Soy-based infant formulas (SFs) are often consumed by cow\'s milk allergic children. However, some concerns have risen since soy intake may adversely affect thyroid function in iodine-deficient or subclinical hypothyroid individuals. We report the first Italian case of SF induced goiter and hypothyroidism registered in our country since National Iodine program has been instituted. Finally, we review cases previously reported in literature. A 22-month-old toddler with a previous diagnosis of cow\'s milk protein allergy came to clinical attention for important goiter and overt hypothyroidism. Detailed dietary anamnesis revealed that he was on a restrictive dietary regimen based on soymilk since 12 months of age. A temporary levothyroxine substitution was instituted to avoid hypothyroidism complications. Adequate iodine supplementation and diet diversification completely reversed SF-induced hypothyroidism and goiter, confirming the diagnostic suspicion of soymilk-induced thyroid dysfunction in a iodine-deficient toddler. This case report demonstrates the importance of careful dietary habits investigation and adequate micronutrients supplementation in children on a restrictive diet due to multiple food allergies in order to prevent nutritional deficits.

Congenital glucose-galactose malabsorption (CGGM) is a rare cause of intractable infantile diarrhea, with only a few hundred cases recognized worldwide. This life-threatening disorder must be considered in the differential diagnosis of an infant who presents with diarrhea and dehydration that fails to respond to standard therapy. The clinical and diagnostic course of an infant with recurrent episodes of watery diarrhea and hypernatremic dehydration found to be homozygous for a rare variant in the SLC5A1 gene, c.187C>T (p.R63X) is described.

Benzophenone (BP) is one of the many contaminants reported as present in foodstuffs due to its migration from food packaging materials. Liquid chromatography/tandem mass spectrometry (LC/MS/MS) is acknowledged in the literature as the method of choice for this analysis. However, cases have been reported where the use of this methodology was insufficient to unambiguously confirm the presence of a contaminant. In previous work performed by the authors, the unequivocal identification of BP in packaged foods was not possible even when monitoring two m/z transitions (precursor ion - product ion), since ion ratio errors higher than 20% were obtained. In order to overcome this analytical problem a fast, sensitive and selective liquid chromatography/high-resolution mass spectrometry (LC/HRMS) methodology has been developed and applied to the analysis of BP in packaged foods. A direct comparison between LC/HRMS and LC/MS/MS data indicated better selectivity when working with LC/HRMS at a resolving power of 50,000 FWHM (full width at half maximum) than when monitoring two m/z transitions by LC/MS/MS. The resolving power used enabled the detection and identification of Harman as the compound impeding the confirmation of BP by LC-MS/MS. Similar quantitative results were obtained by an Orbitrap mass analyser (Exactive™) and a triple quadrupole mass analyser (TSQ Quantum Ultra AM™).

BACKGROUND: To investigate the relationship between soy consumption, COPD risk and the prevalence of respiratory symptoms, a case-control study was conducted in Japan.
METHODS: A total of 278 eligible patients (244 men and 34 women), aged 50-75 years with COPD diagnosed within the past four years, were referred by respiratory physicians, while 340 controls (272 men and 68 women) were recruited from the community. All participants underwent spirometric measurements of respiratory function. Information on demographics, lifestyle characteristics and habitual food consumption was obtained using a structured questionnaire.
RESULTS: Total soy consumption was positively correlated with observed lung function measures. The mean soy intake was significantly higher among controls (59.98, SD 50.23 g/day) than cases (44.84, SD 28.5 g/day). A significant reduction in COPD risk was evident for highest versus lowest quartile of daily intake of total soybean products, with adjusted odds ratio (OR) 0.392, 95% CI 0.194-0.793, p for trend 0.001. Similar decreases in COPD risk were associated with frequent and higher intake of soy foods such as tofu and bean sprouts, whereas respiratory symptoms were inversely associated with high consumption of soy foods, especially for breathlessness (OR 0.989, 95% CI 0.982-0.996).
CONCLUSIONS: Increasing soy consumption was associated with a decreased risk of COPD and breathlessness.

BACKGROUND: Experimental studies have suggested that soybean products may protect against ischemic stroke, but only limited epidemiological evidence is available.
OBJECTIVE: Our aim was to investigate the relationship between soy food consumption and the risk of ischemic stroke among the Chinese population.
METHODS: A case-control study was conducted in southern China during 2007-2008. Soy food consumption, dietary intake and lifestyle information were obtained from 374 incident ischemic stroke patients and 464 hospital-based controls. Logistic regression analyses were performed to assess the association between soy food intake and the ischemic stroke risk.
RESULTS: The mean weekly soy food intake was significantly lower (p = 0.001) among cases (89.9, SD = 239.3 g) than control subjects (267.7, SD = 426.1 g). Increased consumptions of dried soybean, tofu, soymilk and total soy foods were associated with reduced risks of ischemic stroke after adjusting for confounding factors. The corresponding adjusted odds ratios for the highest versus lowest level (<50 g) of intake were 0.20 (95% confidence interval = 0.09-0.48), 0.56 (0.36-0.89), 0.18 (0.06-0.51) and 0.23 (0.14-0.39), with significant dose-response relationships observed.
CONCLUSIONS: The results provided evidence of inverse association between habitual soy food consumption and the risk of ischemic stroke for Chinese adults.

OBJECTIVE: To document a case of gynecomastia related to ingestion of soy products and review the literature.
METHODS: We present the clinical course of a man with gynecomastia in relation to ingestion of 2 different soy products and review related literature.
RESULTS: A 60-year-old man was referred to the endocrinology clinic for evaluation of bilateral gynecomastia of 6 months\' duration. He reported erectile dysfunction and decreased libido. On further review of systems, he reported no changes in testicular size, no history of testicular trauma, no sexually transmitted diseases, no headaches, no visual changes, and no change in muscular mass or strength. Initial laboratory assessment showed estrone and estradiol concentrations to be 4-fold increased above the upper limit of the reference range. Subsequent findings from testicular ultrasonography; computed tomography of the chest, abdomen, and pelvis; and positron emission tomography were normal. Because of the normal findings from the imaging evaluation, the patient was interviewed again, and he described a daily intake of 3 quarts of soy milk. After he discontinued drinking soy milk, his breast tenderness resolved and his estradiol concentration slowly returned to normal.
CONCLUSIONS: This is a very unusual case of gynecomastia related to ingestion of soy products. Health care providers should thoroughly review patients\' dietary habits to possibly reveal the etiology of medical conditions.

Enterocolitis induced in infants by cow\'s milk and/or soy protein has been recognized for decades. Symptoms typically begin in the first month of life in association with failure to thrive and may progress to acidemia and shock. Symptoms resolve after the causal protein is removed from the diet but recur with a characteristic symptom pattern on re-exposure. Approximately 2 hours after reintroduction of the protein, vomiting ensues, followed by an elevation of the peripheral blood polymorphonuclear leukocyte count, diarrhea, and possibly lethargy and hypotension. The disorder is generally not associated with detectable food-specific IgE antibody. There are increasing reports of additional causal foods, prolonged clinical courses, and onset outside of early infancy, leading to description of a food protein-induced enterocolitis syndrome. The disorder poses numerous diagnostic and therapeutic challenges. The purpose of this report is to delineate the characteristic clinical features and review the possible pathophysiologic basis to frame a rational strategy toward management.