Soybean Formula Research Articles

Efektifitas pemberian sari kedelai dan formula kedelai terhadap gula darah penderita diabetes mellitus tipe 2

Background : Diabetes mellitus is caused by a lack of insulin production in the body or insulin resistance. Soybeans can be used as a functional food to lower blood sugar levels because they have a low glycemic index value, sufficient fiber content, so they can slow down the absorption of food in the body, containing the amino acid arginine which is able to maintain the balance of the insulin hormone. Soybean isoflavones in the form of Genistein and Daidzein are useful for repairing cells, metabolizing glucose and fat, and protecting pancreatic cells.Methods : This type of research is a quasy experiment with a pre-post design with two treatment groups. The study was conducted from August to October 2020. The data collected were blood sugar levels, energy and carbohydrate intake, glycemic index, obesity status, physical activity and genetics. The research stages were: manufacture of soybean juice functional foods and soy formula. Functional food in the treatment group was given for 14 days. Data analysis used t-test dependent and independent statistical tests with a confidence degree of 95% (α 0.05) and continued with multiple linear regression analysis.Result : There is an effect of giving soy formula and soybean juice on blood sugar levels of people with Type 2 diabetes. The mean reduction in blood sugar levels in the group given soy formula was 26.30 mg/dl, while the group given soybean juice was 17.96 mg/dl.Conclution : Soybean formula can reduce blood sugar levels by 8.34 mg / dl greater than soybean juice. Physical activity carried out regularly has a role in reducing blood sugar levels by 33,828 mg / dl. Soybean juice and soy formulas can be used as alternatives to lower blood sugar levels in people with type 2 diabetes.

Pemberian minuman formula kacang merah, kacang tanah, dan kacang kedelai terhadap status gizi ibu hamil kurang energi kronis (KEK)

Background: The prevalence of malnutrition in pregnant women DIY reached 22.69%, while at Sleman amounted to 11.72%. The study has been developed drinks formula derived from beans that contain the nutrient according to the needs of pregnant women.Objective: This study aimed to analyze the influence of red beans, peanuts and soybeans drink formula against the nutritional status of pregnant women.Method: The study design is randomized controlled trial (RCT). The inclusion criteria are pregnant women with chronic energy deficiency and gestational age between 14-28 weeks. The research locations in 8 health centers in Sleman with total sample of 84 people. Data obtained by measuring LILA and pregnant women weight before and after being given a drink formula. Data analysis using Chi-Square, paired t-test and Wilcoxon.Results: There was differences between the increase of weight and LILA pregnant women in the treatment group was higher than controls (p<0.005). Increase of BB and LILA on the three groups there is a difference (p<0.001). Based on measurements of nutritional status of pregnant women showed that significant effect giving peanuts formula compared to red beans and soy bean formula that does not significantly (p<0.001). Groups of pregnant women who get peanuts formula showed increased protein intake above the standard of 67 g and a total energy of 2260 calorie.Conclusion: Nutritional status of pregnant women who get the peanut formula higher than by red beans, soy beans, and formula for pregnant women. Pregnant women who received peanuts formula have higher energy and protein intake than the other formulas.

The effect of soybean formula and formula 100 supplementation on the growth of preschool children

Background Preschool children are vulnerable in growth. Soy-bean formula (SF) and formula-100 (F100) are supplementary foodswhich contain of high energy and are available at low price; how-ever, they are not widely used for preschool children.Objectives To investigate the effect of SF compared to F100 onthe growth of preschool children.Methods A cross-over trial was conducted on 96 preschool chil-dren aged 4-7 years. Subjects were randomly divided into 2 groupswhich received 200 ml soybean formula (n=49) or F100 (n=47) for1 month and crossed-over after a six-week wash-out period. Bodyweight was measured weekly. Body height and food analysis by 3-day food recall were measured at the beginning and the end of thestudy. The criteria of the acceptability of the formula was eithergood or poor.Results Supplementation with SF as well as F100 induced catchup growth as shown by the increase of Δz-score. There were nosignificant difference of Δ weight for age z-score, Δ height for agez-score, and Δ weight for height z score between groups duringthe first and second phases of the trial. The acceptability of F100was significantly better than that of SF at the beginning; neverthe-less, the difference was not significant at the second phase trial.Conclusions Soybean formula and F100 given for a one monthperiod can induce catch-up growth in preschool children. Soybeanformula as an alternative health food can be accepted by preschoolchildren

