Death By Supermarket (11 page)

Before the early ninth century doctor and pharmacist were one and the same. The herbalist both prescribed and prepared medical compounds. Drugs at that time were one step removed from their plant sources. But in the late eighteenth century, pharmacology developed and introduced advances that enabled pharmacologists to isolate active ingredients thought to have the primary healing property for a given condition. Isolating the specific active ingredient responsible for a therapeutic effect has since been the focus of Western medicine. This mentality of isolating active
ingredients from their whole-plant form drives the soy isoflavone supplement industry, which isolates isoflavones from the whole soybean and then markets them in supplement form as a panacea for preventing heart disease, cancer, bone loss, and the symptoms of menopause.

It’s worth noting that isoflavones are a factor in the bitter taste of soybeans, and products such as soymilk taste much better with isoflavones removed. With this financial incentive to go to the trouble of removing the isoflavones, more companies have tried to sell the isolated isoflavones as supplements.

According to Dr. Daniel, isoflavones are “hormonally active substances,” or “estrogen mimickers,” that are endocrine disrupters which can cause thyroid damage, reproductive system disorders, and other problems. Isoflavones can lower testosterone levels, sperm count, and sex drive in men, “estrogenize” baby boys (resulting in tiny penises and breast development), and cause premature puberty in boys and girls, and in women they can disrupt menstrual cycles and cause infertility and vulvodynia (swelling and pain in the external genitalia). Boys born to soy-eating mothers can have a birth defect called hypospadias (the opening of their urethra is in the wrong place).
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In the past, women going through menopause bit the bullet and hoped for the best outcome in post-menopausal old age. The outcome ultimately depended on their genetic predispositions, lifelong diet, and lifestyle habits. Today women have four choices: One, bite the bullet and let menopause take its course. Two, use an equine-estrogen drug, such as Premarin. Three, use bioidentical hormone replacement therapy to replace the sex hormones that are no longer being supplied by the ovaries. And four, bite the bullet and use various alternative medicine modalities, including soy isoflavone supplementation, in an attempt to alleviate the symptoms of sex hormone decline and cessation.

Millions of boomer women have decided not to follow in their mother’s footsteps of zero sex, male-pattern-like balding, hot flashes, facial hair, weight gain, emotional roller coasters, and insomnia, and have opted not
to bite the menopause bullet. First they tried the lucrative equine-drug estrogens, erroneously billed as “hormone replacement.” These drugs are made by extracting estrogen from the urine of pregnant mares and adding drugs, and therefore they cannot be “replaced” in a woman’s body, which never made horse estrogen drugs in the first place. In fact, the horse-estrogen drug was never FDA approved as HRT, but rather was approved to alleviate hot flashes and to reduce bone loss. But in July 2002, an eight-year study by the Women’s Health Initiative was halted early when researchers concluded that Prempro, made by Wyeth, didn’t prevent heart disease or breast cancer; rather, it increased the risk for breast cancer, heart attack, stroke, and blood clots—and also it did not prevent Alzheimer’s or memory loss. So millions of women decided against the horse-estrogen drug. (This study as well as bioidentical hormone replacement [BHRT] are covered more extensively in
Healthy, Sexy, Happy
.)

Since the definition of hormone replacement is replacement of the hormones lost when a woman’s own sex-hormone production declines and ultimately ceases, some users of horse-estrogen drugs switched to BHRT. Bioidentical estrogen is synthesized in a laboratory from plant chemicals, mostly wild yams and sometimes soy, to match the exact molecular structure of the estrogens made by the human female body; it can therefore legitimately be referred to as bioidentical hormone replacment. Taking bioidentical estrogen that is synthesized from soy and prescribed in physiologically appropriate doses is not the same as consuming estrogen-mimicking soy products and isoflavone supplements. (Pharmaceutical companies don’t study BHRT, as natural substances can’t be patented and therefore do not produce the same extravagant returns on their research investment that drug companies have enjoyed with the sales of drugs.)

Many women feel that using BHRT is still “unnatural” and choose to bite the bullet through menopause with the help of various alternative approaches, including soy isoflavone supplements. Soy is the most concentrated dietary source of the phytoestrogen isoflavones genistein and daidzein. These phytoestrogens were touted as the natural way to replenish
declining estrogen levels and were said to relieve menopausal symptoms such as hot flashes, as well as to decrease the risk of heart disease and osteoporosis. Although isoflavone supplementation is a booming business, studies have shown that soy isoflavone supplementation does not consistently alleviate hot flashes or other menopausal symptoms. And as Dr. Daniel said, when women use soy isoflavone supplementation during menopause they risk damaging their thyroid glands, which are already vulnerable in midlife women.
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I emailed Dr. Northrup again. “There appear to be many studies that dispute the claims that soy relieves menopausal symptoms and that, in fact, this claim is not authorized by the FDA.”

