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    Help for Hot Flashes

    Is soy the solution to this menopausal symptom?

    Heating Up the Soy Debate continued...

    Mary Hardy, MD, medical director of the Integrative Medicine Program at Cedars-Sinai Medical Center in Los Angeles, believes that even the positive findings for soy in some studies have shown only a modest impact on menopausal symptoms. At the same time, she says, "some individual women say that soy has had a tremendous effect on managing their hot flashes. However, I wonder if it's the soy per se, or did these women also reduce the fat in their diet, or restrict their caffeine or alcohol intake? But as part of moving to an overall healthier diet, I think that soy can be an important component of those changes."

    While Messina tells women that soy may have a modest benefit on menopausal symptoms, he says, "it's not the most important reason to take soy. I think the heart benefits and the possible bone-strengthening benefits of soy foods are more important reasons." For example, the evidence indicating that soy can reduce blood cholesterol levels is so strong that the FDA permits this claim on food labels.

    If you want to give soy a try, most experts suggest consuming one to two servings per day, which translates to an intake of about 25 to 50 mg. of isoflavones. "If you don't experience any benefit from two servings of soy," advises Messina, "then you can try adding another one."

    You'll find soy in foods such as tofu, soy milk, whole soybeans (like edamame), miso, soy yogurt, and tempeh -- although some women report that it takes a little time to develop a taste for soy.

    "There are still people who are in the 'I-won't-eat-soy-and-you-can't-make-me' crowd," says Hardy. But many might be agreeable to eating soybeans, she says, even as a snack food, or drinking a shake prepared with soy powder, or adding "soy crumble" to sauces.

    Soy supplements -- most containing 25 mg. of isoflavones per pill -- are available at health-food stores. "As a general rule, you're better off getting what you're looking for from foods rather than from tablets," says Seibel, author of The Soy Solution for Menopause: The Estrogen Alternative. "Even so, some of the studies showing benefits from soy in reducing hot flashes were conducted with pills containing isoflavones."

    Messina agrees, noting that as a nutritionist, he always prefers food rather than pills. But he adds, "this is a country where most people don't eat any soy, so consuming even two servings can be a challenge for them. For that reason, I don't have a problem with someone saying, 'On the days that I don't eat two servings per day, I'll take a pill to bring my level up to the recommended amount.' But food is still best because hopefully the soy servings will take the place of less healthy foods in your diet. If you were eating soy nuts instead of potato chips, for example, that would be wonderful."

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