A fermented barley and soybean formula enhances skin hydration

Skin hydration is one of the primary aims of beauty and anti-aging treatments. Barley (Hordeum vulgare) and soybean (Glycine max) are major food crops, but can also be used as ingredients for the maintenance of skin health. We developed a natural product-based skin treatment using a barley and soybean formula (BS) incorporating yeast fermentation, and evaluated its skin hydration effects as a dietary supplement in a clinical study. Participants ingested a placebo- (n = 33) or BS- (3 g/day) containing drink (n = 32) for 8 weeks. A significant increase in hydration in the BS group as compared to the placebo group was observed on the faces of subjects after 4 and 8 weeks, and on the forearm after 4 weeks. Decreases in stratum corneum (SC) thickness were also observed on the face and forearm. BS enhanced hyaluronan (HA) and skin barrier function in vitro and reduced Hyal2 expression in human dermal fibroblasts (HDF). BS also recovered ultraviolet (UV) B-induced downregulation of HA in HaCaT cells. These results suggest that BS has promising potential for development as a health functional food to enhance skin health.

In vivo Evidence of Cross-Reactivity between Cow’s Milk and Soybean Proteins in a Mouse Model of Food Allergy

Background: Cow’s milk allergy (CMA) is an important problem worldwide and the development of an in vivo system to study new immunotherapeutic strategies is of interest. Intolerance to soybean formula has been described in CMA patients, but it is not fully understood. In this work, we used a food allergy model in BALB/c mice to study the cross-reactivity between cow’s milk protein (CMP) and soy proteins (SP). Methods: Mice were orally sensitized with cholera toxin and CMP, and then challenged with CMP or SP to induce allergy. Elicited symptoms, plasma histamine, humoral and cellular immune response were analyzed. Th1- and Th2-associated cytokines and transcription factors were assessed at mucosal sites and in splenocytes. Cutaneous tests were also performed. Results: We found that the immediate symptoms elicited in CMP-sensitized mice orally challenged with SP were consistent with a plasma histamine increase. The serum levels of CMP-specific IgE and IgG1 antibodies were increased. These antibodies also recognized soy proteins. Splenocytes and mesenteric lymph node cells incubated with CMP or SP secreted IL-5 and IL-13. mRNA expression of Th2-associated genes (IL-5, IL-13, and GATA-3) was upregulated in mucosal samples. In addition, sensitized animals exhibited positive cutaneous tests after the injection of CMP or SP. Conclusions: We demonstrate that CMP-sensitized mice, without previous exposure to soy proteins, elicited hypersensitivity signs immediately after the oral administration of SP, suggesting that the immunochemical cross-reactivity might be clinically relevant. This model may provide an approach to further characterize cross-allergenicity phenomena and develop new immunotherapeutic treatments for allergic patients.

Clinical efficacy comparison of anti‐wrinkle cosmetics containing herbal flavonoids

Herbal anti-wrinkle cosmetics were formulated from ginkgo (Ginkgo biloba), a mixture of tea and rooibos (Camellia sinensis and Aspalathus linearis) and soybean (Glycine soja). These extracts were incorporated into the preliminary developed stable gel base with good preference. The gingko formulation was found to be more stable than the formula containing a mixture of tea and rooibos and the soybean formula. Clinical efficacies of the ginkgo formula and the formula containing a mixture of tea and rooibos were compared following 28 days of application. The ginkgo preparation increased skin moisturization (27.88%) and smoothness (4.32%) and reduced roughness (0.4%) and wrinkles (4.63%), whereas the formula containing tea and rooibos showed the best efficacy on wrinkle reduction (9.9%). In comparison to the tea and rooibos formula, gingko significantly improved skin moisturization (P = 0.05).

