Is Soy Healthy for Breast Cancer Survivors?

Is Soy Healthy for Breast Cancer Survivors?
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What role do soy phytoestrogens play in the prevention and treatment of breast cancer?

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Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

“[S]oyfoods have become controversial in recent years,…even among health professionals,…exacerbated by misinformation found on the Internet.” Chief among the misconceptions is that soy foods promote breast cancer, because they contain a class of  phytoestrogen compounds called isoflavones. Since estrogens can promote breast cancer growth, it’s natural to assume phytoestrogens might too.

But, people don’t realize there are two types of estrogen receptors in the body—alpha and beta. And, unlike actual estrogen, soy phytoestrogens “preferentially bind to and activate [estrogen receptor beta]. This distinction is important, because the 2 [types of receptors] have different tissue distributions…and often function differently, and sometimes in opposite ways.” And, this appears to be the case in the breast, where beta activation has an anti-estrogenic effect, inhibiting the growth-promoting effects of actual estrogen—something we’ve known for more than ten years. There’s no excuse anymore.

The effects of estradiol, the primary human estrogen, on breast cells are completely opposite to those of soy phytoestrogens, which have antiproliferative effects on breast cancer cells, even at the low concentrations one gets in one’s bloodstream eating just a few servings of soy—which makes sense, given that after eating a cup of soybeans, the levels in our blood cause significant beta receptor activation.

So, where did this outdated notion that soy could increase breast cancer risk come from? The concern was “based largely on research that showed that [the main soy phytoestrogen] genistein stimulates the growth of mammary tumors in [a type of] mouse.” But, it turns out, we’re not actually mice. We metabolize soy isoflavones very differently from rodents. The same soy leads to 20 to 150 times higher levels in the bloodstream of rodents. The breast cancer mouse in question was 58 times higher. So, if you ate 58 cups of soybeans a day, you could get some significant alpha activation, too. But, thankfully, we’re not hairless athymic ovariectomized mice, and we don’t tend to eat 58 cups of soybeans a day.

At just a few servings of soy a day, with the excess beta activation, we would assume soy would actively help prevent breast cancer. And, indeed, “[s]oy intake during childhood, adolescence, and adult life were each associated with a decreased risk of breast cancer.” Those women who ate the most soy in their youth appear to grow up to have less than half the risk.

This may help explain why breast cancer rates are so much higher here than in Asia—yet, when Asians come over to the U.S. to start eating and living like Americans, their risk shoots right up.  For example, women in Connecticut—way at the top of the breast cancer risk heap—in their fifties have, like, ten times more breast cancer than women in their fifties living in Japan. But, it’s not just genetic, since when they move here, their breast cancer rates go up generation after generation, as they assimilate into our culture.

Are the anti-estrogenic effects of soy foods enough to actually change the course of the disease? We didn’t know, until the first human study on soy food intake and breast cancer survival was published in 2009 in the Journal of the American Medical Association, suggesting that “[a]mong women with breast cancer, soy food consumption was significantly associated with decreased risk of death and [breast cancer] recurrence.” Followed by another study, and then another, all with similar findings.

That was enough for the American Cancer Society, who brought together a wide range of cancer experts to offer nutrition guidelines for cancer survivors, to conclude that, if anything, soy foods should be beneficial. Since then, two additional studies have been published, for a total of five, and they all point in the same direction. Five out of five, tracking more than 10,000 breast cancer patients.

Pooling all the results, soy food intake after breast cancer diagnosis was associated with reduced mortality (meaning a longer lifespan) and reduced recurrence—so, less likely the cancer comes back. Anyone who says otherwise hasn’t cracked a journal open in seven years.

And, this improved survival was for both women with estrogen receptor negative tumors and estrogen receptor positive tumors, and for both younger women, and for older women. Pass the edamame.

Please consider volunteering to help out on the site.

Image credit: Kristina DeMuth. Image has been modified.

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

“[S]oyfoods have become controversial in recent years,…even among health professionals,…exacerbated by misinformation found on the Internet.” Chief among the misconceptions is that soy foods promote breast cancer, because they contain a class of  phytoestrogen compounds called isoflavones. Since estrogens can promote breast cancer growth, it’s natural to assume phytoestrogens might too.

But, people don’t realize there are two types of estrogen receptors in the body—alpha and beta. And, unlike actual estrogen, soy phytoestrogens “preferentially bind to and activate [estrogen receptor beta]. This distinction is important, because the 2 [types of receptors] have different tissue distributions…and often function differently, and sometimes in opposite ways.” And, this appears to be the case in the breast, where beta activation has an anti-estrogenic effect, inhibiting the growth-promoting effects of actual estrogen—something we’ve known for more than ten years. There’s no excuse anymore.

The effects of estradiol, the primary human estrogen, on breast cells are completely opposite to those of soy phytoestrogens, which have antiproliferative effects on breast cancer cells, even at the low concentrations one gets in one’s bloodstream eating just a few servings of soy—which makes sense, given that after eating a cup of soybeans, the levels in our blood cause significant beta receptor activation.

So, where did this outdated notion that soy could increase breast cancer risk come from? The concern was “based largely on research that showed that [the main soy phytoestrogen] genistein stimulates the growth of mammary tumors in [a type of] mouse.” But, it turns out, we’re not actually mice. We metabolize soy isoflavones very differently from rodents. The same soy leads to 20 to 150 times higher levels in the bloodstream of rodents. The breast cancer mouse in question was 58 times higher. So, if you ate 58 cups of soybeans a day, you could get some significant alpha activation, too. But, thankfully, we’re not hairless athymic ovariectomized mice, and we don’t tend to eat 58 cups of soybeans a day.

At just a few servings of soy a day, with the excess beta activation, we would assume soy would actively help prevent breast cancer. And, indeed, “[s]oy intake during childhood, adolescence, and adult life were each associated with a decreased risk of breast cancer.” Those women who ate the most soy in their youth appear to grow up to have less than half the risk.

