Wednesday Bubble: Soy takes another hit
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Welcome to the new home of Flashfree! Our URL has changed but the same content that you’ve grown to know and ‘love’ is the same.
Let’s kick off http://flashfree.me with the latest and ‘greatest’ report on soy: it does not help menopausal symptoms or prevent bone loss.
Isn’t this contrary to what’s been reported previously, at least with regards to women with the ability to produce S-equol?
In this latest nail to the soy coffin, research appearing in the Archives of Internal Medicine suggests that part of the issue in proving or disproving the utility of soy for menopause is the lack of trials of long duration, consistent use of low doses of soy isoflavones, small number of participants and too much breadth and depth of age and menopausal status. However, the SPARE trial (Soy Phytoestrogens as Replacement Estrogen), aimed to change this paradigm by examining the effect of daily 200 mg soy isoflavones in tablet form in 248 women between the age of 45 and 60. All participants had been in menopause for one to five years or for six to 12 months. These women were studied for two years, were instructed to take the active pill or placebo tablet before breakfast, and stop taking any hormones for at least six months before the study started. Calcium was supplemented in women who were taking less than 500 to 1000 mg daily. Importantly, women taking the isoflavone tablets were actually receiving a dose equal to approximately twice that normally obtained through food in Asian diets.
At the study’s end, the researchers found that women taking soy or placebo were on equal footing and that soy did not appear to prevent bone loss or reduce bone turnover. Moreover, soy did not appear to have any significant effect on hot flashes, night sweats, libido or vaginal dryness. They also say that even though women who are able to produce S-equol in their guts were likely to benefit from soy compared to women who are not, they did not see any specific benefit when these women were studied separately. Although not considered a dangerous side effect, constipation was experienced by more than a third of women taking soy.
So, what are we to think? Some studies say soy is effective, particularly among S-equol producers while others, like this well designed trial, show that it is now. However, there has been some data suggesting that the ratio of specific isoflavones may play an important role, and there is no information in the published study about this ratio other than to say that the soy supplement used is similar to those obtained in health food stores.
When it comes to soy, the verdict isn’t quite out yet, although the studies that have been conducted to date can’t seem to tease out what’s what. As always, use caution and lower your expectations. There are other non-hormonal approaches that may provide greater benefit when it comes to bone loss and menopausal hot flashes and other symptoms.
Want to read more on soy isoflavones? Check out the Flashfree archives.
Read MoreWednesday Bubble: Got symptoms? Got milk? An udder disaster…
Milk is being touted as the next best thing, that is, when it comes to hormonal symptoms. In fact, a new campaign sponsored by the California Milk Processor Board centers around the claim that milk can help reduce the symptoms of PMS. EverythingIdoiswrong.com offers global gauges of PMS symptoms, packaged apologies for men who feel victimized by PMS and even analyzes or verifies their mistakes so that they can avoid them during the next cycle. In a piece about the marketing effort in the Washington Post, Executive Director of the California Milk Processor Board, Steve James, is quoted as saying that the strategy is to “disarm the situation surrounding PMS and its effects,” both for women and individuals around them who are suffering from their mood swings and other symptoms.
Say what?!!!
Is this advertising for milk or a drug claim?
According to the website, the claims about milk are derived from a review that appeared in the year 2000 in the Journal of the American College of Nutrition. In the review, the authors discuss the potential links between altered calcium balance and affective disorders, such as depression and anxiety. Because women with PMS reportedly have calcium fluctuations that interfere with hormonal balance, some researchers have hypothesized that this imbalance can lead to both mood and other features of PMS. In these studies, however, participants obtained their calcium through supplements and not through dietary means; this enabled the researchers to control and standardize intakes (which averaged as much as 1300 mg calcium daily). Translated into daily milk consumption, this means that a person would have to drink more than 4, 8 oz glasses of milk daily to achieve the level of calcium used in clinical studies.
Honestly, do you know anyone over the age of “tween” who consumes that much milk?
