Monday, November 17, 2008
Allergy to soy is often said to be rather common, and the food is listed with other foods that commonly cause allergy, such as milk, eggs, peanuts, tree nuts, shellfish. However, a critical review of medical literature reveals surprisingly little solid information on the topic. The problem has been reported amongst younger children and the diagnosis of soy allergy is often based on symptoms reported by parents and/or results of skin tests or blood tests for allergy. Only a few reported studies have attempted to confirm allergy to soy by direct challenge with the food under controlled conditions. In these circumstances it is clear that skin/blood tests considerably overestimate the problem, as do parental reports. It is very difficult to give a reliable estimate of the true prevalence of soy allergy in the general population. To the extent that it does exist, soy allergy may cause cases of urticaria (hives) and angioedema (swelling), usually within minutes to two hours of ingestion of the food. In rare, severe cases true anaphylaxis may occur, a condition that is much more common with allergy to foods such as peanut and shellfish. The reason for the discrepancy is likely that soy proteins, the causative factor in allergy, are far less potent at triggering allergy symptoms than the proteins of peanut and shellfish. An allergy test that is positive demonstrates that the immune system has formed IgE antibodies to soy proteins. However, when soy is ingested proteins must evade digestion and be absorbed in a form capable of triggering allergy and also in sufficient quantities to reach a threshold to provoke actual symptoms. The low potency of soy proteins as allergens may help explain why allergy skin/blood tests suggest that soy allergy is common, yet few cases are confirmed when the food is eaten under observation.
Soy can also trigger symptoms via food intolerance, a situation where no immunologic (allergic) mechanism can be proven. One scenario is seen in very young infants who have vomiting and diarrhoea when fed soy-based formula. The symptoms resolve when the formula is withdrawn and recur when it is re-administered. Older infants can suffer a more severe disorder with vomiting, diarrhoea that may be bloody, anemia, weight loss and failure to thrive. The commonest cause of this unusual disorder is a sensitivity to cow's milk, but there is no doubt that soy formulas can also be the trigger. The precise mechanism is unclear and it could be immunologic, although not through the IgE-type antibodies that have the leading role in urticaria and anaphylaxis. Fortunately it is also self-limiting and will often disappear in the toddler years.
Promotion as health food
Soy consumption has been promoted by natural food companies and the soy industry's aggressive marketing campaign in various magazines, television ads and in health food markets. Research has been conducted examining the validity of the beneficial health claims with regard to the increase in consumption of soybeans which mimic hormonal activity.
A practice guideline published in the journal Circulation questions the efficacy and safety of soy isoflavones for preventing or treating cancer of the breast, endometrium, and prostate (although the same study also concludes that soy in some foods should be beneficial to cardiovascular and overall health) and does not recommend usage of isoflavone supplements in food or pills. A review of the available studies by the United States' Health and Human Services' Agency for Healthcare Research and Quality (AHRQ) found little evidence of substantial health improvements and no adverse effects, but also noted that there was no long-term safety data on estrogenic effects from soy consumption.
Brain
Estrogen helps protect and repair the brain during and after injury. The mimicry of estrogen by the phytoestrogens in soy has introduced a controversy over whether such a replacement is harmful or helpful to the brain. Several studies have found soy to be harmful for rats. Nevertheless the cited study was based on rats fed with concentrated phytoestrogens and not common soybeans. The common amounts of phytoestrogens in soy beans are not to be compared to concentrated estrogen. One study followed over 3000 Japanese men between 1965 and 1999, and that showed a positive correlation between brain atrophy and consumption of tofu. This study by L.R. White, et al., from the National Institute of Aging, NIH, was rejected as not credible by the Food and Drug Administration.
Carcinogen
Raw soy flour is known to cause pancreatic cancer in rats. Whether this is also true in humans is unknown because no studies comparing cases of pancreatic cancer and soy intake in humans have yet been conducted, and the doses used to induce pancreatic cancer in rats are said to be larger than humans would normally consume. Heated soy flour may not be carcinogenic in rats. Existing cancer patients are being warned to avoid foods rich in soy because they can accelerate the growth of tumours.
Iron
One single small-scale study published in 1995 concluded that "a vegetarian diet that is rich in soybean products and restricted in animal foods is limited in bioavailable iron and is not adequate for maintaining iron balance in men and women".
Soy can also trigger symptoms via food intolerance, a situation where no immunologic (allergic) mechanism can be proven. One scenario is seen in very young infants who have vomiting and diarrhoea when fed soy-based formula. The symptoms resolve when the formula is withdrawn and recur when it is re-administered. Older infants can suffer a more severe disorder with vomiting, diarrhoea that may be bloody, anemia, weight loss and failure to thrive. The commonest cause of this unusual disorder is a sensitivity to cow's milk, but there is no doubt that soy formulas can also be the trigger. The precise mechanism is unclear and it could be immunologic, although not through the IgE-type antibodies that have the leading role in urticaria and anaphylaxis. Fortunately it is also self-limiting and will often disappear in the toddler years.
Promotion as health food
Soy consumption has been promoted by natural food companies and the soy industry's aggressive marketing campaign in various magazines, television ads and in health food markets. Research has been conducted examining the validity of the beneficial health claims with regard to the increase in consumption of soybeans which mimic hormonal activity.
A practice guideline published in the journal Circulation questions the efficacy and safety of soy isoflavones for preventing or treating cancer of the breast, endometrium, and prostate (although the same study also concludes that soy in some foods should be beneficial to cardiovascular and overall health) and does not recommend usage of isoflavone supplements in food or pills. A review of the available studies by the United States' Health and Human Services' Agency for Healthcare Research and Quality (AHRQ) found little evidence of substantial health improvements and no adverse effects, but also noted that there was no long-term safety data on estrogenic effects from soy consumption.
Brain
Estrogen helps protect and repair the brain during and after injury. The mimicry of estrogen by the phytoestrogens in soy has introduced a controversy over whether such a replacement is harmful or helpful to the brain. Several studies have found soy to be harmful for rats. Nevertheless the cited study was based on rats fed with concentrated phytoestrogens and not common soybeans. The common amounts of phytoestrogens in soy beans are not to be compared to concentrated estrogen. One study followed over 3000 Japanese men between 1965 and 1999, and that showed a positive correlation between brain atrophy and consumption of tofu. This study by L.R. White, et al., from the National Institute of Aging, NIH, was rejected as not credible by the Food and Drug Administration.
Carcinogen
Raw soy flour is known to cause pancreatic cancer in rats. Whether this is also true in humans is unknown because no studies comparing cases of pancreatic cancer and soy intake in humans have yet been conducted, and the doses used to induce pancreatic cancer in rats are said to be larger than humans would normally consume. Heated soy flour may not be carcinogenic in rats. Existing cancer patients are being warned to avoid foods rich in soy because they can accelerate the growth of tumours.
Iron
One single small-scale study published in 1995 concluded that "a vegetarian diet that is rich in soybean products and restricted in animal foods is limited in bioavailable iron and is not adequate for maintaining iron balance in men and women".
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