This may help explain why breast cancer rates are so much higher here than in Asia—yet, when Asians come over to the U.S. to start eating and living like Americans, their risk shoots right up.  For example, women in Connecticut—way at the top of the breast cancer risk heap—in their fifties have, like, ten times more breast cancer than women in their fifties living in Japan. But, it’s not just genetic, since when they move here, their breast cancer rates go up generation after generation, as they assimilate into our culture.

Are the anti-estrogenic effects of soy foods enough to actually change the course of the disease? We didn’t know, until the first human study on soy food intake and breast cancer survival was published in 2009 in the Journal of the American Medical Association, suggesting that “[a]mong women with breast cancer, soy food consumption was significantly associated with decreased risk of death and [breast cancer] recurrence.” Followed by another study, and then another, all with similar findings.

That was enough for the American Cancer Society, who brought together a wide range of cancer experts to offer nutrition guidelines for cancer survivors, to conclude that, if anything, soy foods should be beneficial. Since then, two additional studies have been published, for a total of five, and they all point in the same direction. Five out of five, tracking more than 10,000 breast cancer patients.

Pooling all the results, soy food intake after breast cancer diagnosis was associated with reduced mortality (meaning a longer lifespan) and reduced recurrence—so, less likely the cancer comes back. Anyone who says otherwise hasn’t cracked a journal open in seven years.

And, this improved survival was for both women with estrogen receptor negative tumors and estrogen receptor positive tumors, and for both younger women, and for older women. Pass the edamame.

Please consider volunteering to help out on the site.

Image credit: Kristina DeMuth. Image has been modified.

Doctor's Note

This is probably the same reason flax seeds are so protective. See Flax Seeds & Breast Cancer Survival: Epidemiological Evidence and Flax Seeds & Breast Cancer Survival: Clinical Evidence.

What about women who carry breast cancer genes? I touched on that in BRCA Breast Cancer Genes & Soy, and it’s the topic of my next video, Should Women at High Risk for Breast Cancer Avoid Soy?

What about genetically modified soy? I made a video abut that too; see GMO Soy & Breast Cancer.

Who Shouldn’t Eat Soy? Glad you asked. Watch that video too! :)

Not all phytoestrogens may be protective, though. See The Most Potent Phytoestrogen is in Beer and What are the Effects of the Hops Phytoestrogen in Beer?

If you haven’t yet, you can subscribe to my videos for free by clicking here.

91 responses to “Is Soy Healthy for Breast Cancer Survivors?

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  1. Very informative video, thank you. While on the subject could you comment of the equivalency of a serving of soy and a serving of tofu, which is my family’s primary source of soy. In other words is a serving of tofu as listed on a standard tofu “brick” package the same as a serving of soy? Thanks in advance for your help, and thank you for all you do.




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    1. Hello Scott,
      Tofu (aka bean curd) is made by coagulating soy milk — which is made from raw soybeans. But, they don’t use the entire soybean in making soy milk. As you’ve probably read multiple times on this site, it often turns out that whole plants are healthier than foods that are refined from whole plants (e.g. whole wheat vs. white flour) — because healthy components are left out in the refining process. Here is an older Nutrition Facts video which compares tofu, edamame (whole soy beans), and tempeh. Dr. G discusses which is “healthier” without really defining that. Turns out that edamame is healthier than tofu. And tempeh is healthier than edamame. Tempeh is made using the entire soybean, but it is fermented, making tempeh “more antimutagenic than unfermented beans”.

      So, bottom line is that tofu is a healthy food, which contains phytoestrogens, but not as healthy for you as raw soy beans or tempeh. I hope this helps.




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          1. Any chance you have a favorite tempeh recipe you can share with us? I’m trying to switch to tempeh but don’t have some old standby recipes.
            Cheers!




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              1. Thank you!!! This is why I love this site! A great community of like-minded folks trying to make good choices for themselves and their loved ones and sharing the information. Thank you and love back at ya!




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        1. George: Your premise is not true in my part of the country. If we are talking about traditional soy products: tofu, tempeh, soy milk etc, the vast majority (all?) of the products that I see are either organic (which means not GMO) or specifically labeled as non-GMO. It might be true that the highly processed foods have GMO soy, but those products are not what we are talking about when we tell people about the health benefits of soy.
          .
          Have you looked recently at the tofu/tempeh section of your grocery store? Are you seeing something different than I see?




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        2. According to USDA figures (see attached) about 93% of the soy grown in the US is GMO. As Thea points out, a way to ensure you are not getting GMO is to read the label and go for organic or products labeled “non GMO.” So far as GMO safety is concerned, I think the jury is (or should be) still out. Particularly since the majority of the studies done do not consider glyphosate. Heres a good review of studies supporting this as an issue: https://enveurope.springeropen.com/articles/10.1186/s12302-015-0052-7
          https://uploads.disquscdn.com/images/38aaf7b37c99459d68b3ad2cebc5ec8c0b8b5b2d6f6bce35a64d3bd37fc058e4.png .




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        3. My family had a farm when I was growing up and we grew soybeans. We used to play hide-n-seed in the soy bean rows and ate them while lying still. Great memories. Pre-GMO of course.
          A great deal if not most soybeans grown now are, in fact, GMO soybeans. However, then as now, a great majority – if not all – of GMO beans are raised as feed for animals. We also raised feed corn which is not something you would ever want to eat.
          As a matter of personal interest and because of comments like yours, I regularly look at the various manufacturers of tofu and tempeh I see in the stores. I have not ever seen packaging that does not state “No GMO” soy. And this is whether the product is organic or non-organic.
          We feed a great deal more soy, over all, – and other garbage – to our animals than to ourselves. I”m sure someone out there knows how many pounds of grain it takes to make one pound of meat – and its astronomical. But the GMO stuff goes for feed animals and its an important piece of information to be aware of.