Proteomic evaluation of milk from different mammalian species as a substitute for breast milk

As milk represents the main source of nutrition for infants, the question of an effective human milk substitute becomes mandatory when a formula-fed baby is allergic to cows' milk proteins. In this case, formulas containing extensively hydrolysed milk proteins should be preferred, but even such a formula may cause allergic reactions in highly sensitive patients. If there is evidence of cows' milk allergy with IgE-associated symptoms, after 6 mo of age, a soy bean formula may be recommended only when tolerance to soy protein has been established by clinical challenge. In infants with allergic reactions to cows' milk proteins, even after extensive hydrolyzation, proteomic techniques coupled to immunological methods may make it possible to select other milk products that do not contain the same allergens as ordinary cow's milk. In this paper, evidence will be presented that proteomic evaluation of proteins from different mammalian species may be a suitable method of testing whether proteins from the milk of different mammalian species may be used as a substitute for untreated bovine milk. Proteomic evaluation of milk from different mammalian species may not only be of help when recommending suitable feeding in cases of cows' milk allergy but also gives new insight into the background to allergic reactions caused by milk proteins.

Nutritive value of chicken and potato mixtures for infant and preschool children feeding

AbstractTwo chicken/potato protein mixtures (50:50 and 60:40) were prepared for use in formulas of high nutritive value and low cost for the diet of undernourished children and those with lactose intolerance. The proximate analysis and amino acid content of the raw materials and mixtures were determined and the chemical score (CS) was calculated. The proximate analysis and amino acid content of a commercial soybean formula were used as reference. The protein quality of the mixtures was evaluated by protein efficiency ratio (PER) and digestibility measurements. The protein content of cooked chicken and potato on a dry basis was 889 and 70 g kg−1 respectively and the carbohydrate content of potato was 762 g kg−1. Tryptophan was the limiting amino acid in chicken for infants according to the 1985 FAO pattern (CS = 76), but not for preschool children. Valine was limiting in potato for both infants and preschool children (CS = 56 and 88 respectively). Tryptophan was limiting in both 50:50 and 60:40 mixtures for infants; also the PER was higher in the 60:40 mixture and not significantly different from the control (casein), but both were different from the 50:50 mixture. Since both chicken and potato are available even for low‐income people, a formula prepared in the 60:40 ratio is of potential benefit for infants or preschool children who have lactose intolerance, mainly in developing countries. Copyright © 2003 Society of Chemical Industry

Asthma and TNF variants in Chinese and Malays.

edema, cough, and dyspnea developed. Theyouth’s pre-event meal 2 h earlier hadincluded Parmesan, a cow’s milk cheese.Referred to our clinic, the patient and hisparents gave their informed consent tochallenges. Fresh-food SPT were negative forcow’s milk lactoalbumin, beef, and lamb, butpositive (wheal diameter 5 mm) for freshcow’s milk casein and ewe’s milk (whealdiameter 6 mm). Positive RAST for cow’smilk casein (3.44 IU/ml) and elevated total IgE(195 IU/ml) were then found. During double-blind, placebo-controlled, food-exercisechallenge (DBPCFEC) with four planneddoubling doses (5, 10, 20, 40 ml) of cow’s milkmasked in soybean formula, a reaction tocow’s milk was confirmed when symptomsdeveloped with the 20-ml dose. Atimmunoblotting (following methodsdescribed elsewhere), however, serum IgEreacted strongly to ewe’s and weakly to cow’smilk proteins (Fig. 1).This patient, who had been allergic to ewe’smilk since childhood, was observed to developallergy to cow’s milk at food-exercisechallenge. Cow’s milk and cow’s milkproducts had been tolerated from birth untilsevere anaphylactic reactions were triggeredby ingestion (with other foods) after exerciseduring adolescence. To the best of ourknowledge, this is the second case of food-dependent, exercise-induced anaphylaxisdiagnosed at DBPCFEC (6). Although ewe’smilk allergy is usually coexistent with cow’smilk allergy, it can also occur in isolation. Thesame phenomenon applies in the case ofallergies to the milk of the goat, the mare, andother animals (7, 8). Common allergenicepitopes can be shared by ewe’s and cow’smilk protein; therefore, cow’s milk allergymay be associated.Caseins are held responsible for this cross-reaction, justifying caution regarding theconsumption of dairy products by childrenwho are allergic to the milk of nonbovinespecies. Weak food sensitization, whichappears only after strenuous exercise, couldtrigger more severe allergic symptoms (9).Furthermore, there is a compelling need foraccurate labeling of all dairy products as to thenature and origin of the milk from which theyare made. We conclude that hypersensitivityreaction to ewe’s milk may be viewed as aforerunner of cow’s milk intolerance when afresh-food workup and carefully conductedDBPCFEC establish sensitization.

