HOME

TheInfoList



OR:

Soy allergy is a type of
food allergy A food allergy is an abnormal immune response to food. The symptoms of the allergic reaction may range from mild to severe. They may include itchiness, swelling of the tongue, vomiting, diarrhea, hives, trouble breathing, or low blood pressur ...
. It is a
hypersensitivity Hypersensitivity (also called hypersensitivity reaction or intolerance) refers to undesirable reactions produced by the normal immune system, including allergies and autoimmunity. They are usually referred to as an over-reaction of the immune ...
to ingesting compounds in
soy The soybean, soy bean, or soya bean (''Glycine max'') is a species of legume native to East Asia, widely grown for its edible bean, which has numerous uses. Traditional unfermented food uses of soybeans include soy milk, from which tofu and ...
(''Glycine max''), causing an overreaction of the
immune system The immune system is a network of biological processes that protects an organism from diseases. It detects and responds to a wide variety of pathogens, from viruses to parasitic worms, as well as cancer cells and objects such as wood splinte ...
, typically with physical symptoms, such as
gastrointestinal discomfort Gastrointestinal diseases (abbrev. GI diseases or GI illnesses) refer to diseases involving the gastrointestinal tract, namely the oesophagus, stomach, small intestine, large intestine and rectum, and the accessory organs of digestion, the liver, ...
,
respiratory distress Shortness of breath (SOB), also medically known as dyspnea (in AmE) or dyspnoea (in BrE), is an uncomfortable feeling of not being able to breathe well enough. The American Thoracic Society defines it as "a subjective experience of breathing disc ...
, or a skin reaction. Soy is among the eight most common foods inducing allergic reactions in children and adults. It has a prevalence of about 0.3% in the general population. Soy allergy is usually treated with an exclusion
diet Diet may refer to: Food * Diet (nutrition), the sum of the food consumed by an organism or group * Dieting, the deliberate selection of food to control body weight or nutrient intake ** Diet food, foods that aid in creating a diet for weight loss ...
and vigilant avoidance of foods that may contain soy ingredients. The most severe food allergy reaction is
anaphylaxis Anaphylaxis is a serious, potentially fatal allergic reaction and medical emergency that is rapid in onset and requires immediate medical attention regardless of use of emergency medication on site. It typically causes more than one of the follo ...
, which is a
medical emergency A medical emergency is an acute injury or illness that poses an immediate risk to a person's life or long-term health, sometimes referred to as a situation risking "life or limb". These emergencies may require assistance from another, qualified ...
requiring immediate attention and treatment with
epinephrine Adrenaline, also known as epinephrine, is a hormone and medication which is involved in regulating visceral functions (e.g., respiration). It appears as a white microcrystalline granule. Adrenaline is normally produced by the adrenal glands and ...
.


Signs and symptoms

Acute Acute may refer to: Science and technology * Acute angle ** Acute triangle ** Acute, a leaf shape in the glossary of leaf morphology * Acute (medicine), a disease that it is of short duration and of recent onset. ** Acute toxicity, the adverse ef ...
soy allergy can have fast onset (from seconds to one hour) or slow onset (from hours to several days), depending on the conditions of exposure, whereas long-term soy allergy may begin in infancy with reaction to soy-based infant formula. Although most children outgrow soy allergy, some may have the allergy persist into adulthood.


IgE allergy

Symptoms may include: rash,
hives Hives, also known as urticaria, is a kind of skin rash with red, raised, itchy bumps. Hives may burn or sting. The patches of rash may appear on different body parts, with variable duration from minutes to days, and does not leave any long-last ...
, itching of the mouth, lips, tongue, throat, eyes, skin, or other areas, swelling of lips, tongue, eyelids, or the whole face, difficulty swallowing, runny or congested nose, hoarse voice, wheezing, shortness of breath, diarrhea, abdominal pain, lightheadedness, fainting, nausea and vomiting. Symptoms of allergies vary from person to person and may vary from incident to incident. Serious danger regarding allergies can begin when the
respiratory tract The respiratory tract is the subdivision of the respiratory system involved with the process of respiration in mammals. The respiratory tract is lined with respiratory epithelium as respiratory mucosa. Air is breathed in through the nose to ...
or
blood circulation The blood circulatory system is a system of organs that includes the heart, blood vessels, and blood which is circulated throughout the entire body of a human or other vertebrate. It includes the cardiovascular system, or vascular system, tha ...
is affected. The former can be indicated by wheezing, a blocked airway and
cyanosis Cyanosis is the change of body tissue color to a bluish-purple hue as a result of having decreased amounts of oxygen bound to the hemoglobin in the red blood cells of the capillary bed. Body tissues that show cyanosis are usually in locations ...
, the latter by weak pulse, pale skin, and fainting. When such severe symptoms occur, the allergic reaction is called
anaphylaxis Anaphylaxis is a serious, potentially fatal allergic reaction and medical emergency that is rapid in onset and requires immediate medical attention regardless of use of emergency medication on site. It typically causes more than one of the follo ...
. Anaphylaxis occurs when
IgE antibodies Immunoglobulin E (IgE) is a type of antibody (or immunoglobulin (Ig) " isotype") that has been found only in mammals. IgE is synthesised by plasma cells. Monomers of IgE consist of two heavy chains (ε chain) and two light chains, with the ε c ...
are released into the
systemic circulation The blood circulatory system is a system of organs that includes the heart, blood vessels, and blood which is circulated throughout the entire body of a human or other vertebrate. It includes the cardiovascular system, or vascular system, t ...
in response to the allergen, affecting multiple organs with severe symptoms. Untreated, the anaphylactic response can proceed to a rapid heart beat, systemic
vasodilation Vasodilation is the widening of blood vessels. It results from relaxation of smooth muscle cells within the vessel walls, in particular in the large veins, large arteries, and smaller arterioles. The process is the opposite of vasoconstrictio ...
and a rapid decrease in blood pressure as conditions of
anaphylactic shock Anaphylaxis is a serious, potentially fatal allergic reaction and medical emergency that is rapid in onset and requires immediate medical attention regardless of use of emergency medication on site. It typically causes more than one of the follow ...
, requiring emergency intervention to prevent a fatality (rare for soy allergy).