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        4. George: Excellent question. I just looked in PubMed, and found this interesting article, which certainly gives me pause. I guess you know that the main reason companies like Monsanto grow GM soy (and maize and rapeseed oil) is to make them tolerant to herbicide treatment, especially RoundUp. My understanding from this article is that these GM crops contain pesticide residues. They also mention a rat study in which the group fed GM feed had increased weight of their hearts, and increased plasma triglycerides.

          I just checked the “Organic” tofu in my fridge, and in small print it says that products labeled organic are “not permitted by U.S. Law” to contain genetically modified ingredients.




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    2. In this video:
      Who Shouldn’t Eat Soy?
      Dr Greger quantifies serving sizes in terms of the amount of protein:
      “A significantly lower risk of bone fracture associated with just a
      single serving of soy a day—the equivalent of 5 to 7 grams of soy
      protein, or 20 to 30 milligrams of phytoestrogens.”

      To me, it is easier to track the total grams of soy protein consumed in a day (I use cronometer). I love soy (soy milk, tofu, natto, tempeh, miso), but it is possible to eat too much:
      http://nutritionfacts.org/video/how-much-soy-is-too-much




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    3. http://clincancerres.aacrjournals.org/content/23/3/814

      This recently published article suggests a slightly different message re: breast cancer survivors and soy consumption. It suggests thatonlybreast cancer survivors who have previously consumed soy, should continue. I appreciate it is based on a mouse model which your article clearly identifies as not the same as humans with respect to genisten metabolism.

      Does this new information change your final conclusions at all?




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  2. I’m not buying it! Soy and corn are the most easily genetically modified foods and that in itself is a concern. I’m also not comforted by the statement that “we’re not hairless athymic ovariectomized mice”…. If a mouse got breast cancer as a result of being fed soy products, regardless of the amount, for me it is a good enough reason to be cautious of it. I personally eliminated it from my diet, also because I believe that its daily consumption contributed to my daughter and my mom’s thyroid disease.




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    1. As often said, everything is toxic if taken in excess. A few unfortunate marathon runners died from excessive water consumption. We need fluorine, sodium, chlorine, iodine, selenium – and I believe arsenic. All of which are deadly poisons if taken in excess.

      The devil is in the details whether you’re a mouse or a caveman.




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    2. Then simply buy non-GMO soy. It is very easy to do since anything labeled “organic” is prohibited from containing GMO ingredients. I understand your concern, but I think I’ll stick with the science that says that soy in normal amounts, as amply supported by the studies cited in this video, is actually protective of breast cancer and even increases the lifespan of women who have already been diagnosed with breast cancer.

      As to thyroid impacts, I think a good indication of this would be to examine the rates of thyroid disease in populations who eat soy as a part of their normal and regular diet. I searched to see if I could find a scientific journal article on the relative rates of thyroid diseases between western and asian countries to see if populations eating a diet higher in soy foods have a higher incidence rates, but I couldn’t find that information in a short search on Google Scholar. I did find the following meta-analysis of 14 studies, Effects of soy protein and soybean isoflavones on thyroid function in healthy adults and hypothyroid patients: a review of the relevant literature that indicates that healthy adults need not be concerned about consumption of soy. However, soy foods may have a small impact on absorption of synthetic thyroid hormone and so those that require thyroid hormone replacement may need to increase the amount they take, but these people need not avoid soy.




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    3. As someone who has hypothyroidism in the family and want to avoid it myself if possible, I continue to enjoy 1.5 cups of soy milk and the occasional tempeh burger or tofu vegie curry. Thanks to Dr Greger, I am confident of the health benefits. I am so glad however that I removed seafood, fish products, most seaweed and other high iodine products from my diet. http://www.thyroid.org/hypothyroidism/

      gmo soy is used in animal feed products. nongmo and organic soy products are widely available for human consumption.




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        1. hi WFPBRunner! Thanks for the article. It did mention that other trials have had different results NOT showing rising tsh with soy consumption. I have a couple of questions for my next doctor’s visit in mind now. I do get tested for tsh, and though it had been starting to climb prior to wfpb eating, it has since tested at 4 or below. I had asked her about taking iodine supplements, but she said definitly not.. iodine can put a person with genetic predisposition for hashimotos into hypothyroidism. Whats frustrating is that too low od iodine can do the same. I did find info on the net about this months ago, and will post it if I can find it again.




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      1. Many vegans and vegetarians are iodine deficient. My TSH went down after a year of supplementing Iodine/selenium. Iodine is an important nutrient for the whole body, not just the thyroid.




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  3. Thanks for the clarification of this subject!
    Mrs Plantstrongdoc likes soy-products…
    Very soon we will se various health claims for junk products containing soybean derivatives – but they won’t fool us here at NF! :-)




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  4. I am unable to find a source of frozen edamame that is not sourced from China. This year I plan to grow my own soybeans,apparently they’re quite easy to do. My mouth is already watering at the thought of them……can’t wait for summer.




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        1. A matter of debate. Personally I don’t care to be the lab rat that gets to test the consequences of lateral gene transfer genetically integrating its T-DNA into the human cell genome from a chemical company bastardizing our food supply to increase their profits!




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      1. We are very lucky to have mild winters here. However snow is in the forecast for the weekend. What the heck, a good time to settle down with seed catalogues and plan the garden.




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  5. Informative and enlightening as always. Now my only dilemma seems to be whether or not I debate my breast cancer survivor grandmother AGAIN on this information she just refuses to accept because her “educated” Dr says, “stay away from all soy!” Other than changing my life completely because of your book Dr Greger, you’ve also forced me into an awkward position of unwanted teacher. No one in my life (family or friends) excepts my new (4 wonderful months) of fully whole plant based lifestyle or excepts any knowledge I learn and would like desperately to kindly and non aggressively pass along. It’s a headache and heartache to carry knowledge of a better way when no one cares to learn or even consider a shift. But never the less YOU have changed my life. And consequently my two daughters (7 and 8). They have simply no real choice but to soak in what I pass along at this age. At 28 I am learning how to finally love myself from the inside out and I have your book and your hours devoted to this website to thank. So, thank you … from the bottom of my healthy heart!

