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Abbott Malaysia - Childcare Handbook

THE WONDERS OF SOY

Healthy Life with Soy

Soy protein has been used for centuries in Asia.1,2 In fact, Asian children regularly consume soy-based formulas (SBF) and soy products from a very young age; 2 up to 70% of children have consumed soy products before they reach 10 years of age.2 Soy protein is of the highest quality, 3 and is a complete protein providing all the essential amino acids that the body needs.4 The protein value of soy is in fact equivalent to proteins of animal origin. 4,5 Soy is good for the heart as it contains no cholesterol and is low in saturated fat, and it is also a good source of fibre, iron, calcium, zinc, and vitamin B. 6 Concerns have been raised regarding the safety and nutritional adequacy of SBF. 7,8 However, there is no conclusive evidence of any adverse effects with SBF and it can play a major role in fulfilling the dietary requirements of children. 9 The health benefits of SBF ensure that it should remain an integral part of an every day diet.

 

Q1: Will a soy-based formula support normal child growth?
  SBF is adequately packed with energy, proteins, vitamins, minerals, and fibre necessary for a child’s normal growth
 
  SBF supports :
 
  ● Normal growth and development:10,11  
    ● SBFs are as good as cow’s milk-based formula (CMBF) in supporting growth. Children fed with SBFs enjoy normal and comparable growth to children fed with CMBF. 11,18 SBF-fed children enjoyed comparable growth rate as compared with children fed with CMBF.11 Importantly, children fed with SBF or CMBF how improvements in terms of weight gain, and length and head circumference, which are similar with either formula.11
 
  ● Normal bone mineralization:18  
    ● Calcium absorption is essentially equivalent with SBF or CMBF.14 Both SBF and CMBF produce comparable serum levels of calcium, magnesium, alkaline phosphatase and parathyroid hormone, which support bone growth.18 Furthermore,children fed with SBF have good bone mineral content and bone width, similar to CMBF fed children.18
 
  ● Normal immune system development.19,20  
 
  ● An iron-fortified formula that is as effective as cow’s milk in preventing iron deficiency.21  
 

Q2: Does SBF support the immune system of growing children?
  SBF has a high nucleotide content (300 mg/L), as these protein building blocks are found naturally in soy. The need for nucleotides increases during a child’s growth and development, and the inclusion of dietary nucleotides in SBF ensures normal immune development as measured by antibody response to childhood immunization.
 

Q3: When is SBF most suitable?
  SBF is a safe and cost-effective alternative feed for children with galactosemia and primary lactase deficiency.23 The American Academy of Pediatrics (AAP) has advocated that formula-fed children with lactose intolerance to cow’s milk-based formula, congenital galactosemia or strict dietary restrictions like vegetarianism should be given SBF.23 Soy products in fact have been consumed by Asian children for centuries and are commonly used to wean children with an allergy to cow’s milk protein.2 Furthermore, SBF can be used to provide relief of perceived formula intolerance such as vomiting, fussiness or colic.23 Consumption of SBF is very popular due to the widespread understanding that soy is both good and nutritious.
 

Q4: Can SBF be a replacement for cow’s milk based formula?
  CMBF is a good source of calcium and protein; however, fortified SBF containing calcium, vitamins A and D is as good as cow’s milk in its nutritive value. SBF provides additional nutrients such as vitamins B1, B3, and fibre. SBF also provides trace minerals such as magnesium, which helps in calcium absorption, and copper and manganese, which enhance bone formation. Moreover, SBF is lactose-free, making it an attractive option for children who are lactose intolerant. SBF can help achieve a healthy diet in children who are avoiding dairy products due to health reasons, ie cow’s milk protein allergy or personal beliefs.
 

Q5: My child is allergy to cow’s milk protein, how long should I give him/her soy-based formula?
  Cow’s milk protein allergy (CMPA) is common in young children,26 and it was widely believed that most children would outgrow the allergy by the age of 3 years.27 However, a recent study suggests that the CMPA could last longer than previously reported, and some children outgrow the allergy only during adolescence.27 Based on a study conducted by researchers at the John Hopkins University, it has been demonstrated that CMPA persists into school age and well into adolescence. The study found that up to 64% of children outgrew CMPA by age 12 and 79% by age 16. Some took longer and remained allergic until age 18.27 Allergies in children are more common today than 20 years ago, and the average age of outgrowing them is also higher. Since there is no medication or an intervention to speed up the process of outgrowing allergies, it is critical that children with CMPA receive adequate nutrition through alternative food sources such as SBF to help support their normal growth and development.
 

