WASHINGTON, July 6 (UPI)--The North American Menopause Society, the professional
organization that represents doctors and other providers who treat middle-aged
women, has issued a split decision on soy: they say it is a good idea to add
some tofu to the diet but it's too soon to recommend taking soy supplements said
to contain estrogens derived from plants.
Sadja Greenwood, MD, MPH, who chaired the NAMS expert panel that drafted the new
consensus statement said there are good data to suggest that dietary soy can
help control cholesterol and thus reduce the risk of heart attacks.
Greenwood said her group was prodded to tackle the soy issue by their patients
who are demanding a safer alternative to estrogen. Physicians prescribe estrogen
to treat some common symptoms associated with menopause, especially hot flashes
and vaginal dryness. For years it has also been recommended as a protection
against heart disease and osteoporosis. But estrogen has been linked to an
increased risk of breast cancer and recent studies have cast doubt on its value
as a protector of the heart.
Greenwood said that the so-called natural hormone substitutes, actually
substances called phytoestrogens that are derived from plants, are heavily
marketed to women. One of these plant estrogens is called isoflaovone and it is
found in soy. Although women are particularly interested in soy and breast
cancer, Greenwood said there are insufficient data about isoflavones and breast
cancer.
Bottom line, said Greenwood, is that while "adding whole foods is not a bad idea
and is a healthy choice, we don't really have sufficient data on the safety or
effectiveness of isoflavone supplements to make a recommendation about their
use." A good way to add soy to the diet, she says, would be to "substitute
calcium fortified soy milk for skim or 1% milk or to try a modified vegetarian
diet where every few days one would substitute tofu for other protein sources."
The NAMS panel recommends 25 g/day of soy protein for cholesterol control. They
say the same amount may also protect bones, but again say that data are scarce.
For women interested in relief from hot flashes, the panel reports that 40-89
mg/d of isoflavone supplement may provide some help. But again Greenwood warned
that blood levels of isoflavones vary widely among persons taking the same oral
doses so there is some question about "achieving a therapeutic level."
Dr. Sandra A. Fryhofer, an Atlanta-based physician with a practice focused on
women's health, applauded the new consensus statement, which she said was
overdue. "I think it is an excellent consensus opinion. It goes through the
evidence that we have thus far and makes some good recommendations." Fryhofer,
an associate clinical professor of medicine at Emory University School of
Medicine and president of the American College of Physicians/American Society of
Internal Medicine. Fryhofer says "the nation, and particularly women, seem to
have a fascination with natural products" and women bring this fascination to
their physicians. She says that many of her patients ask about the use of
"natural estrogens."
Fryhofer said she, too, thinks that whole foods are the best source for
isoflavones. "I just recommend adding a little tofu to the diet because you can
mix tofu into just about anything." Supplements, she says, are not as easily
tolerated because they "are sticky and can cause flatulence."
