Soy (Glycine max [L.] Merr.)

 

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Soy
Soy

Background

Soy is a subtropical plant, native to southeastern Asia. This member of the pea family (Fabaceae) grows from one to five feet tall and forms clusters of three to five pods, each containing two to four beans per pod. Soy has been a dietary staple in Asian countries for at least 5,000 years, and during the Chou dynasty in China (1134-246 B.C.), fermentation techniques were discovered that allowed soy to be prepared in more easily digestible forms such as tempeh, miso, and tamari soy sauce. Tofu was invented in 2nd Century China.

 

Soy was introduced to Europe in the 1700s, and to the United States in the 1800s. Large-scale soybean cultivation began in the United States during World War II. Currently, Midwestern U.S. growers produce approximately half of the world's supply of soybeans.

 

Soy and components of soy called "isoflavones" have been studied scientifically for numerous health conditions. Isoflavones (such as genistein) are believed to have estrogen-like effects in the body, and as a result are sometimes called "phytoestrogens." In laboratory studies, it is not clear if isoflavones stimulate or block the effects of estrogen, or both (acting as "mixed receptor agonists/antagonists").

 

Synonyms

Coumestrol, daidzein, edamame, frijol de soya, genistein, greater bean, haba soya, hydrolyzed soy protein, isoflavone, isoflavonoid, legume, natto, phytoestrogen, plant estrogen, shoyu, soja, sojabohne, soya, soya protein, soybean, soy fiber, soy food, soy product, soy protein  Ta-tou , texturized vegetable protein.

 

Evidence

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Uses based on scientific evidence Grade*
Dietary source of protein

Soy products such as tofu are high in protein and are an acceptable source of dietary protein.

A
High cholesterol

Numerous human studies report that adding soy protein to the diet can moderately decrease blood levels of total cholesterol and low-density lipoprotein ("bad" cholesterol). Small reductions in triglycerides may also occur, while high-density lipoprotein ("good" cholesterol) does not seem to be significantly altered. Some scientists have proposed that specific components of soybean, such as the isoflavones genistein and daidzein, may be responsible for the cholesterol-lowering properties of soy. However, this has not been clearly demonstrated in research, and remains controversial. It is not known if products containing isolated soy isoflavones have the same effects as regular dietary intake of soy protein. Dietary soy protein has not been proven to affect long-term cardiovascular outcomes such as heart attack or stroke.

A
Diarrhea (acute) in infants and young children

Numerous studies report that infants and young children (ages 2 to 36 months) with diarrhea who are fed soy formula experience fewer bowel movements per day and fewer days of diarrhea. This research suggests soy to have benefits over other types of formula, including cow milk-based solutions. The addition of soy fiber to soy formula may increase the effectiveness. Better quality research is needed before a strong recommendation can be made.Parents are advised to speak with a qualified healthcare provider if infants experience prolonged diarrhea, become dehydrated, develop signs of infection such as fever, or experience blood in the stool. A healthcare provider should be consulted for current breastfeeding recommendations, and to suggest long-term formulas with adequate nutritional value.

B
Menopausal hot flashes

Soy products containing isoflavones have been studied for the reduction of menopausal symptoms such as hot flashes. The scientific evidence is mixed in this area, with several human trials suggesting reduced number of hot flashes and other menopausal symptoms, but more recent research reporting no benefits. Overall, the scientific evidence does suggest benefits, although better quality studies are needed in this area in order to form a firm conclusion.

B
Breast cancer prevention

Several large population studies have asked women about their eating habits, and reported higher soy intake (such as dietary tofu) to be associated with a decreased risk of developing breast cancer. However, this type of research can only be considered preliminary, because people who choose to eat soy may also partake in other lifestyle decisions that may lower the risk of cancer. These other habits, rather than soy, could theoretically be the cause of the benefits seen in these studies (for example, lower fat intake, more frequent exercise, lack of smoking). Until better research is available, it remains unclear if dietary soy or soy isoflavone supplements increase or decrease the risk of developing breast cancer.