Q6: Is SBF safe for my child?
  Despite the widespread use of soy products in Asia, there are concerns about the chemical make up of soy and its use in SBFs. Isoflavones in the SBFs weakly mimic the action of estrogen (a female hormone present in the human body) raising concerns among parents about the adverse effects this would have on human growth, development and reproduction. However, studies have shown that exposure to SBF does not affect general health or outcomes when compared with cow’s milk.28 Young adults who had been fed with SBF as children show similar reproductive development and pubertal maturation to those who were fed with CMBF.28 The American Academy of Pediatrics Committee on Nutrition (AAPCON 2008) has concluded that there is no conclusive evidence from animal studies or studies on children/adults that dietary isoflavones adversely affect human development, reproduction or endocrine function. Given the long history of use, acceptance of SBF feeding by the United States Food and Drug Administration (FDA) and the AAP, and several clinical studies showing an absence of adverse health effects, it is clear that SBF is safe and supports normal growth, development and reproduction.
 

Key take home messages

● SBFs are formulated with essential nutrients
● SBFs support normal growth and development
● SBFs support normal bone mineralization
● SBFs support normal immune system development
● SBFs prevent iron deficiency
● SBFs help relief in intolerant and sensitive children
● SBFs can help achieve a healthy diet in children who are avoiding dairy products due to health reasons or personal beliefs
 

Soy-based Formula Recipe
Isomil Plus® Milk Protein Free Vanilla Ice Cream (For eight 4-oz servings)

1. Soften the agar in cold water in a saucepan.
2. Add the sugar and heat slowly to dissolve. Cool the mixture.
3. Add all the remaining ingredients and blend in blender until thick and creamy.
4. Pour into an ice-cube tray or a loaf pan and freeze until icy.
5. Return mixture to blender and blend until smooth. Return to freezer.
6. Allow to soften slightly before serving.
 

Ingredients

1 tbsp unflavoured agar
2 tbsp cold water
¼cup sugar
2 tbsp light corn syrup
2 tbsp vegetable oil
2 tsp vanilla essence
 

Enjoy it as several different flavours

Added flavour when chocolate syrup, honey, cinnamon, coffee or brown sugar is mixed in.

For a fruity flavour, add either frozen drained berries or fresh fruits such as strawberries or bananas before freezing.

For a chocolate marshmallow ice-cream, add to the basic recipe before freezing 2 squares of unsweetened chocolate and 1 cups of miniature marshmallows which have been melted in ¾ cup hot water.
 
 
 
Go Play
 
Just answer 3 simple questions on Cow’s Milk Protein Allergy (CMPA) and Lactose Intolerance. The first 30 members with the correct answer will take home a 900g tin of Isomil Plus Advanced EYEQ formula.

References:

  1. American Academy of Pediatrics: Committee on Nutrition. Pediatrics. 1998;101:148–153.
  2. Quak SH, et al. Am J Clin Nutr.1998;68:1444S–1446S
  3. Mateos-Aparicio I, et al. Nutr Hosp. 2008;23:305–312.
  4. Velasquez MT, et al. Int J Med Sci. 2007;4:72–82.
  5. Young VR. J Am Diet Assoc. 1991;91:828–835.
  6. Montgomery KS, et al. J Perinat Educ. 2003;12:42–45.
  7. Miniello VL, et al. Acta Paediatr Suppl. 2003;91:93–100.
  8. Turck D. Curr Opin Clin Nutr Metab Care. 2007;10:360–365.
  9. Merritt RJ, et al. J Nutr. 2004;134:1220S–1224S.
  10. Erdman JW, et al. Am J Clin Nutr. 1989;49:725–737.
  11. Lasekan JB, et al. Clin Pediatr. 1999;38:563–571.
  12. Sicherer SH, et al. Allergy. 2000;55:515–521.
  13. Businco L, et al. J Pediatr. 1992;121:S21–S28.
  14. Zhao Y, et al. J. Nutr. 2005;135:2379–2382.
  15. Peñalvo JL, et al. Eur Food Res and Technol. 2004;219:251–253.
  16. Setchell KDR, et al. Am J Clin Nutr. 1998;68:1453S–1461S.
  17. Vincent A, et al. Mayo Clin Proc. 2000;75:1174–1184.
  18. Venkatraman PS, et al. Am J Dis Child. 1992;146:1302–1305.
  19. Christopher CT, et al. J Pediatr Gastroenterol Nutr. 2002;34:145–153.
  20. Horton C, et al. The FASEB Journal. 2008;22:Abstract 150.6.
  21. Hertrampf E, et al. Pediatrics. 1986;78:640–645.
  22. Ostrom KM, et al. J Pediatr Gastroenterol Nutr. 2002;34:137–144.
  23. Bhatia J, et al. Pediatrics. 2008;121:1062–1068.
  24. Cantani A, et al. Pediatr Allergy Immunol. 1997;8:59–74.
  25. Cordle CT. J Nutr. 2004;134:1213S–1219S.
  26. Bianca-Maria E, et al. Nutrition. 2001;17:642–651.
  27. Skripak JM, et al. J Allergy Clin Immunol. 2007;120:1172–1177.
  28. Strom BL, et al. JAMA. 2001;286:807–814.
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