Non-IgE allergy

Non- IgE mediated allergic reactions are slower to appear, and tend to manifest as
gastrointestinal The gastrointestinal tract (GI tract, digestive tract, alimentary canal) is the tract or passageway of the digestive system that leads from the mouth to the anus. The GI tract contains all the major organs of the digestive system, in humans and ...
symptoms, without
cutaneous Skin is the layer of usually soft, flexible outer tissue covering the body of a vertebrate animal, with three main functions: protection, regulation, and sensation. Other animal coverings, such as the arthropod exoskeleton, have different d ...
or
respiratory The respiratory system (also respiratory apparatus, ventilatory system) is a biological system consisting of specific organs and structures used for gas exchange in animals and plants. The anatomy and physiology that make this happen varies gre ...
symptoms. Within non-IgE reactions, clinicians distinguish among: *
food protein-induced enterocolitis syndrome Food Protein-Induced Enterocolitis Syndrome (FPIES) is a systemic, non IgE-mediated response to a specific trigger within food - most likely food protein. FPIES presents in two different forms: an acute form and a chronic form. In its acute form ...
(FPIES) * food protein-induced allergic proctocolitis (FPIAP) * food protein-induced enteropathy (FPE) The most common trigger-foods for these types of reaction are cow's milk and soy. FPIAP is considered to be at the milder end of the spectrum, and is characterized by intermittent bloody stools. FPE is identified by chronic
diarrhea Diarrhea, also spelled diarrhoea, is the condition of having at least three loose, liquid, or watery bowel movements each day. It often lasts for a few days and can result in dehydration due to fluid loss. Signs of dehydration often begin w ...
which resolves when the allergenic food is removed from the individual's diet. FPIES can be severe, even leading to anaphylaxis characterized by persistent vomiting 1–4 hours after an allergen-containing food, to the point of lethargy. Other symptoms may include headache and abdominal swelling (distension). Watery and sometimes bloody diarrhea can develop 5–10 hours after the triggering meal, to the point of dehydration and low blood pressure. Infants reacting to soy formula may also react to cow's milk formula. International consensus guidelines have been established for the diagnosis and treatment of FPIES.