Prospective oral food challenge study of two soybean protein isolates in patients with possible milk or soy protein enterocolitis.

The soybean protein isolate used in powdered soybean formula is hydrolyzed more extensively than the isolate which is used in liquid soybean formula in most commercial soybean formulas. Previous in vitro studies have shown differences in human antibody response to these soybean protein isolates. Therefore, a prospective clinical study was undertaken to determine if there were differences in adverse reaction rates to these soybean protein isolates. Forty-three patients with possible milk- and/or soy-protein enterocolitis were enrolled in this study. Patients had 3 separate oral food challenges; using milk formula, soybean powder formula and soybean liquid formula. Ten (23%) patients challenged with milk had positive challenges. Fourteen (33%) patients challenged with powdered soy formula had positive challenges while thirteen (30%) challenged with liquid soy formula had positive challenges. In the 10 patients with positive milk challenges, 6 (60%) had a positive soy challenge. In the group with positive soy challenges, 5 reacted to the powdered soy challenge done first, but not the second challenge with the liquid soy formula, and 4 patients reacted to the liquid soy formula challenge done first, but not the second challenge with the powdered soy formula. These results indicate that a significant number of patients with milk protein enterocolitis have soy protein enterocolitis. In addition, an order effect can be demonstrated in the soy challenges because of the tendency to react to the first soy challenge regardless of the type of isolate. These results suggest that a local immune effect caused by the protein may be present.

Recommendations for Soy Infant Formula: A Review of the Literature and a Survey of Pediatric Allergists

Statements in the pediatric and gastroenterology literature to the effect that use of soybean formula should be avoided because of its high "allergenicity" seem to be unfounded. A review of the literature as well as personal experience in practice and with two dietary prophylactic studies spanning 15 years suggest that the availability of soybean formula constitutes a useful contribution to our knowledge of the handling of many nutritional problems of infants and children. The availability of soybean formula provides parents of infants with cow's milk allergy a nutritional food that can be used in the preparation of many kinds of food dishes and desserts to provide variety for children on restrictive diets. Over the past four decades, the use of soybean formula as a part of a dietary prophylaxis against the development of atopy in children of allergic families has been well accepted by the vast majority of infants who have received it. A survey of pediatric allergists showed the limits of what can be obtained by even the least demanding questionnaire. Given the rarity of reactions and the difficulty in identifying a clear causal agent, the average allergist is "overasked" by even a simple one-page set of questions. If anything, the wide range of answers indicates widespread confusion. A definitive answer about the existence of soybean allergies cannot be obtained without a detailed protocol for reporting and cross-validating such observations in a collaborative study. The use of soybean in infant feeding goes back many centuries in Chinese and Japanese cultures. In modern Japan, soy formula is commonly used either as a substitute for human breast milk or as a postweaning protein source in the first year of life. The first reported use of a soybean preparation for feeding infants with milk allergy was reported by Hill and Stuart in 1929.(1) Yet recommendations for soybean formula have remained controversial. We review the evidence for and against soybean formula and present data from a survey of pediatric allergists.

