IETARY PHYTOESTROGENS ARE plant-derived nonsteroidal compounds with weak estrogen-like activity. Most phytoestrogens exist in the diet as inactive compounds and, following consumption, undergo enzymatic conversion in the gastrointestinal tract, resulting in the formation of compounds with a steroidal structure similar to that of estrogens. 1 Phytoestrogens are subdivided into 3 main classes: isoflavones, lignans, and cumestrans. The isoflavones and the lignans are the 2 main groups of hormone-like diphenolic dietary phytoestrogens. On ecologic analysis, both have been found in high levels in the plasma of individuals living in areas with relatively low cancer incidence. 2 Isoflavones are the most common form, and most extensively investigated, of the phytoestrogens. The 2 major forms of isoflavones, genistein and daidzein, are formed from the precursors genistin and daidzin and are found in a variety of sources, including soy products, soybeans, chickpeas, and red clover. 2,3 The lignan metabolites, enterolactone and enterodiol, are formed from the precursors matairesinol and secoisolariciresinol. Lignans are derived from rye grains, linseeds, carrots, tea, spinach, broccoli, and other vegetables. 1,2 Coumesterol is the predominant estrogenic phytoestrogen in the cumestran group and is mainly found in beans, peas, clover, spinach, and sprouts. 4 A fourth group of plantderived steroidal compounds that is believed to have estrogenic properties are See also pp 1505 and 1550.