Mechanisms

Allergic reactions Allergies, also known as allergic diseases, refer a number of conditions caused by the hypersensitivity of the immune system to typically harmless substances in the environment. These diseases include hay fever, food allergies, atopic derm ...
are hyperactive responses of the
immune system The immune system is a network of biological processes that protects an organism from diseases. It detects and responds to a wide variety of pathogens, from viruses to parasitic worms, as well as cancer cells and objects such as wood splinte ...
to substances that are normal components of foods, such as proteins. Food protein allergens are detected by allergen-specific immune cells which produce reactions and characteristic symptoms primarily when raw foods are eaten, and even after they have been cooked or digested. Conditions caused by food allergies are classified into three groups according to the mechanism of the allergic response: # IgE-mediated (classic) – the most common type, manifesting acute changes that occur shortly after eating, and may progress to
anaphylaxis Anaphylaxis is a serious, potentially fatal allergic reaction and medical emergency that is rapid in onset and requires immediate medical attention regardless of use of emergency medication on site. It typically causes more than one of the follo ...
# Non-IgE mediated – characterized by an immune response not involving
immunoglobulin E Immunoglobulin E (IgE) is a type of antibody (or immunoglobulin (Ig) " isotype") that has been found only in mammals. IgE is synthesised by plasma cells. Monomers of IgE consist of two heavy chains (ε chain) and two light chains, with the � ...
; may occur hours to days after eating, complicating diagnosis # IgE and non-IgE-mediated – a hybrid of the above two types In the early stages of an acute IgE-mediated allergic reaction,
lymphocyte A lymphocyte is a type of white blood cell (leukocyte) in the immune system of most vertebrates. Lymphocytes include natural killer cells (which function in cell-mediated, cytotoxic innate immunity), T cells (for cell-mediated, cytotoxic a ...
s previously sensitized to a specific protein or protein fraction react by quickly producing a particular type of antibody known as secreted IgE (sIgE), which circulates in the blood and binds to IgE-specific receptors on the surface of other kinds of immune cells called
mast cell A mast cell (also known as a mastocyte or a labrocyte) is a resident cell of connective tissue that contains many granules rich in histamine and heparin. Specifically, it is a type of granulocyte derived from the myeloid stem cell that is a par ...
s and
basophil Basophils are a type of white blood cell. Basophils are the least common type of granulocyte, representing about 0.5% to 1% of circulating white blood cells. However, they are the largest type of granulocyte. They are responsible for inflammator ...
s. Activated mast cells and basophils undergo a process called
degranulation Degranulation is a cellular process that releases antimicrobial cytotoxic or other molecules from secretory vesicles called granules found inside some cells. It is used by several different cells involved in the immune system, including gra ...
, during which they release
histamine Histamine is an organic nitrogenous compound involved in local immune responses, as well as regulating physiological functions in the gut and acting as a neurotransmitter for the brain, spinal cord, and uterus. Since histamine was discover ...
and other inflammatory chemical mediators into the surrounding tissue causing effects, such as
vasodilation Vasodilation is the widening of blood vessels. It results from relaxation of smooth muscle cells within the vessel walls, in particular in the large veins, large arteries, and smaller arterioles. The process is the opposite of vasoconstrictio ...
, mucous secretion,
nerve A nerve is an enclosed, cable-like bundle of nerve fibers (called axons) in the peripheral nervous system. A nerve transmits electrical impulses. It is the basic unit of the peripheral nervous system. A nerve provides a common pathway for the ...
stimulation, and smooth-muscle contraction. This results in
runny nose Rhinorrhea, rhinorrhoea, or informally runny nose is the free discharge of a thin mucus fluid from the nose; it is a common condition. It is a common symptom of allergies ( hay fever) or certain viral infections, such as the common cold or COV ...
, itchiness,
shortness of breath Shortness of breath (SOB), also medically known as dyspnea (in AmE) or dyspnoea (in BrE), is an uncomfortable feeling of not being able to breathe well enough. The American Thoracic Society defines it as "a subjective experience of breathing di ...
, and potentially
anaphylaxis Anaphylaxis is a serious, potentially fatal allergic reaction and medical emergency that is rapid in onset and requires immediate medical attention regardless of use of emergency medication on site. It typically causes more than one of the follo ...
. Depending on the individual, the allergen, and the mode of introduction, the symptoms can be system-wide (general anaphylaxis), or localized to the respiratory system (
asthma Asthma is a long-term inflammatory disease of the airways of the lungs. It is characterized by variable and recurring symptoms, reversible airflow obstruction, and easily triggered bronchospasms. Symptoms include episodes of wheezing, co ...
) or skin (
eczema Dermatitis is inflammation of the skin, typically characterized by itchiness, redness and a rash. In cases of short duration, there may be small blisters, while in long-term cases the skin may become thickened. The area of skin involved c ...
). After the chemical mediators of the acute response subside, typically 2–24 hours after the original reaction, late-phase responses referred to as non-IgE mediated can occur due to the migration of other types of
white blood cells White blood cells, also called leukocytes or leucocytes, are the cells of the immune system that are involved in protecting the body against both infectious disease and foreign invaders. All white blood cells are produced and derived from mult ...
to the initial reaction sites, causing diarrhea and other signs of
gastrointestinal upset Gastrointestinal diseases (abbrev. GI diseases or GI illnesses) refer to diseases involving the gastrointestinal tract, namely the oesophagus, stomach, small intestine, large intestine and rectum, and the accessory organs of digestion, the liver, ...
. Allergenic proteins from soy are named under a nomenclature decided by IUIC, which is also responsible for numbering many of the proteins. Proteins numbered by IUIC include: * Gly m 1, a hydrophobic protein * Gly m 2,
defensin Defensins are small cysteine-rich cationic proteins across cellular life, including vertebrate and invertebrate animals, plants, and fungi. They are host defense peptides, with members displaying either direct antimicrobial activity, immune ...
* Gly m 3,
profilin Profilin is an actin-binding protein involved in the dynamic turnover and reconstruction of the actin cytoskeleton. It is found in all eukaryotic organisms. Profilin is important for spatially and temporally controlled growth of actin microfilame ...
* Gly m 4, PR-10 * Gly m 5, vicilin, a cupin * Gly m 6, legumin, a cupin * Gly m 7, seed biotinylated protein * Gly m 8, 2S
albumin Albumin is a family of globular proteins, the most common of which are the serum albumins. All the proteins of the albumin family are water- soluble, moderately soluble in concentrated salt solutions, and experience heat denaturation. Album ...
These proteins are recognized by the immune system as antigens in susceptible individuals. As many as 8 other soy allergenic proteins are known.