    Rebecca Mousseau
    Rebeccamousseau@aol.com




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    1. Don’t take it personally. My experience is that very few people are willing to even consider a change to a whole food plant-based diet (WFPBD). They think the diet is extreme and open heart surgery is normal. Be thankful that you can pass on your knowledge to your two daughters.

      By the way, did you mean to publish your email address? You can edit that out if you want to avoid the spammers.




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    2. Maybe print out the journal articles that Dr. Greger referenced for this video and give your Grandmother a copy. And while you are at it print an extra copy for her doctor that either you or she can give to him/her. As for general acceptance I am right there with you. It is very very hard to watch people committing slow motion suicide with their forks.

      But if they won’t believe you on health, but they pride themselves on being environmentalists and good stewards of the earth, you might also mention that something around 30% (with estimates ranging from 18% to 51%) of all greenhouse gases originate directly and indirectly from animal agriculture. Every car, truck, bus, train, plane and ship in the world accounts for 14% of greenhouse gases. So with a simple change in diet they can eliminate their largest single impact on global climate change. Animal agriculture is responsible for 90% of the deforestation in the Amazon rain forest. Also is the fact that animal agriculture is responsible for 50% of all freshwater usage. In California 47% of all freshwater usage is due to the meat and dairy industries with direct household usage only accounting for 4%. So California only has a drought because animal agriculture uses up more than half of the freshwater. No amount short showers and low flow toilets will fix this.

      And of course you could always ask them if they would ever eat a cat or a dog, and if that is abhorrent to them, ask them why eating a pig, cow or chicken doesn’t. Health, environmentalism and compassion for animals all point to exactly the same place, a whole food, plant based diet. It doesn’t matter how you get there, just that you do.




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      1. Jim Felder: I would add that when you say, “…compassion for animals…”, that includes human animals too. I understand that the devastation that the animal industry has on the environment is causing human suffering and will just get worse. Then add in the suffering of the humans who work in the animal industry, everything from PTSD to cancer. Even people who care only for humans have good reasons to enjoy a delicious WFPB diet.




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      2. Jim,

        Re your statement : “47% of California’s water use is attributable to meat and dairy”.

        You didn’t tell the whole story! Another 46% goes onto other agricultural products, however even that combined figure does not give us a look at the big picture.

        Unlike the metals that go into our landfill water can not be destroyed or lost forever.
        The ‘environmental cost’ of water is loss of river habitat et. c, and thereafter species, but can we put a number on that?

        If we compare food production to water used then fish easily wins the race.
        After that it is not clear-cut that cereals and pulses are the most water efficient foods.
        From reports available from the water footprint site we can calculate the estimated water input relative to protein, calories and fat:

        – roots and tubers use the least water per calorie produced;
        – butter uses the least water per gram of fat production;
        – and cereals/pulses use the least per gram of protein (after seed oils?) … next comes milk and eggs.

        However, as the cereals and pulses are less complete, in protein, than milk and eggs it is necessary to eat more of them to obtain protein sufficiency. In addition to that their protein availability is also lower and so they come a lot closer to milk and eggs when allowance is made for those facts.

        http://waterfootprint.org/media/downloads/Report47-WaterFootprintCrops-Vol1.pdf
        http://wfn.project-platforms.com/Reports/Mekonnen-Hoekstra-2012-WaterFootprintFarmAnimalProducts.pdf

        http://www.nutribodyprotein.com/protein-types.php

        Soy Protein
        Soy protein is not an effective alternative. It is high in allergens (some 28 different proteins present in soy have been found to bind to IgE antibodies). It’s also worth noting that the more soy protein you eat, the more likely you are to develop allergies to it — and the more severe those allergies are likely to become. Soy also blocks the absorption of important minerals such as calcium unless the phytates have been removed, and soy contains high levels of phytoestrogens, which although beneficial in moderate amounts, can be counter-productive in large amounts — particularly for children.
        In addition, although its biological value is not bad at 70-80, it’s net protein utilization at 61 is quite low. In fact, unless it has been fermented, soy protein contains potent enzyme inhibitors that block the action of trypsin and other enzymes needed for protein digestion. This can create significant amounts of gas, in addition to promoting pathological conditions of the pancreas, including cancer. As a side note, soy protein was once considered a waste product of the soy oil industry and used almost exclusively as cattle feed.




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        1. Rada: I don’t have time to address all the issues with your post. I’ll address one important point for now. You wrote: “…landfill water can not be destroyed or lost forever.” Humans are using our drinking water faster than it can be replenished. We are using up our reservoirs of fresh water at alarming rates. That is the issue. That is why the vast amount of water used for animal agriculture compared to plants is a serious problem.

          There are a lot of articles out there to explain the crisis. Here are two to get you started: http://earthobservatory.nasa.gov/blogs/earthmatters/2014/11/05/earths-disappearing-groundwater/ and http://www.alternet.org/story/64948/our_drinkable_water_supply_is_vanishing/ “California’s Department of Water Resources predicts that, by 2020, if more supplies are not found, the state will face a shortfall of fresh water nearly as great as the amount that all of its cities and towns together are consuming today,…” and “The crisis is also worldwide, most noticeable in Mexico, the Middle East, China and Africa.” and “Water promises to be to the 21st century what oil was to the 20th century; the precious commodity that determines the wealth of nations.” That’s not the world I want to live in. With the continued consumption of animal products, it’s the world we are going to get.

          We can not address a problem until we understand that it exists. It is vital that we not tell people or imply that water use does not matter because it “cannot be destroyed”. Animal agriculture is undeniably a serious problem for a very basic need – the future of drinking water.




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          1. Thea,

            The world we are living in now is not the world that I prefer to live in.
            I am just as passionate about it as you are however I think the view that it can all be put down to animal agriculture is naïve.
            It is a complex matter and I’m not an economic environmentalist so I don’t know what the answer is.
            I do know that the root cause is global population growth and the attitudes and behaviours of the majority.

