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Soy

Soy products are made from soybeans. Soybeans can be processed into soy protein, a powder, soy milk, a beverage that is partially fortified with extra calcium, or soy fiber, which contains the fibrous parts of the bean. Soy products are used to treat high cholesterol levels, high blood pressure and to prevent diseases of the heart and blood vessels. Soy products are also used to treat type 2 diabetes, asthma, lung cancer, endometrial cancer, prostate cancer and thyroid cancer, as well as to prevent osteoporosis and slow the progression of liver disease. Other uses include treating constipation and diarrhea, reducing protein in the urine in kidney disease, improving memory and treating muscle soreness after exercise. Women use soy products for breast pain, to prevent breast cancer, to prevent hot flushes, for symptoms of menopause and for premenstrual syndrome. In the field of nutrition, soy products are used as a substitute for milk in infant formula and as an alternative to cow's milk. Soybeans are eaten boiled or roasted. Soy flour is used as an ingredient in foods, drinks and seasoning mixes. The active ingredients in soy products are known as isoflavones. A study of the isoflavone content of commercial soy products found that the isoflavone content of less than 25% of the products was in the range of at least 90% of the label claim, which in other words means that you can't necessarily rely on the claims on the label.

How do soy products work?

Soy products contain isoflavones, which are converted in the body into phytoestrogens, which are similar to the hormone oestrogen.

How effective are soy products?

Soy products are potentially effective in the following areas of application:

  • High cholesterol: Consuming soy protein instead of other dietary proteins appears to slightly reduce total cholesterol levels and levels of bad LDL cholesterol. However, not all studies come to the same conclusion. Some studies have failed to show any benefits.
  • Hot flashes during menopause: Consuming soy protein seems to help with hot flashes during menopause. However, soy protein does not appear to have any effect on hot flushes due to breast cancer.
  • Reducing the risk of osteoporosis - especially in post-menopausal women: Most studies suggest that soy protein may increase bone mineral density or slow a reduction in bone mineral density in women who are near or past menopause. Soy protein does not appear to help younger women.
  • Reducing the risk of breast cancer: Scientists believe that early consumption of soy products is the key. Asian women who traditionally follow a soy-rich diet appear to have a lower risk of breast cancer. This advantage remains even when Asian women move to Western countries, where soy is less often a part of the diet. This suggests that early exposure to soy products (i.e. before menopause) offers the greatest protection against breast cancer.
  • Reducing the duration of diarrhea in children
  • Prevention and treatment of nerve problems associated with diabetes
  • For feeding infants who cannot digest milk
  • Reducing protein in urine in people with kidney disease
  • Treatment of type 2 diabetes
  • Treatment of young children who have problems digesting lactose.

Soy products may be effective in reducing muscle soreness after exercise.

There is not enough scientific data to make a statement regarding the effectiveness of soy products in the following areas of application.

  • Prevention of thyroid cancer: A high proportion of soy products in the diet could help prevent thyroid cancer.
  • Endometrial cancer: There is evidence that increasing soy intake could reduce the risk of endometrial cancer. Endometrial cancer is less common in Japan, China and other Asian countries where diets are usually low in calories and high in soy, whole grains, vegetables and fruit.
  • Lung cancer: Scientific research suggests that men and women who consume higher levels of phytoestrogens such as the isoflavones in soy are less likely to develop lung cancer than those who consume lower levels. Soy products appear to prevent lung cancer better in men than in women.
  • Prostate cancer: Studies that have investigated the effects of soy products on the risk of prostate cancer have come to different conclusions. Men who follow an Asian diet, which includes 10 times more soy than the average Western diet, appear to have a lower risk of prostate cancer. However, it is unclear whether the soy content of the diet or other factors such as genetic differences or differences in the fat content of the diet protect against prostate cancer.
  • Improving memory: Some studies suggest that a diet rich in soy may slightly improve performance on memory tests.
  • Reducing breast pain: There is limited evidence that soy milk may reduce monthly breast pain in some women.
  • Weight loss support: There is evidence to suggest that consuming soy protein in combination with a low-calorie diet for six months may reduce weight in obese and overweight people more than a low-calorie diet alone.
  • High blood pressure: Some evidence suggests that consuming soy protein could reduce systolic blood pressure (the upper value) by about 4 mmHg and diastolic blood pressure (the lower value) by about 3 mmHg in people with borderline or slightly elevated blood pressure. However, this is only a relatively small reduction.

There is also insufficient scientific information on the effectiveness of soy products on asthma, premenstrual syndrome and heart disease.

Further scientific research is needed to evaluate the effectiveness of soy products in these applications.

Safety and side effects

The consumption of soy foods such as soy protein is probably safe and harmless. Taking dietary soy supplements appears to be safe and harmless for most people when used for short periods of up to six months. Soy products can cause mild side effects such as constipation, bloating and nausea. They can also cause allergic reactions in some people, including skin rashes and itching.

Long-term use of soy products in high quantities may not be safe and harmless. There are concerns that the use of high doses may cause abnormal tissue growth in utero.

Precautions and warnings

Pregnancy and lactation: Soy protein is probably safe during pregnancy and lactation when consumed in normal amounts. Higher amounts during pregnancy could harm the baby's development. Not enough is known about the safety and harmlessness of consuming higher amounts of soy products while breastfeeding, so breastfeeding women should avoid such amounts to be on the safe side.

