Effects of dietary intervention on IGF-I and IGF-binding proteins, and related alterations in sex steroid metabolism: the Diet and Androgens (DIANA) Randomised Trial
Abstract
Objective To assess the effects of a comprehensive change in dietary composition on endogenous hormone metabolism. The specific aim was to examine whether this intervention could lead to favourable changes in insulin sensitivity, levels of IGF-I and IGF-binding proteins (IGFBPs), and total and bioavailable testosterone and estradiol, that would be expected to reduce breast cancer risk.Design Randomised dietary intervention study; duration of 5 months.Subjects From a total of 99 postmenopausal women, who had elevated baseline plasma testosterone levels, 49 women were randomly assigned to the dietary intervention arm and the other 50 to a control group.Interventions Main aspects of the dietary intervention were reductions in the intake of total fat and refined carbohydrates, an increase in the ratio of n-3 over n-6 plus saturated fatty acids, and increased intakes of foods rich in dietary fibre and phytooestrogens.Results Relative to the control group, women of the intervention group showed a significant reduction of body weight, waist circumference, fasting serum levels of testosterone, C peptide, glucose, and insulin area after glucose tolerance test, and a significant increase of serum levels of sex hormone-binding globulin, IGFBP-1, -2, and growth hormone-binding protein. Serum levels of IGF-I did not change.Conclusion This comprehensive dietary intervention strategy proved to be successful in inducing changes in endogenous hormone metabolism that might eventually result in reduced breast cancer risk. Additional studies are needed to show whether the dietary intervention and related hormonal changes can be both maintained over longer periods, of at least several years.
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In a 5-month study, women randomized to an ad libitum modified Mediterranean diet lost almost 4 kg.
“For example, in a 5-month study, women randomized to an ad libitum modified Mediterranean diet lost almost 4 kg (66).”
From Health Benefits of the Mediterranean Diet: Metabolic and Molecular Mechanisms (2018) · cites this paper as [66]
Women on the Mediterranean diet had a significant elevation of the plasma concentration of IGFBP-1, IGFBP-2, and SHBG, resulting in a reduction of the biological activity of IGF-1, testosterone, and estradiol.
“Moreover, the women on the Mediterranean diet had a significant elevation of the plasma concentration of several binding proteins, such as IGFBP-1, IGFBP-2, and SHBG, resulting in a reduction of the biological activity of insulin-like growth factor 1 (IGF-1), testosterone, and estradiol (66).”
From Health Benefits of the Mediterranean Diet: Metabolic and Molecular Mechanisms (2018) · cites this paper as [66]
The reduction in body fat induced by the low-energy density high-fiber Mediterranean diet explains most of the improvement in insulin sensitivity, because the beneficial effects on insulin were no longer statistically significant after adjustment for changes in weight and/or waist circumference.
“Most likely, the reduction in body fat induced by this low-energy density high-fiber Mediterranean diet explains most of the improvement in insulin sensitivity, because the beneficial effects on insulin were no longer statistically significant after adjustment for changes in weight and/or waist circumference (66).”
From Health Benefits of the Mediterranean Diet: Metabolic and Molecular Mechanisms (2018) · cites this paper as [66]
Individuals randomized to an ad libitum modified Mediterranean diet lost a significant amount of body weight and experienced a substantial reduction in fasting glucose and C-peptide, in the area under the curve for insulin, and in total and free testosterone.
“Importantly, the individuals randomized to the ad libitum modified Mediterranean diet not only lost a significant amount of body weight, but experienced a substantial reduction in fasting glucose and C-peptide, in the area under the curve for insulin, and in total and free testosterone (66).”
From Health Benefits of the Mediterranean Diet: Metabolic and Molecular Mechanisms (2018) · cites this paper as [66]
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References 65 · Cited by 120
- Authors
- Kaaks, R., Bellati, C., Venturelli, E., Rinaldi, S., Secreto, G., Biessy, C., Pala, V, Sieri, S., & Berrino, F.
- Affiliations
- Centre international de recherche sur le cancer (FR)
- Fondazione IRCCS Istituto Nazionale dei Tumori (IT)
- Corresponding author
- Kaaks, R
- Venue
- European Journal of Clinical Nutrition
- Published
- 2003-08-29
- Volume
- 57
- Issue
- 9
- Pages
- 1079-1088
- ISSN
- 0954-3007 (ISSN-L)
- 1476-5640
- OpenAlex
- W2091054642
- Cited by
- 120
- References
- 65
- Citations by year
- 2026: 2 · 2025: 5 · 2024: 5 · 2023: 9 · 2022: 3 · 2021: 6 · 2020: 2 · 2019: 3 · 2018: 2 · 2017: 5 · 2016: 1 · 2015: 3 · 2014: 4 · 2013: 8 · 2012: 3
- FWCI
- 4.27
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Journal of Clinical Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Growth Hormone and Insulin-like Growth Factors
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Medicine › Oncology › Cancer Risks and Factors
- Keywords
- dietary intervention, insulin-like growth factor I, IGF binding proteins, sex steroid metabolism, testosterone, estradiol, sex hormone-binding globulin, insulin sensitivity, postmenopausal women, breast cancer risk, dietary fiber, phytoestrogens, weight loss, hyperandrogenism
- MeSH terms
- Aged, Analysis of Variance, Anthropometry, Body Weight, Diet, Female, Humans, Insulin-Like Growth Factor I, Italy, Middle Aged, Reference Values, Gonadal Steroid Hormones, Diet, Vegetarian, Postmenopause, Statistics, Nonparametric, Insulin-Like Growth Factor Binding Proteins
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