Regardless of the studies cited, the claims about milk are exaggerated and inconclusive. Many of the studies were poorly designed or relied upon recall. However, one has to wonder if the milk-PMS claims will set off a cascade of others that stretch to the other end of the hormonal spectrum –menopause — where too much calcium is believed to be too much of a good thing: although calcium may offer protection against osteoporosis, it may also increase the risk for heart disease in some women.
Let’s get away from the hard science for a moment and take a closer look at the campaign. The inference:
- Women: your PMS causes undue suffering to people around you, especially your male partners
- Men: humor the woman in your life. If you want to save your relationship, friendship, partnership, etc, create a photo with puppy eyes, film a video apology or better yet, make fun of her. Oh, and have her drink milk.
Don’t know about you but this one is so absurd it may not even be bubble-worthy. Hey California Milk Processor Board – you may want to add a few women to your marketing team. This one’s an udder disaster.
Hat tip to Reuters Health Executive Editor, Ivan Oransky for the campaign heads up. (I tried to milk it Ivan – how’d I do?!!)
Read MoreWednesday Bubble: wrinkles and bone density – what’s the connection?
There’s a connection between wrinkles and bones? When I caught wind of the research, I thought immediately of a Wednesday Bubble. But this one appears to be the real deal.
Researchers presenting at The Endocrine Society’s Annual Meeting this past weekend say that severity of facial wrinkles during the early years of menopause may indicate a low bone density (thereby leading to an increased risk for osteoporosis). Wow!
This information comes out of the ongoing Kronos Early Estrogen Prevention Study (KEEPS), which is looking at the effect of oral and transdermal estrogen therapy on measures of the carotid artery that might indicate thickening of the arteries (and eventual heart disease) as well as the build up of calcium in the blood. A subgroup of 114 women in their late 40s and early 50s and within three years of starting menopause were examined for this part of the trial.
The researchers looked at and scored severity and depth of skin wrinkling based on number of sites on the face and neck. They also measured skin rigidity (or firmness) on the forehead and cheek. Additionally, they evaluatd total body bone mineral density as well as at the lumbar spine and left hip.
The findings? Higher wrinkle scores (meaning more severe wrinkles) were associated with lower bone density measures at all sites, while firmer skin on the forehead and face were related to greater bone density, especially at the hip and spine.
The connection? Pun unintended but the researchers say that collagen, protein that naturally occurs in connective tissue in tendons, ligaments and even bones, is the common factor. They add that as women age, changes in collagen not only contribute to sagging skin and more facial lines but may also negatively affect both the quality and quantity of bone.
Although more research is needed, it might be worthwhile to obtain a dermatologic and bone density assessment at the start of menopause to see where you stand. And then speak to your health practitioner about the need for regular follow up and monitoring to insure that fragile bones don’t lead to fractures. Ultimately, if the link between wrinkling and bone quality is proven, it might eliminate or at least lessen the need for costly DEXA ( dual energy X-ray absorptiometry) that are currently used to measure how tightly calcium and other minerals are packed into bone.
Who would thunk that wrinkles could actually be useful?!
Read MorePuffing away the years: smoking and early menopause
A few years ago, I wrote a post linking cigarette smoking to early menopause. And yet, questions remained about duration of smoking and the quantity of cigarettes in terms of their influence on timing. Hence, I thought that it might be worthwhile to take a closer look at the issue and see if there was more information.
A few facts:
It’s estimated that by the year 2030, there will be over 1 billion menopausal women in the world, with roughly 47 million women entering menopause annually. Yikes! That’s a whole lotta hot flashes, night sweats, mood swings and the like. And, what this means is that information is power (and empowering). Importantly, research has also shown that early menopause is associated with greater mortality, heart disease cases and osteoporosis. In fact, for every year that menopause is postponed, there is a 2% reduced chance of death due to heart disease. On the other end of the spectrum is late menopause, which is also associated with health issues, including an increased risk for breast, ovarian and uterine cancer.