Diagnosis

Diagnosis of an IgE-mediated soy allergy is based on the person's history of allergic reactions,
skin prick test Skin allergy testing comprises a range of methods for medical diagnosis of allergies that attempts to provoke a small, controlled, allergic response. Methods A microscopic amount of an allergen is introduced to a patient's skin by various mean ...
(SPT), patch test and measurement of soy protein specific serum
immunoglobulin E Immunoglobulin E (IgE) is a type of antibody (or immunoglobulin (Ig) " isotype") that has been found only in mammals. IgE is synthesised by plasma cells. Monomers of IgE consist of two heavy chains (ε chain) and two light chains, with the � ...
(IgE or sIgE). A negative IgE test does not rule out non-IgE mediated allergy, which is also described as cell-mediated allergy. SPT and sIgE have sensitivities of 55% and 83%, respectively, and specificities of 68% and 38%. These numbers mean that either test may miss diagnosing an existing soy allergy, that both could be positive for other food allergens, and that the tests have wide variability leading to a false-positive outcome of 30%. Confirmation is by
double-blind In a blind or blinded experiment, information which may influence the participants of the experiment is withheld until after the experiment is complete. Good blinding can reduce or eliminate experimental biases that arise from a participants' expec ...
,
placebo-controlled Placebo-controlled studies are a way of testing a medical therapy in which, in addition to a group of subjects that receives the treatment to be evaluated, a separate control group receives a sham "placebo" treatment which is specifically designed ...
food challenges, conducted by an allergy specialist. A diagnostic laboratory test is not available for non-IgE-mediated allergies, reflecting the obscure
pathophysiology Pathophysiology ( physiopathology) – a convergence of pathology with physiology – is the study of the disordered physiological processes that cause, result from, or are otherwise associated with a disease or injury. Pathology is ...
of these conditions. Instead, a person's history of symptoms is studied, and if the symptoms cease with the removal of soy, the diagnosis is made.


Treatment

Treatment for accidental ingestion of soy products by allergic individuals varies depending on the sensitivity of the person. An
antihistamine Antihistamines are drugs which treat allergic rhinitis, common cold, influenza, and other allergies. Typically, people take antihistamines as an inexpensive, generic (not patented) drug that can be bought without a prescription and provide ...
such as
diphenhydramine Diphenhydramine (DPH) is an antihistamine and sedative mainly used to treat allergies, insomnia, and symptoms of the common cold. It is also less commonly used for tremor in parkinsonism, and nausea. It is taken by mouth, injected into ...
(Benadryl) may be prescribed.
Prednisone Prednisone is a glucocorticoid medication mostly used to suppress the immune system and decrease inflammation in conditions such as asthma, COPD, and rheumatologic diseases. It is also used to treat high blood calcium due to cancer and ad ...
may be prescribed to prevent a possible late phase Type I hypersensitivity reaction. Severe allergic reactions (anaphylaxis) may require treatment with a
bronchodilator A bronchodilator or broncholytic (although the latter occasionally includes secretory inhibition as well) is a substance that dilates the bronchi and bronchioles, decreasing resistance in the respiratory airway and increasing airflow to the lung ...
and epinephrine pen, i.e., an injection device designed to be used by a non-healthcare professional when emergency treatment is warranted. A second dose is needed in 16–35% of episodes.


