Urinary phytoestrogens in relation to metabolic disturbances among children and adolescents

Previous studies have examined whether phytoestrogens affect glucose and lipid metabolism. However, data on children and adolescents are still limited, with most of the evidence pertaining to one phytoestrogen, namely genistein. To investigate the effect of six phytoestrogens [daidezin, enterodiol, enterolactone, equol, genistein and O-Desmethylangolensin (O-DMA)] on metabolic disturbances among youths, a cross-sectional study was conducted using a sample of 2,429 children and adolescents, 6-18 years, from the 2009-2010 National Health and Nutrition Examination Surveys (NHANES). The main outcome measures were body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), high-density lipoprotein (HDL-C), low-density lipoprotein (LDL-C) and total cholesterol (TC), fasting glucose, triglycerides and glycohemoglobin. SBP was inversely related to enterolactone and equol. Triglycerides were inversely related to daidezin, equol, genistein and O-DMA. Whereas TC and LDL-C were inversely related to equol, an HDL-C was inversely related to genistein and O-DMA. Whereas fasting glucose was associated with enterodiol (β = 0.33, 95% CI: 0.028, 0.63), a positive relationship was observed between enterodiol and risk of HDL-C ≥ 35 mg dl(-1) (β = 0.04, 95% CI: 0.01, 0.07). In conclusion, certain phytoestrogens may contribute either positively or negatively to disturbances in lipid and glucose metabolism. Large prospective cohort studies are needed to confirm our study findings.