Reaching that time in your life: A role for soya foods?

1. Reaching that time in your life:A role for soya foods? Kate Arthur Company Dietitian Alpro UK

2. Health concerns for women 45+ • Obesity/ overweight • Heart/ lipid/ vascular health issues • Diabetes • Osteoporosis/ joint problems • Cancers Menopause Characterised by the cessation of menstruation as ovaries fail to respond to FSH, producing less progesterone & oestrogen.

3. Soya can be part of a healthy balanced diet

4. The Soya Bean • High in protein : protein quality similar to meat & dairy • Healthy fat profile – low in saturated fat, high in PUFA • 8% Alpha Linolenic Acid (Omega 3) • 53% Linoleic Acid (Omega 6) • Soluble Fibre • Source of Isoflavones (phytoestrogens)

5. Healthy eating - What should we be advising?

6. Heart Disease INCREASE Risk Stroke/Thrombosis INCREASED Blood Cholesterol Average 5.6mmol/l Weight Gain Osteoporosis Vasomotor Hot Flushes Sweats Body Temp Palpitations Other Insomnia Joint Aches Headaches Vaginal Dryness Menopause Association with Reduced Oestrogen

7. Where does soya fit in? • Soya beans & products contain naturally occurring isoflavones/ phytoestrogens • Ability to exert a weak oestrogenic-type effect • Fit and interaction at oestrogen receptors different to endogenous oestrogen – ability to positively effect various tissues

8. Soya and the menopause Controversy in literature but recent studies indicate that IF can be of help in some women The more hot flushes a women experiences the better effect of IF • Isoflavone supplements: • 60 mg isoflavones/d for 12 weeks reduced number of hot flushes (57%)and night sweats (43%) (Cheng et al., 2007, Menopause 14, 468-473) • Genistein (54 mg/d) for 1 year: decrease in hot flushes (56%) (D'Anna et al., 2007, Menopause 14, 648-655) • Soya food: • 8 weeks of soya nuts (56g; 25g soy protein; 100 mg IF)Consumed 3-4 times throughout the day • associated with a decrease in hot flushes (45%) and improvement in menopausal symptoms Welty et al., 2007, J Womens Health (Larchmt ) 16,361-36

9. Soya and the menopause • Position of the North American Menopause Society ‘In women who need relief for mild vasomotor symptoms, NAMS recommends first considering lifestyle changes, either alone or combined with a non prescription remedy, such as dietary isoflavones.’ (position statement of The North American Menopause Society. Menopause. 2004 Jan-Feb;11(1):11-33.) • Consensus from Phytohealth EU Funded Project ‘Soya bean isoflavone extracts maybe effective in reducing hot flushes but the effect is half that observed with hormone replacement therapy...’ (Cassidy A, et al (2006) Proc Nutr Soc 65; 76-92)

10. Isoflavone rich diet :

11. Bone Health • Hip fractures are lower in traditional soya consuming countries. Suggested that isoflavones may have a protective role • Meta-analysis of 10 studies with 608 women (Ma et al., 2008) • Increase in BMD more significant when IF intake was ≥90mg/d and intervention lasted >6 months • Isoflavone intervention significantly inhibits bone resorption and stimulates bone formation – further studies required

12. 91.4% 6.8 6.5 6.6 88.6% 6.4 6.2 6.2 73.6% 6.0 5.7 5.8 5.6 Blood Cholesterol Levels mmol/L 5.4 5.2 5.2 5.0 4.9 4.8 4.6 4.6 4.4 4.2 4.0 16-24 35-44 45-54 55-64 65-74 25-34 Age Groups in Years Blood Cholesterol UK Women - BHF stats • World Health Report 2002 – 60% CHD & 40% Ischaemic stroke attributed to raised blood cholesterol (WHO).

13. Heart Health - Soya • Fat profile: • Low is saturated fat, • contains Omega 3 & 6 PUFA • Soya protein – independent cholesterol lowering effects proven in several meta analyses. • Approved Health Claims for heart health: JHCI (UK) studies published 1999-2002, <30g SP. “The inclusion of at least 25g soya protein per day as part of a diet low in saturated fat can help reduce blood cholesterol”

14. Heart Health - Soya • Review of 33 studies published in past 10 years – 3-5% LDL reduction In modest hypercholesterolemia (Sirtori et al., 2007 Br J Nutr 97, 816-822) • Meta-analysis of 30 studies with soya protein intake ranging 15-40g/d: - 6% reduction in LDL - 3.7% reduction in total cholesterol (Harland et al., 2008 Atherosclerosis 200,200,13-27) Consclusion - inclusion of modest amounts of soya protein (15-25g/d) have beneficial effects on blood cholesterol

15. Soya and breast cancer • Singapore Chinese health study of 34028 women and 629 breast cancer patients(Wu et al., Br J Cancer 2008 Singapore Chinese Health study) • >11mg IF / d was related with a 18% reduction in breast cancer (26% reduction in post menopausal women) • Soya intake during childhood is associated with a decreased risk of breast cancer:< 1 soy serving/week vs >6 soy servings/month results in 60% decreased risk(Korde et al., Cancer Epidemiol Biomarkers Prev 2009) • Eating soya foods early in life appears to offer greater protection

16. And not forgetting the men

17. Soya and prostate cancer Men Living in East Asian countries have lower rates of prostate cancer compared to men living in Europe A meta analysis of 14 population studies found that men eating more soya foods have a 26% reduced risk of prostate cancer (Yan L. Am.J. Clin. Nutr 2009; 89(4):1155-63) Conclusion - Evidence is suggestive of a protective effect from soya foods against developing prostate cancer.

18. Thankyou Kate Arthur Company Dietitian Alpro UK