Consumption of Flavonoids and Risk of Hormone-related Cancers: a Systematic Review and Meta-analysis of Observational Studies

Overview

Journal Nutr J

Publisher Biomed Central

Specialty Nutritional Sciences

Date 2022 May 11

PMID 35545772

Authors

Fubin Liu

Yu Peng

Yating Qiao

Yubei Huang

Fengju Song

Ming Zhang

Fangfang Song

Affiliations

Soon will be listed here.

Abstract

Background: Flavonoids seem to have hormone-like and anti-hormone properties so that the consumption of flavonoids may have potential effects on hormone-related cancers (HRCs), but the findings have been inconsistent so far. This meta-analysis was aimed to explore the association between flavonoids intake and HRCs risk among observational studies.

Methods: Qualified articles, published on PubMed, EMBASE, and China National Knowledge Infrastructure (CNKI) from January 1999 to March 2022 and focused on relationships between flavonoids (total, subclass of and individual flavonoids) and HRCs (breast, ovarian, endometrial, thyroid, prostate and testicular cancer), were retrieved for pooled analysis. Random effects models were performed to calculate the pooled odds ratios (ORs) and corresponding 95% confidence intervals (CIs). Funnel plots and Begg's/Egger's test were used to evaluate the publication bias. Subgroup analyses and sensitivity analyses were conducted to explore the origins of heterogeneity.

Results: All included studies were rated as medium or high quality. Higher consumption of flavonols (OR = 0.85, 95% CI: 0.76-0.94), flavones (OR = 0.85, 95% CI: 0.77-0.95) and isoflavones (OR = 0.87, 95% CI: 0.82-0.92) was associated with a decreased risk of women-specific cancers (breast, ovarian and endometrial cancer), while the higher intake of total flavonoids was linked to a significantly elevated risk of prostate cancer (OR = 1.11, 95% CI: 1.02-1.21). A little evidence implied that thyroid cancer risk was augmented with the higher intake of flavones (OR = 1.24, 95% CI: 1.03-1.50) and flavanones (OR = 1.31, 95% CI: 1.09-1.57).

Conclusions: The present study suggests evidence that intake of total flavonoids, flavonols, flavones, flavanones, flavan-3-ols and isoflavones would be associated with a lower or higher risk of HRCs, which perhaps provides guidance for diet guidelines to a certain extent.

Trial Registration: This protocol has been registered on PROSPERO with registration number CRD42020200720 .

Citing Articles

Isoflavones: Promising Natural Agent for Cancer Prevention and Treatment.

Ul Hassan M, Shahbaz M, Imran M, Momal U, Naeem H, Mujtaba A Food Sci Nutr. 2025; 13(3):e70091.

PMID: 40078339 PMC: 11896816. DOI: 10.1002/fsn3.70091.

Targeting serotonin receptors with phytochemicals - an in-silico study.

Elalouf A, Rosenfeld A, Maoz H Sci Rep. 2024; 14(1):30307.

PMID: 39638796 PMC: 11621125. DOI: 10.1038/s41598-024-76329-6.

Association between dietary intake of flavonoid and chronic kidney disease in US adults: Evidence from NHANES 2007-2008, 2009-2010, and 2017-2018.

Liu P, Peng W, Hu F, Li G PLoS One. 2024; 19(8):e0309026.

PMID: 39190642 PMC: 11349111. DOI: 10.1371/journal.pone.0309026.

Non-genetic factors and breast cancer: an umbrella review of meta-analyses.

Yiallourou A, Pantavou K, Markozannes G, Pilavas A, Georgiou A, Hadjikou A BMC Cancer. 2024; 24(1):903.

PMID: 39061008 PMC: 11282738. DOI: 10.1186/s12885-024-12641-8.

Risk factors for prostate cancer: An umbrella review of prospective observational studies and mendelian randomization analyses.

Cui H, Zhang W, Zhang L, Qu Y, Xu Z, Tan Z PLoS Med. 2024; 21(3):e1004362.

PMID: 38489391 PMC: 10980219. DOI: 10.1371/journal.pmed.1004362.

References

Ren W, Qiao Z, Wang H, Zhu L, Zhang L . Flavonoids: promising anticancer agents. Med Res Rev. 2003; 23(4):519-34. DOI: 10.1002/med.10033. View

Zand R, Jenkins D, Diamandis E . Steroid hormone activity of flavonoids and related compounds. Breast Cancer Res Treat. 2000; 62(1):35-49. DOI: 10.1023/a:1006422302173. View

Denison M, Tachibana H, Yamada K . Relationship between estrogen receptor-binding and estrogenic activities of environmental estrogens and suppression by flavonoids. Biosci Biotechnol Biochem. 2002; 66(7):1479-87. DOI: 10.1271/bbb.66.1479. View

