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Isabel Drake

Isabel Drake

Associate professor

Isabel Drake

Plasma enterolactone and risk of prostate cancer in middle-aged Swedish men


  • Peter Wallström
  • Isabel Drake
  • Emily Sonestedt
  • Bo Gullberg
  • Anders Bjartell
  • Håkan Olsson
  • Herman Adlercreutz
  • Matti J Tikkanen
  • Elisabet Wirfält

Summary, in English

Purpose: Enterolactone (ENL) is formed in the human gut after consumption of lignans, has estrogenic properties, and has been associated with risk of prostate cancer. We examined the association between plasma ENL levels and prostate cancer in a nested case–control study within the population-based Malmö Diet and Cancer cohort. We also examined the association between plasma ENL and dietary and lifestyle factors. Methods: The study population consisted of 1010 cases occurring during a mean follow-up of 14.6 years, and 1817 controls matched on age and study entry date. We used national registers (95%) and hospital records (5%) to ascertain cases. Diet was estimated by a modified diet history method. Plasma ENL concentrations were determined by a time-resolved fluoroimmunoassay. Odds ratios were calculated by unconditional logistic regression. Results: There were no significant associations between plasma ENL and incidence of all prostate cancer (odds ratio 0.99 [95% confidence interval 0.77–1.280] for the highest ENL quintile versus lowest, p for trend 0.66). However, in certain subgroups of men, including men with abdominal obesity (p for interaction = 0.012), we observed associations between high ENL levels and lower odds of high-risk prostate cancer. Plasma ENL was positively associated with consumption of high-fibre bread, fruit, tea, and coffee; with age, and with height, while it was negatively associated with smoking and waist circumference; however, although significant, all associations were rather weak (r ≤ |0.14|). Conclusion: ENL concentration was not consistently associated with lower prostate cancer risk, although it was weakly associated with a healthy lifestyle.


  • EXODIAB: Excellence of Diabetes Research in Sweden
  • EpiHealth: Epidemiology for Health
  • Nutrition Epidemiology
  • Diabetes - Cardiovascular Disease
  • BioCARE: Biomarkers in Cancer Medicine improving Health Care, Education and Innovation
  • Urological cancer, Malmö
  • Lund Melanoma Study Group
  • Tumor microenvironment
  • Medical oncology

Publishing year







European Journal of Nutrition





Document type

Journal article




  • Cancer and Oncology


  • Diet
  • Enterolactone
  • Lignans
  • Nested case–control
  • Prostate cancer



Research group

  • Nutrition Epidemiology
  • Diabetes - Cardiovascular Disease
  • Urological cancer, Malmö
  • Lund Melanoma Study Group


  • ISSN: 1436-6207