The clinical importance of the metabolite equol-a clue to the effectiveness of soy and its isoflavones
Open accessAbstract
Equol [7-hydroxy-3-(4'-hydroxyphenyl)-chroman] is a nonsteroidal estrogen of the isoflavone class. It is exclusively a product of intestinal bacterial metabolism of dietary isoflavones and it possesses estrogenic activity, having affinity for both estrogen receptors, ERalpha and ERbeta. Equol is superior to all other isoflavones in its antioxidant activity. It is the end product of the biotransformation of the phytoestrogen daidzein, one of the two main isoflavones found in abundance in soybeans and most soy foods. Once formed, it is relatively stable; however, equol is not produced in all healthy adults in response to dietary challenge with soy or daidzein. Several recent dietary intervention studies examining the health effects of soy isoflavones allude to the potential importance of equol by establishing that maximal clinical responses to soy protein diets are observed in people who are good "equol-producers." It is now apparent that there are two distinct subpopulations of people and that "bacterio-typing" individuals for their ability to make equol may hold the clue to the effectiveness of soy protein diets in the treatment or prevention of hormone-dependent conditions. In reviewing the history of equol, its biological properties, factors influencing its formation and clinical data, we propose a new paradigm. The clinical effectiveness of soy protein in cardiovascular, bone and menopausal health may be a function of the ability to biotransform soy isoflavones to the more potent estrogenic isoflavone, equol. The failure to distinguish those subjects who are "equol-producers" from "nonequol producers" in previous clinical studies could plausibly explain the variance in reported data on the health benefits of soy.
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Daidzin and genistin, glycoside isoflavones, are converted to daidzein and genistein by bacterial beta-glucosidases, with the important estrogen equol being the end product following further biotransformation of daidzein.
“Daidzin and genistin, glycoside isoflavones, are converted to daidzein and genistein by bacterial b-glucosidases, with the important estrogen equol being the end product following further biotransformation of daidzein (Setchell et al., 2002).”
From Gut reactions: Breaking down xenobiotic–microbiome interactions (2019) · cites this paper as Setchell et al., 2002
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- Authors
- Setchell, K. D. R., Brown, N. M., & Lydeking-Olsen, E.
- Affiliations
- Cincinnati Children's Hospital Medical Center (US)
- Corresponding author
- Setchell, Kenneth D.R.
- Venue
- The Journal of Nutrition
- Publisher
- Elsevier BV
- Published
- 2002-12
- Volume
- 132
- Issue
- 12
- Pages
- 3577-3584
- ISSN
- 0022-3166 (ISSN-L)
- OpenAlex
- W2114379216
- Cited by
- 1,209
- References
- 121
- Citations by year
- 2026: 29 · 2025: 30 · 2024: 30 · 2023: 31 · 2022: 37 · 2021: 41 · 2020: 38 · 2019: 42 · 2018: 43 · 2017: 35 · 2016: 50 · 2015: 39 · 2014: 66 · 2013: 66 · 2012: 73
- FWCI
- 7.18
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5r01ca073328-03, 5r01ca056303-03, RR08084)
- National Cancer Institute (R01CA73328, R01CA56303)
- National Center for Research Resources (M01RR008084, RR08084)
- Topics
- Health Sciences › Medicine › Pathology and Forensic Medicine › Phytoestrogen effects and research
- Health Sciences › Medicine › Biochemistry › Phytochemicals and Antioxidant Activities
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Estrogen and related hormone effects
- Keywords
- equol, soy isoflavones, daidzein, gut microbiota, phytoestrogens, estrogen receptor alpha, estrogen receptor beta, antioxidant activity, soy protein, equol producers, menopausal health, bone health, cardiovascular health, hormone-dependent diseases
- MeSH terms
- Adult, Animals, Chromans, Estrogens, Non-Steroidal, Humans, Isoflavones, Glycine max, Equol
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