Dong J, Qin L . Soy isoflavones consumption and risk of breast cancer incidence or recurrence: a meta-analysis of prospective studies. Breast Cancer Res Treat. 2010; 125(2):315-23. DOI: 10.1007/s10549-010-1270-8. View

Corcoran M, McKay D, Blumberg J . Flavonoid basics: chemistry, sources, mechanisms of action, and safety. J Nutr Gerontol Geriatr. 2012; 31(3):176-89. DOI: 10.1080/21551197.2012.698219. View

Hui C, Qi X, Qianyong Z, Xiaoli P, Jundong Z, Mantian M . Flavonoids, flavonoid subclasses and breast cancer risk: a meta-analysis of epidemiologic studies. PLoS One. 2013; 8(1):e54318. PMC: 3548848. DOI: 10.1371/journal.pone.0054318. View

Zamora-Ros R, Cayssials V, Franceschi S, Kyro C, Weiderpass E, Hennings J . Polyphenol intake and differentiated thyroid cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Int J Cancer. 2019; 146(7):1841-1850. DOI: 10.1002/ijc.32589. View

DerSimonian R, Laird N . Meta-analysis in clinical trials. Control Clin Trials. 1986; 7(3):177-88. DOI: 10.1016/0197-2456(86)90046-2. View

Chang E, Lee V, Canchola A, Clarke C, Purdie D, Reynolds P . Diet and risk of ovarian cancer in the California Teachers Study cohort. Am J Epidemiol. 2007; 165(7):802-13. PMC: 2093945. DOI: 10.1093/aje/kwk065. View

10.

Nagata Y, Sonoda T, Mori M, Miyanaga N, Okumura K, Goto K . Dietary isoflavones may protect against prostate cancer in Japanese men. J Nutr. 2007; 137(8):1974-9. DOI: 10.1093/jn/137.8.1974. View

11.

Rossi M, Edefonti V, Parpinel M, Lagiou P, Franchi M, Ferraroni M . Proanthocyanidins and other flavonoids in relation to endometrial cancer risk: a case-control study in Italy. Br J Cancer. 2013; 109(7):1914-20. PMC: 3790154. DOI: 10.1038/bjc.2013.447. View

12.

Luo J, Gao Y, Chow W, Shu X, Li H, Yang G . Urinary polyphenols and breast cancer risk: results from the Shanghai Women's Health Study. Breast Cancer Res Treat. 2009; 120(3):693-702. PMC: 2842475. DOI: 10.1007/s10549-009-0487-x. View

13.

Van Weelden W, Massuger L, Pijnenborg J, Romano A . Anti-estrogen Treatment in Endometrial Cancer: A Systematic Review. Front Oncol. 2019; 9:359. PMC: 6513972. DOI: 10.3389/fonc.2019.00359. View

14.

Walcott F, Hauptmann M, Duphorne C, Pillow P, Strom S, Sigurdson A . A case-control study of dietary phytoestrogens and testicular cancer risk. Nutr Cancer. 2003; 44(1):44-51. DOI: 10.1207/S15327914NC441_6. View

15.

Grosso G, Godos J, Lamuela-Raventos R, Ray S, Micek A, Pajak A . A comprehensive meta-analysis on dietary flavonoid and lignan intake and cancer risk: Level of evidence and limitations. Mol Nutr Food Res. 2016; 61(4). DOI: 10.1002/mnfr.201600930. View

16.

Nielsen A, McNulty J . Polyphenolic natural products and natural product-inspired steroidal mimics as aromatase inhibitors. Med Res Rev. 2018; 39(4):1274-1293. DOI: 10.1002/med.21536. View

17.

Zheng W, Dai Q, Custer L, Shu X, Wen W, Jin F . Urinary excretion of isoflavonoids and the risk of breast cancer. Cancer Epidemiol Biomarkers Prev. 1999; 8(1):35-40. View

18.

Wang L, Lee I, Zhang S, Blumberg J, Buring J, Sesso H . Dietary intake of selected flavonols, flavones, and flavonoid-rich foods and risk of cancer in middle-aged and older women. Am J Clin Nutr. 2009; 89(3):905-12. PMC: 2667658. DOI: 10.3945/ajcn.2008.26913. View

19.

Neill A, Ibiebele T, Lahmann P, Hughes M, Nagle C, Webb P . Dietary phyto-oestrogens and the risk of ovarian and endometrial cancers: findings from two Australian case-control studies. Br J Nutr. 2013; 111(8):1430-40. DOI: 10.1017/S0007114513003899. View

20.

Perez-Cornago A, Appleby P, Boeing H, Gil L, Kyro C, Ricceri F . Circulating isoflavone and lignan concentrations and prostate cancer risk: a meta-analysis of individual participant data from seven prospective studies including 2,828 cases and 5,593 controls. Int J Cancer. 2018; 143(11):2677-2686. PMC: 6283047. DOI: 10.1002/ijc.31640. View