An Evaluation With Piglets of Bovine Milk, Hydrolyzed Bovine Milk, and Isolated Soybean Proteins Included in Infant Milk Formulas. II. Stomach-Emptying Rate and the Postprandial Change in Gastric pH and Milk-Clotting Enzyme Activity

The piglet was used as a model for the human infant to determine the effect of the protein source of a milk formula on stomach-emptying rate and the postprandial changes in gastric pH and milk-clotting enzyme activity. Three liquid milk formulas containing either intact bovine milk protein, hydrolyzed bovine milk protein, or isolated soybean protein as the sole source of dietary protein were given to five 37-day-old piglets that had undergone surgery for the preparation of a simple gastric fistula. At set times after commencement of a meal, the stomach contents were removed via a gastric cannula and weighed; then pH and milk-clotting enzyme activity were determined. The isolated soybean protein-based formula tended to empty from the stomach more slowly than did the bovine milk-based formulas. Maximum difference (p less than 0.05) was found at 3 h postfeeding, where 30% of the ingested soybean formula dry matter remained in the stomach; comparable values for the intact bovine milk-based formula and hydrolysate were 22 and 12%, respectively. The type of protein did not significantly (p greater than 0.05) affect the postprandial change in gastric pH or gastric milk-clotting enzyme activity. Gastric pH increased sharply after feeding, from pH 1.5 at 0 h to pH 5.2 at 1 h, and then fell gradually over the following 4 h to pH 1.84.

An Evaluation With Piglets of Bovine Milk, Hydrolyzed Bovine Milk, and Isolated Soybean Proteins Included in Infant Milk Formulas. II. Stomach‐Emptying Rate and the Postprandial Change in Gastric pH and Milk‐Clotting Enzyme Activity

SummaryThe piglet was used as a model for the human infant to determine the effect of the protein source of a milk formula on stomach‐emptying rate and the postprandial changes in gastric pH and milk‐clotting enzyme activity. Three liquid milk formulas containing either intact bovine milk protein, hydrolyzed bovine milk protein, or isolated soybean protein as the sole source of dietary protein were given to five 37‐day‐old piglets that had undergone surgery for the preparation of a simple gastric fistula. At set times after commencement of a meal, the stomach contents were removed via a gastric cannula and weighed; then pH and milk‐clotting enzyme activity were determined. The isolated soybean protein‐based formula tended to empty from the stomach more slowly than did the bovine milk‐based formulas. Maximum difference (p < 0.05) was found at 3 h postfeeding, where 30% of the ingested soybean formula dry matter remained in the stomach; comparable values for the intact bovine milk‐based formula and hydrolysate were 22 and 12%, respectively. The type of protein did not significantly (p > 0.05) affect the postprandial change in gastric pH or gastric milk‐clotting enzyme activity. Gastric pH increased sharply after feeding, from pH 1.5 at 0 h to pH 5.2 at 1 h, and then fell gradually over the following 4 h to pH 1.84.

Mineral and vitamin D adequacy ininfants fed human milk or formula between 6 and 12 months of age

During the latter half of an infant's first year, adequate mineral and vitamin D intakes may be important not only for the prevention of rickets but also for the attainment of optimal adult peak bone mass. Ingestion of 400 IU vitamin D per day, either as a supplement or contained in formula or table milk, will result in normal serum concentrations of vitamin D,25-hydroxyvitamin D, and 1,25-dihydroxyvitamin D. Human milk from a vitamin D-sufficient mother provides a marginal amount, less than 100 IU/L/day of total vitamin D activity from the vitamin D and 25-hydroxyvitamin D. Infants exclusively fed human milk of vitamin D-deficient mothers, who do not receive additional vitamin D or adequate exposure to sunlight, are at significant risk for vitamin D-deficiency rickets. The low concentration of phosphorus in human milk is adequate for most term infants but probably compounds any vitamin D deficiency. Intake of phosphorus from formula or table milk is more than adequate, and the addition of baby foods increases this mineral's intake to generous levels. Calcium is well absorbed and adequate in human milk if vitamin D is sufficient, but concern exists about calcium intake from infant formulas for this older group. My colleagues and I have conducted studies of bone mineral content and mineral homeostasis in term infants fed human milk (300 mg/L calcium), standard cow milk formula (440/mg/L calcium), or a soybean formula (600 mg/L calcium); our findings suggest that all three types of feedings provided comparable bone mineralization and normal indicators of mineral homeostasis. Mean calcium retentions at 6 months, 9 months, and 12 months in all three groups were between 138 and 205 mg/day, substantially more than the 130 mg/day estimated to be needed from body composition data. Estimates for phosphorus were similarly generous. The questions of whether higher calcium intakes will result in further increases in bone mineral content and of the effect of beikost on calcium absorption from different milks require further study.

