Soy foods 'reduce sperm numbers'

Soy products contain chemicals mimicking female hormones

A regular diet of even modest amounts of food containing soy may halve sperm concentrations, suggest scientists.

The study, published in the journal Human Reproduction, found 41 million fewer sperm per millilitre of semen after just one portion every two days.

The authors said plant oestrogens in foods such as tofu, soy mince or milk may interfere with hormonal signals.

However, a UK expert stressed that most men in Asia eat more soy-based products with no fertility problems.

Oestrogenic compounds in food or the environment have been of concern for a number of years, but we have mostly thought that it was boys exposed in the uterus before birth who were most at risk Dr Allan Pacey Sheffield University

Animal studies have suggested that large quantities of soy chemicals in food could affect fertility, but other studies looking at consumption in humans have had contradictory findings.

The Harvard School of Public Health study looked at the diets of 99 men who had attended a fertility clinic with their partners and provided a semen sample.

The men were divided into four groups depending on how much soy they ate, and when the sperm concentration of men eating the most soy was compared with those eating the least, there was a significant difference.

The "normal" sperm concentration for a man is between 80 and 120 million per millilitre, and the average of men who ate on average a portion of soy-based food every other day was 41 million fewer.

Dr Jorge Chavarro, who led the study, said that chemicals called isoflavones in the soy might be affecting sperm production.

These chemicals can have similar effects to the human hormone oestrogen.

Dr Chavarro noticed that overweight or obese men seemed even more prone to this effect, which may reflect the fact that higher levels of body fat can also lead to increased oestrogen production in men.

Worried men

However, the study pointed out that soy consumption in many parts of Asia was significantly higher than even the maximum found in these volunteers.

Dr Allan Pacey, a senior lecturer in andrology from the University of Sheffield, said that if soy genuinely had a detrimental effect on sperm production, fertility might well be affected in those regions, and there was no evidence that this was the case.

"Many men are obviously worried about whether their lifestyle or diet could affect their fertility by lowering their sperm count.

"Oestrogenic compounds in food or the environment have been of concern for a number of years, but we have mostly thought that it was boys exposed in the uterus before birth who were most at risk.

"We will have to look at adult diet more closely, although the fact that such large parts of the world have soy food as a major part of their diet and don't appear to suffer any greater infertility rates than those on western diets suggests that any effect is quite small."

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Billionaires Back Antismoking Effort

Nicole Bengiveno/The New York Times

Bill Gates and Mayor Michael R. Bloomberg announced their half-billion-dollar pledge in Midtown on Wednesday.

Bill Gates and Mayor Michael R. Bloomberg announced on Wednesday that they would spend $500 million to stop people around the world from smoking.

The World Health Organization estimates that tobacco will kill up to a billion people in the 21st century, 10 times as many as it killed in the 20th.

This time, most are expected to be in poor countries like Bangladesh and middle-income countries like Russia. In an effort to cut that number, Mr. Bloomberg’s foundation plans to commit $250 million over four years on top of a $125 million gift he announced two years ago. The Bill and Melinda Gates Foundation is allocating $125 million over five years.

Since 1999, the Gates Foundation has spent more than $2 billion on AIDS programs and about $1.2 billion on malaria. Mr. Gates has just left his Microsoft post for full-time foundation work and said he intends to form partnerships with other philanthropists.

The announcement was made at a joint news conference at TheTimesCenter in Midtown Manhattan attended by foundation staffers and foreign students enrolled in a tobacco control program at Johns Hopkins University that is supported by Mr. Bloomberg. He has campaigned against smoking for years, but this is a new direction for the Gates Foundation.

Thanking Mr. Gates, Mr. Bloomberg said, “I’m an optimist, but I’m also a realist.”

“All the money in the world will never eradicate tobacco,” he added. “But this partnership underscores how much the tide is turning against this deadly epidemic.” The new donations far outstrip current spending of about $20 million a year on antismoking campaigns in poor and middle-income countries, according to a recent W.H.O. report.

The $500 million would be spent on a multipronged campaign — nicknamed Mpower — that Mr. Bloomberg and Dr. Margaret Chan, director of the health organization, outlined in February. It coordinates efforts by the Bloomberg Initiative to Reduce Tobacco Use, the World Health Organization, the World Lung Foundation, the Johns Hopkins Bloomberg School of Public Health, the foundation of the Centers for Disease Control and Prevention and the Campaign for Tobacco-Free Kids.

It will urge governments to sharply raise tobacco taxes, prohibit smoking in public places, outlaw advertising to children and cigarette giveaways, start antismoking advertising campaigns and offer people nicotine patches or other help quitting. Health officials, consumer advocates, journalists, tax officers and others from third world countries will be brought to the United States for workshops on topics like lobbying, public service advertising, catching cigarette smugglers and running telephone help lines for smokers wanting to quit. A list of grants is at tobaccocontrolgrants.org.

Dr. Richard Peto, an Oxford epidemiologist who leads studies on the effects of smoking in the developing world, called the announcement “excellent news.”

“I reckon this will avoid tens of millions of deaths in my lifetime and hundreds of millions in my kids’ lifetimes,” he said.

Catherine Armstrong, a spokeswoman for British American Tobacco — one of the Western tobacco companies that focuses on sales to the third world — would not comment directly on the new initiative. But she said, “We have no problem with government organizations educating people on the risks of tobacco.”

A spokesman for Philip Morris, which makes Marlboro, the world’s most popular cigarette brand, said the company agreed that children should be kept from smoking but thought that raising cigarette taxes promoted smuggling and counterfeiting.