Children: Soy products are likely to be safe for children when consumed in normal amounts or in the amounts found in formulas for young children. The use of soy formula does not appear to cause health or reproductive problems later in life. However, soy milk not formulated for infants should not be used as a substitute for infant soy formula. Regular soymilk could lead to deficiency symptoms in infants.

Soy may not be safe and harmless when used as an alternative to cow's milk in children who are allergic to cow's milk. Although soy protein-based infant formulas are often touted as an alternative for children who are allergic to cow's milk, these children often suffer from an allergy to soy products as well.

Children should not be given soy in larger quantities than those found in the normal diet or in special soy products for children. Scientists do not yet know whether soy products are safe and harmless for children in higher quantities.

Cystic fibrosis: Soy milk can affect the way children with cystic fibrosis process protein. Therefore, soy products should not be given to these children.

Breast cancer: The effects of soy products on people suffering from breast cancer are unclear. Some research suggests that soy may promote certain types of breast cancer because it can act like estrogen. Other studies have found that soy appears to protect against breast cancer. The different effects may have something to do with the amount used. Since there is not enough reliable information about the effects of soy products in women who have breast cancer or have suffered from breast cancer in the past, it is best for these women to avoid soy products until more is known.

Endometrial cancer: Long-term use of concentrated isoflavone tablets may increase the incidence of precancerous changes in the endometrium. Women suffering from endometrial cancer should not use isoflavone supplements.

Kidney disease: There are concerns that soy products may increase the risk of kidney stones because they contain large amounts of a group of chemicals called oxalates. There are also concerns that people who suffer from serious kidney conditions may not be able to process some of the chemicals in soy. For these reasons, people who suffer from kidney problems or kidney stones should avoid large amounts of soy products.

Bladder cancer: Soy products may increase the risk of bladder cancer. You should avoid soy foods if you suffer from bladder cancer or have a family history of increased risk of bladder cancer.

Hypothyroidism: There are concerns that consuming soy milk could exacerbate this condition.

Asthma: People who suffer from asthma are more likely to have an allergic reaction to soy hulls and should therefore avoid soy products.

Hay fever: People who suffer from hay fever are more likely to be allergic to soy hulls.

Interactions

Soy products should not be taken in combination with the following medications

Medication for depression (monoamine oxidase inhibitors)

Fermented soy products such as tofu and soy sauce contain tyramine. Tyramine is an amino acid that is involved in the regulation of blood pressure. Tyramine is broken down by monoamine oxidase. So-called monoamine oxidase inhibitors, which are used to treat depression, can reduce the breakdown of tyramine. Consuming more than 6 mg of tyramine while taking these drugs can increase the risk of serious side effects such as high blood pressure. The amount of tyramine contained in fermented soy products is usually low, often less than 0.6 mg per serving. However, variations are possible depending on the specific product, storage conditions and length of storage time. Storing a particular type of tofu for a week, for example, can increase the tyramine content from 0.23 mg to 4.8 mg per serving. If you are taking monoamine oxidase inhibitors, you should avoid fermented soy products that contain large amounts of tyramine.

Care should be taken when combining soy products with the following medications:

Antibiotics

Antibiotics are used to reduce the amount of harmful bacteria in the body. However, antibiotics can also reduce the amount of friendly bacteria in the gut. Friendly bacteria in the gut appear to support the effectiveness of soy products. By reducing the number of bacteria in the gut, antibiotics could reduce the effectiveness of soy. However, it is too early to say whether this interaction is a major cause for concern.

Estrogens

Large amounts of soy products may have some of the effects of estrogen. However, soy does not have as strong an effect as estrogen tablets. Consuming soy products in combination with estrogen supplements could reduce the effect of estrogen supplements.

Care should be taken when combining soy products with the following medications:

Drugs that are broken down by the liver (cytochrome P450 2C9 (CYP2C9) substrates).

Some drugs are broken down by the liver. Soy could increase the rate at which the liver breaks down certain drugs. However, it is too early to say whether this interaction occurs in all people or whether it affects the effectiveness of drugs.

Dosage

The following dosages have been investigated in scientific studies:

Oral:

  • For high cholesterol levels: 20 to 50 grams of soy protein per day.

  • For the prevention of osteoporosis: 40 grams of soy protein per day, which contains 2 to 2.25 mg of isoflavones per gram.

  • For symptoms of the menopause such as hot flushes:

    • 20 to 60 grams of soy protein per day, which provides 34 to 76 mg of isoflavones.
    • Concentrated soy isoflavone extracts, which provide 50 to 120 mg of isoflavones per day.
    • Genistein, a soy isoflavone: 54 mg per day
    • For protein in urine in people with kidney disease: A diet limited to 700 to 800 mg of soy protein per kilogram of body weight per day was used.
    • For diarrhea in infants: A soy fiber-enriched formula containing 18 to 20 grams of soy protein per liter was used.
    • For type 2 diabetes: A Touchi extract at a dosage of 300 mg three times a day. Touchi is a traditional Chinese food made from soybeans.
    • For type 2 diabetes in postmenopausal women: 30 grams of soy protein per day, which contained 132 mg of phytoestrogens, for up to 12 weeks.

Soy foods contain variable amounts of isoflavones. Soy flour contains 2.6 mg of isoflavones per gram, fermented soybeans contain 1.3 mg per gram, cooked soybeans contain 0.6 mg per gram, soymilk contains 0.4 mg per gram, soy curd contains 0.5 mg per gram, fried soy curd contains 0.7 mg per gram, soybean paste contains 0.4 mg per gram and soy sauce contains 0.016 mg per gram.

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