An Evaluation with Piglets of Bovine Milk, Hydrolyzed Bovine Milk, and Isolated Soybean Proteins Included in Infant Milk Formulas. I. Effect on Organ Development, Digestive Enzyme Activities, and Amino Acid Digestibility

A study, using the piglet as a model for the human infant, was undertaken to determine the effect of the protein source of a milk formula on organ development, the activity of digestive enzymes, and the absorption of amino acids as measured at the terminal ileum and over the entire digestive tract. Three isocaloric liquid milk formulas containing equal amounts of either intact bovine milk, hydrolyzed bovine milk, or isolated soybean protein as the sole source of this nutrient and with equal levels of fat and carbohydrate were each given to six 14-day-old piglets over a 19-day period in a manner that mimicked human infant feeding practice. Following a 6-day metabolism study, the piglets were killed, their organs removed, and samples of digesta collected. The protein source of the milk-based formula did not affect (p greater than 0.05) the weight/unit body weight of the small intestine, large intestine, liver, or pancreas, but the relative weight of the kidneys was lower (p less than 0.05) for animals fed the intact bovine milk-based formula and that of the stomach was higher (p less than 0.01) for piglets receiving the isolated soybean formula. The activities of pepsin, intestinal trypsin and chymotrypsin and pancreatic chymotrypsin were not influenced (p greater than 0.05) by protein source, but piglets receiving the bovine milk-based formula had a lower level of activity (p less than 0.01) for pancreatic trypsin. The apparent ileal and fecal absorption of nitrogen was similar for the three milk-based formulas, the overall mean ileal absorption of nitrogen (+/- SE) being 89.0% (+/- 1.44). Excluding cystine, where ileal absorption was relatively lower (p less than 0.05) with the isolated soybean formula (86.7%) compared with the intact bovine milk (91.5%), protein source had little effect on the apparent absorption of essential amino acids. It was concluded that the replacement of intact cow's milk protein in human infant formulas by either hydrolyzed cow's milk or isolated soybean protein is unlikely to cause any major disturbance in the digestive process.

An Evaluation with Piglets of Bovine Milk, Hydrolyzed Bovine Milk, and Isolated Soybean Proteins Included in Infant Milk Formulas. I. Effect on Organ Development, Digestive Enzyme Activities, and Amino Acid Digestibility

SummaryA study, using the piglet as a model for the human infant, was undertaken to determine the effect of the protein source of a milk formula on organ development, the activity of digestive enzymes, and the absorption of amino acids as measured at the terminal ileum and over the entire digestive tract. Three isocaloric liquid milk formulas containing equal amounts of either intact bovine milk, hydrolyzed bovine milk, or isolated soybean protein as the sole source of this nutrient and with equal levels of fat and carbohydrate were each given to six 14‐day‐old piglets over a 19‐day period in a manner that mimicked human infant feeding practice. Following a 6‐day metabolism study, the piglets were killed, their organs removed, and samples of digesta collected. The protein source of the milk‐based formula did not affect (p > 0.05) the weight/unit body weight of the small intestine, large intestine, liver, or pancreas, but the relative weight of the kidneys was lower (p<0.05) for animals fed the intact bovine milk‐based formula and that of the stomach was higher (p<0.01) for piglets receiving the isolated soybean formula. The activities of pepsin, intestinal trypsin and chymotrypsin and pancreatic chymotrypsin were not influenced (p > 0.05) by protein source, but piglets receiving the bovine milk‐based formula had a lower level of activity (p<0.01) for pancreatic trypsin. The apparent ileal and fecal absorption of nitrogen was similar for the three milk‐based formulas, the overall mean ileal absorption of nitrogen (±SE) being 89.0% (±1.44). Excluding cystine, where ileal absorption was relatively lower (p<0.05) with the isolated soybean formula (86.7%) compared with the intact bovine milk (91.5%), protein source had little effect on the apparent absorption of essential amino acids. It was concluded that the replacement of intact cow's milk protein in human infant formulas by either hydrolyzed cow's milk or isolated soybean protein is unlikely to cause any major disturbance in the digestive process.

