Phytoestrogens: to eat soy or to not eat soy?

Phytoestrogens

Yes, this meal is safe to eat. Photo courtesy of United Soybean Board.

Are phytoestrogens like soy safe to eat?

This is a common question in my office. People tell me they have heard soy has strong estrogen-like effects that will worsen PMS or PCOS. They have heard that soy is bad for the thyroid. Soy might even disrupt men’s hormones and cause them to grow breasts. These stories are circulated in the media, particularly online and social media, often enough that I appreciate why people ask the question: are phytoestrogens like soy safe?

The TLDR answer is: yes, soy and other phytoestrogens are safe for women and men to eat.  In many cases, they may even be protective for women experiencing problems related to high or low estrogen levels.

What are phytoestrogens?

Phytoestrogens are plant compounds that have estrogen-like properties. This is because their shapes loosely resemble the shape of a naturally occurring estrogen molecule, estradiol. But whereas estradiol fits in an estrogen receptor perfectly, like a key in a lock, phytoestrogens do not. Phytoestrogens are more like a toy key that you give a toddler to play with. Phytoestrogens gently nudge estrogen receptors, simultaneously creating a small amount of estrogenic activity and blocking the receptor from receiving stronger stimulation from other sources.

And this is where the therapeutic effect of phytoestrogens comes from: in situations where estrogen levels are already too high, phytoestrogens protect estrogen receptors from overstimulation. And in situations where estrogen levels are uncomfortably low, like menopause, the gentle nudge against an estrogen receptor may provide just enough activity to relieve discomfort.

In other words, phytoestrogens modulate estrogen levels. When natural estrogen levels are high phytoestrogens have a net anti-estrogen effect, and when natural estrogen levels are low their effect becomes more estrogenic.

Where do phytoestrogens come from?

There are 2 main types of phytoestrogen: isoflavones and lignans.

  • Isoflavones: a plant molecule found in the plant family Fabacea (bean family), especially soybeans.
    • Highest concentrations in: edamame or whole soy beans, tempeh, tofu, miso, soy butter
    • Other sources: chickpeas, peanuts
  • Lignans: a component of insoluble fiber, found in many plants.
    • High concentrations in: flax seeds, sesame seeds, cereal brans (e.g. oat bran, rice bran)
    • Other sources: whole grains (wheat, millet, rye, barley), legumes, nuts, asparagus, grapes, kiwi, lemons, oranges & pineapple

Dietary lignans depend on healthy gut flora to metabolize or change them into a form where they are biologically active. And it is not just the estrogen receptor activity that makes lignans healthy, they also have beneficial effects on the cardiovascular system.

Phytoestrogens and Digestive Health:

If phytoestrogens were a cure-all for estrogen related problems, it wouldn’t be a secret. But they do have a measurable and meaningful impact on many hormonal imbalances. For example:

A 2015 meta-analysis of 15 studies done on phytoestrogens and menopausal symptoms shows that they are able to reduce frequency of hot flashes compared to placebo.

A 2012 quasi-randomized study of 146 women with PCOS in Italy showed that use of a phytoestrogen lignan isolate for 3 months reduced levels of DHEA-S and testosterone and improved lipid profiles by reducing triglycerides and LDL (aka “bad cholesterol”) levels.

Clinically, I suspect that one of the keys to how people respond to phytoestrogens is contingent on the state of their digestive health. It is known that lignans, for example, need to undergo transformation by healthy gut bacteria to become fully active as phytoestrogens in the body. And the balance between healthy and unhealthy gut bacteria is also likely the lynch pin for whether people find foods containing phytoestrogens beneficial for their hormonal and metabolic balance, or a cause of gas, bloating and fatigue.

Not everyone responds well to soy and other foods rich in phytoestrogens. Digestive problems are common among people who do not tolerate soy and other legumes well.  One reason for this is the fructo-oligo-saccharide content of legumes, recall that the legume family is the plant family most well known for producing phytoestrogens, are fodder for the fermenting bacteria responsible that cause the digestive condition SIBO (small intestine bowel overgrowth).