            I understand the subject is too big for us to discuss and we are too busy anyway.
            I am just challenging the belief that cereals and pulses are the most water efficient foods.
            If you do the numbers they are not number one in any category (fat, protein or carbs).
            In practical terms they are the most water efficient means of producing carbs, based on the raw numbers, but if we dig into the numbers they are not e.g. soy is the most water efficient cereal but in the WaterFootprint data they don’t calculate how much water is used to produce the fermented soy, soy milk or soy derived products that most of us eat (I asked my local produce store owner about canned soy beans and she just laughed. She no longer stocks them because no one eats them).
            Using Chickpeas as the example (based on their shelf space in local supermarkets I assume they are the most popular legume in the western world?) the raw estimates, for Chickpeas, is 4177 cubic metres water/ton produced, which is worse than milk and eggs and only marginally better than chicken meat.

            The data used by the WF site is also very general and old.
            It doesn’t calculate water use for minority products like Tempeh, grass feed animals and aquaculture let alone the emerging technologies.

            P.S

            coffee is 18925 cubic meters/ton
            nuts are 9063 cubic meters/ton
            The good news is red wine is only 870 cm/ton so I can continue to enjoy a glass or two :-)




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    3. Rebecca, I totally understand your heartache. However, as the old saying goes, you can lead a horse to water, but you can’t make them drink. All you can do is put it out there by doing what Jim Felder and Thea suggested. But if she & her doctor still adamantly refuse to listen, you have to let it go & not take it personally. Perhaps with time if she sees a change in you and sees how much healthier, happier, energetic, etc. you are, she might come around. But until then, please give yourself a pat on the back for trying as well as for having an open mind & finding a better way for you & your kids!




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    4. Rebecca, I can certainly relate, but good for you! Nobody wants to hear they need to make a change, no matter the obvious benefits, even when they are losing limbs, eyesight, and have no quality of life. Truly SAD.




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  6. I’m allergic to soy but can have it in very small quantities maybe once or twice a week. I’ve been told that people who are allergic to soy can still eat tempeh because it’s fermented. Has anyone else ever heard this or know if it’s true? I haven’t tried tempeh because the last time I ate too much soy, I was so sick that I thought I was going to have to go to the hospital. Don’t want to go through that ever again.




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  7. Soy beans are highest in fat of any legume (except peanuts). Shouldn’t we be eating fewer soybeans to avoid the negative health effects of a high fat diet, such as diabetes, heart disease etc? Aren’t there other beans we can eat that are also help prevent cancer? I understand that it’s the colored beans, not soy, that have the highest antioxidant values also. So, why not eat red and black beans and red lentils and cut back on soy for better health?




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    1. I don’t believe the amount of fat from whole soy foods eaten in reasonable amounts represents an overconsumption of fat. But you are correct that other beans have much lower percentage of calories from fat (which is why we probably don’t see bottle of black bean oil in the store). Oh, and interesting little fact, red lentils are just decorticated yellow lentils. So basically inside each yellow lentil is a little red lentil yearning to turn into mush in our soups to give them a nice thick texture.




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    2. I’m not sure about a “high” fat diet, however long ago the notion was debunked that a low fat diet was ideal (at least one consisting of common Western refined, high glycemic index carbohydrates, like white flour, white rice and potatoes). I believe that healthy fats in normal amounts are OK. In addition to fats, soybeans contain fiber and other healthy components (as discussed in this video), and soy oil is not an unhealthy saturated fat.
      Over 10 years ago I used to be on an extremely low fat “healthy” diet. Then I had my lipid profile done and the Dr. said all OK; everything was low. Then I checked the numbers myself online and while everything was acceptable, considering how much I avoided fats the numbers were barely in the acceptable range. I then began exercising more, and no longer minimized the consumption of “healthy” fats such as nuts, avocado, olive oil (at the time I also ate other oils and some mostly white meats). I continued to prefer whole foods, I don’t remember but I may then have increased this. This was a more pleasant diet to maintain. One year late my lipids were measured again, and HDL was way up, LDL down, and the ratio of total cholesterol/HDL dropped by 1/2 (that’s good), so now I had less than 1/2 the average risk of heart disease, even though my family tends toward high cholesterol .




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      1. “long ago the notion was debunked that a low fat diet was ideal (at least
        one consisting of common Western refined, high glycemic index
        carbohydrates, like white flour, white rice”

        That statement mixes two independent characteristics. Low fat on the one hand and refined carbohydrates on the other. If you have scientific studies that back the assertion that a low fat diet, say 10-20% fat by calories, of whole plant food (w/ or w/o a very small animal food) is not “ideal” or healthy I’d seriously be interested in reading them. (Blog posts and books/articles by science journalists don’t count.)




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        1. “If you have scientific studies that back the assertion that a low fat diet, say 10-20% fat by calories, of whole plant food (w/ or w/o a very small animal food) is not “ideal” or healthy I’d seriously be interested in reading them. ”
          I didn’t mean to say this.
          I tried to say that a low fat diet “one consisting of common Western refined, high glycemic index carbohydrates, like white flour, white rice and potatoes” wasn’t healthy, and I gave my own case as an example, although my diet should have been better than the typical, bad “low fat diet”.

          I said, “I believe that healthy fats in normal amounts are OK.”. So I don’t think we have any disagreement. However, on second thought I shouldn’t commit to whether or not fat consumption is good or not in a whole foods plant based diet.
          I only meant to tell Rhonda that the old concept that all fat was bad, and all low fat diets were good was out of date.




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  8. Sloan Kettering medical oncologists still tell their breast cancer survivors to avoid soy. If you are ER+ and taking an aromatase inhibitor why do they tell you to avoid soy? They are suppose to be the country’s leading experts on breast cancer. None of them crack open any medical research? They are a leader if not the leader in breast cancer research as well as other cancer research in the USA.

