Neither soy nor isoflavone intake affects male reproductive hormones: An expanded and updated meta-analysis of clinical studies.

Reproductive toxicology (Elmsford, N.Y.). 2021;100:60-67
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Plain language summary

Much of the soy-related health research published over the past 3 decades has taken place because among commonly consumed foods, the soybean is a uniquely rich source of isoflavone. Isoflavones have a chemical structure similar to the hormone oestrogen. The aim of this meta-analysis was to update and expand the 2010 meta-analysis in order to determine whether soy or isoflavone intake affects total testosterone, free testosterone, estradiol, estrone, and sex hormone binding globulin. The study included a total of 41 studies in the analyses of which 20 utilized a parallel design (controlled), eight a crossover design and 15 single arm or parallel arms designs. Results confirm the findings of a meta-analysis published in 2010 that found neither soy nor isoflavone intake affects total or bioavailable circulating testosterone concentrations in men. Authors conclude that in men, neither soy nor isoflavone intake, even when exposure occurs for an extended period of time and exceeds typical Japanese intake, affects levels of total testosterone, free testosterone, estradiol or estrone.

Abstract

Concerns that the phytoestrogens (isoflavones) in soy may feminize men continue to be raised. Several studies and case-reports describing feminizing effects including lowering testosterone levels and raising estrogen levels in men have been published. For this reason, the clinical data were meta-analyzed to determine whether soy or isoflavone intake affects total testosterone (TT), free testosterone (FT), estradiol (E2), estrone (E1), and sex hormone binding globulin (SHBG). PubMed and CAB Abstracts databases were searched between 2010 and April 2020, with use of controlled vocabulary specific to the databases. Peer-reviewed studies published in English were selected if (1) adult men consumed soyfoods, soy protein, or isoflavone extracts (from soy or red clover) and [2] circulating TT, FT, SHBG, E2 or E1 was assessed. Data were extracted by two independent reviewers. With one exception, studies included in a 2010 meta-analysis were included in the current analysis. A total of 41 studies were included in the analyses. TT and FT levels were measured in 1753 and 752 men, respectively; E2 and E1 levels were measured in 1000 and 239 men, respectively and SHBG was measured in 967 men. Regardless of the statistical model, no significant effects of soy protein or isoflavone intake on any of the outcomes measured were found. Sub-analysis of the data according to isoflavone dose and study duration also showed no effect. This updated and expanded meta-analysis indicates that regardless of dose and study duration, neither soy protein nor isoflavone exposure affects TT, FT, E2 or E1 levels in men.

Lifestyle medicine

Fundamental Clinical Imbalances : Hormonal
Patient Centred Factors : Mediators/Male reproductive hormones
Environmental Inputs : Diet ; Nutrients
Personal Lifestyle Factors : Nutrition
Functional Laboratory Testing : Not applicable

Methodological quality

Jadad score : Not applicable
Allocation concealment : Not applicable
Publication Type : Journal Article ; Meta-Analysis ; Review

Metadata

Nutrition Evidence keywords : Isoflavone ; Hormones ; Phytoestrogens ; Soy ; Plant protein