Women's health

Plant-based foods are a good choice as part of a woman’s healthy diet.


  • Bone health: Calcium loss increases during menopause because of the loss of oestrogen. Many nutrients help to keep bones healthy, so it’s important that the diet is balanced containing calcium and vitamin D.
  • Hot flushes: The impact of soya and isoflavones on alleviating hot flushes during the menopause has been the focus of a considerable number of investigations.
Weight management: Plant-based eating, that includes eating more fruit, vegetables, legumes, whole-grains, nuts and seeds and limiting the amount of energy-rich foods, is a simple and effective way to manage weight.

Cholesterol-lowering: Plant-based foods and eating patterns tend to be lower in saturated fat. It’s widely accepted that a reduced saturated fat intake is associated with lower total blood cholesterol and LDL-cholesterol.

  • Plant foods and plant-based eating patterns have shown a number of beneficial characteristics in cancer. Health professionals can reassure their patients with breast cancer that soya products are completely safe and may even have long term protective effects on health.
  • Following an exhaustive review (November 2012) of the latest evidence, the American Institute for Cancer Research (AICR) has categorically stated that soya foods are perfectly safe to be consumed by women pre and post breast cancer diagnosis.

To ensure a lifetime of healthy bones the World Health Organization (WHO) recommends it’s important to: achieve the highest possible bone mass during the time of growth (childhood and adolescence), maintain bone health in early adulthood and reduce the rate of bone loss later in life. Bone health throughout life is highly dependent on peak bone mass (PBM) achieved in young adulthood.  90% of PBM occurs by the age of 18 in girls and 20 in boys (when growth ceases).
Adequate calcium intake and vitamin D status is required for optimal bone health. Also, ensuring a sufficient protein intake is important to keep bones healthy.
Evidence from observational studies indicates those who follow plant-based eating patterns have a healthy bone mass, with no difference in bone mass between omnivore and vegetarian populations.
However, it appears that those who consume vegan-type diets should take care to preserve protein and calcium intake, particularly during adolescence and young adulthood when peak bone mass is attained. There are a wide variety of plant-based protein sources, including peas, beans, lentils, nuts, soya dairy alternatives, tofu and soya mince, that can be consumed to ensure protein intakes are maintained. To make sure sufficient calcium is provided in the diet preference should be given to dairy alternatives fortified with calcium. Calcium is also found in plant foods such as dried fruits, nuts, green leafy vegetables (especially Kale and Pak-Choi, but not spinach), sesame seeds and tahini.
A more alkaline diet, rich in fruit and vegetables with smaller amounts of meat, reduces the acid/base challenge that can result in minerals such as calcium being leached out of bones.
Plant-based eating tends to be associated with other beneficial lifestyle factors, such as being more physically active, smoking less and an overall lower energy dense, nutrient-rich diet, all of which contribute to good bone health.
As soya foods provide high quality protein and many are also a good source of calcium, soyaa can help and support normal growth and bone development. Many other plantbased drinks are enriched with calcium and vitamine D. As a result these foods can be helpful in maintaining bone health.
Several observational studies consistently show an inverse association between vegetarian diets and Body Mass Index (BMI).

Information from the Adventist Health Studies provides an insight into weight status as people progress from a vegan diet through to an omnivore diet. As more animal products are included in the diet, BMI gradually increases.