This underscores why digestive health is such a critical piece of the puzzle in finding hormonal balance for many women. Fortunately, there are tests available to evaluate digestive health, including tests for SIBO to see if there is a bacterial overgrowth that requires treatment before phytoestrogens can be successfully tolerated and metabolized, as well as tests to determine the presence, abundance and diversity of healthy gut bacteria.

About the author:

Miranda Marti, ND, LAc is a body positive naturopathic physician and acupuncturist specializing in the holistic treatment of PCOS and other chronic conditions affecting hormonal, digestive and mental health.

Body Positive Yoga and PCOS

Body positive yoga

All bodies are yoga bodies. Photo courtesy of Lydia Mann, Flickr Creative Commons.

Why Body Positive Yoga Matters

I wish I could write that all yoga programs are welcoming to all body shapes and sizes. The reality is, though, that many yoga programs cater to a thin body standard and narrow view of what constitutes health and wellness. And sometimes they do not offer the modifications or recommendations that help make all yoga poses comfortably accessible to larger bodies. Or they over-emphasize poses and, however well-intentioned, single out larger students for special assistance or treatment even if none is needed or desired. In short, not everyone feels comfortable in a conventional yoga class. If these words resonate with you, please read on:

Body Positive Yoga: recommended event and resources

As a body positive naturopathic physician, I want all my patients have access to yoga instructors whose teaching caters to their mind, body and spirit as they are, not as they should be. And when it comes to instruction and personal practice, nothing quite compares to being able to see a body that looks like your body do yoga.

This is why I am delighted to tell you about an upcoming event with body positive yoga instructor and author Jessamyn Stanley at the Seattle Central Library on April 21 from 7 – 8:30 pm. She will be discussing her body positive approach to yoga and her new book “Every Body Yoga”

“Jessamyn Stanley is known for combining a deep understanding of yoga with a willingness to share her personal struggles. Now she brings her body-positive, emotionally uplifting approach in a book that will help every reader discover the power of yoga. Jessamyn will appear in conversation with local writer and yoga instructor Nicole Tsong.

As an internationally recognized yoga teacher and Instagram star, Jessamyn Stanley conducts yoga workshops across the country, teaching students of all shapes, sizes, and colors how to make yoga a permanent part of their lives.”

If you have ever wondered whether yoga is for you, or if you have ever wanted to try a yoga class but were worried that you wouldn’t fit in or feel comfortable participating, please check out Jessamyn’s website and go see her speak in Seattle.

Where to find in-person or online body positive yoga instruction:

A benefit of living in or near Seattle is that we have some great body positive yoga studios for in-person classes and instruction. A benefit of the internet age is that it is increasingly easy to start a home yoga practice. Yoga instructors from around the world offer online videos and tutorials, many of them free or available by monthly subscription.

Here are several resources to get you started:

  • Whole Life Yoga: a Seattle-based body positive yoga studio located in the Greenwood neighborhood. They have drop in classes 7 days a week and regularly offers a Yoga for Round Bodies series of 4-6 classes.
  • Tiger Lily Yoga: a Seattle-based yoga body positive yoga studio located in the Columbia City neighborhood. They offer in-person classes 7 days a week, including pay-what-you-can donation based classes.
  • Curvy Yoga: online yoga videos that are searchable by length, energy level, pose type and body part. Free and paid memberships are available.
  • Body Positive Yoga: online yoga classes, tutorials for pose modifications. She also offers helpful advice for other yoga instructors on how to incorporate body positive language into their instruction and how to present pose modifications that keep students safe and prevent injury.

For writing on body positive yoga, I highly recommend Vancouver, BC-based Lisa Papez’s blog and manifesto. I took a workshop from her at the 2013 Realize Your Radiance conference in Seattle and was so inspired by her approach and instruction.

If you are a body positive yoga instructor or know of body positive yoga resources in Seattle or the Eastside, I would love to know about them!

