Over-Estimation of Soy Allergenicity: Laboratory Versus Challenge Tests: A Meta-Analysis

Abstract

Soybeans have been cultivated in Eastern countries for many centuries and soy protein formulas (SPFs) have been developed, which have been widely used for feeding infants with cow's milk (CM) allergy (CMA) since more 70 years. Several long-term studies have shown that the nutritional adequacy of SPFs allows normal growth and development when fed to normal and high risk infants. We emphasize that most studies base the diagnosis of soy allergy on clinical evaluation or anecdotal case histories reported by parents, but not on challenge tests, thus soy allergy has been highlighted in the last decades, due to an excessive reliance on skin prick tests (SPTs) and/or RAST. We deem that the incorrect definition of soy allergy and non appropriate diagnostic criteria have led to a large discrepancy on the prevalence of soy allergy in the medical literature which ranges from 3% up to 80%, but was very seldom compared to results of DBPCFC (double-blind placebo controlled challenge tests). In this paper we present factual evidence that objective scientific and laboratory data establish the true prevalence of soy allergy in children with CMA and in the general pediatric population. We demonstrate that the importance attributed to SPTs is completely not justifiable