The Science of Soy - The Eastern Viewpoints; Part A1:

Soy and the risk of cerebral infarction (CI) and

myocardial infarction (MI) in Japan population
By Kyle J. Norton
Health article writer and researcher; Over 10.000 articles and research
papers have been written and published on line, including world wide health,
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Some articles have been used as references in medical research, such as
international journal Pharma and Bio science, ISSN 0975-6299.
Soy foods, including tofu have been in traditional Chinese diet over
thousands of year, according to Chinese literature. The reduced risk of
chronic disease in Asian population, including metabolic syndrome such as
cardiovascular diseases, obesity and diabetes and lesser menopause
symptoms in advanced age, may be aided by eating a lot of soy food
accompanied with large portion of vegetables and fruits. Indeed, according
to the study, only 10% of women in the East are experience symptoms of
menopause in advanced age compared to over 70% of their Western
counterparts.
According to Dr. Mark Messina, Ph.D., Soy foods contributed from 6.5%8
to 12.8%7 of total protein intake in older adult in Japan.(b)
The approval of cardiovascular benefit of soy by FDA in 1999 accompanied
with the discovery of health benefits in clinical studies over past
decade, prompted the promotion and advertisement of soy's health benefits
in every aspect in Western society. Evidences could be seen by walking
through the supermarkets and drug stores. Soy supplements and products
such as tofu, soy milk, soy-based infant formula, and meatless texturized
vegetable protein burgers were widely available. According to the United
Soybean Boards 20042005, 25% of Americans consumed soy foods or
beverages at least once per week, and 74% viewed soy products as healthy.

Today, the promotion of soy is no longer existed, it may be results of

discovery of adverse effects in single ingredient and animal studies, as
intake of soy is associated to induce risk of certain mammary cancers and
infertility. The publication of the result have drawn many criticisms.
According to Thomas Badger, director and senior investigator at the
Arkansas Childrens Nutrition Center in Little Rock, these effects are seen
only under certain experimental conditions that are not likely to occur in
humansand therein lies the crux of the debate(a). Equol (4',7isoflavandiol), an isoflavandiol metabolized from daidzein may be the
causes, as 90% of Eastern population are equol producers but only 30% in
the West.
The explanation of the positive effect of soy isoflavones in reduced risk of
mammary cancers by University of Goettingen may be interesting, as
researchers said" Most importantly, there is dispute as to whether
isoflavones derived from soy or red clover have negative, positive or any
effect at all on the mammary gland or endometrium. It is beyond any doubt
that soy products may have cancer preventing properties in a variety of
organs including the mammary gland. However, these properties may only
be exerted if the developing organ was under the influence of isoflavones
during childhood and puberty".
Soybean is genus Glycine, the family Fabaceae, one of the legumes that
contains twice as much protein per acre as any other major vegetable or
grain crop, native to Southeast Asia. Now, it is grown worldwide with
suitable climate for commercial profits.
Nutrients
1. Carbohydrates
2. Dietary fiber
3. Fat
4. Protein
5. Essential amino acid
6. Vitamin A
7. Vitamin B6
8. Vitamin B12
9. Vitamin C
10. Vitamin K
11. Calcium
12. Iron
13. Magnesium
14. Phosphorus

15. Potassium
16. Sodium
17. Zinc
18. Etc.
Phytochemicals
1. Isoflavones
2. Genistein
3. Saponins
4. Beta-sitosterol
5. Daidzein
I. Soy in Eastern population
A. The Japanese population
Japan, an island nation in the Pacific Ocean, lies to the east of the Sea of
Japan, China, North Korea, South Korea and Russia, stretching from the Sea
of Okhotsk in the north to the East China Sea and Taiwan in the south(1).
According to Moriyama, Japanese women and men live longer and healthier
than everyone else on Earth, it may be result of healthier Japanese diet and
lifestyle. According to the World Health Organization, the Japanese have an
average of 75 years healthy living with disability-free, it may be due to
average soy intake 10 to 70 times higher than in Western people(1a)(1b)
A.1. Soy and the risk of cerebral infarction (CI) and myocardial
infarction (MI) in Japan population
The searching of the Keywords in PubMed, soy and heart diseases and
stroke in Japan found 3 studies, all showed the positive effect of soy in
reduced risk heart disease and stroke.
Cerebral infarction (CI) is defined as a type of ischemic stroke due to
blockage in the blood vessels supplying blood to the brain.
Myocardial infarction (MI) is also known as heart attack. It is defined as a
condition of blood stop flowing properly to part of the heart as a result of not
receiving enough oxygen.
According to National Cardiovascular Center, Japan, the studied 40,462
Japanese (40 to 59 years old, without cardiovascular disease or cancer at
baseline), yields interest results.
People who consume more soy are less likely to be current smokers but
more likely to be hypertensive, with men are more likely to have diabetes
mellitus. The frequency of soy intake was positively related to daily intake

