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To the Editor: In their study of phytoestrogens and risk of lung cancer, Dr Schabath and colleagues¹ report on the intake of lignans in a US population. Their results, while interesting, are discrepant with those of other studies.

In their article, the total intake of lignans was calculated as the sum of the plant lignans secoisolariciresinol and matairesinol and the mammalian enterolignans enterodiol and enterolactone. Enterolignans are not present in foods but can be determined via in vitro fermentation. Enterolignans are formed by bacteria in the colon at the expense of plant lignans. Summing plant lignans and enterolignans counts food contribution to the lignan intake twice. As a result, the estimates of total lignan intakes and the odds ratios based on these (in Tables 2, 4, and 6) may be biased.

Apart from secoisolariciresinol and matairesinol, other plant lignans can also be converted to enterolignans. We determined the intake of . . . [Full Text of this Article]

Peter C. H. Hollman, PhD
peter.hollman@wur.nl
RIKILT-Institute of Food Safety
Wageningen, the Netherlands

Ivon E. J. Milder, MSc
Centre for Nutrition and Health
National Institute for Public Health
Bilthoven, the Netherlands

Ilja C. W. Arts, PhD
RIKILT-Institute of Food Safety

Edith J. M. Feskens, PhD
Division of Human Nutrition and Epidemiology
Wageningen University
Wageningen, the Netherlands

H. Bas Bueno de Mesquita, PhD
Centre for Nutrition and Health
National Institute for Public Health
Bilthoven, the Netherlands

Daan Kromhout, PhD, MPH
Division of Human Nutrition and Epidemiology
Wageningen University

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