So, what are the factors that appear to determine the timing of menopause? Well, things like obesity, alcohol consumption, mother’s age, social class, long menstrual cycles, multiple childbirths, oral contraceptive use and even exposure to pesticides have been linked to later menopause, while smoking has been shown in multiple studies to increase the likelihood for early menopause. This issue may be even more relevant for the late Boomer generation who came to age in the 70s, a time when cigarette and marijuana smoking were the norm and not the exception. That generation, by the way, is my generation.
Here’s what we know:
In a thorough review of 109 published studies, researchers have found the following:
- Current smokers appear to enter menopause anywhere from 2.5 months to 2.5 years earlier than non-smokers and have 1.3 to 1.7 times greater odds for early menopause
- Former smokers appear to start menopause as much as 2 years earlier than non-smokers, with the risk ranging from 30% to as high as 80%
- Although there is not a lot of information on the severity of smoking habit and menopause (i.e. number of cigarettes smoked daily), there is some indication that women who smoked more than 20 cigarettes daily were likely to start menopause as much as 2 years earlier than women who smoked 11 to 20 cigarettes daily
- The relationship between number of years having smoked and early menopause is unclear
There are numerous reasons why smoking may lead to earlier menopause, including interference with estradiol levels, an increased loss of eggs and an increase in the levels of androgen hormones, which counteract activity of estrogen in the body. And, despite the differences between the studies that the researchers examined, they say that a clear link was demonstrated between smoking and starting menopause at an earlier age. The impact of quantity and time (or years) smoking is less consistent and still not completely clear.
The overriding message is that if, like me, you are a former smoker, you might find yourself in a position of starting menopause a wee bit earlier than expected. Consequently, there’s no time like the present to start taking preventive measures, like increasing calcium intake, changing your dietary habits or improving your exercise regimen. Mind-body exercises like meditation or yoga can ameliorate stress and improve overall wellbeing. And black cohosh? Personally, I swear by it. In concert, these steps might shut down or at least keep the magic menopause dragon at bay.
Read MoreWednesday Bubble: is there a connection between dry mouth and osteoporosis?
This week’s bubble is neither burstable or good news. But it is important:
Dry mouth and bone mineral density appear to be related.
Say what?!!!
A bit of background is needed…
Osteoporosis is fast becoming a major health problem and as I’ve written time and again on this blog, is a significant characteristic of menopause, namely as the result of waning estrogen levels that lead to an imbalance between the build up and turnover of bone cells. Parathyroid hormone and cortisol have also been linked to bone turnover.
Dry mouth (i.e. a feeling of dryness in the mouth and need to use liquids while eating) and burning mouth syndrome (i.e. burning in the tongue or oral mucus membranes and taste alterations) are also common during menopause, affecting up to 40% of women. Until now, experts have not been able to adequately determine why these symptoms occur and more importantly, effective management strategies.
The link? Recent data have shown that estrogen levels may be significantly lower and both parathyroid and cortisol levels significantly higher in menopausal women who complain of dry mouth. Moreover, as the results of a new study in Menopause show, there may be a true relationship between these two conditions and that bone loss may be the actual cause of oral dryness and related symptoms. In this study, researchers evaluated 60 women in menopause (mean age 56) for the presence and severity of dry mouth and then based on their results, divided them into two groups. Dry mouth was confirmed by responses to a scientific questionnaire and collections of saliva. The researchers also measured bone mineral density at the spine.
Importantly, the participants were not particularly active and none engaged in any sports activity, except walking. The women were also matched by body mass index, age, or years of menopause. And yet, women with low bone mineral density, including relationship to other women in the same age group and 30 years younger, were significantly more likely to experience dry mouth and had significantly less saliva when their appetites were not stimulated.
Clearly, more research is needed. However, there are some things you can do now. The first strategy to combat osteoporosis and bone loss is to get measured for bone loss and disease markers. Steps like calcium supplementation, a healthy diet and regular exercise are critical. And if you suffer from dry mouth? You may want to speak to your dentist about a referral for a bone mineral density scan or better yet, have him or her contact your gynecologist or regular health practitioner for a pow wow. Not only may you help your bones, but you may actually change that dry feeling.
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