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=Hot Flash and Diet= The term vasomotor symptom is the same as hot flash symptom. Menopausal women who experience mild hot flashes might be seeking alternative options other than pharmacological routes to reduce their symptoms. Are there foods that can alleviate or exacerbate the intensity and/or frequency of hot flash symptoms? The results from following studies showed whether consuming dietary products such as phytoestrogens, isoflavones, coumestrol, lignans, and/or dietary fiber can reduce the intensity and/or frequency of hot flash symptoms.

Secoisolariciresinol diglucoside (SDG) is a major lignan whereas matairesinol is a minor lignan, and both are found in foods. Secoisolariciresinol diglucoside (SDG) and matairesinol were the first lignan precursors to be identified in human diets and became popular among researchers. They are known as phytoestrogenes or “dietary estrogens”. Their chemical structures are similar to endogenous estrogen and can deliver or act as estrogen-like effects. They are nonsteroidal plants with similar structural compounds as 17-B-estradiol. This structure can act as estrogenic and/or antiestrogenic effects.

STUDIES:
This was a Longitudinal Study of Women’s Health, as part of multiracial/ethnic cohort research. There were 3,302 premenopausal and early premenopausal women. At baseline, 1,651 (or 50%) did not experience vasomotor symptoms. The participants completed a food frequency and vasomotor symptoms questionnaire and were followed annually for ten years. Dietary questionnaires included intakes of isoflavones, coumestrol, lignans, and fiber. The results from the study showed inconsistent findings between vasomotor symptoms and intakes of any dietary phytoestrogen and/or dietary fiber. The results showed dietary phytoestrogen did not improve the intensity of vasomotor symptoms. However, increased dietary phytoestrogen and/or dietary fiber might have decreased the frequency of vasomotor symptoms slightly. This study was a phase III, randomized, placebo controlled trial to determine the efficacy of flaxseed and hot flash symptoms. There were 188 postmenopausal women, who were randomly assigned to receive flaxseed bars (7.5 grams of flaxseed or 5% lignans which contained 410 mg of lignans and 20% dietary fiber) or to receive the placebo bars (20% fiber; no lignans). The women kept daily hot flash records for six weeks. The study revealed the mean frequency of hot flashes decreased by 4.9 (flaxseed group) compared to 3.5 (placebo group). The flaxseed group improved slightly better than placebo group. Both groups reported side effects: abdominal distension, flatulence, diarrhea, and nausea. A pilot trial (Phase II) included 30 women. The women received 40 grams of flaxseed (1% SDG =400 mg of lignans) to add to their foods. The result showed a mean decrease in daily hot flash frequency by 50%. This study investigated complementary and alternative medicine (CAM) remedies for reducing Low Density Lipoprotein (LD), total cholesterol, bone mineral density, and hot flash symptoms. In regards to phytoestrogen and hot flash improvement, the authors indicated phytoestrogen extracts such as isoflavones and lignans showed minimal effect on hot flash reduction. However, both isoflavones and lignans provided health benefits such as improved serum lipids and decreased bone mass loss. This study was a double-blind, placebo-controlled, randomized clinical trial involving 38 postmenopausal women (1-10 years). The participants of group A ate 2 slices of bread (25 grams of flaxseed or 46 milligrams of lignans) daily. Group B ate wheat bran (< 1mg lignans) daily. The duration of the study was 12 weeks. There was no significant difference between the two groups. This article discussed the efficacy of flaxseed meal and flaxseed extract in reducing climacteric symptoms. The 90 menopausal women were randomly divided into 3 study groups: Group 1 received one gram per day of flaxseed extract (at least 100 mg of SDG; 500 mg capsules twice daily). Group 2 received 90 grams of flaxseed meal (270 mg of SDG; ground whole flaxseed 2 tablespoons). Group 3 received 1 gram of collagen (two 500 mg capsules of collagen; placebo group). The duration of the study was six months. The results showed a reduction in the intensity of hot flashes but not the frequency. The placebo group showed minimal changes. The bioactivity of lignans from flaxseed relies on the gut bacterial transformation. Future studies should obtain the plasma levels of lignans in order to evaluate the absorption and metabolism of lignans.

SUMMARY:
The findings from these studies remain inconclusive and inconsistent. There are inconsistent and insufficient data to support the association among phytoestrogen, isoflavones, lignans, and dietary fiber and hot flash symptom reduction. Some studies found the subjects who received lignan in a form of flaxseed showed slight improvement with their hot flash symptoms. Furthermore, the duration of the studies was short because of the large consumption of flaxseed accompanied with the gastrointestinal side effects. More studies are warranted to further assess the effectiveness on specific foods and hot flash symptom reductions.

Foods that aggravate hot flash symptoms
According to the North American Menopause Society (NAMS) there are foods and some unhealthy lifestyle habits that can aggravate or trigger hot flashes such as: hot/spicy foods, alcohol, or caffeine.

Weight status and hot flash symptoms
Women who are overweight or obese, a gradual weight loss, can have potential benefits for menopausal symptom reduction.

Lignan Content Table
Modified From Adlercreutz et al. Ann Med 1997; 29:95