Soy Sense: science to date

A brief scientific update on the nutritional adequacy and safety of soy formulas.

Soy formula (SF) has been available for over a century and is fed to millions of infants worldwide. Concerns over the adequacy and safety of its use have been raised, mostly due to the potential estrogenic effects of isoflavones contained in SF. This concern however is not supported by convincing data1; recent studies and meta-analyses have provided reassurance on the long-term use of soy in infants and toddlers.

Soy supports normal growth

While it is recognised that infants go through developmental stages that are sensitive to estrogens, a meta-analysis by Vandenplas et al published in 2013 showed that SF intake in normal full-term infants (even during the most rapid phase of growth) is associated with normal anthropometric growth, adequate protein status, bone mineralisation and normal immune development.2

The same research also concluded that feeding SF to young infants does not negatively impact levels of haemoglobin, zinc, calcium and overall growth. Although SF contains significantly higher levels of aluminum than cow’s milk formula and human milk, there is no risk of aluminium toxicity from SF among term infants with normal renal function.2

Soy allergy overrated

Furthermore, a 2014 meta-analysis which included 40 studies, identified only 2 studies that found a prevalence of soy allergy in infants and children in the general population.3Out of the 1,430 infants analysed in the meta-analysis, only two infants showed evidence of a soy allergy (0.1%).

Soy is safe

The American Academy of Pediatrics supports the use of SF as a safe and effective alternative to provide appropriate nutrition for the normal growth and development of term infants, whose nutritional needs are not being met by breast milk or formulas based on cows’ milk. The previous age-specific recommendation for using SF has been rescinded.4 Clinical practice guidelines established by the Singapore Ministry of Health similarly recommends soy-based formula in the management of IgE-mediated CMPA.5

Clinical Pearl

Modern soy formulas are safe and nutritious options for young children needing them, including those below 6 months of age.



References

1. Badger TM et al. Am J Clin Nutr 2009;89:1668S-72S.
2. Vandenplas Y et al. Br J Nut 2014;10:1-21.
3. Katz Y, et al. Clinic Rev Allerg Immunol. 2014;46:272-81.
4. Kleinman RE, Greer FR (Editors). Pediatric Nutrition Handbook, 7th Edition. American Academy of Pediatrics. 2014.
5. AMS-MOH Clinical Practice Guidelines. Management of Food Allergy. Ministry of Health, Singapore. 2010


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