C
Cancer treatment

Genistein, an isoflavone found in soy, has been found in laboratory and animal studies to possess anti-cancer effects, such as blocking new blood vessel growth (anti-angiogenesis), acting as a tyrosine kinase inhibitor (a mechanism of many new cancer treatments), or causing cancer cell death (apoptosis). In contrast, genistein has also been reported to increase the growth of pancreas tumor cells in laboratory research. Until reliable human research is available, it remains unclear if dietary soy or soy isoflavone supplements are beneficial, harmful, or neutral in people with various types of cancer.

C
Cardiovascular disease

Dietary soy protein has not been shown to affect long-term cardiovascular outcomes such as heart attack or stroke. Research does suggest cholesterol-lowering effects of dietary soy, which in theory may reduce cardiovascular risk. Soy has also been studied for blood pressure-lowering and blood sugar-reducing properties in people with type 2 diabetes, although the evidence is not definitive in these areas. Further investigation is needed before a recommendation can be made.

C
Cognitive function

A recent study suggests that isoflavone supplementation in postmenopausal women may have favorable effects on cognitive function, particularly verbal memory. Further research is necessary before a firm conclusion can be drawn.

C
Colon cancer prevention

There is not enough scientific evidence to determine if dietary intake of soy affects the risk of developing colon cancer. Study results are mixed and more research is needed before a recommendation can be made.

C
Crohn's disease

Due to limited human study, there is not enough evidence to recommend for or against the use of soy as a therapy in preventing Crohn's disease. Further research is needed before a recommendation can be made.

C
Cyclical breast pain

It has been theorized that the presence in soy of "phytoestrogens" (plant-based compounds with weak estrogen-like properties) such as isoflavones may be beneficial to pre-menopausal women with cyclical breast pain. However, due to limited human study, there is not enough evidence to recommend for or against the use of dietary soy protein as a therapy for this condition.

C
Diarrhea in adults

Due to limited human study, there is not enough evidence to recommend for or against the use of soy-polysaccharide/fiber in the treatment of diarrhea. Further research is needed before a recommendation can be made.

C
Endometrial cancer prevention

There is not enough scientific evidence to determine if dietary intake of soy affects the risk of developing endometrial cancer.

C
Gallstones (cholelithiasis)

Due to limited human study, there is not enough evidence to recommend for or against the use of soy as a therapy in cholelithiasis. Further research is needed before a recommendation can be made.

C
High blood pressure

Due to limited human study, the effects of dietary soy on blood pressure are not clear. Further research is necessary before any recommendation can be made.

C
Kidney disease (chronic renal failure, nephrotic syndrome, proteinuria)

Due to limited human study, there is not enough evidence to recommend for or against the use of soy in the treatment of kidney diseases such as nephrotic syndrome. People with kidney disease should speak to their healthcare provider about recommended amounts of dietary protein, and should bear in mind that soy is a high protein food.

C
Menstrual migraine

One study of a phytoestrogen combination showed a reduced the number of migraine attacks suffered. Further research is needed before a recommendation can be made.

C
Obesity, weight reduction

Due to limited human study, there is not enough evidence to recommend for or against the use of soy for weight reduction. Further research is needed before a recommendation can be made.

C
Osteoporosis, post-menopausal bone loss

It has been theorized that the presence in soy of "phytoestrogens" (plant-based compounds with weak estrogen-like properties) such as isoflavones may increase bone mineral density in post-menopausal women and reduce the risk of fractures. However, most studies have not been well designed or reported. Until better research is available, a firm conclusion cannot be drawn. Individuals at risk for osteoporosis should speak with a qualified healthcare provider about the therapeutic options for increasing bone mineral density.

C
Prostate cancer prevention

Preliminary research has examined the effects of dietary soy intake on prostate cancer development in humans, but results have not been conclusive. Better study is needed before a recommendation can be made.

C
Stomach cancer

Preliminary study suggests that intake of soy products may be associated with a reduced risk of death from stomach cancer. Further investigation is needed before a conclusion can be drawn.