Plant-based eating, that includes eating more fruit, vegetables, legumes, whole-grains, nuts and seeds and limiting the amount of energy-rich foods, is a simple and effective way to manage weight.
Menopause is defined as the permanent loss of menstruation after a period of amenorrea lasting over one year. This happens when levels of the female hormones, estrogen and progesterone, fall and the ovaries stop making eggs. Menopause starts between 40 and 55 years of age and is often accompanied by a number of complaints: hot flushes, night sweats, a feeling of tiredness, irritability, headaches, etc. These symptoms occur as a result of decreasing estrogen levels and can begin before menstruation stops and persist for months to years afterwards.
Hormone Replacement Therapy (HRT), which involves taking estrogen with or without progestin, effectively alleviates these menopausal symptoms. However, since results from the Women’s Health Initiative (WHI) have been published, many women are unwilling to take HRT because they’re concerned about some of the potential side-effects. In this study it was found that women who received hormone therapy actually had a higher risk of heart disease, stroke, and some types of cancer (breast and endometrial cancer) than women who didn’t receive hormone therapy. As a result, many women are looking for alternative solutions.
The severity and frequency of menopausal symptoms are remarkably lower in Asian women than in Western women. In Asia, only 10% to 20% of postmenopausal women experience hot flushes compared to 50% - 70% of women in Western Countries. A possible reason for this could be due to the higher intake of soya, and their respective isoflavones, among Asians.
This has been confirmed in many clinical studies which have found that hot flush frequency and/or severity is reduced in groups receiving isoflavones compared to placebo groups.
The newest meta-analysis by Taku et al in 2012 found that soya (equivalent to 2 - 3 servings a day) reduces the number of hot flushes by 20% and reduces the intensity of hot flushes by 25%. This meta-analysis is based on data from 19 studies involving over 1500 subjects investigating the impact of soya isoflavones on menopausal symptoms.
Reducing uncomfortable symptoms can greatly improve the quality of life for menopausal women. As such women should consider including soya foods into their diet as part of a lifestyle approach to help manage these symptons.

The World Cancer Research Fund confirms that soya foods fit in to healthy eating guidelines for breast cancer survivors.

The World Cancer Research Fund published its update report “Diet, Nutrition, Physical Activity and Breast Cancer Survivors” in October 2014. The independent panel of scientists concluded that there are indications of links between better survival after breast cancer and:
  1. A healthy body weight
  2. Being physically active
  3. Eating foods containing fibre
  4. Eating foods containing soya
  5. A lower intake of total fat and, in particular, saturated fat

Body weight

Before and after diagnosis of breast cancer. The scientific evdience demonstrates that there is a link between a healthy BMI and surviving breast cancer. However, the report highlights that more research is needed to fully understand why overweight and obese women have a greater risk of dying from the disease.
Risk of developing breast and other cancer. The report also highlights that being overweight or obese is associated with the development of eight cancers: bowel, womb, oesophageal, kidney, pancreatic, ovarian, gallbladder as well as post-menopausal breast cancer.

Physical activity

Both before and after diagnosis, being physically active provides women with a greater chance of surviving breast cancer.


Although the evidence is not conclusive and more research is needed especially with respect to diet and cancer survival, the report does highlight that despite the limited evidence, there are general and consistent findings from various studies:

  • Eating more fibre containing foods.  Both before and after diagnosis – eating more fibre may reduce the risk of dying from breast cancer.

  • Soya food consumption and breast cancer survivorsWomen who consume more soya foods after diagnosis, may improve their survival rate whilst a higher consumption of soya foods afterprimary breast cancer diagnosis may reduce risk of all cause mortality.

  • High fat and saturated fat intakes. Consuming high fat and saturated fat diets prior to diagnosis, may place women at increased risk of dying following their diagnosis

The American Cancer Reserarch Institute has developed some impactful on-line visuals to communicate the findings: http://www.aicr.org/learn-more-about-cancer/infographics/breast-cancer-survivorship.html

For the full report - click here 

Breast Cancer Prevalence
Breast cancer is by far the most frequent cancer among women with an estimated 425,000 new cancer cases diagnosed in 2008 (28.2% of all cancers) in Europe and almost 129,000 deaths per year. Breast cancer is still the leading cause of death from cancer in women. In Asian countries, the incidence of breast cancer is 2.4 times lower than the incidence in Western counties: the age-standardized incidence rate in Europe is 62.8 per 100,000 compared to 26.1 per 100,000 in Asia.