She replied, “My position that [soy] relieves menopausal symptoms is based on my clinical experience with hundreds of women. The studies vary widely on what type of soy was used, how much was used, over what period of time, etc. I generally recommend soy powders made from whole soybeans that contain over 100 milligrams of soy isoflavones per day. Any dose that’s lower than that doesn’t give much benefit. But at doses of 100 to 180 milligrams day, you see a decrease in hot flashes, an increase in vaginal moisture, and also a nice effect on skin.”

Dr. Daniel disagreed. “As a clinical nutritionist, I’ve seen many premenopausal and menopausal women who trace hypothyroidism, weight gain, depression, fatigue, poor skin, and hair loss to ‘health food’ regimens including ‘natural hormone replacement’ programs based on soy.”
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But what about taking soy isoflavone supplements to ward off cancer and heart disease? Some studies on the cancer-preventative properties of soy suggest that soy isoflavones might ward off some cancers, but other studies indicate that soy isoflavones may actually increase the risk of cancer, especially breast cancer.

In fact, there is a growing uneasiness within the scientific community that soy isoflavone supplements and products are being marketed without iron-clad proof of the health benefits and, more important, in the face of potential health risks of consuming arbitrary amounts of isoflavones.
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When I attempted to question the safety of isoflavones with one celebrity doctor, the author of numerous books on supplements and other aspects of nutrition, as well as soy, he became defensive and argumentative, accusing the dairy industry of making up lies about soy. Another high-profile nutritionist also became hostile, and accused me of entering into my research with a bias against the FDA. I’d like to pause here and say that fifteen years ago I coauthored my first book, in which we endorsed soy without really researching it. I regret that and no longer endorse that book, and in I fact recently put my remaining thirty copies into recycling. I understand, though, how easy it is to get swept up in the excitement of new research—even though as I wrote that book and the two accompanying cookbooks in the back of my mind I was pondering my own experience in Japan. I sincerely believe that anyone who attempts to educate the public on nutrition has to admit mistakes. Because if I was swept away, then someone who’s not spending their days reading and researching is not likely to question what the media is presenting in easily digested sound bites. In deference to the soy experts mentioned above, I chose not to name them, as my position isn’t to pick fights but to arrive at a truth that will result in the best positive outcome for public health.

Regarding soy isoflavones, Mike Fitzpatrick, Ph.D., is an environmental scientist whose research on phytoestrogens led him to the conclusion that soy isoflavones disrupt the endocrine system. Fitzpatrick found that high daily doses increase the risk for hypothyroidism. “There is potential for certain individuals to consume levels of isoflavones in the range that could have goitrogenic [thyroid inhibiting] effects,” Fitzpatrick writes. “Most at risk appear to be infants fed soy formulas, followed by high soy users and those using isoflavone supplements.”
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Hypothyroidism currently affects up to 40 percent of our population—though many go undiagnosed—and the incidence of hypothyroidism is increasing. The thyroid is a small, butterfly-shaped endocrine gland located just below the Adam’s apple. Every cell, tissue, and organ of your body is affected by the actions of the thyroid gland. Symptoms
of low-functioning thyroid are anemia and bruising easily, weight gain and inability to lose weight, constipation, depression or extreme agitation/anxiety, dry skin, decreased sex drive, dull facial expression, droopy eyelids, emotional instability, fatigue, feeling cold, low body temperature, hoarse, husky voice, slow reflexes, impaired memory, brain fog, infertility, migraines, tinnitus, vertigo, muscle cramps, muscle weakness, puffiness in the face and hands, thinning, coarse, dry hair, and a yellow cast to the skin.
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Hypothyroidism is a life-altering condition that is very difficult to reverse. If you develop hypothyroidism, you’ll likely spend your life in an uphill battle with your weight and suffer the symptoms listed above, which can contribute to type 2 diabetes and heart disease.

Consuming soy isoflavones isn’t the only cause of our rise in hypothyroidism. Fluoride, mercury, and other xenohormones (environmental estrogen mimickers) have also been implicated. But according to Fitzpatrick those “most at risk” are adults who consume a lot of soy products or soy isoflavone supplements and babies who are fed soy formula.

