

To Soy or Not to Soy
by Pat Battaglia
Survivors of breast cancer, especially those whose tumors were estrogen-receptor positive, are often advised by well-meaning friends and family members to avoid soy foods. This myth persists despite evidence to the contrary.
It is true that soybeans contain a significant amount of phytoestrogens, which are plant-based compounds similar to human estrogen, but there are important differences. While early studies conducted in mice models suggested that phytoestrogens may have contributed to the growth of estrogen-receptor-positive breast cancer tumors, further research has shown that humans and mice metabolize these compounds differently. More recent studies revealed that breast cancer rates are lower in Asian countries, where soy foods are a staple, than in the United States. The overall body of evidence indicates that unprocessed soy foods, eaten in moderation, do not increase the risk of breast cancer recurrence.(1) Sue Czap, RD, a registered dietitian at the Integrative Oncology and Wellness Center of the Wilmot Cancer Institute, says “Statements issued in 2012 by the American Institute for Cancer Research and the American Cancer Society said that moderate intake of soy is safe for patients with hormone sensitive breast cancer.”
It may be helpful to know that soy is not converted to estrogen in the body. No single food is capable of the type of hormone disruption that may lead to cancer growth.(2)
Although foods derived from whole soybeans can be part of a healthy eating pattern, processed soy isoflavones contained in products such as protein powders, nutritional bars, some meatless entrees, and dietary supplements have not been evaluated in large, randomized clinical trials, and their effect on cancer growth is unknown.(3) These may be listed on ingredient labels as ‘soy protein isolate’ or ‘soy protein concentrate’ and are best avoided, at least until more is known about them. “Be a label detective,” advises Czap.
Whole soy foods include such things as edamame, tofu, soy milk, miso, and tempeh. “Moderate intake of soy foods is one to two servings a day, ”Czap shares. Some examples of serving sizes for these foods are one-half cup of edamame, one cup of soy milk or one-quarter cup of tofu.(2) Soy-based condiments and by-products such as soy sauce, soybean oil, and soy lecithin are also regarded as safe, Czap confirms, and do not contain appreciable amounts of phytoestrogens.
For those taking Tamoxifen or an aromatase inhibitor, studies do not show any harmful interactions between soy and these anti-estrogen medications. In fact, a few studies suggest there may be some benefit to consuming soy foods in these cases, but more research is needed to confirm this.(4)
“Instead of being fearful of food, I encourage patients to become empowered by their food choices,” says Czap. “Adding more plant-based foods to the diet can be an empowering choice. Foods based on whole soybeans are a plant-based source of high quality protein; they contain all the essential amino acids.”
Food choices are personal, and fortunately there is a wide array of healthy foods to choose from. Soy foods are just one option among many. Breast cancer survivors who choose to consume small-to-moderate amounts of whole soy have solid evidence to alleviate any concerns they or others may have about their risk of recurrence. And an informed choice is an empowered choice.
1. https://www.roswellpark.org/cancertalk/201905/should-cancer-patients-avoid-soy
2. https://www.cancernutrition.org/2018/03/30/is-soy-safe-for-cancer-patients/
3. https://acsjournals.onlinelibrary.wiley.com/doi/full/10.1002/cncr.30614
4. https://www.aicr.org/cancer-prevention/food-facts/soy/
This story appeared in the Winter 2021 edition of Voices of the Ribbon newsletter.
Sesame Noodles with Crispy Baked Tofu
(makes 4 servings)
Crispy Baked Tofu:
1 block (12 to 15 ounces) organic extra-firm tofu
1 tablespoon olive oil
½ teaspoon salt
½ teaspoon garlic powder
½ teaspoon turmeric
¼ teaspoon black pepper
1 tablespoon cornstarch
Sesame Noodles:
8 ounces uncooked linguine
¼ cup low-sodium soy sauce
1 tablespoon rice vinegar
1 to 2 tablespoons toasted sesame oil
1 teaspoon ground ginger
½ – 1 teaspoon sriracha or your favorite hot sauce
½ teaspoon garlic powder
¼ teaspoon freshly-cracked black pepper
½ cup thinly-sliced green onions
Tofu:
Drain the tofu and pat dry with a clean towel or paper towel. Slice it into two or three even slabs about ¾ inch thick. Line a flat surface with a kitchen towel or paper towels. Place the tofu on the towel(s). Fold the towel(s) over the tofu, and then place a cutting board over the top. Set something heavy (like a cast iron pan or several large books) on top of the cutting board. Let the tofu drain for 15 to 30 minutes. (This step helps ensure your finished tofu will be crispy.)
Heat the oven to 400 degrees. Line a cookie sheet or other flat pan with parchment; or, if you prefer, oil the pan. Cut the pressed tofu into ¾-inch cubes and place in a bowl. Add the oil and seasonings and toss to coat.
Sprinkle in the corn starch and toss again until the tofu cubes are evenly coated. Turn the tofu cubes out onto the prepared pan and arrange in an even layer. Bake 15 minutes, then turn the cubes over (tongs work well for this) and bake another 10-15 minutes until golden brown and crispy.
Noodles:
Cook pasta according to package instructions. While the pasta is boiling, whisk together the soy sauce, rice vinegar, 1 tablespoon of sesame oil, and remaining ingredients except the green onions. Taste and adjust seasonings, adding more sesame oil and/or sriracha if desired.
When the pasta is al dente, drain it and return it to the cooking pot with a 2-3 tablespoons of the cooking water. Immediately add the sauce and green onions; toss until the pasta is evenly coated.
Place the pasta on plates or in bowls, then top it with the tofu cubes. Serve.
*Adapted from gimmesomeoven.com