Soya intake early in life

Migrant studies indicate that it takes 2-3 generations for women moving from a low risk to a high risk country to adopt the risk of the host country. After 100 years in Hawaii, Japanese-Americans now have a breast cancer risk close to that of Caucasian women. This suggests that some etiological factors may act during childhood or adolescence (11).
Several epidemiologic studies have examined the effect of early soya intake on adult breast cancer risk later in life. During adolescence, the developing breast tissue is most sensitive to environmental stimuli. The observation that soya intake during childhood and adolescence is associated with a reduced risk of breast cancer later on in life is consistent with migration data, highlighting that early life events are particularly important for breast cancer.
The Shanghai Breast Cancer Study found that adolescent soya food intake was associated with a decreased risk of breast cancer: young women consuming around 2-3 soya foods a day were half as likely to develop breast cancer later in life compared to young women who rarely consumed soya. Another study in the US came to similar conclusions: women who reported consuming soya four times a week during adolescence had a 35% lower risk of developing breast cancer later in life compared to those having soya less than once a month.
Overall there is strong scientific evidence to recommend young girls consume at least 1 serving of soya foods a day. Protection may stem from the estrogenic activity of isoflavones, resulting in breast cell differentiation enabling the breast tissue to be more resistant to carcinogens later in life.

Breast cancer patients: soya foods are breast cancer friendly

Scientists from AICR extensively evaluated the findings from laboratory, animal and human studies and have concluded that regular soya isoflavone consumption has no detrimental effect, and in fact has the potential to reduce breast cancer risk.  This is also the case for breast cancer survivors consuming soya foods. 
The Shanghai Breast Cancer Survival Study followed 5042 female breast cancer survivors in China. Soya food intake was associated with lower mortality (29%) and recurrence (32%) among breast cancer patients. The association of soya food with mortality and recurrence appears to be dose related until soya food intake reached around 12 g of soya protein a day; no additional benefits on mortality and recurrence were observed with higher intakes of soya food. This study suggests that moderate soya food intake (12 g of soya protein per day) is safe and potentially beneficial for women with breast cancer. Furthermore, soya food intake did not interfere with tamoxifen use.
Similarly two large studies in breast cancer patients in the US have found similar reassuring results.
In early 2013, Pamela Magee reviewed all the data, involving over 9000 breast cancer survivors, and again concluded that soya consumption did not have any adverse effects. In fact, regular soya consumption had the potential to lower mortality and tumor recurrence rates – depending on the type of breast tumor involved. Women consuming around 12g of soya protein daily (equivalent to 400ml soyadrink or 80g of soya mince) had a 25% lower risk of breast cancer recurrence compared to women who consumed no soya.  This favourable effect in cancer survivors was seen in patients treated with and without tamoxifen.

Extensive analysis of the current research shows that consuming 1-2 servings of soya foods (equivalent to 1-2 glasses of soya drink or 50-100g of soya mince/tofu) a day has the potential to lower breast cancer risk, and for some breast cancer survivors can lower mortality and tumor recurrence rates.
Chronic kidney disease is associated with a decreased capability of the kidneys to excrete waste products. The symptoms of worsening kidney function are non-specific, and might include feeling generally unwell and reduced appetite. Chronic kidney disease is usually diagnosed as a result of screening of people known to be at increased risk such as those with high blood pressure or diabetes. Patients suffer from lower glomerular filtration rate resulting in higher levels of creatinine in blood. Severe chronic kidney disease requires renal replacement therapy in the form of dialysis or kidney transplantation.
In 2014 a meta-analysis consisting of nine trials comprising 197 pre-dialysis chronic kidney disease patients reviewed the effect of soy protein consumption.
New, S.A., Intake of fruit and vegetables: implications for bone health. Proc Nutr Soc, 2003. 62(4): p. 889-99.

Egana JI, Fuentes A, Steinke FH, Uauy R: Protein quality comparison of a new isolated soya protein and milk in Chilean preschool children. Nutr Res 3,195-202 (1983)

Anonymous: Guidelines for school health programs to promote lifelong healthy eating. Centers for Disease Control and Prevention. MMWR Recomm Rep 45, 1-41 (1996).
Health Survey for England 2007. Latest Trends. NHS. National Statistics. The Information Centre for Health and Social Care
Tonstad S, Butler T, Yan R, Fraser GE. Type of vegetarian diet, body weight, and prevalence of type 2 diabetes. Diabetes Care 2009;32:791-6.