    Putting breast cancer aside for a moment Dr. Cauldwell Esselstyn (a preeminent plant based heart surgeon) not recommend soy, nuts, or avocado for his heart disease patients. Is soy (either tofu, tempeh or edaname) recommended for people who have arteriosclerosis or heart disease, and if so why does Dr. Esselstyn say it is not recommended?




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    1. One has to remember what Esselstyn is working on with his diet. IF you are working on reversing years of fat accumulation in your veins and arteries, you do not want to add more fat (flames) to the body (the fire). So he is very strict about no fat if you are reversing your heart disease. In his book, he also states that if you do not have heart disease and are not trying to reverse that, then you can have some fat in your diet. But not a lot. He explains this clearly in his book.




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      1. The American Heart Association recommends that you keep your saturated fat to about 13 grams a day or less. Half a cup of firm tofu has 1.1 grams; a cup of green raw soybeans has 2 and a cup of cooked mature soybeans has 2.2 grams of saturated fat. So it seems that a few servings of soy won’t reach the safety limit for saturated fat, as long as you don’t eat too much else that’s high in saturated fat that day. So be careful with nuts. An ounce of shredded coconut meat has 16 grams of saturated fat; Brazil nuts have 0.8 grams per kernel, an ounce (a good-sized handful, or around a quarter cup) of cashews have 2.2 grams if raw, 2.4 if roasted in oil, filberts come in at 1.3 grams per ounce; macadamias: 3.4 gm/oz, peanuts: 1.9 gm/oz pine nuts: 1.4 gm/oz, pistachios: 1.5 gm/oz and walnuts 1.7 gm/oz. Other plant foods that are high in saturated fat include olives at 0.3 gm/oz (about 4 olives) and avocados at 2.2 grams per half a fruit.




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  9. Thank you so much for clarifying this issue. I was born and raised in Japan and have been saddened that soy has received such bad reputation in the US. I always believed that organic soy was a far better protein choice than red meat that is not organic/grass-fed. My question is that is it still better to limit soy consumption if someone has thyroid issues? I once read somewhere that the amount of soy we normally eat would not really affect the thyroid. Another question is that when it comes to soy milk, my gut always told me that soy milk was not as healthy as almond milk or coconut milk. Am I wrong?




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  10. Hey Doc,

    This question is off-topic because I found no relevant video for this question:
    There are some studies that show that the chances of children developing egg allergy is higher if they’re not exposed to eggs at a very young age. Since we live in a world where important vaccines, such as yellow-fever vaccine, contain egg proteins in their composition (and so there are advantages in not being allergic to eggs that go beyond being able to eat foods that contain eggs), would you recommend feeding eggs to small children right after they start eating real foods?

    Thanks in advance.




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    1. Good question Tyler! I just did a brief search to try to see if I could find some information for you on Pub Med but I’m not turning up any helpful studies on egg allergies in children. Would you mind sharing the ones you’ve seen so we can try to gather information to answer your question? In the meantime I’ll search some other sources to see what might be available in the literature pertinent to the topic.




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  11. Battered Gingered Tofu & Salad
    Tofu cut into blocks is marinade with Light Soya Sauce and grated fresh ginger in a zip bag overnight.(or flavoued bread crumb as well Garlic/Onion powder/black pepper)
    The batter is 1 tbl of self raising flour & 1 tbl of rice flour, plus freshly grated ginger in the batter & Pink Himalayan Salt.
    For non Vegans top with sour cream and sweet chilly sauce & drizzle Sriracha Chilly sauce, being Vegan I used Lemon juice and black pepper. https://uploads.disquscdn.com/images/42dd5548dd6d4db676e8275cb30f073da0b6b556bef94d93fc2a7d167e2af60f.jpg




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    1. Tony-you live in a country where the government actually wants the people to be healthy. In the US, the government backs the corporations in any conflict with health.




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  12. Here is a note from NF staff: As you may have seen, we’ve updated our commenting platform and are no longer using Disqus. We will be updating the commenting information in our Help Center shortly. Now, rather than logging into Disqus to post a comment, you will simply use your NF.org account information to log into the site and post comments – simple as that! If you have any issues right now, please submit a question to our help desk and we will respond as soon as we can. Thank you!




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  13. What about the lectin content in soy? I’ve been a vegan for many years and have enjoyed the health benefits it has brought.
    Recently I’ve been challenged by some friends about eating foods with high lectin content (many of which I eat every day including soy).
    They are basically quoting the beliefs of Dr. Gundry that most health problems are caused by high lectin foods.
    I would love to hear Dr. Greger’s take on the Gundry diet.