C
Type 2 diabetes

Several small studies have examined the effects of soy products on blood sugars in people with type 2 ("adult-onset") diabetes. Results are mixed, with some research reporting decreased blood glucose levels, and other trials noting no effects. Overall, research in this area is not well designed or reported, and better information is needed before the effects of soy on blood sugars can be clearly described.

C

 

*Key to grades
A: Strong scientific evidence for this use;
B: Good scientific evidence for this use;
C: Unclear scientific evidence for this use;
D: Fair scientific evidence against this use;
F: Strong scientific evidence against this use.

 

Grading rationale

Uses based on tradition or theory
The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Anemia, anorexia, antifungal, antioxidant, antithrombotic (preventing clots), atherosclerosis, athletic endurance, attention deficit hyperactivity disorder (ADHD), autoimmune diseases, breast enlargement, cancer prevention (general), chronic respiratory problems (cough, phlegm), cystic fibrosis, diabetic neuropathy, fever, gastric cancer, gastrointestinal motility, headache, hepatitis (chronic), inflammation, insect repellant, lymphoma, memory enhancement, nosebleed (chronic), osteosarcoma, pancreatic cancer, premature ovarian failure, rheumatoid arthritis, urinary tract cancer, vaginitis, vasoregulator.

Dosing

The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.

Adults (over 18 years old)
Studies have examined regular intake of dietary soy, or 40 to 80 milligrams of isoflavones taken by mouth daily.

 

A soy protein drink (17 grams of soy protein per 200 milliliters) has undergone limited study.

 

A fermented soybean-derived extract tea, various doses of soy protein (such as Abalon®), and up to 7 grams of daily soya fibers taken by mouth have undergone limited study in humans.

 

Soymilk (1,000 milliliters daily for three months) has undergone limited study.

 

25 to 50 grams of soy protein taken daily by mouth has been studied in people with high cholesterol. Isoflavone content has ranged from 60 to 90 milligrams per day. Cholesterol and low-density lipoprotein levels have been reduced in individuals using 28 grams daily of soy protein with a high isoflavone content, or with Abacor®, a brand that contains 26 grams of soy protein. There is limited study of soymilk (400 milliliters daily) in pre-menopausal women, with reported benefits on cholesterol levels.

 

Isolated soy protein, such as Supro® (60 grams), soy flour (45 grams), and a range of isoflavone products have been studied for menopausal symptoms. Doses of 50 to 75 milligrams of isoflavones have been used in research.

 

Isoflavones/isoflavone-rich soy (60 to 80 milligrams daily by mouth) and soy protein (for example, 40 grams daily of Supro 675®) have also been studied.

 

Children (under 18 years old)
Due to potential safety concerns, a qualified healthcare provider should be consulted regarding the choice of infant formula.

 

Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies
Soy can act as a food allergen similar to milk, eggs, peanuts, fish, and wheat.

 

Side Effects and Warnings
Soy has been a dietary staple in many countries for over 5,000 years, and is generally not regarded as having significant long-term toxicity. Limited side effects have been reported in infants, children, and adults aside from allergic reactions.

 

Soy protein taken by mouth has been associated with stomach and intestinal difficulties such as bloating, nausea, and constipation. More serious intestinal side effects have been uncommonly reported in infants fed soy protein formula, including vomiting, diarrhea, growth failure and damage/bleeding of the intestine walls. Soy protein fed to infants recovering from acute gastroenteritis may cause persistent intestinal damage and diarrhea. People who experience intestinal irritation (colitis) from cow's milk may also react to soy formula.

 

Based on human case reports and animal research, decreased thyroid hormone and increased thyroid stimulating hormone (TSH) levels may occur during the use of soy formula in infants. This includes rare reports of goiter (enlarged neck due to increased thyroid size). Hormone levels have become normal again after stopping soy. Infants fed soy or cow's milk formula may also have higher rates of atopic eczema than infants who are breast-fed.

