knasmuller S, Kassie F (2001) Effects of cruciferous vegetables and their constituents on drug metabolizing enzymes involved in the bioactivation of DNA-reactive dietary carcinogens. Mutat Res 480–481:285–297CrossRefPubMed

26.

Tsuchiya Y, Nakajima M, Yokoi T (2005) Cytochrome P450-mediated metabolism of estrogens and its regulation in human. Cancer Lett 227(2):115–124. https://doi.org/10.1016/j.canlet.2004.10.007 CrossRefPubMed

27.

Zhang Y (2012) The molecular basis that unifies the metabolism, cellular uptake and chemopreventive activities of dietary isothiocyanates. Carcinogenesis 33(1):2–9. https://doi.org/10.1093/carcin/bgr255 CrossRefPubMed

28.

Portenoy RK, thaler HT, Kornblith AB, Lepore JM, Friedlander-Klar H, Kiyasu E, Sobel K, Coyle N, Kemeny N, Norton L (1994) The Memorial Symptom Assessment Scale: an instrument for the evaluation of symptom prevalence, characteristics and distress. Eur J Cancer 30A:1326–1336CrossRefPubMed

29.

Cella D, Land SR, Chang C-H, Day R, Costantino JP, Wolmark N, Ganz PA (2007) Symptom measurement in the Breast Cancer Prevention Trial (BCPT) (P-1): psychometric properties of a new measure of symptoms for midlife women. Breast Cancer Res Treat 109(3):515–526. https://doi.org/10.1007/s10549-007-9682-9 CrossRefPubMed

30.

Lam WWT, Law CC, Fu YT, Wong KH, Chang VT, Fielding R (2008) New insights in symptom assessment: the Chinese versions of the Memorial Symptom Assessment Scale Short Form (MSAS-SF) and the condensed MSAS (CMSAS). J Pain Symptom Manag 36(6):584–595. https://doi.org/10.1016/j.jpainsymman.2007.12.008 CrossRef

31.

Epplein M, Shu XO, Xiang YB, Chow WH, Yang G, Li HL, Ji BT, Cai H, Gao YT, Zheng W (2010) Fruit and vegetable consumption and risk of distal gastric cancer in the Shanghai women’s and men’s health studies. Am J Epidemiol 172(4):397–406. https://doi.org/10.1093/aje/kwq144 CrossRefPubMedPubMedCentral

32.

Fred Hutchinson Cancer Research Center (2010) Food frequency questionnaires. Fred Hutchinson Cancer Research Center. http://sharedresources.fhcrc.org/services/food-frequency-questionnaires-ffq. Accessed 2 May 2012

33.

Hakim IA, Hartz V, Harris RB, Balentine D, Weisgerber UM, Graver E, Whitacre R, Alberts D (2001) Reproducibility and relative validity of a questionnaire to assess intake of black tea polyphenols in epidemiological studies. Cancer Epidemiol Biomark Prev 10(6):667–678

34.

Thomson CA, Newton TR, Graver EJ, Jackson KA, Reid PM, Hartz VL, Cussler EC, Hakim IA (2007) Cruciferous vegetable intake questionnaire improves cruciferous vegetable intake estimates. J Am Diet Assoc 107(4):631–643. https://doi.org/10.1016/j.jada.2007.01.016 CrossRefPubMed

35.

Martinez ME, Marshall JR, Graver E, Whitacre RC, Woolf K, Ritenbaugh C, Alberts DS (1999) Reliability and validity of a self-administered food frequency questionnaire in a chemoprevention trial of adenoma recurrence. Cancer Epidemiol Biomark Prev 8(10):941–946

36.

Thomson CA, Giuliano A, Rock CL, Ritenbaugh CK, Flatt SW, Faerber S, Newman V, Caan B, Graver E, Hartz V, Whitacre R, Parker F, Pierce JP, Marshall JR (2003) Measuring dietary change in a diet intervention trial: comparing food frequency questionnaire and dietary recalls. Am J Epidemiol 157(8):754–762CrossRefPubMed

37.

Bhagwat S HD, Holden JM, (2008) USDA Database for the Isoflavone Content of Selected Foods, Release 2.0. U.S. department of agriculture. https://www.ars.usda.gov/northeast-area/beltsville-md/beltsville-human-nutrition-research-center/nutrient-data-laboratory/docs/usda-database-for-the-isoflavone-content-of-selected-foods-release-20/. Accessed 15 August 2016

38.

McNaughton SA, Marks GC (2003) Development of a food composition database for the estimation of dietary intakes of glucosinolates, the biologically active constituents of cruciferous vegetables. Br J Nutr 90(03):687–697. https://doi.org/10.1079/BJN2003917 CrossRefPubMed

39.

