Transcript
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Soy Health Effects -
Evaluating theScience, Overcomingthe Misinformation
August 2,2010
Mark Messina
markm@olympus.net
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Soy protein products
Meat/dairy analogues
Traditional soyfoods
Traditional soyfoods
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Macronutrient (% calories)Content of Beans and Soybeans
Protein
Carbohydrate
Fat
27
70
3
3340
27
Mostly
oligosaccharides
Common beans
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Grams (g) Protein/(Serving)
Tofu(100 g)10-15 g
Edamame
80 g, 8.5 g
Soymilk(250 ml)
6 8 g
Soynuts(28 g)15 g
Tempeh100 g,18 g
Soybeans(85 g), 14 g
http://images.google.com/imgres?imgurl=http://www.biotechnologyonline.gov.au/images/contentpages/soybeans.jpg&imgrefurl=http://www.biotechnologyonline.gov.au/popups/img_soybeans.cfm&h=498&w=600&sz=41&hl=en&start=1&tbnid=Zph-VGK1HA1ldM:&tbnh=112&tbnw=135&prev=/images?q=soybeans&gbv=2&svnum=10&hl=en7/30/2019 Indonesia Messina August 2010
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Protein Digestibility CorrectedAmino Acid Score of Plant Proteins
PDCAAS
Limiting amino acidcontent (mg/g protein)
Amino acid requirement
for 1-2 year olds
X
Digestibility=
Soy protein concentrate 0.99
Kidney beans 0.68Rolled oats 0.57
Lentils 0.51
Wheat gluten 0.25
Equal toanimal
protein
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Linoleic (n-6, 18:2)*Oleic (18:1)
Saturated -Linolenic (n-3, 18:3)*
12%(7-22)
29%(21-36)
50%(39-53)
6%(3-9)
Fatty Acid Profile of SoyOil from Yellow Soybeans
*essentialJ Agric FoodChem 57:11174, 2009
Independentcoronarybenefits
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Disinformation:False or inaccurateinformation that isdeliberately spread
Search10/08/09
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Heart disease
Isoflavones
Cancer
Osteoporosis
Misconceptions
and safety issues
Soy Health Effects -Evaluating the
Science, Overcomingthe Misinformation
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25 grams of soy protein perday, as part of a diet low insaturated fat and cholesterol,
may reduce risk of heart disease
Product Labels
Brazil
Indonesia
Japan
Korea
Malaysia
PhilippinesUnited (JHCI)
Kingdom
Health Claims
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Soy, Cholesterol Reductionand Heart Disease Risk
4% in LDL-cholesterol
10% indisease risk
Additional reduction (~4%)by substituting soyfoods forhigher-saturated-fat, foods
Soy protein8 meta-
analyses
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1. Direct cholesterol reduction
2. Substition effects
3. Benefits independentof cholesterol
Three-way
Protection
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27,435 women
Subjects 40-59 years
FFQs in 1990 and 1995
12.5 y follow up period140 strokes
66 heart attacks
Prospective Study
The Japan PublicHealth Center-Based
Study Cohort ICirculation 2007;116:2553
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The Japan PublicHealth Center-Based
Study Cohort ICirculation 2007;116:2553
Q5 versus Q1(1.5 v 0.5 serv/d)
Stroke
Heart attack
CVD
RiskIntake comparison
*
*HRs adjusted for age; sex; smoking; ROH, BMI; history of hypertension & diabetes; medication forhypercholesterolemia; education; sports, intake of F & V, fish, salt, & Kcal & menopausal status .
Results SS. Mean isoflavone intakes in Q5 and Q1 = 41 and 11 mg/d, respectively
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The Japan PublicHealth Center-Based
Study Cohort ICirculation 2007;116:2553
Q5 versus Q1(1.5 v 0.5 serv/d)
Stroke 65%
Heart attack 63%
CVD 75%
RiskIntake comparison
*
*HRs adjusted for age; sex; smoking; ROH, BMI; history of hypertension & diabetes; medication forhypercholesterolemia; education; sports, intake of F & V, fish, salt, & Kcal & menopausal status .
Results SS. Mean isoflavone intakes in Q5 and Q1 = 41 and 11 mg/d, respectively
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LDL particle size LDL oxidation Blood pressure Arterial compliance Endothelial function
Effects Possibly Contributingto the CHD Risk Reduction
Associated with Soyfood Intake
Future Lipid 2007;2:55AJCN 2008;88:38EJCN 2003;57:889
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Only
soyfoods
contain
nutritionally
significant
amounts
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Mean dailyintake, ~40 mg
~25 mg/serving
250 ml (1 cup) soymilk
100 grams tofu100 grams edamame
28 grams soynuts
Nutr Cancer 55: 1, 2006
~3.5 mg isoflavones/g protein in traditional soyfoods
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O
OH
O
R1
R2OH
7
5
1
A C
B
2
4
17-Estradiol
Genistein (50%)Daidzein (40%)Glycitein (10%)
Essentiallyuniqueto soy
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Referred toas phyto-
estrogensbut different
from thehormone
estrogen
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Isoflavones
Preferentially bind toand transactivate ER
in comparison to ER
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Estrogenreceptor-
andestrogen
receptor-
havedifferent
tissue
distributionsand different
functions
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192,370 cases
40,170 deaths
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Is Soy
Protective?
Soypreventsbreastcancer
Soycausesbreast
cancer
Soycausesbreast
cancer
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Evidencethat adultintake is
protectiveis very
unimpressive
Soypreventsbreastcancer
Is Soy
Protective?
