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Many postmenopausal women are looking for alternatives to hormone therapy, especially in light of research findings in 2003 from the Women's Health Initiative. With major funding from the National Institutes of Health, this initiative studied the risks of combined estrogen and progestin therapy, among other health issues of critical importance to postmenopausal women. Of particular interest are phytoestrogens, which have been gaining popularity because they are marketed as "natural," because of the alleged health benefits they provide, and because they are available in a wide range of foods and supplements. This fact sheet provides an overview of phytoestrogens and discusses their potential role in osteoporosis prevention and treatment.

High tofu intake is associated with worse memory in elderly Indonesian men and women. Hogervorst E, Sadjimim T, Yesufu A, Kreager P, Rahardjo TB. Dement Geriatr Cogn Disord. 2008;26(1):50-7. Epub 2008 Jun 27. PMID: 18583909 DOI: 10.1159/000141484 CONCLUSION: The results for tofu consumption as a risk factor for low memory function may tie in with the Honolulu Asia Aging Study data. It is unclear whether these negative associations could be attributed to potential toxins or to its phytoestrogen levels. Estrogen (through which receptors phytoestrogens can exert effects) was found to increase dementia risk in women over 65 years of age. Tempe contains high levels of phytoestrogens, but (due to fermentation) also exhibits high folate levels which may exert protective effects. Future studies should validate these findings and investigate potential mechanisms.

"Eating high levels of some soy products - including tofu - may raise the risk of memory loss, research suggests. The study focused on 719 elderly Indonesians living in urban and rural regions of Java. ' The latest study suggests phytoestrogens - in high quantity - may actually heighten the risk of dementia. Lead researcher Professor Eef Hogervorst said previous research had linked oestrogen therapy to a doubling of dementia risk in the over-65s. She said oestrogens - and probably phytoestrogens - tended to promote growth among cells, not necessarily a good thing in the ageing brain. Alternatively, high doses of oestrogens might promote the damage caused to cells by particles known as free radicals. A third theory is that damage is caused not by the tofu, but by formaldehyde, which is sometimes used in Indonesia as a preservative. The researchers admit that more research is required to ascertain whether the same effects are found in other ethnic groups. However, previous research has also linked high tofu consumption to an increased risk of dementia in older Japanese American men. The researchers found high tofu consumption - at least once a day - was associated with worse memory, particularly among the over-68s. "

Dalais FS, Meliala A, Wattanapenpaiboon N, Frydenberg M, Suter DA, Thomson WK, Wahlqvist ML. Effects of a diet rich in phytoestrogens on prostate-specific antigen and sex hormones in men diagnosed with prostate cancer. Urology. 2004 Sep;64(3):510-5.

An ecologic study of dietary and solar ultraviolet-B links to breast carcinoma mortality rates. Grant WB. Cancer. 2002 Jan 1;94(1):272-81. PMID: 11815987 CONCLUSIONS It is hypothesized that animal products are associated with risk for breast carcinoma because they are associated with greater amounts of insulin-like growth factor-1and lifetime doses of estrogen. Vegetable products contain several risk reduction components including antioxidants and phytoestrogens. The association with latitude is very likely because of solar UV-B radiation and vitamin D. Alcohol modulates estrogen's effects on breasts. Fish intake is associated with risk reduction through vitamin D and n-3 oils. These results are consistent with those of many case-control and cohort studies but should be assessed in well designed cohort studies.

Fruit and vegetables: the unexpected natural answer to the question of osteoporosis prevention? Lanham-New SA. Am J Clin Nutr. 2006 Jun;83(6):1254-5. No abstract available. PMID: 16762933

"Results indicated that mice on diets supplemented with flaxseed meal and flaxseed oil had, on average, 45 percent fewer tumors in the small intestine and the colon compared to the control group." The scientists published their research findings in February in the academic peer-reviewed international journal Nutrition and Cancer.

Soy Food Intake and Breast Cancer Survival. Xiao Ou Shu et al. JAMA Vol. 302 No. 22, December 9, 2009; 302(22):2437-2443. Results During the median follow-up of 3.9 years (range, 0.5-6.2 years), 444 deaths and 534 recurrences or breast cancer-related deaths were documented in 5033 surgically treated breast cancer patients. Soy food intake, as measured by either soy protein or soy isoflavone intake, was inversely associated with mortality and recurrence. The hazard ratio associated with the highest quartile of soy protein intake was 0.71 (95% confidence interval [CI], 0.54-0.92) for total mortality and 0.68 (95% CI, 0.54-0.87) for recurrence compared with the lowest quartile of intake. The multivariate-adjusted 4-year mortality rates were 10.3% and 7.4%, and the 4-year recurrence rates were 11.2% and 8.0%, respectively, for women in the lowest and highest quartiles of soy protein intake. The inverse association was evident among women with either estrogen receptor-positive or -negative breast cancer and was present in both users and nonusers of tamoxifen. Conclusion Among women with breast cancer, soy food consumption was significantly associated with decreased risk of death and recurrence.

"The common culprit is soy, a plant that contains chemicals with estrogen-like and anti-estrogenic properties - making it a nutritional minefield for breast cancer survivors. While Western diets are relatively low in soy - compared with the typical diet in Asia, where people eat soy daily - the percentage of Americans consuming soy at least once a week has increased from 15% in 1997 to 28% in 2003. In the meantime, studies on the effect of soy on breast cancer recurrence and mortality have been conflicting, with some showing that it can reduce risk, while others show an elevated rate of recurrent disease among high soy consumers. Now the largest study to date of soy's effect on breast cancer suggests that eating soy, even in large amounts, may not be harmful after all, and may even reduce recurrence and death from the disease. But while the findings are intriguing, not all doctors are ready to tout the benefits of tofu

A preliminary study of the safety, feasibility and cognitive efficacy of soy isoflavone supplements in older men and women. Gleason CE, Carlsson CM, Barnet JH, Meade SA, Setchell KD, Atwood CS, Johnson SC, Ries ML, Asthana S. Age Ageing. 2009 Jan;38(1):86-93. Epub 2008 Dec 2. PMID: 19054783 doi:10.1093/ageing/afn227 Conclusions: these data suggest that administration of 100 mg/day of isoflavones was well tolerated. Plasma genistein and daidzein levels, but not equol, increased with isoflavone administration. Finally, data support the potential cognitive effects of soy isoflavones in older adults.