of rice, vegetables, fruits, fish, potassium, calcium, carbohydrate,

polyunsaturated fatty acid, saturated fatty acid, fiber, and isoflavones for
both sexes.
The study started in the 1990 with food-frequency questionnaire included 44
foods with 3 questions to assess soy, bean, and miso consumption. The 1995
follow-up questionnaire covered 147 foods with 8 questions on soy
products.
The result is astonishing, during a follow-up period that averaged 12.5 years,
1230 strokes were documented, of which 1137 were confirmed through
imaging or autopsy. eventhrough high isoflavone intake was associated with
reduced risk of CI and MI in middle-aged Japanese subjects, but not in men
and dietary isoflavones and may be beneficial to postmenopausal women for
the prevention of ischemic CVD(2). Intake of miso soup showed to reduce
risk of hypertension but did not contributed to ischemic CVD mortality in
neither men or women.
Strong evidences of epidemiological studies from the East and West have
shown that hyperlipidemia is a major risk factor in contribution to heart
diseases, notably on intermediate end points(3)(4). Soy foods intake has
been known to contain lowering cholesterol and blood pressure effects.
According to the Veterans Affairs Medical Center, daily soy protein showed
a significantly decreased serum concentrations of total cholesterol, LDL
cholesterol, and triglycerides without significantly affecting serum HDL
cholesterol concentrations.(4). But the study suggested that the mechanism
of reduced risk of cerebral infarction (CI) and myocardial infarction (MI) for
postmenopausal Japanese women may not be through reduction of lipid
profile but through exposure to a large quantity of isoflavones, which act as
estrogen agonist because estrogen receptors are not occupied with plasma
estradiol in postmenopausal women.
In case of hypertension in the subject of study, although the disease have
been shown to contribute to the early risk factor for the progression heat
disease and stroke(6)(7)(8)(9). Consumption of soy has no effect in reduce
risk of the development of cerebral infarction (CI) and myocardial infarction
for people with histories of hypertension and diabetes mellitus and
medication use for hypercholesterolemia, even soy has shown effectively in
reduced high blood pressure(12)

In support to the above, the dietary intervention study targeting female

students by using cake containing soybean protein and isoflavone at the
Mukogawa Women's University, 4 weeks dietary intake of soy protein found
to reduce CHD risk among Japanese female students with a high plasma
cholesterol level(10) and Dr. Nagata C. at the Gifu University School of
Medicine, Gifu, Japan, in the study of association between soy product
intake and mortality from cancer and heart disease in Japan, suggested that
soy foods intake showed a preventive role in against stomach cancer and
heart disease death(11).
Dr. Yoshihiro Kokubo and the research team also acknowledged the
limitation of the study such as ethic group, measurement errors with nutrient
intake or due to it self report, but insisted that nationwide annual health
screenings may ease the self report concern.
They also clarified that the result of the study of dietary intake of
isoflavones, are not relevant to the association of isoflavone supplement use
with ischemic CVD.
In deed, the effectiveness of soy isoflavone in reduced risk of cerebral
infarction (CI) and myocardial infarction in this case, yields some questions
due to it ethnicity.
a. If soy is found to be effective in reduce risk of hypertension and
hyperlipidemia, why it does not contribute to the reduce risk of cerebral
infarction (CI) and myocardial infarction in men with histories of
hypertension and diabetes mellitus and medication use for
hypercholesterolemia.
Would the medication be the cause? As epidemiological study insisted the
lowering effect of blood pressure and cholesterol are associated to reduce
risk heart disease and stroke.
b. Although soy isoflavone showed an effectiveness in reduce risk of
cerebral infarction (CI) and myocardial infarction and mortality, would
dietary with high in fruit and vegetable also best known for the reduce risk
of heart disease and stroke be also taken into account?
c. The effectiveness of the study may only be true for equol producers
population as 90% of subjects' study are equol producers?
d. Would the "Japanese Phenomenon" interfere with the study, as
administration of isoflavone "inexperienced" women at the time of