Avoiding soy

People with a confirmed soy allergy should avoid foods containing soy-sourced ingredients. In many countries,
packaged food Convenience food, also called tertiary processed food, is food that is commercially prepared (often through processing) to optimise ease of consumption. Such food is usually ready to eat without further preparation. It may also be easily po ...
labels are required to list ingredients, and soy is identified as an allergen. Many
fast-food restaurant A fast-food restaurant, also known as a quick-service restaurant (QSR) within the industry, is a specific type of restaurant that serves fast-food cuisine and has minimal table service. The food served in fast-food restaurants is typical ...
s commonly use soy protein in
hamburger bun A hamburger, or simply burger, is a food consisting of fillings—usually a patty of ground meat, typically beef—placed inside a sliced bun or bread roll. Hamburgers are often served with cheese, lettuce, tomato, onion, pickles, bacon, o ...
s (
soy flour The soybean, soy bean, or soya bean (''Glycine max'') is a species of legume native to East Asia, widely grown for its edible bean, which has numerous uses. Traditional unfermented food uses of soybeans include soy milk, from which tofu ...
), or as substitute meat (
soy protein Soy protein is a protein that is isolated from soybean. It is made from soybean meal that has been dehulled and defatted. Dehulled and defatted soybeans are processed into three kinds of high protein commercial products: soy flour, concentrates, ...
) preparations. Packaged foods, school meals, and restaurant foods may contain soy ingredients. Some food contains soy-based ingredients that are not considered allergens under national regulations, and thus are not labeled, such as foods cooked in highly refined soy oil, which is considered safe due to absence of soy protein. Products containing soy protein: *
edamame is a preparation of immature soybeans in the pod, found in cuisines with origins in East Asia. The pods are boiled or steamed and may be served with salt or other condiments. In Japan, they are usually blanched in 4% salt water for 5 minu ...
(boiled or steamed immature soybean pods) * hydrolyzed vegetable protein (HVP) * hydrolyzed plant protein *
miso is a traditional Japanese seasoning. It is a thick paste produced by fermenting soybeans with salt and ''kōji'' (the fungus '' Aspergillus oryzae'') and sometimes rice, barley, seaweed, or other ingredients. It is used for sauces and ...
*
nattō , spelled as natto in standard English language use, is a traditional Japanese food made from whole soybeans that have been fermented with ''Bacillus subtilis'' var. ''natto''. It is often served as a breakfast food with rice. It is served wi ...
* okara: pulp consisting of insoluble parts of the soybean that remains after pureed soybeans are filtered in the production of soy milk and tofu * shoyu sauce *
soy The soybean, soy bean, or soya bean (''Glycine max'') is a species of legume native to East Asia, widely grown for its edible bean, which has numerous uses. Traditional unfermented food uses of soybeans include soy milk, from which tofu and ...
(''Glycine max'', soy albumin, soy fiber, soy flour, soy grits, soy nuts, soy sprouts) *
soybean The soybean, soy bean, or soya bean (''Glycine max'') is a species of legume native to East Asia, widely grown for its edible bean, which has numerous uses. Traditional unfermented food uses of soybeans include soy milk, from which tofu ...
(
curd Curd is obtained by coagulating milk in a sequential process called curdling. It can be a final dairy product or the first stage in cheesemaking. The coagulation can be caused by adding rennet or any edible acidic substance such as l ...
, granules) * soybean butter (product similar to peanut butter) * Soybean
margarine Margarine (, also , ) is a spread used for flavoring, baking, and cooking. It is most often used as a substitute for butter. Although originally made from animal fats, most margarine consumed today is made from vegetable oil. The spread was or ...
(vegetable
shortening Shortening is any fat that is a solid at room temperature and used to make crumbly pastry and other food products. Although butter is solid at room temperature and is frequently used in making pastry, the term ''shortening'' seldom refers to b ...
) *
soy protein Soy protein is a protein that is isolated from soybean. It is made from soybean meal that has been dehulled and defatted. Dehulled and defatted soybeans are processed into three kinds of high protein commercial products: soy flour, concentrates, ...
(
concentrate A concentrate is a form of substance that has had the majority of its base component (in the case of a liquid: the solvent) removed. Typically, this will be the removal of water from a solution or suspension, such as the removal of water from ...
, isolate) *
soy milk Soy milk (simplified Chinese: 豆浆; traditional Chinese: 豆漿) also known as soya milk or soymilk, is a plant-based drink produced by soaking and grinding soybeans, boiling the mixture, and filtering out remaining particulates. It is a sta ...
*
soy sauce Soy sauce (also called simply soy in American English and soya sauce in British English) is a liquid condiment of Chinese origin, traditionally made from a fermented paste of soybeans, roasted grain, brine, and ''Aspergillus oryzae'' or '' As ...
(tamari,
teriyaki ''Teriyaki'' (kanji: 照り 焼き) is a cooking technique used in Japanese cuisine in which foods are broiled or grilled with a glaze of soy sauce, mirin, and sugar. Fish – yellowtail, marlin, skipjack tuna, salmon, trout, and mac ...
sauce) *
tempeh Tempeh or tempe (; jv, ꦠꦺꦩ꧀ꦥꦺ, témpé, ) is a traditional Indonesian food made from fermented soybeans. It is made by a natural culturing and controlled fermentation process that binds soybeans into a cake form. A fungus, '' Rhizo ...
(fermented whole soybeans) *
textured vegetable protein Textured or texturized vegetable protein (TVP), also known as textured soy protein (TSP), soy meat, or soya chunks is a defatted soy flour product, a by-product of extracting soybean oil. It is often used as a meat analogue or meat extender ...
(used as meat substitute or extender in school and prison meal programs) *
tofu Tofu (), also known as bean curd in English, is a food prepared by coagulating soy milk and then pressing the resulting curds into solid white blocks of varying softness; it can be ''silken'', ''soft'', ''firm'', ''extra firm'' or ''super f ...
(prepared from soy milk, coagulated, pressed to remove excess water) The following food additives may contain soy protein: *
flavoring A flavoring (or flavouring), also known as flavor (or flavour) or flavorant, is a food additive used to improve the taste or smell of food. It changes the perceptual impression of food as determined primarily by the chemoreceptors of the g ...
(including
natural Nature, in the broadest sense, is the physical world or universe. "Nature" can refer to the phenomena of the physical world, and also to life in general. The study of nature is a large, if not the only, part of science. Although humans ar ...
and
artificial Artificiality (the state of being artificial or manmade) is the state of being the product of intentional human manufacture, rather than occurring naturally through processes not involving or requiring human activity. Connotations Artificiality ...
) * prepared
broth Broth, also known as bouillon (), is a savory liquid made of water in which meat, fish or vegetables have been simmered for a short period of time. It can be eaten alone, but it is most commonly used to prepare other dishes, such as soups, ...
s, including chicken broth, vegetable broth, and
bouillon cube A bouillon cube ( Canada and US), stock cube ( Australia, Ireland, New Zealand, South Africa and UK), or broth cube (Asia) is dehydrated broth or stock formed into a small cube about wide. It is typically made from dehydrated vegetable ...
s * vegetable gum * fruit wax: Potentially allergenic proteins (soy, peanut, dairy, wheat) may be combined with
shellac Shellac () is a resin secreted by the female lac bug on trees in the forests of India and Thailand. It is processed and sold as dry flakes and dissolved in alcohol to make liquid shellac, which is used as a brush-on colorant, food glaze and ...
to create a shiny coating on some fruits and vegetables. * vegetable starch * Mono- and diglyceride *
Monosodium glutamate Monosodium glutamate (MSG), also known as sodium glutamate, is the sodium salt of glutamic acid. MSG is found naturally in some foods including tomatoes and cheese in this glutamic acid form. MSG is used in cooking as a flavor enhancer ...
(MSG)