Mr. Bloomberg, founder of the financial news company bearing his name and creator of the Bloomberg Family Foundation, has long been known for his antipathy to tobacco. During his administration, New York has adopted several antismoking measures, including a ban on smoking in bars and restaurants, and significant increases in cigarette taxes.

The global campaign promises to be a struggle. Cigarettes not only are highly addictive and supported by huge advertising campaigns, they are also an important source of income for many foreign governments. In China and other countries, tobacco is a state-owned monopoly, and low- and middle-income countries collect $66 billion a year in tobacco taxes.

Only about 5 percent of the world’s countries have any antismoking measures like those the campaign envisions. But Dr. Peto said antismoking campaigns were already having some effects, even in countries where no-smoking signs are often ignored. He surveyed thousands of tobacco users in China in the 1990s — “before the government was taking it seriously,” he said — and found 4 percent who identified themselves as former smokers. Now, he said, 20 percent do.

In India, where people have long chewed tobacco but widespread smoking is more recent, Dr. Peto said he found almost no one who had quit. “India is where China was in the mid-1990s,” he said.

Smoking is not widespread in most of Africa, where only about 20 percent of men smoke, and Mr. Gates said on Wednesday that he hoped to prevent a surge in smoking there.

Waves of lung cancer deaths — which typically begin about 40 years after smoking takes hold in a society — help convince the next generation that smoking is dangerous, as in the United States in the 1960s, Dr. Peto said. And, he added, “When doctors and journalists start to take it seriously, things start to change.”

The Gates Foundation’s main focus has been global health, but up until now it has concentrated mostly on infectious diseases. Mr. Gates said he had been “looking at” tobacco deaths but was unsure what to do. “We were thrilled when Michael and his experts took the lead,” he said.

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In Cancer Battle, Do Appearances Deceive?

As Patrick Swayze walked through Los Angeles International Airport on Sunday, evidence of the pancreatic cancer diagnosis he received earlier this year was conspicuously absent.

While Patrick Swayze is still looking well nearly five months after his cancer diagnosis, Steve...

While Patrick Swayze is still looking well nearly five months after his cancer diagnosis, Steve Jobs' gaunt frame has investors worried. It is a widely held notion that the appearance of cancer survivors point to their health, but doctors say there is more to cancer than meets the eye.

(AP Photo/Splash News)
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He greeted reporters with a smile, and when asked about his health, he gave a thumbs-up and replied, "I'm a miracle, dude, I don't know why."

As the media single out Swayze for his healthy looks despite his disease, another public figure's appearance has also been the subject of speculation -- but on the opposite end of the spectrum.

Apple CEO Steve Jobs was diagnosed with the same disease in October 2003 and had surgery the following year to remove a pancreatic tumor.

Though his condition was thought to have been cured by the surgery, last month when he spoke at the company's annual developers conference Jobs seemed to have lost a significant amount of weight, leaving investors questioning the state of his health.

On average, patients diagnosed with pancreatic cancer have only a one-in-20 chance of being alive five years after the cancer is found, according to the National Cancer Institute.

The average life expectancy is grim as well. The patient-advocacy group Pancreatic Cancer Action Network reports that 75 percent of pancreatic cancer patients die within a year of their diagnosis.

While Wall Street-watchers might search for slight indications of trouble ahead, medical experts say that you simply can't judge cancer patients by their appearance.

"Looks can be deceiving, and it can happen in either direction," says Dr. Michael Fisch, director of the general oncology program at the University of Texas M.D. Anderson Cancer Center.

Fooled by Face-Value

For one, a person's seemingly ill outward appearance could actually indicate that they are undergoing treatment and not that they are in the stages of advanced disease.

"Some people can really look terrible right after a dose of chemotherapy, and then they look better," says Dr. Steven Greer, CEO of The Healthcare Channel. "That's not indicative of them being on their deathbed."

A person with cancer typically recuperates from the hair loss, weight loss and skin changes that accompany treatment within a few months, Greer says.

Fisch agrees that the side effects of treatment could be transient. "If you catch [a patient] on a difficult day ... they might not look good, but it might not tell you how they are doing in general," he says.

The only people who can accurately gauge a person's internal health status based on looks are the healthcare professionals treating the patient, Fisch says. They understand the circumstances surrounding treatment, and they can use this information to estimate the "realistic ideal" for the patient's appearance.

"The truth is that knowledgeable health care providers do put great weight on the way someone looks at a glance ... but it takes knowledge and skills to get it correct," Fisch says.

Living Longer

Appearances aside, Dr. John Chabot, director of the Pancreas Center at Columbia University Medical Center, says he is careful to tell patients that in terms of cancer survival, "averages don't predict the outcome for any one individual."

Some may die just a few months after diagnosis and some may respond well to chemo. He says he has seen several patients who outlived the average lifespan by several years.

Doctors don't completely understand why some people respond better to treatment than others, but overall health, emotional wellbeing and fitness levels may play a roll, Chabot says.

"It's pretty clear to me that patients who are in better health when they began treatment generally do better," he says.

But looking healthy can also be misleading.

"It's very common for patients to look awfully good, even in the face of advanced cancer," Fisch says. "This can happen because sometimes those folks are incredibly vulnerable, and they try especially hard to look good."

They may pay special attention to their appearance in order to preserve their dignity in the face of illness. When they walk into his office, Fisch says his patients may look healthy and shake his hand, but when he asks them how they are feeling, their words may tell a different story.

So as for Swayze's looking good in the airport earlier this week, Chabot says, "It's better than looking bad in the airport."

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