Craig CL, Marshall AL, Sjostrom M, Bauman AE, Booth ML, Ainsworth BE, Pratt M, Ekelund U, Yngve A, Sallis JF, Oja P (2003) International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exercise 35:1381–1395CrossRef

40.

Macfarlane DJ, Lee CCY, Ho EYK, Chan KL, Chan DTS (2007) Reliability and validity of the Chinese version of IPAQ (short, last 7 days). J Sci Med Sport 10(1):45–51. https://doi.org/10.1016/j.jsams.2006.05.003 CrossRefPubMed

41.

Guidelines for Data Processing and Analysis of the International Physical Activity Questionnaire (IPAQ) (2005). https://docs.google.com/viewer?a=v&pid=sites&srcid=ZGVmYXVsdGRvbWFpbnx0aGVpcGFxfGd4OjE0NDgxMDk3NDU1YWRlZTM. Accessed 5 Oct 2015

42.

Thomson C, Rock C, Thompson P, Caan B, Cussler E, Flatt S, Pierce J (2011) Vegetable intake is associated with reduced breast cancer recurrence in tamoxifen users: a secondary analysis from the women’s healthy eating and living study. Breast Cancer Res Treat 125(2):519–527. https://doi.org/10.1007/s10549-010-1014-9 CrossRefPubMed

43.

Comhaire FH, Depypere HT (2015) Hormones, herbal preparations and nutriceuticals for a better life after the menopause: part II. Climacteric 18(3):364–371. https://doi.org/10.3109/13697137.2014.985646 CrossRefPubMed

44.

Comhaire FH, Depypere HT (2015) Hormones, herbal preparations and nutriceuticals for a better life after the menopause: part I. Climacteric 18(3):358–363. https://doi.org/10.3109/13697137.2014.985645 CrossRefPubMed

45.

Medina D (2005) Mammary developmental fate and breast cancer risk. Endocr-Relat Cancer 12(3):483–495. https://doi.org/10.1677/erc.1.00804 CrossRefPubMed

46.

Fritz H, Seely D, Flower G, Skidmore B, Fernandes R, Vadeboncoeur S, Kennedy D, Cooley K, Wong R, Sagar S, Sabri E, Fergusson D (2013) Soy, red clover, and isoflavones and breast cancer: a systematic review. PLoS ONE 8(11):e81968. https://doi.org/10.1371/journal.pone.0081968 CrossRefPubMedPubMedCentral

47.

Nechuta SJ, Caan BJ, Chen WY, Lu W, Chen Z, Kwan ML, Flatt SW, Zheng Y, Zheng W, Pierce JP, Shu XO (2012) Soy food intake after diagnosis of breast cancer and survival: an in-depth analysis of combined evidence from cohort studies of US and Chinese women. Am J Clin Nutr 96(1):123–132. https://doi.org/10.3945/ajcn.112.035972 CrossRefPubMedPubMedCentral

48.

Kang X, Zhang Q, Wang S, Huang X, Jin S (2010) Effect of soy isoflavones on breast cancer recurrence and death for patients receiving adjuvant endocrine therapy. Can Med Association J 182(17):1857–1862. https://doi.org/10.1503/cmaj.091298 CrossRef

49.

Shu XO, Zheng Y, Cai H, Gu K, Chen Z, Zheng W, Lu W (2009) Soy foods intake and breast cancer survival. JAMA 302:2437–2443CrossRefPubMedPubMedCentral

50.

Fink BN, Steck SE, Wolff MS, Britton JA, Kabat GC, Gaudet MM, Abrahamson PE, Bell P, Schroeder JC, Teitelbaum SL, Neugut AI, Gammon MD (2007) Dietary flavonoid intake and breast cancer survival among women on Long Island. Cancer Epidemiol Biomark Prev 16(11):2285–2292. https://doi.org/10.1158/1055-9965.epi-07-0245 CrossRef

51.

Zhang YF, Kang HB, Zhang RM (2012) Positive effects of soy isoflavone food on survival of breast cancer patients in China. Asian Pac J Cancer Prev 13:479–482CrossRefPubMed

52.

Freedman RR (2014) Menopausal hot flashes: mechanisms, endocrinology, treatment. J Steroid Biochem Mol Biol 142:115–120. https://doi.org/10.1016/j.jsbmb.2013.08.010 CrossRefPubMed

53.

Liu ZM, Ho SC, Woo J, Chen YM, Wong C (2014) Randomized controlled trial of whole soy and isoflavone daidzein on menopausal symptoms in equol-producing Chinese postmenopausal women. Menopause 21(6):653–660. https://doi.org/10.1097/GME.0000000000000102 CrossRefPubMed

54.

Ye YB, Wang ZL, Zhuo SY, Lu W, Liao HF, Verbruggen M, Fang S, Mai HY, Chen YM, Su YX (2012) Soy germ isoflavones improve menopausal symptoms but have no effect on blood lipids in early postmenopausal Chinese women: a randomized placebo-controlled trial. Menopause 19(7):791–798. https://doi.org/10.1097/gme.0b013e31823dbeda CrossRefPubMed

55.