Less-allergenic soy derivatives

Many foods that contain soy are exempt from being labelled as a major allergen under US FDA regulations because they contain negligible soy protein, and individuals with a mild allergy may not experience any symptoms when exposed. * Highly refined soybean oil (
vegetable oil Vegetable oils, or vegetable fats, are oils extracted from seeds or from other parts of fruits. Like animal fats, vegetable fats are ''mixtures'' of triglycerides. Soybean oil, grape seed oil, and cocoa butter are examples of seed oils, or f ...
): When tested, this product contains little to no soy proteins. Note that soybean oils extracted using only mechanical means (pressed or extruded) should still be avoided. *
Soy lecithin Lecithin (, from the Greek ''lekithos'' "yolk") is a generic term to designate any group of yellow-brownish fatty substances occurring in animal and plant tissues which are amphiphilic – they attract both water and fatty substances (and so ar ...
: Usually derived from soybean oil, presents minimal amounts of soy protein. However, with few exceptions, the US FDA does not exempt soy lecithin containing foods from its mandatory allergenic source labeling requirements.


Non-food exposure to soy

Propofol Propofol, marketed as Diprivan, among other names, is a short-acting medication that results in a decreased level of consciousness and a lack of memory for events. Its uses include the starting and maintenance of general anesthesia, sedation f ...
(Diprivan, Propoven) is a commonly used
intravenous Intravenous therapy (abbreviated as IV therapy) is a medical technique that administers fluids, medications and nutrients directly into a person's vein. The intravenous route of administration is commonly used for rehydration or to provide nutrie ...
sedative A sedative or tranquilliser is a substance that induces sedation by reducing irritability or excitement. They are CNS depressants and interact with brain activity causing its deceleration. Various kinds of sedatives can be distinguished, but ...
. Because it is only slightly soluble in water, it is incorporated into a lipid emulsion containing 10% refined soybean oil and 1.2% highly purified egg lecithin. Product instructions state: "Diprivan Injectable Emulsion is contraindicated in patients with allergies to eggs, egg products, soybeans or soy products." The potential allergenicity of the propofol emulsion is disputed. According to the American Academy of Allergy Asthma and Immunology, and to 2019 reviews,
hives Hives, also known as urticaria, is a kind of skin rash with red, raised, itchy bumps. Hives may burn or sting. The patches of rash may appear on different body parts, with variable duration from minutes to days, and does not leave any long-last ...
or systemic allergic reactions to propofol (including life-threatening anaphylaxis) may occur, but most of those instances are in people who do not have a soy or egg allergy, and the vast majority of people with known soy or egg allergies do not have a reaction to propofol. Protein contact dermatitis may occur in some individuals when a product containing soy protein contacts skin.


