Exposure to soy-based formula in infancy and endocrinological and reproductive outcomes in young adulthood.

CONTEXT: A large body of evidence documents the role of phytoestrogens in influencing hormone-dependent states. Infants fed soy formula receive high levels of phytoestrogens, in the form of soy isoflavones, during a stage of development at which permanent effects are theoretically possible. However, a paucity of data exists on the long-term effects of infant soy formulas. OBJECTIVE: To examine the association between infant exposure to soy formula and health in young adulthood, with an emphasis on reproductive health. DESIGN, SETTING, AND PARTICIPANTS: Retrospective cohort study conducted from March to August 1999 among adults aged 20 to 34 years who, as infants, participated during 1965-1978 in controlled feeding studies conducted at the University of Iowa, Iowa City (248 were fed soy formula and 563 were fed cow milk formula during infancy). MAIN OUTCOME MEASURES: Self-reported pubertal maturation, menstrual and reproductive history, height and usual weight, and current health, compared based on type of formula exposure during infancy. RESULTS: No statistically significant differences were observed between groups in either women or men for more than 30 outcomes. However, women who had been fed soy formula reported slightly longer duration of menstrual bleeding (adjusted mean difference, 0.37 days; 95% confidence interval [CI], 0.06-0.68), with no difference in severity of menstrual flow. They also reported greater discomfort with menstruation (unadjusted relative risk for extreme discomfort vs no or mild pain, 1.77; 95% CI, 1.04-3.00). CONCLUSIONS: Exposure to soy formula does not appear to lead to different general health or reproductive outcomes than exposure to cow milk formula. Although the few positive findings should be explored in future studies, our findings are reassuring about the safety of infant soy formula.

Gender-related differences in iron absorption by preadolescent children.

In a study of absorption of iron from meals by preadolescent children (Tanner stage 1), we had noted that erythrocyte incorporation of the extrinsic iron label was somewhat greater by girls than by boys. Although the difference was not significant, the observation seemed to warrant further study. Study A: A precisely determined quantity of ferrous sulfate enriched with the stable isotope 58Fe was given without food to 15 boys and 15 girls (Tanner stage 1) after an overnight fast and was immediately followed by a dose of 70 mg of ascorbic acid. 58Fe enrichment of the erythrocytes was determined by inductively coupled plasma mass spectrometry at baseline and 14 and 42 d after administration of the 58Fe dose. Geometric mean erythrocyte incorporation of the 58Fe label was 35.2% of intake by boys and 45.0% of intake by girls. The difference was significant (analysis of covariance with serum ferritin as covariate, p = 0.035). Study B: Fifteen boys and 15 girls (Tanner stage 1) were fed a breakfast labeled with 58Fe. Geometric mean erythrocyte incorporation of the 58Fe label was 14.8% of intake by boys and 24.7% of intake by girls. The difference was significant (analysis of covariance with serum ferritin as covariate, p = 0.004). Because serum ferritin concentrations were similar in boys and girls, the gender-related difference in iron absorption (as reflected by erythrocyte incorporation of the label) does not appear to be explained by a difference in body stores of iron. We hypothesize that hormonal differences between boys and girls in Tanner stage 1 favor iron absorption by girls.

Use of the stable isotope, 58Fe, for determining availability of nonheme iron in meals.

Because of reluctance to use radioisotopes for studies of iron absorption in children, we have explored the feasibility of using the least abundant stable isotope of iron, 58Fe (natural abundance, 0.322 weight %) in a study of nonheme iron absorption. With a balanced cross-over design, each of 16 school-age children was fed a standardized lunch on 3 consecutive days and, 28 days later, an alternate standardized lunch on 3 consecutive days. The lunch included either a beef patty or a beef-soy patty. The mass isotope ratio, 58Fe/57Fe (MIR58/57), was measured in blood by inductively coupled plasma mass spectroscopy before and 14 days after (i.e. study day 15) consuming the three lunches. The MIR58/57 on study day 15 was used as a baseline value for lunches fed on study days 29, 30, and 31. Incorporation of 58Fe into erythrocytes was greater from the lunch with beef patty than from the lunch with beef-soy patty (geometric mean values 2.02 and 1.05% of the dose, p less than 0.03). Based on the similarity of our results with those obtained in adults with radioisotopes, we conclude that 58Fe is a satisfactory tag for studies of nonheme iron absorption from meals.