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    1. Tom Halverson: I found one blog post on NutritionFacts which talks about lectins. Here is a quote:
      .
      “Modern paleo advocates claim that these foods weren’t part of Paleolithic-era diets, but new research challenges that assumption.5 They also argue that lectins naturally present in these starchy foods are harmful to human health. Consuming too many lectins can cause significant gastrointestinal distress. However, because legumes and grains are almost always consumed in a cooked form—and lectins are destroyed during cooking—eating beans and grains doesn’t result in lectin overload. Sprouting also reduces lectin levels in plants, although not as effectively as cooking. Generally, pea sprouts, lentil sprouts, and mung bean sprouts are safe to consume, as are sprouted grains, which are naturally low in lectins. Most larger legumes contain higher amounts and should be cooked.” from: http://nutritionfacts.org/2014/09/23/will-the-real-paleo-diet-please-stand-up/
      .
      Since I eat my grains and legumes cooked, I consider the lectin brouhaha to be much ado about nothing.
      .
      In the past, Tom Goff has posted some additional helpful takes on the subject. Here are some quotes from Tom Goff’s previous posts.
      .
      “…problem with such claims is that people in the past ate huge amounts of (whole) grains (compared to modern-day Americans). Some people still do. There is no record of such people suffering abnormally high rates of toxicity or inflammation-related diseases. If anything, the exact opposite is the case eg
      .
      “This meta-analysis provides further evidence that whole grain intake is associated with a reduced risk of coronary heart disease, cardiovascular disease, and total cancer, and mortality from all causes, respiratory diseases, infectious diseases, diabetes, and all non-cardiovascular, non-cancer causes. These findings support dietary guidelines that recommend increased intake of whole grain to reduce the risk of chronic diseases and premature mortality.”
      http://www.bmj.com/content/353/bmj.i2716
      .
      Further, reviews of the health effects of grain lectins do not support the wild claims found on the internet or sensational mass market “health ” books
      .
      “We conclude that there are many unsubstantiated assumptions made. Current data about health effects of dietary lectins, as consumed in cooked, baked, or extruded foods do not support negative health effects in humans. In contrast, consumption of WGA containing foods, such as cereals and whole grain products, has been shown to be associated with significantly reduced risks of type 2 diabetes, cardiovascular disease, some types of cancer, as well as a more favourable long-term weight management.”
      http://www.sciencedirect.com/science/article/pii/S0733521014000228
      .
      Sure, it is possible to find toxic effects from grain lectins in the laboratory or in rat studies. You can find toxic effects from virtually anything if you design the study appropriately. Even water is toxic in high doses and specific circumstances. And you can turn such findings into sensational claims that garner a lot of publicity (and sales) – if you leave out all the evidence that does not suit your argument or book sales.”
      .
      And from another post:
      “The Paleo community attitude is certainly strange because there is evidence to show that humans in the Paleolithic period actually did eat legumes – and significant amounts at that – at least in certain locations and in the relevant season eg
      http://www.sciencedirect.com/science/article/pii/S0305440304001694
      .
      However, it seems that once an idea becomes established in the Paleo canon it becomes sacrosanct and no mere inconvenient fact is powerfu l enough to overturn it.
      .
      On lectins and health specifically, blogger has summarised the (Paleo) argument like this:
      “There is evidence that legumes provide health benefits. There is speculation that lectins cause diseases. Unfortunately, the autoimmune diseases some speculate are caused by legume lectins appear to occur more frequently in nations like the U.S., where legume consumption is rather low, than in Asian nations, where legume consumption is higher.”
      http://donmatesz.blogspot.com/2011/08/legumes-neolithic-or-not.html




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  14. Love these videos where you correct misconceptions!! We’ve also been seeing a lot of negative news on alternative milks like almond, soy and rice; anyone know what the studies say in regards to something like Almond milk. My guess is that the American Dairy Association is working hard to win back it’s customers by throwing mud at it’s competition. Muddy the waters so no body knows what is correct, that’s a popular practice with food and nutrition.




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    1. Ben: The NutritionFacts staff are working on making this new platform acceptable. The old platform had a huge number of daily problems. Just yesterday, disqus started including ads without our permission or ability to stop! I kid you not. NutritionFacts is an ad-free site… The NutritionFacts staff had a plan to change the forum when the new site is released anyway. Once the ads started, they moved up the release of the forum part to today.

      If someone experiences a bug, please report it to the Help Center area. You may also want to report if there is something specific about the look/feel/functionality of the new platform that you would to see changed. Another poster, Lynda (thank you Lynda!) posted earlier, there may be changes we can make. It just make may take a bit of time to get it all on board.

      NOTE EVERYONE!!!: One of the problems with this new system is that I’m not able to review all the comments like I could before. So, at least for now, please don’t assume that I’m seeing all the comments. The best way to communicate with staff for now will be through the Help Center (link at the bottom of the page – then click the link at the upper right of the screen).




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  15. Off Topic-what happened to our social media logins/avatars? Is this no longer an option or is everything looking normal to y’all-the other members of this choir?

    I just did a password reset in order to use the NF.O login, and everything is weird this way. LMK thanks!




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  16. Hello, I’m a somewhat new vegan (going on 5 months) and I started out by reading Dr.Fuhrman’s book and following his guide a lot then I discovered Dr. McDougall and even though he’s also plant based, he recommends different things such as starches like potatoes, quinoa and rice while Dr. Fuhrman says to limit them. I know there’s a few different vegan diets to live by (high carb/low fat, fully raw, whole foods), aside from fully raw, what is the healthiest way to go about this lifestyle? And also, what is your take on potatoes specifically? Can I eat them everyday like some recommend and not gain weight or should they be limited like others recommend?




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    1. Hi Cindy
      Both of those doctors are amazing. Dr. Furhman is all about the nutritional value of a food. So obviously a purple sweet potato is going to have more nutrients than a russet. Dr. McDougall is all about starch. I personally don’t stay away from russets but if given a choice I pick the purple potato.




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    2. Congrats on 5 months Cindy, your personal choice to go vegan is a benefit to all, whether they know it or not! Try and stick with whole foods, organic, (PBD) and avoid processed and preservatives. Keep nuts, seeds, fruits and plenty of leafy greens in your diet, and it really will not matter what other types of vegetables you eat, so eat the foods you like. You could do an food allergy check, to weed out foods your body rejects if you want to optimize and add vitamin B12.

      Someone was telling me about a smoothie they were eating, adding all these healthy foods, and after listening to the ingredients… I was thinking “ick”, and “why!”. It was not a surprise to hear he had not done a smoothie in a long while… I have a green smoothie every day for breakfast (2 years running now), make it so it tastes great, and love it! You’re a 100 times more likely to stick with the diet and stay healthy when you enjoy your meals. Excellent health is really very simple, don’t eat poison (meat, junk food, preservatives, smoking, etc.).

      Best of luck; in five months’ time, what do you see as being the greatest benefit to your new diet?




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    1. To my knowledge Dr. Greger has never advocated for the consumption of any dietary oil, including soy oil. He makes it very clear that whole-food plant-based sources of fats are far preferable to any kind of extracted oil. If you still find it difficult to follow a healthy path in regard to eggs after watching Dr. Greger’s (and many other MD’s) many videos on the subject, then perhaps delving into the research for yourself might be helpful. Good luck!