Sabate J, Wien M. Vegetarian diets and childhood obesity prevention. Am J Clin Nutr 2010;91:1525S-9S.

Rossouw JE, Anderson GL, Prentice RL et al. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results From the Women's Health Initiative randomized controlled trial. JAMA 2002;288:321-33.

Sturdee DW. The menopausal hot flush-Anything new? Maturitas 2008;60:42-9.

D'Anna R, Cannata ML, Atteritano M et al. Effects of the phytoestrogen genistein on hot flushes, endometrium, and vaginal epithelium in postmenopausal women: a 1-year randomized, double-blind, placebo-controlled study. Menopause 2007;14:648-55.

Howes LG, Howes JB, Knight DC. Isoflavone therapy for menopausal flushes: a systematic review and meta-analysis. Maturitas. Oct 20 2006;55(3):203-211.

Taku K, Melby MK, Kronenberg F, Kurzer MS, Messina M. Extracted or synthesized soyabean isoflavones reduce menopausal hot flash frequency and severity: systematic review and meta-analysis of randomized controlled trials. Menopause 2012;1:776-90.

Ziegler RG, Hoover RN, Pike MC et al. Migration patterns and breast cancer risk in Asian-American women. J Natl Cancer Inst 1993;85:1819-27.

Messina M, Caskill-Stevens W, Lampe JW. Addressing the soya and breast cancer relationship: review, commentary, and workshop proceedings. J Natl Cancer Inst 6 A.D.;98:1275-84.

Shu XO, Jin F, Dai Q et al. Soya food intake during adolescence and subsequent risk of breast cancer among Chinese women. Cancer Epidemiol Biomarkers Prev 2001;10:483-8.

Wu AH, Wan P, Hankin J, Tseng CC, Yu MC, Pike MC. Adolescent and adult soy intake and risk of breast cancer in Asian-Americans. Carcinogenesis 2002;23:1491-6.

Thanos J, Cotterchio M, Boucher BA, Kreiger N, Thompson LU. Adolescent dietary phytoestrogen intake and breast cancer risk (Canada). Cancer Causes Control 2006;17:1253-61.

Korde LA, Wu AH, Fears T et al. Childhood Soy Intake and Breast Cancer Risk in Asian American Women. Cancer Epidemiol Biomarkers Prev 2009.

Lamartiniere CA. Protection against breast cancer with genistein: a component of soy. Am J Clin Nutr 2000;71:1705S-7S.
Soy is safe for breast cancer survivors. AICR – November 21, 2012 | Issue 109 (http://www.aicr.org/cancer-research-update/november_21_2012/cru-soy-safe.html)

Shu XO, Zheng Y, Cai H et al. Soy food intake and breast cancer survival. JAMA 2009;302:2437-43.

Ballard-Barbash R, Neuhouser ML. Challenges in design and interpretation of observational research on health behaviors and cancer survival. JAMA 2009;302:2483-4.

Kang X, Zhang Q, Wang S, Huang X, Jin S. Effect of soy isoflavones on breast cancer recurrence and death for patients receiving adjuvant endocrine therapy. CMAJ 2010;182:1857-62.

Guha N, Kwan ML, Quesenberry CP, Jr., Weltzien EK, Castillo AL, Caan BJ. Soy isoflavones and risk of cancer recurrence in a cohort of breast cancer survivors: the Life After Cancer Epidemiology study. Breast Cancer Res Treat 2009.

Magee P, Rowland I: Soy products in the management of breast cancer

Zhang,J.; Liu,J.; Su,J.; Tian,F.The effects of soy protein on chronic kidney disease: a meta-analysis of randomized controlled trials. ur J Clin Nutr, 2014