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EarlyIntake
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Toward an understanding
of breast cancer etiology
BCa risk = # cells at risk
# cells at riskearly lifeSemin Cancer Biol 8: 255, 1998
Earlypregnancyextremelyprotective
In the WHI cohort, women whohad their first child over the
age of 30 were 50% > likely todevelop breast cancer thanwomen who had their first
child before the age of 20
JNCI2007;99:1695
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EarlyIntake
E id i l i R h h i
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Author/
Year
Location (N) RiskWu, 2008 USA 345
Shu, 2001 Shanghai 3015
Korde, 2009 USA 255
Lee, 2009 Shanghai 305
Epidemiologic Research ShowingSoy Intake During Childhood and/
or Adolescence Reduces BCa Risk
AJCN 89; 1145 2009; CEBP;10:483, 2001; 18: 1, 2009; AJCN 89:1920, 2009
E id i l i R h Sh i
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Author/
Year
Location (N) RiskWu, 2008 USA 345 28
Shu, 2001 Shanghai 3015 49
Korde, 2009 USA 255 60
Lee, 2009 Shanghai 305 43
Epidemiologic Research ShowingSoy Intake During Childhood and/
or Adolescence Reduces BCa Risk
AJCN 89; 1145 2009; CEBP;10:483, 2001; 18: 1, 2009; AJCN 89:1920, 2009
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Young
girlsshouldbe sure
to eat 1
serving
per day
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Country /100,000
USA 101
England 29.3
Japan 9.0Hong Kong 7.9
China 2.3
Prostate Cancer Incidence Ratesin Soy and Non-Soy-Consuming Countries
Rates, age-adjusted; Int. J. Cancer : 85, 60, 2000
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Inhibit development
Inhibit metastases
Lower risk among
soy consumers
Slow PSA rise
in PCa patients
Prostate CancerSoy/Isoflavones:J Nutr 133: 516,
2003; Can Res 68:2024, 2008; AJCN2009; J AOAC Int89:1121, 2006, JNutr 2009; JNCI101: 1141, 2009
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Inhibits bone loss
Reduces fractures
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Isoflavone Intakeand Fracture Risk
Shanghai Womens Health Study
Singapore Chinese Health Study
24,403 women
4.5 y follow-up
1770 fractures
Q1 v Q5
~1/3 RRQ1 v Q4
~1/3 RR
35,298 women
7.1 y follow-up
692 hip fractures
Arch Intern Med 2005;165:1890-5.
Woon-Puay Koh, PhD, NationalUniv. Singapore; AJE 170: 901, 2009
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Clinicaltrials
Supplements
Short term
Epidemiologicstudies
Traditional soy
Long term
Isoflavones
and BoneHealth
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Soy and
Skin Health(emerging research area)
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Skin lightening
Prevent UV damage
Improve elasticity
Prevent hair growth
Topical
Application
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Does eatingsoy improveskin health?
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Soycausesbreastcancer
Soycausesbreastcancer
Are soyfoodscontraindicated
for estrogen-
sensitive
breast cancer
patients?
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Ath i
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AthymicOVX MiceImplantedwith ER+
Breast CancerCells (MCF-7)
William G. Helferich, PhDUniversity of Illinois
1997-present
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Evidence indicates the tumor-
stimulatory effects of isoflavones
observed in rodents likely dont
apply to women
Rodentsarent little
women
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Human
Research
Effects of isoflavones on in vivo
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No effects
No effects
No effects Tissuedensity
Cellproliferation
(8)
(5)
Effects of isoflavones on in vivomarkers of breast cancer risk
Estrogenlevels(47)
Human Reproduction Update
Contrast with effects of EPT (hormone therapy)
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56: 323, 2006
For the breastcancer survivor:
Up to 3 servings/dayof traditional soyfoods
unlikely to be harmful
Th Sh h i B
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N=5,033 BCa survivors
Intake assessed at 6, 18,36 & 60 mo post diagnosis
Median follow-up, 3.9 years
During FU; 444 deaths, 534recurrences or BCa-related deaths
The Shanghai BreastCancer Survival Study
JAMA. 2009;302:2437
Th Sh h i B t
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High soy consumers* ~1/3less likely to die or suffera recurrence
High soy consumption* wasas beneficial as tamoxifen use
The Shanghai BreastCancer Survival Study
JAMA. 2009;302:2437
Major findings:
*>15.31 g/d soy protein or 62.8 mg/d isoflavones
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1. Prohibit soy intake
(current default position)
2. Permit soy intake forthose who already use it
or want to begin doing so
3. Recommend soy foods for the
purpose of improving prognosis
Options
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Summary of Clinical
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No effects on testosterone (N=36)
No effects on estrogen in men (N=9)
No effects on sperm/semen (N=3)
Very minor effects on femalereproductive hormones (N=47)
May cycle length 1 day (n=10)
Summary of ClinicalResults Related to Soy and
Feminization and Fertility
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TheThyroidIssue
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Healthy, euthyroid individuals
Subclinical hypothyroidism?
Insufficient iodine intake?
Isoflavonesand theThyroid
Bitto et al. JCEM,2010
Alekel et al. AJCN, 2009
C l f f th iti
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Complex form of arthritischaracterized by sudden,
severe attacks of pain, rednessand tenderness in joints
Urate crystalaccumulation dueto high levels ofuric acid in blood
Gout
T
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Does the presence of aglyconeisoflavones affect health effects?
Is mineral absorption superior to
that from non-fermented soyfoods?
Does fermentation lead to thecreation of beneficial compounds?
Tempe
ResearchNeeds
Ad lt I t k R d ti
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Adult Intake Recommendations
Based on clinical and epidemiologic studiesand principles of sound dietetic practice
Womens Health (Lond Engl) 2008;4:337.
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