Abstract
Soybean (Glycine max) is a species of legume native to East Asia and used in childhood diet for over 2,000 years in the East. Soy protein formulas have been available for almost a century. Nowadays, the increase in cow's milk allergy and vegetarian dietary preferences are driving consumers toward cow's milk alternatives. In this paper, we reviewed the nutritional composition of soy-based infant formula and discussed their possible use in pediatric age, mainly focusing on prevention and treatment of cow's milk allergy. Protein quality is determined by digestibility and amino acid content. Purified or concentrated vegetable proteins (e.g., soy protein and gluten) have high digestibility (>95%), similar to those of animal ones. For some intact vegetable products (e.g., whole cereals and pulses), protein digestibility is lower (80–90%). Food processing and heat treatment also influence protein digestibility. Considering these data, we tried to evaluate the possible use of soybean and derivatives in pediatric age, including the nutritional composition of soy formulas and the clinical indications for their use. Moreover, since plant-based beverages are being perceived as healthy by consumers and their use is growing on the market, we recommend that soy drink should not be used as a substitute for infant formulas or cow's milk in children younger than 24 months.
Highlights
The soybean (Glycine max L.) is a legume crop of East Asian origin, but its use has nowadays spread worldwide due to its nutritional value
The ESPGHAN and Academy of Pediatrics (AAP) recommend not using soy in infants with food allergy during the first 6 months of life and not using soy in preterm infants. It is still unclear if the routine use of soy-based formulas may have roles in the prevention of allergic diseases, and further largescale studies are required to clarify the safety of soy and its use for the treatment of cow’s milk allergy. Since their first use as cow’s milk substitute formulas for children with CMA, many changes have occurred over the years to improve digestibility, nutritional values, and protein quality of soy-based formulas
There are no valid indications for replacing cow’s milk with soy-based drinks, remembering that, up to 6 months of life, human milk (HM) remains the best way to feed infants. It is still unclear if soy protein formulas may have roles in the prevention of allergic diseases, but, for CMA infants, they certainly represent a valid, economic, and well-tolerated alternative to Extensively hydrolyzed formulas (eHFs)
Summary
The soybean (Glycine max L.) is a legume crop of East Asian origin, but its use has nowadays spread worldwide due to its nutritional value (i.e., high protein and oil contents). In the West, soybeans are mainly processed to obtain full-fat flakes that are defatted by using organic solvents and pressed into soybean meal, a high-quality protein source. This is subsequently used to obtain texturized vegetable protein, soy concentrate, and soy isolates, used as a protein supplement for various foods, including infant formulas [1, 2]. We reviewed the nutritional composition of soy-based infant formula (SIF) and discussed their possible use in pediatric age, mainly focusing on prevention and treatment. For enzymes, lipo-oxygenases are not antinutritional factors but give the soybean their characteristic, undesirable, beany flavor [14, 15], whereas urease is used mainly in production processes as an indicator of adequate heat treatment [1, 16]
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