Cross-reactivity with dairy

Infants – either still 100% breastfeeding or on infant formula – may be prone to a combined cow milk and soy protein allergy referred to as ''milk soy protein intolerance'' (MSPI). The
Nebraska Nebraska () is a state in the Midwestern region of the United States. It is bordered by South Dakota to the north; Iowa to the east and Missouri to the southeast, both across the Missouri River; Kansas to the south; Colorado to the sout ...
government states that soy proteins from processed foods in the breast milk of nursing mothers may cause intolerance in infants. In opposition, one review stated that there was not yet sufficient clinical evidence to conclude that maternal dietary food avoidance during lactation would prevent or treat allergic symptoms from soy in breastfed infants. Another review concluded that
milk allergy Milk allergy is an adverse immune reaction to one or more proteins in cow's milk. Among the possible symptoms is anaphylaxis, a potentially life-threatening condition that requires treatment with Epinephrine (medication), epinephrine, among o ...
occurred in 2-3% of infants, and declined with age, while soy allergy had an incidence of less than 1% in young children. The review indicated that 10-14% of infants and young children with confirmed cow milk allergy may also be sensitized to soy, but did not address whether the cause was two separate allergies or a cross-reaction due to a similarity in protein structure. There is no
medication A medication (also called medicament, medicine, pharmaceutical drug, medicinal drug or simply drug) is a drug used to diagnose, cure, treat, or prevent disease. Drug therapy ( pharmacotherapy) is an important part of the medical field and ...
to treat MSPI or a soy sensitivity in infants, but rather the breastfeeding mother can remove soy foods from her diet.


Dosage tolerance

People with a mild soy allergy can tolerate small or moderate amounts of soy protein: the typical dose needed to induce a strong allergic response in a person with a mild soy allergy is about 100 times higher than for many other food allergens. Individuals with a severe soy allergy may experience allergic reactions to even trace amounts of soy, such as found in soy lecithin, but will rarely go into anaphylactic shock unless they have asthma, a
peanut allergy Peanut allergy is a type of food allergy to peanuts. It is different from tree nut allergies, because peanuts are legumes and not true nuts. Physical symptoms of allergic reaction can include itchiness, hives, swelling, eczema, sneezing, ast ...
or other complications.


Society and culture

With awareness about the potential for food allergy increasing during the early 21st century, the quality of life for families and caregivers was affected. Soy is one of the most widely used food additives worldwide as one of eight foods having mandatory precautionary labeling. School systems have protocols about foods with potential allergenicity. Despite these precautions, people with serious allergies are aware that accidental exposure can easily occur in family homes, school or restaurants. Food fear has a significant impact on quality of life. For children with allergies, their quality of life may be affected by peers.
Bullying Bullying is the use of force, coercion, hurtful teasing or threat, to abuse, aggressively dominate or intimidate. The behavior is often repeated and habitual. One essential prerequisite is the perception (by the bully or by others) of an ...
may occur, including threats or acts of deliberately being touched with allergenic foods. Despite these trends and concerns, most children having soy allergy during their early years will outgrow soy sensitivity.


Regulation of labelling

In response to the risk that certain foods pose to those with food allergies, some countries have established labeling laws that require food products to clearly inform consumers if their products contain major allergens or byproducts of major allergens among the ingredients intentionally added to foods. Except in Canada and Brazil, there are no labeling laws to declare the presence of trace amounts in the final product as a consequence of cross-contamination."Food allergen labelling and information requirements under the EU Food Information for Consumers Regulation No. 1169/2011: Technical Guidance"
(April 2015).


Ingredients intentionally added

In the United States, the Food Allergen Labeling and Consumer Protection Act of 2004 (FALCPA) requires companies to disclose on the label whether a packaged food product contains any of the eight most common food allergens, added intentionally: cow milk, peanuts, eggs, shellfish, fish, tree nuts, soy and wheat. This list originated in 1999 from the
World Health Organization The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. The WHO Constitution states its main objective as "the attainment by all peoples of the highest possible level o ...
Codex Alimentarius Commission The Codex Alimentarius () is a collection of internationally recognized standards, codes of practice, guidelines, and other recommendations published by the Food and Agriculture Organization of the United Nations relating to food, food production ...
. To meet FALCPA labeling requirements, if an ingredient is derived from one of the required-label allergens, then it must either have its "food sourced name" in parentheses, such as "Soy," or as an alternative, there must be a statement separate but adjacent to the ingredients list: "Contains soy" (and any other of the allergens with mandatory labeling). The FDA emphasizes to consumers that "it's very important to read the entire ingredient list to see if your allergen is present". The European Union requires listing of soy and seven other common allergens, plus other potentially allergenic foods. FALCPA applies to packaged foods regulated by the FDA and by the
Food Safety and Inspection Service The Food Safety and Inspection Service (FSIS), an agency of the United States Department of Agriculture (USDA), is the public health regulatory agency responsible for ensuring that United States' commercial supply of meat, poultry, and egg pro ...
(FSIS), which requires that any ingredient be declared in the labeling only by its common or usual name. Neither the identification of the source of a specific ingredient in a parenthetical statement nor the use of statements to alert for the presence of specific ingredients, like "Contains: soy", is mandatory, according to FSIS. FALCPA does not apply to food prepared in restaurants. The EU Food Information for Consumers Regulation 1169/2011 requires food businesses to provide allergy information on food sold as unpackaged in public food outlets.