Yoga, Body Positivity and PCOS:

80% of women with PCOS experience hormonal and metabolic dysregulation that leads to insulin resistance and weight gain, which can be closely tied to experiences of body dysmorphia, a challenging relationship with body image and anxiety.

A 2012 study of adolescents with PCOS showed that a 12 week holistic yoga program was better for reducing anxiety than a traditional physical exercise program. The teenage girls recruited for this study practiced yoga and meditation for 1 hour per day for 12 weeks, while their study counterparts in the control group participated in a 1 hour daily of traditional exercise (e.g. leg lifts and crunches) and group lectures on healthy diet and lifestyle. Researchers believe that the benefit that yoga had for reducing symptoms of anxiety was both neurological, by reducing activity of the sympathetic (fight-or-flight) nervous system, as well as psychological by enhancing mindfulness and stress resilience.

This same group of teenage girls with PCOS was also seen to have better glucose metabolism, measured by fasting insulin and fasting glucose, and lower cholesterol levels than their counterparts in traditional exercise programs.

About the author:

Hello, I’m Miranda Marti, ND, LAc, a body positive naturopathic physician and acupuncturist specializing in the holistic treatment of PCOS. I started doing yoga to support my stress resilience and stabilize my neck and back muscles to help alleviate my migraine headaches. What began as a very goal-oriented experiment (wildly successful, btw) with yoga has blossomed into a regular, self-sustaining practice.

Is plastic disrupting my estrogen?

BPA-free plastic food containers and utensils remain ubiquitous in our kitchens. Photo by Miranda Marti, ND.

The investigative journalism magazine, Mother Jones, just published a compelling story on the presence of xenoestrogens in BPA-free plastics.

Xenoestrogens, synthetic chemicals that are capable of stimulating estrogen receptors in human (and other animal) bodies, are a growing concern worldwide. Exposure to xenoestrogens can come from the food supply, as they accumulate in the fat of animals that are exposed to some to them, primarily through herbicides and pesticides (atrazine is the most notorious), and then find their way into milk, butter, and meat. They can also come from direct contact with certain plastics, or from food  stored in plastic containers. The now-banned BPA-containing plastics were the most notorious offenders, but now we have strong reason to believe that they are not the only ones.

This topic is of significant interest to those of us at Whole Life Medicine who care for women with diseases of estrogen-dominance, such as PCOS, fibroids, endometriosis.  Is part of what’s driving these disease processes environmental exposure from plastics? And if so, how can we limit that exposure to protect our health?

I have a personal stake in this game. I am one of those estrogen-dominant women. I even have genetic test results that show my body is a slow estrogen metabolizer. What this means is that I don’t make a full compliment of the enzymes that break estrogen and estrogen-like chemicals down and inactivate them, so they spend a longer time in circulation with the opportunity to stimulate my estrogen receptors, which in the long run can cause tissues that are sensitive to estrogen to be overactive and create health problems.

I’d also like to state very clearly that I am not “anti-chemical” by any stretch of the imagination. I’ve had too many years of chemistry, organic chemistry and biochemistry education to fear “chemicals” or even “synthetic chemicals” generally; I understand that chemicals generally speaking make up pretty much everything we are and interact with and do not inherently pose a threat to health. But as an Environmental Studies-Biology major at Whitman College, I began getting curious if some of the synthetic chemicals we interact with on a daily basis like plasticizers, specifically phthalates, might not be interacting with our bodies’ hormone system in ways that could be harmful to our health.

Years after undergrad, my interest was reignited after reading Nena Baker’s The Body Toxic. In this book Baker, an investigative journalist, considers the evidence about what is and isn’t known about common industrial and synthetic chemicals that haven’t been subjected to rigorous safety screening; and whether multiple exposures from daily living might lead to a “chemical body burden” that is beyond the scope of individual safety profiles to comprehend. For example, if over the course of the day I am exposed to ScotchGuard and food heated in plastic and the  plastic in my toothbrush, those exposures together could accumulate to levels  that are dangerous, even if individually each exposure would be considered safe by the safety data on ScotchGuard, the plastic in my tupperware and the plastic in my tooth brush. Xenoestrogens feature prominently in the book as a case study for chemicals needing further human safety data.