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  17. My wife was diagnosed with stage three breast cancer just before Christmas. I am new to this page and apologise if this question has been asked and answered before but wondering if the pro-soy diet position applies to an HER2+ cancer. I noted the video reviewing the article saying that soy is good for both ER- and ER+, so that is good to hear. Her cancer is triple +ve, including PR+ as well. Thank you. Michael




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  18. I came across a YouTube video of Dr. McDougall in 2006 showing that isolated soy protein increases insulin growth factor 1 more than dairy products. Is this still considered to accurate? Do the studies differentiate fermented and unfermented soy products? I know that Dr. Greger promotes plant-based whole foods. Where does soy milk fall in all of this? I have three young daughters and have been choosing soy milk instead of dairy for them, but am confused about the best milk alternative. Thank you for your advice.




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    1. Shannon Martin: In watching the videos on this website and having read Dr. Greger’s book How Not To Die, I’ve been left with the impression that Dr. Greger is generally in favor of soy milk – especially if starting at a young age when soy consumption does the most good. You might consider looking at what goes in the soy milk. Some brands have nothing but soy and water. Other brands have quite a bit added, including sugar. Something to think about.
      .
      As for the fermented soy question, I put together a post some time ago to address this general question. I copied it below in the hopes that you will find it helpful.
      .
      ***********************
      There has been a lot of confusion over a) how much soy traditional Asian cultures ate and b) how much of that soy was fermented vs unfermented.
      .
      Dr. Greger covers safe amounts of soy in the following video: http://nutritionfacts.org/video/how-much-soy-is-too-much/ 3 servings a day looks to be perfectly safe. This information is derived from a study in Japan showing that 3 servings cleared the IGF1 promotion issue.
      .
      I did a little research outside of NutritionFacts. Not a lot and not definitive, but I think the following information is helpful. The following quote comes from the page: http://www.theveganrd.com/2011/03/soyfoods-in-asia-how-much-do-people-really-eat.html
      .
      “The confusion about how much soy Asians consume is based partly on a simple mathematical misunderstanding. In studies of intake, findings are sometimes expressed as the amount of soy protein that people consume—which is different from the total amount of soy food in their diets. For example, according to surveys in Japan, older adults consume around 10 grams of soy protein per day, which is the amount of protein in about 1 to 1 ½ servings of traditional soyfoods. Because a number of authors have misunderstood the relationship between soy protein and soyfood, they’ve greatly underestimated the amount of soy in Japanese diets.
      .
      Information about soy intake in Asia comes from a number of different resources including studies designed to examine the effects of diet on health, Japan’s National Nutrition Survey, and the Food and Agriculture Organization (FAO) of the United Nations. The most important of these are the studies designed to look at diet and disease relationships because many of them evaluated soy intake comprehensively. That is, they recorded frequency, and amounts of all types of soy products consumed using validated dietary intake instruments.
      .
      The results show a fairly wide range of intake among different countries and even within populations. While average Japanese intake is 1 to 1 ½ servings, the surveys reveal that the upper range among older Japanese—who would be expected to eat a more traditional diet—is about 3 servings of soyfoods per day.

      And contrary to popular opinion, the soy products regularly consumed in these countries are not all—or even mostly—fermented. In Japan, about half of soy consumption comes from the fermented food miso and natto and half comes from tofu and dried soybeans. In Shanghai, most of the soyfoods consumed are unfermented, with tofu and soymilk making the biggest contributions. In fact, even in Indonesia, where tempeh is a revered national food, unfermented soy products like tofu account for around half of soy intake.”
      .
      Soyfoods have been consumed in China for at least 1,500 years and in Japan for 1,000 years. The evidence shows that soyfoods—both unfermented and fermented—continue to be a significant part of traditional Asian diets.”
      .
      The article is worth a full read as it covers information about soy intakes varying by region.
      .
      Jack Norris is a well respected RD who does a lot of research into various nutrition issues. He has a detailed article covering soy, complete with 136 references. http://www.veganhealth.org/articles/soy_wth#asia Here are some important points:
      .
      “In Japan and Shanghai, China, average intakes are about 1.5 servings per day, but many people consume an average of two or more servings per day. About half the soy eaten in Asia is not fermented. … In both Japan and China, non-fermented foods provide approximately half of the total soy intake. In Shanghai, nearly all soy is non-fermented.” Jack Norris’s article has a lot more details about soy, including soy consumption, for anyone interested.




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  19. I’m a bit angry tbh. The last year I’ve changed from SAD diet to WFPB 80-90% compliance and all I got was a bit of weight loss (not much, mostly maintaining from my 5:2 diet), a smidge lower in cholesterol results, gallstones and presumably malignant breast cancer. I’m only 29 and i participate in 0 risk factors to increase my chance of getting breast cancer but low and behold…. (I have a test to take in a few hours but it’s looking like malignant cancer).
    I really think it must have been the soy. I didn’t eat too much in case, but i do eat about a 3-5 serves of soy every week.
    I mean what else could cause it, nothing i do would do so!




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  20. Tessha,

    I’m sorry to hear of the potential cancer. I applaud your efforts to address your health with good lifestyle and diet and would request that you ask your physician to sequence you. Seriously, if indeed you received bad news…don’t wait. I’d like to suggest that your changes are 1/29th of your time on the planet….. be patient and give your body a chance to change.

    There are no lack of lifestyle related factors, such as contact with endocrine disruptors (think receipts to shampoo’s) to familial genetics that it’s literally impossible to finger one component as the “bad guy”, with limited exceptions.

    As you address you health, consider the whole exposome of your exposures from prenatal to today. Often times there is no obvious identifiable factor and we are left with more not less questions, however the sequencing can be another opportunity to really dig deep and get some answers.

    Wishing you your best health . Dr. Alan Kadish moderator for Dr. Greger




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