Products that are not allergen labeled

While many countries require allergen warnings on labels of food containing soy ingredients, such labeling requirements may not apply to certain food and
personal care Personal care or toiletries are consumer products used in personal hygiene, personal grooming or for beautification. Products Personal care includes products as diverse as cleansing pads, colognes, cotton swabs, cotton pads, deodorant, eye ...
items containing soy ingredients, including prescription and over-the-counter drugs and cosmetics. Without actually ingesting an allergen, a person allergic to soy would not likely have a reaction.


Trace amounts as a result of cross-contamination

Labeling regulations in the
European Union The European Union (EU) is a supranational union, supranational political union, political and economic union of Member state of the European Union, member states that are located primarily in Europe, Europe. The union has a total area of ...
require mandatory labeling of certain ingredients, and allow voluntary labeling, termed Precautionary Allergen Labeling (PAL) for "may contain" statements to account for product ingredients included as inadvertent, trace amount or cross-contamination during production. PAL labeling may be confusing to consumers, possibly due to variations of wording on labels. The European Union initiated a process to create labeling regulations for unintentional contamination, although it may not be official until 2024. The US FDA requires reporting by government inspectors and manufacturers to reduce or eliminate the potential cross-contact of product ingredients, including soy, and to state possible cross-contamination on food labels, using the words "may contain".


Genetically modified soybeans

Although there have been concerns that
GMO A genetically modified organism (GMO) is any organism whose genetic material has been altered using genetic engineering techniques. The exact definition of a genetically modified organism and what constitutes genetic engineering varies, with ...
soybeans might produce new or more allergic reactions than conventionally grown soybeans, a 2017 review, reporting on 20 years of analysis on GM crops, showed that allergenic proteins were unchanged in GM soybeans, indicating GM soybeans were safe, nutritious, and had similar low-allergenicity for food consumption in the general public as conventional soybeans. The same review concluded that consuming GM foods, including foods derived from GM soy, does not cause new allergies to develop. In 2018, a
European Food Safety Authority The European Food Safety Authority (EFSA) is the agency of the European Union (EU) that provides independent scientific advice and communicates on existing and emerging risks associated with the food chain. EFSA was established in February 2002, ...
scientific panel on GMO reported that the GMO soybean, '' Vistive Gold'' (MON 87751, produced by
Monsanto The Monsanto Company () was an American agrochemical and agricultural biotechnology corporation founded in 1901 and headquartered in Creve Coeur, Missouri. Monsanto's best known product is Roundup, a glyphosate-based herbicide, developed in ...
as an insect-resistant crop used worldwide), had no unusual allergenicity. The
Food and Agriculture Organization of the United Nations The Food and Agriculture Organization of the United Nations (FAO)french: link=no, Organisation des Nations unies pour l'alimentation et l'agriculture; it, Organizzazione delle Nazioni Unite per l'Alimentazione e l'Agricoltura is an intern ...
and
Health Canada Health Canada (HC; french: Santé Canada, SC)Health Canada is the applied title under the Federal Identity Program; the legal title is Department of Health (). is the department of the Government of Canada responsible for national health poli ...
also determined that MON 87751 soybeans had as low allergenicity as conventional soybeans.


See also

*
Allergy Allergies, also known as allergic diseases, refer a number of conditions caused by the hypersensitivity of the immune system to typically harmless substances in the environment. These diseases include hay fever, food allergies, atopic derm ...
(has diagrams showing involvement of different types of white blood cells) *
Food allergy A food allergy is an abnormal immune response to food. The symptoms of the allergic reaction may range from mild to severe. They may include itchiness, swelling of the tongue, vomiting, diarrhea, hives, trouble breathing, or low blood pressur ...
(has images of hives, skin prick test and patch test) * List of allergens (food and non-food)


References


External links


Soy Allergy
information page. Asthma and Allergy Foundation of America
Soy Allergy
at the Food Allergy Initiative {{DEFAULTSORT:Soy Allergy Food allergies Medical emergencies Allergy, soy