menopause, the phytoestrogens appear to share the same effects as estrogen

used in classical preparations for hormone replacement therapy?
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References
(a) The Science of Soy: What Do We Really Know? by Julia R. Barrett
(b) Guideline for healthy soy intake(the Unite Soybean board)
(1) Japan, Wikipedia
(1a) Erdman JW Jr. AHA Science Advisory: soy protein and cardiovascular
disease: a statement for healthcare professionals from the Nutrition
Committee of the AHA. Circulation. 2000; 102: 25552559
(Soy protein and cardiovascular disease)
(1b) van der Schouw YT, Kreijkamp-Kaspers S, Peeters PH, Keinan-Boker
L, Rimm EB, Grobbee DE. Prospective study on usual dietary phytoestrogen
intake and cardiovascular disease risk in Western women. Circulation. 2005;
111: 465471(Cardiovascular diseases in women)
(5) Soy intake and breast cancer risk: an evaluation based on a systematic
review of epidemiologic evidence among the Japanese population by Nagata
C1, Mizoue T, Tanaka K, Tsuji I, Tamakoshi A, Matsuo K, Wakai K, Inoue
M, Tsugane S, Sasazuki S; Research Group for the Development and
Evaluation of Cancer Prevention Strategies in Japan.(PubMed)
(6) Probiotic Beverage with Soy Isoflavone Consumption for Breast Cancer
Prevention: A Case-control Study by Toi M1, Hirota S, Tomotaki A, Sato N,
Hozumi Y, Anan K, Nagashima T, Tokuda Y, Masuda N, Ohsumi S, Ohno S,
Takahashi M, Hayashi H, Yamamoto S, Ohashi Y.(PubMed)
(7) Associations of intakes of fat, dietary fiber, soy isoflavones, and alcohol
with levels of sex hormones and prolactin in premenopausal Japanese

women by Tsuji M1, Tamai Y, Wada K, Nakamura K, Hayashi M, Takeda N,

Yasuda K, Nagata C.(PubMed)
(8) Plasma isoflavone level and subsequent risk of breast cancer among
Japanese women: a nested case-control study from the Japan Public Health
Center-based prospective study group by Iwasaki M1, Inoue M, Otani T,
Sasazuki S, Kurahashi N, Miura T, Yamamoto S, Tsugane S; Japan Public
Health Center-based prospective study group.(PubMed)
(9) Isoflavones--safe food additives or dangerous drugs? by Wuttke W1,
Jarry H, Seidlov-Wuttke D.(PubMed)
(10) Effect of a soybean product on serum lipid levels in female university
students by Takahashi K1, Kamada Y, Hiraoka-Yamamoto J, Mori M, Nagata
R, Hashimoto K, Aizawa T, Matsuda K, Kometani T, Ikeda K, Yamori Y.
(PubMed)
(11) Ecological study of the association between soy product intake and
mortality from cancer and heart disease in Japan by Nagata C.(PubMed)
(12) Association of blood pressure with intake of soy products and other
food groups in Japanese men and women by Nagata C1, Shimizu H, Takami
R, Hayashi M, Takeda N, Yasuda K.(PubMed)
(13) Effects of dietary intake of soy protein and isoflavones on
cardiovascular disease risk factors in high risk, middle-aged men in Scotland
by Sagara M1, Kanda T, NJelekera M, Teramoto T, Armitage L, Birt N, Birt
C, Yamori Y.(PubMed)