L‐Carnitine Supplementation of a Soybean‐Based Formula in Early Infancy

SummaryThe absence of carnitine in the diet of normal infants results in marked reduction of plasma carnitine levels. In order to evaluate the effects of L‐carnitine supplementation of soybean formula, plasma and urine levels of free carnitine and acylcarnitine were compared in infants receiving carnitine‐free soybean protein‐based formula and the same formula supplemented with 50 and 250 nmol/ml L‐carnitine. In infants receiving soybean formula with 50 nmol/ml L‐carnitine, the plasma levels of free carnitine were not significantly different from those in infants receiving formula with 250 nmol/ml L‐carnitine; however, urine levels of free carnitine were significantly increased when the infants received formula with 250 nmol/ml L‐carnitine. In normal full‐term infants, supplementation of soybean formula with 50 nmol/ml L‐carnitine was sufficient to maintain normal plasma levels that were comparable to breast‐fed infants.

Chloride-Deficient Formulas

To the Editor.— In addition to the numerous caveats described in the paper by Willoughby et al (Pediatrics 1987;79:851-857), a number of other serious criticisms should be noted. General recommendations for the use of soy bean formula frequently included the assumption that some risk factor existed in the child, limiting the use of milk-based formulas. Indeed, in the 20 infants reported by Willoughby et al, 11 are said to have had other risk factors, such as hyperbilirubinemia in six, ventricular septal defects in two, and one each with low birth weight, twinning, and Pierre-Robin anomalad.

Manifestation einer Kuhmilchproteinintoleranz bei Mukoviszidose mit der Symptomtrias - Hypoproteinämie, Ödeme und Anämie

The symptom complex--hypoproteinemia, edema and anemia--occurs in approximately 5 percent of CF-patients during the first 6 months of life. Since milk is the only nutritional source in this age group, a hypocaloric nutrition respectively marginaly low protein intake may contribute to these symptoms in case of an exocrine pancreatic insufficiency. Even if breast milk and soy bean formulas can advance the disease it must be mentioned that relapses of the symptom triad had never occurred under pancreatic enzyme supplementation independently of the source of milk being fed. A cow's milk protein intolerance and coincidental exocrine pancreatic insufficiency lead to the symptom complex in an infant in spite of an adequate caloric and protein intake. This case revealed again that sweat electrolyte tests are unreliable during the acute period of disease, sweat tests were positive when the presenting symptoms were resolved. The case demonstrates that repeated sweat chloride tests are mandatory during an asymptomatic phase of disease besides the exclusion of a renal or cardiac origin of the symptom complex. An early postnatal diagnosis of CF and immediate initiation of pancreatic enzyme and fat soluble vitamin supplementation could prevent such courses of disease.

Aflatoxin and Reye's Syndrome: A Case Control Study

What may be one of the most significant findings of our time was noted by Nelson and coworkers in reporting the finding of aflatoxin in the serum of 23% of the subjects in their study. Aflatoxins, which are potent carcinogens in animals,2 are widespread in our environment, and the effects are noted to be more potent in the young of the species.3 Hayes et al4 found aflatoxin in a significant number of soybean infant formula samples, and we have found aflatoxin in the serum of two patients with primary hepatic carcinoma5 as well as two children with leukemia who never went into remission (B. B. Wray and A. W. Hayes, unpublished data).