If isoflavone supplements are questionable, what about eating soy, and how much soy should we eat? We continue to hear that Asians have less disease because they eat a lot of soy. But how much soy do Asians really eat? In ancient times, farmers cultivated soybeans to instill nitrogen into the soil so that other crops would thrive. When they did begin to eat small amounts of soy, they subjected it to a long fermentation process to make foods such as miso and
shoyu
(soy sauce). Historically, Asians understood that it was imperative to soak and naturally ferment soy to rid it, at least in part, of naturally occurring antinutrients (compounds that decrease the nutritional value of the plant) and toxins (which serve to protect plants from annihilation by insect and animal predators). The fermenting process, aided by healthy microorganisms, deactivated or eliminated most antinutrients and toxins, improved the soybean’s nutritional profile, made the resulting food item more digestible, and imparted disease-fighting microorganisms to the intestinal tract.

Naturally occurring antinutrients and toxins include allergens, which
can cause a range of reactions from sneezing to death; lectins, which can affect the functioning of your immune system; oligosaccharides, which cause painful gas; oxalates, which block calcium absorption and contribute to kidney stones and, in women, the aforementioned condition called vulvodynia; phytates, which impair absorption of minerals; isoflavones (explained above); protease inhibitors, which interfere with digestion and stress the pancreas; saponins, which may lower cholesterol but also may damage your intestinal lining; and goitrogens, which damage the thyroid gland and can lead to hypothyroidism and cancer.

Since my experience in Japan was contrary to the claims of the soy industry, I felt it was important to understand where the claims that Asians ate a lot of soy were coming from. According to Dr. Willcox, “Our studies of the Okinawan population, who are among the world’s healthiest and longest-lived people, show that adults consume between 60 to 120 grams per day [one to two cups] of soy (ten to one hundred times what Americans consume).”
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Dr. Daniel, however, said that there is inconsistent and contradictory data in
The Okinawa Diet Plan
, Willcox’s subsequent book, regarding the consumption of soy products by Okinawans. In addition, she told me, “Although reported levels of soy consumption in China, Indonesia, Korea, Japan, and Taiwan vary from study to study, Asians eat small amounts of soy, as condiments in the diet, not as staple foods.”
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Suffice it to say, there is much debate about how much soy Asians eat or don’t eat, but everyone agrees that Asians are eating whole, mostly naturally fermented soy food condiments as part of a whole foods diet. In agreement was David Zava, Ph.D., a biochemist with twenty-five years of experience in breast cancer research and the coauthor of
What Your Doctor May Not Tell You About Breast Cancer
, who told me, “I believe [soy] should be consumed in the manner that Asians have consumed it for thousands of years—well complemented with animal protein and a broad variety of vegetables.”
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But what exactly comprised this whole foods diet historically eaten by Asians?

Since space doesn’t allow the analysis of every single Asian diet, let’s take a quick look at the Japanese diet as another example of the whole foods diet Asians historically consumed. While the Japanese traditionally ate more soy than Westerners (we ate virtually none until just recently) the traditional Japanese diet did not comprise soy, soy, soy, and more soy. The average Japanese consumes a diet of more than 100 biologically different foods per week. (In Western countries the recommended minimum is only thirty.)

The traditional Japanese diet includes
meguro
(raw tuna),
shiokara
(pickled squid guts),
kusaya
(dried fish), eggs, pork, beef, and chicken; white rice, linseeds and wholegrain bread, sesame seeds,
soba
(buckwheat noodles),
seitan
(seasoned wheat gluten), and
udon
(wheat noodles); bamboo shoots, eggplant, sweet potato, Chinese cabbage, seaweed, sea vegetables, shitake and matsutake mushrooms, ginger, broccoli, garlic, onions, lotus root, yam, taro, ginger, chicory, truffles, welsh onion, shallots, corn, sansai (garlic, bamboo grass shoots, and fiddlehead fern), green leafy vegetables, carrots, burdock root, diakon radish, and cucumber;
nankusu
(rice porridge); tofu, bean paste, bean curd,
nato
(fermented soy cheese),
okara
(pulp from soymilk), tempeh, edamame (steamed soy pods); azuki beans; toasted sesame oil, coconut oil, rice-bran oil, butter, talo, lard; wasabi, miso, curry, lemon, kuzu root, pickled ginger, sesame seed, mustard, rice based sake wine, dashi-stock and seasoning made from kelp and mackerel,
shoyu
, pickled plums, tea twig, brown rice vinegar, and tamari; sake, soy coffee, and ocha (green tea); and all types of fruits.
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