What I took away from The Body Toxic is that BPA-contianing plastic is worth avoiding, but that BPA is probably not the end all and be all of  my xenoestrogen exposure because all plastic may be suspect, which is indeed the point that the recent Mother Jones article makes. And that foods that are moist or have an appreciable fat content are the ones most likely to leach xenoestrogens from their plastic containers into the food I would consume, so those are the foods I can prioritize creating, storing and consuming from non-plastic containers. I also read labels of all products that I put on my skin to avoid those containing “phthalates.”

To the right is a picture of my stash of containers for storing left-overs, prepared foods and things I don’t want to wilt in the refrigerator.

My glass food storage collection. Photo by Miranda Marti, ND

And after making those changes around 4-5 years ago, which proved to be sustainable in my life in terms of time and money spent on them, I considered myself reasonably protected. Certainly I still receive exposures to xenoestrogens but my goal isn’t 100% avoidance, it’s harm-reduction.

The new news on BPA-free plastic, however, has me wondering if that is enough. While the data on exposure to plastics and causation of estrogen-related diseases is not strong enough for me to offer much proscriptive advice. What I will say is probably in everybody’s best interest to avoid xenoestrogen exposure from plasticizers is:

  • Store moist or fat-containing foods in metal, ceramic or glass containers, not plastic.
  • Do not heat foods in plastic containers, no matter how microwave safe.
  • Check labels in grooming products to avoid anything with “phthalates.”
  • Be aware anything listed as “fragrance” may be diethyl phthalate (DEP).
  • Avoid air fresheners: many brands contain phthalates but are not required to list them on the label.
  • Choose ethylene vinyl acetate (EVA) over PVC plastics in toys and building materials, as EVA does not require plastic softeners, polyethylene or other plastic polymers.
  • Read the Mother Jones article on BPA-free plastics and other well-researched work on the issue, and check to make sure they cite their sources if they make strong claims about risk or safety.

Beyond that, I think it’s up to the individual to decide what’s right for them in terms of time and money costs, as well as availability. Here are some of the issues I’ve started thinking about in my pantry, which currently looks like this:

My plastic-filled pantry. Photo by Miranda Marti, ND.

What amongst this plastic-wrapped shelf must I worry about? The reality is, I don’t know that I can make the switch for everything that comes in plastic packaging. So here are the top three daily-consumed foods I’m considering making changes for re: purchasing and storing habits:

  • I love sunflower seed butter and use it almost every morning with breakfast, but the brand I’ve been buying lately from Trader Joe’s is in a plastic container, which is concerning because of the product’s high fat content. Perhaps it’s time to switch to a brand that comes in glass. This should be easy to do with the occasional trip to another store, such as PCC or Whole Foods.
  • For the past few years I’ve used coconut flour, which is high in fiber, to make my morning waffle. Ordinarily I wouldn’t worry too much about grains or flours in plastic packaging because these products are generally dry and have very little fat that could leach xenoestrogens, but coconut flour is an exception due to it’s fat content. I’d like to buy and store it in non-plastic packaging, but I don’t recall ever seeing it offered outside of a plastic bag. Perhaps there is a bulk buying option at PCC where I could bring my own glass or paper container….but honestly, will I? Those are extra steps to take that I might not be motivated to actually take, but I will at least explore my options.
  • Almonds are another food I consume frequently, going through at least a pound per week. I usually buy a 1 lb bag from Trader Joe’s or a 3 lb bag from Costco. Almonds are not moist, but they do have a considerable fat content. I know for sure I could buy the in bulk in a non-plastic container, but the price difference for doing so would be considerable compared to what I’m used to paying.

As I continue to peruse my pantry over the next several days, I’m sure I’ll come across many more oft-consumed items that are packaged or stored in plastic to consider. It’s an on-going process, and I’ll be sure to let you know if I come up with any brilliant ideas to avoid plastics without great inconvenience cost or inconvenience.

This post is courtesy of Dr. Miranda Marti.