indonesia messina august 2010

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Soy Health Effects -

Evaluating theScience, Overcomingthe Misinformation

August 2,2010

Mark Messina

[email protected]


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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=en


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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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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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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.

indonesia messina august 2010

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