Franco OH, Chowdhury R, Troup J et al (2016) Use of plant-based therapies and menopausal symptoms: a systematic review and meta-analysis. JAMA 315(23):2554–2563. https://doi.org/10.1001/jama.2016.8012 CrossRefPubMed

56.

Quella SK, Loprinzi CL, Barton DL, Knost JA, Sloan JA, LaVasseur BI, Swan D, Krupp KR, Miller KD, Novotny PJ (2000) evaluation of soy phytoestrogens for the treatment of hot flashes in breast cancer survivors: a North Central Cancer Treatment Group trial. J Clin Oncol 18(5):1068CrossRefPubMed

57.

Adlercreutz H, Fotsis T, Bannwart C, Wahala K, Makela T, Brunow G, Hase T (1986) Determination of urinary lignans and phytoestrogen metabolites, potential antiestrogens and anticarcinogens, in urine of women on various habitual diets. J Steroid Biochem 25(5B):791–797CrossRefPubMed

58.

Ishiwata N, Melby MK, Mizuno S, Watanabe S (2009) New equol supplement for relieving menopausal symptoms: randomized, placebo-controlled trial of Japanese women. Menopause 16(1):141–148. https://doi.org/10.1097/gme.0b013e31818379fa CrossRefPubMed

59.

Zhao J, Harada N, Kurihara H, Nakagata N, Okajima K (2011) Dietary isoflavone increases insulin-like growth factor-I production, thereby promoting hair growth in mice. J Nutr Biochem 22(3):227–233. https://doi.org/10.1016/j.jnutbio.2010.01.008 CrossRefPubMed

60.

Ding J, Xi Y-D, Zhang D-D, Zhao X, Liu J-M, Li C-Q, Han J, Xiao R (2013) Soybean isoflavone ameliorates β-amyloid 1-42-induced learning and memory deficit in rats by protecting synaptic structure and function. Synapse 67(12):856–864. https://doi.org/10.1002/syn.21692 CrossRefPubMed

61.

Yuan-Di X, Xiao-Ying L, Juan D, Huan-Ling Y, Wei-Wei M, Lin-Hong Y, Jian W, Rong X (2013) Soy isoflavone alleviates Aβ1-42-induced impairment of learning and memory ability through the regulation of RAGE/LRP-1 in neuronal and vascular tissue. Curr Neurovascular Res 10(2):144–156. https://doi.org/10.2174/1567202611310020007 CrossRef

62.

Cheng PF, Chen JJ, Zhou XY, Ren YF, Huang W, Zhou JJ, Xie P (2015) Do soy isoflavones improve cognitive function in postmenopausal women? a meta-analysis. Menopause 22:198–206CrossRefPubMed

63.

Herber-Gast GC, Mishra GD (2013) Fruit, Mediterranean-style, and high-fat and -sugar diets are associated with the risk of night sweats and hot flushes in midlife: results from a prospective cohort study. Am J Clin Nutr 97(5):1092–1099. https://doi.org/10.3945/ajcn.112.049965 CrossRefPubMed

Title: Dietary intake of soy and cruciferous vegetables and treatment-related symptoms in Chinese-American and non-Hispanic White breast cancer survivors
Authors: Sarah J. O. Nomura
Yi-Ting Hwang
Scarlett Lin Gomez
Teresa T. Fung
Shu-Lan Yeh
Chiranjeev Dash
Laura Allen
Serena Philips
Leena Hilakivi-Clarke
Yun-Ling Zheng
Judy Huei-yu Wang
Publication date: 01-04-2018
Publisher: Springer US
Published in: Breast Cancer Research and Treatment / Issue 2/2018
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI: https://doi.org/10.1007/s10549-017-4578-9

Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras

Prof. Fabrice Barlesi

Developed by: Springer Medicine

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 2/2018

Advantages with prophylactic PEG-rhG-CSF versus rhG-CSF in breast cancer patients receiving multiple cycles of myelosuppressive chemotherapy: an open-label, randomized, multicenter phase III study

Enrichment of high-grade tumors in breast cancer gene expression studies

CD14+ HLA-DR−/low MDSCs are elevated in the periphery of early-stage breast cancer patients and suppress autologous T cell proliferation

Characterization of a novel germline BRCA1 splice variant, c.5332+4delA

Associations between ALDH1A1 polymorphisms, alcohol consumption, and mortality among Hispanic and non-Hispanic white women diagnosed with breast cancer: the Breast Cancer Health Disparities Study

Relevant factors for the optimal duration of extended endocrine therapy in early breast cancer

Keynote webinar | Spotlight on antibody–drug conjugates in cancer