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Original Contribution
August 15, 2001

Exposure to Soy-Based Formula in Infancy and Endocrinological and Reproductive Outcomes in Young Adulthood

Author Affiliations

Author Affiliations: Center for Clinical Epidemiology and Biostatistics and Department of Biostatistics and Epidemiology (Drs Strom, Barnhart, Sammel, and Macones and Ms Schinnar), Division of General Internal Medicine, Department of Medicine (Dr Strom), Department of Obstetrics and Gynecology (Drs Barnhart and Macones), and Division of Gastroenterology and Nutrition, Children's Hospital, and Department of Pediatrics (Dr Stallings), University of Pennsylvania School of Medicine, Philadelphia; and Fomon Infant Nutrition Unit, Department of Pediatrics, University of Iowa, Iowa City (Dr Ziegler, Mr Nelson, and Mss Drulis and Hanson).

JAMA. 2001;286(7):807-814. doi:10.1001/jama.286.7.807

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.