Letters to the Editor

Osteoporosis and Fractures

Am Fam Physician. 2000 Feb 15;61(4):960.

to the editor: I enjoyed the excellent article by Dr. Ullom-Minnich on the prevention of osteoporosis and fractures.1 For practicing physicians, the preventive aspects of managing osteoporosis can have a significant impact on the lives of patients.

The article1 contained little mention, however, of the nutritional methods of preventing osteoporosis that specifically relate to soy proteins. Dr. Ullom-Minnich correctly identified women of Asian descent as being at higher risk for fracture secondary to osteoporosis but failed to clarify that these are westernized women now eating a western diet. Asian women residing in their home countries actually have a significantly lower risk of osteoporosis and subsequent fractures that seem to be related to large amounts of soy in their diets.2,3 A growing body of data show that the isoflavones found in soy protein produce a stabilizing effect on the bone matrix.46 Animal and human studies increasingly show that a diet rich in soy proteins has some of the positive effects of estrogen replacement therapy without the risky side effects.46 Further studies are ongoing and will no doubt continue to support the nutritional value of soy proteins for osteoporosis prevention.

Dr. Van Zandt is a practicing family physician and the family medicine director of Physician Laboratories, makers of a nutritional soy supplement.

REFERENCES

1. Ullom-Minnich P. Prevention of osteoporosis and fractures. Am Fam Physician. 1999;60:194–202.

2. Knight DC, Eden JA. A review of the clinical effects of phytoestrogens. Obstet Gynecol. 1996;875 Pt 2897–904.

3. Tham DM, Gardner CD, Haskell WL. Clinical review 97: potential health benefits of dietary phytoestrogens. J Clin Endocrinol Metab. 1998;83:2223–35.

4. Potter SM, Baum JA, Teng H, Stillman RJ, Shay NF, Erdman JW Jr. Soy protein and isoflavones: their effects on blood lipids and bone density in post-menopausal women. Am J Clin Nutr. 1998;686 suppl1375S–9S.

5. Ishimi Y, Miyaura C, Ohmura M, Onoe Y, Sato T, Uchiyama Y, et al. Selective effects of genistein, a soybean isoflavone, on B-lymphopoiesis and bone loss caused by estrogen deficiency. Endocrinology. 1999;140:1893–900.

6. Harrison E, Adjei A, Ameho C, Yamamoto S, Kono S. The effect of soybean protein on bone loss in a rat model of postmenopausal osteoporosis. J Nutr Sci Vitaminol (Tokyo). 1998;44:257–68.

editor's note: This letter was sent to the author of “Prevention of Osteoporosis and Fractures,” who declined to reply.

 

Send letters to Kenneth W. Lin, MD, MPH, Associate Deputy Editor for AFP Online, e-mail: afplet@aafp.org, or 11400 Tomahawk Creek Pkwy., Leawood, KS 66211-2680.

Please include your complete address, e-mail address, and telephone number. Letters should be fewer than 400 words and limited to six references, one table or figure, and three authors.

Letters submitted for publication in AFP must not be submitted to any other publication. Possible conflicts of interest must be disclosed at time of submission. Submission of a letter will be construed as granting the American Academy of Family Physicians permission to publish the letter in any of its publications in any form. The editors may edit letters to meet style and space requirements.


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