 

Acute migraine headache has been reported with the use of a soy isoflavone product. Based on animal research, damage to the pancreas may theoretically occur from regularly eating raw soybeans or soy flour/protein powder made from raw, unroasted, or unfermented beans.

 

The use of soy is often discouraged in patients with hormone-sensitive malignancies such as breast, ovarian, or uterine cancer, due to concerns about possible estrogen-like effects (which theoretically may stimulate tumor growth). Other hormone-sensitive conditions such as endometriosis may also theoretically be worsened. In laboratory studies, it is not clear if isoflavones stimulate or block the effects of estrogen, or both (acting as a "receptor agonist/antagonist"). Until additional research is available, patients with these conditions should be cautious and speak with a qualified healthcare practitioner before starting use.

 

It is not known if soy or soy isoflavones share the same side effects as estrogens, such as increased risk of blood clots. Preliminary studies suggest that soy isoflavones, unlike estrogens, do not cause the lining of the uterus (endometrium) to build up.

 

There has been a case report of vitamin D deficiency rickets in an infant nursed with soybean milk (not specifically designed for infants). Patients should consult a qualified healthcare practitioner for current breastfeeding recommendations, use formulas with adequate nutritional value.

 

Pregnancy and Breastfeeding
Soy as a part of the regular diet is traditionally considered to be safe during pregnancy and breastfeeding, although scientific research is limited in these areas. The effects of high doses of soy or soy isoflavones in humans are not clear, and therefore are not recommended.

 

Recent study demonstrates that isoflavones, which may have estrogen-like properties, are transferred through breast milk from mothers to infants. High doses of isoflavones given to pregnant rats have resulted in tumors in female offspring, although this has not been tested in humans.

 

In one human study, male infants born to women who ingested soymilk or soy products during pregnancy experienced more frequent hypospadias (a birth defect in which the urethral meatus, the opening from which urine passes, is abnormally positioned on the underside of the penis). However, other human and animal studies have examined males or females fed soy formula as infants, and have not found abnormalities in infant growth, head circumference, height, weight, occurrence of puberty, menstruation, or reproductive ability.

 

Research in children during the first year of life has found that the substitution of soy formula for cow's milk may be associated with significantly lower bone mineral density. Parents considering the use of soy formula should speak with a qualified healthcare practitioner to make sure the appropriate vitamins and minerals are provided in the formula.

 

Interactions

Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.

Interactions with Drugs
Soy contains "phytoestrogens" (plant-based compounds with weak estrogen-like properties) such as isoflavones. In laboratory studies, it is not clear if isoflavones stimulate or block the effects of estrogen, or both (acting as a "receptor agonist/antagonist"). It is not known if taking soy or soy isoflavone supplements increases or decreases the effects of estrogen on the body, such as the risk of blood clots. It is unclear if taking soy alters the effectiveness of oral contraceptives containing estrogen.

 

It is not known what the effects of soy phytoestrogens are on the anti-tumor effects of selective estrogen receptor modulators (SERMs) such as tamoxifen. The effects of aromatase inhibitors such as anastrozole (Arimidex®), exemestane (Aromasin®), or letrozole (Femara®) may be reduced. Because of the potential estrogen-like properties of soy, people receiving these drugs should speak with their oncologist prior to taking soy in amounts greater than normally found in the diet.

 

Soy protein may interact with warfarin (Coumadin®), although this potential interaction is not well characterized. Patients taking warfarin should check with a doctor and pharmacist before taking soy supplementation.

 

Interactions with Herbs and Dietary Supplements
The effects of soy protein or flour on iron absorption are not clear. Studies in the 1980s reported decreases in iron absorption, although more recent research has noted no effects or increased iron absorption in people taking soy. People using iron supplements as well as soy products should consult a qualified healthcare practitioner to follow blood iron levels. Calcium and phosphate levels may be altered.

 

Some experts believe that there may be a potential interaction between soy extract and  Panax ginseng  although this potential interaction is not well characterized.