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The Fluoride Contents of Commercially-Available Soya Milks in the UK

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The Fluoride Contents of Commercially-Available Soya Milks in the UK The fluoride contents of IN BRIEF • Provides information on the fluoride RESEARCH content of soya milks, highlighting the commercially-available wide range of fluoride concentrations seen in soya milks in the UK market. • Stresses the need for dental professionals to evaluate their child patients’ daily soya milks in the UK fluoride intake when prescribing appropriate preventive therapies. H. Lal,*1 F. V. Zohoori,2 N. Omid,1 R. Valentine1,3 and A. Maguire1 • Concludes that soya milks do not pose an increased risk for the development of dental fluorosis. Background In some parts of the world, soya milks are found to be a significant source of fluoride (F). Among western commercial markets, although there has been a sustained increase in soya milk products available for purchase, there are limited data on their F content. Objective To determine the F content of soya milk products available in the UK market including fresh and ultra-high temperature products in addition to sweetened and unsweetened soya milks. Materials and methods Fifty-two traditional and UK-produced soya milk samples commercially available in northeast England were analysed to determine their F concentration using a modified hexamethyldisiloxane-facilitated diffusion method with a F‑ion-selective electrode coupled to a potentiometer. Results The median F concentration of all products was 0.293 µg/ml ranging from 0.015 µg/ml to 0.964 µg/ml. The median F concentration of ultra-high temperature (UHT) (n = 42) milks was 0.272 µg/ml lower than 0.321 µg/ml obtained for fresh (n = 10) soya milks. Organic soya milks contained less F compared with non-organic for sweetened and unsweetened categories. Conclusion Commercially available soya milks in the UK do not pose an increased risk for dental fluorosis development. Further research is necessary into the manufacturing process of soya milks, which may influence the overall F content of the end product. INTRODUCTION remains a popular alternative to bovine milk soya products. The soya bean itself is known The soya bean plant (Glycine max Merrill), and the volumes of soya milk produced in for its ‘beany’ flavour, prolonged cooking originating from China, is a popular and the UK has steadily increased from 76.2 to time and disagreeable taste. It is also rich in important crop in many countries and 82.5 (million litres) from January 2010 to phytate,17 which has been shown to have an particularly the Far East. Soya beans January 2014.6 This mirrors the increase inhibitory effect on iron, zinc, magnesium belong to the Leguminosae species,1 and are seen in the production and popularity of and calcium absorption.18 There is also recognised largely due to their high quality soya milk globally. In a recent report7 from growing evidence of an increase in the protein content in comparison to other the United States, soya milk continues to be prevalence of food allergies to foods such as legumes, but also due to their beneficial the most popular non-dairy milk with 11% of soya.19 The immune response develops from health implications.2 They have numerous adults drinking soya-based beverages. an IgE-mediated hypersensitivity reaction to uses including the manufacture of the soya The use of soya-based products has the soya protein although, like cows’ milk milk beverage, an aqueous extract of whole some advantages as well as disadvantages. allergy,10 the majority of individuals affected soya bean, which is used in preparation They are positively noted for their health outgrow the allergy, which tends to present of other soya foods such as tofu skin and properties, being low in saturated fat during childhood.20 tofu.3 Depending on the growth conditions and containing no lactose, as well as for Soya products have various additional and variety, the composition of soya their hypocholesterolemic effect.8 With consequences in the oral environment. beans vary and this consequently affects the increase in demand for bovine milk Soya-based milk and formulas have the the composition of the extract; chemical substitutes for various reasons, including ability to lower plaque pH and can produce pollutants can also produce a change in the lactose intolerance9 and a desire for a drop in plaque pH to below the critical chemical composition of soya beans.4 Due to vegetarian alternatives, soya milks have pH for enamel of 5.7.21–23 Soya milk has a improvements in flavour and taste with the provided an alternative. The prevalence of lower buffering capacity than bovine milk addition of gum and flavourings,5 soya milk an allergy to cows’ milk is estimated to be with the rate of acid production by mutans up to 7% in infants10 and 0.8% in European streptococci found to be significantly higher 1Centre for Oral Health Research, School of Dental adults.11 In addition to the nutritional value than its comparator at different pH levels,24 Sciences, Newcastle University, Newcastle upon Tyne; 2School of Health and Social Care, Teesside University, of the soya bean, the possible protective resulting in a group of beverages with a Middlesbrough; 3Human Nutrition Research Centre, effects of soya against chronic diseases higher acidogenic and cariogenic potential. Newcastle University, Newcastle upon Tyne have been demonstrated in preventing heart Conversely, limited studies have shown *Correspondence to: Hari Lal 12 13 14 Email: [email protected]; Tel: +44 (0)19 1222 8197 disease, osteoporosis, particular cancers that the fluoride (F) concentration of soya- and regulating blood pressure.15 Moreover, based products is higher than bovine-based Online article number E8 dietary soya can relieve the symptoms products.25–28 Fluorides (F) have been shown Refereed Paper - accepted 20 May 2014 16 DOI: 10.1038/sj.bdj.21014.736 of menopausal hot flushes. There are, to have a beneficial impact on the prevention ©British Dental Journal 2014; 217: E8 however, potential drawbacks with the use of and decline of dental caries universally.29–31 BRITISH DENTAL JOURNAL VOLUME xxx NO. x MON xx 2014 1 © 2014 Macmillan Publishers Limited. All rights reserved. RESEARCH However, the excessive ingestion of F during Analysis of samples tooth development can result in structural Each sample (n = 52) was analysed in 8% changes in enamel, which may lead to triplicate (total number of individual dental fluorosis.32 If this occurs, the enamel samples measured = 156). Measurements of is hypomineralised, porous and appears as F concentration were made in micrograms/ opaque spots or brown and yellow stains. The ml (µg/ml) which is equivalent to parts severity of the condition depends on factors per million (ppm). The analysis for F including the dose, duration and timing of concentration was undertaken using a 40% 52% F intake.32,33 If products containing a high F modified hexamethyldisiloxane (HMDS)- content are consistently consumed at critical facilitated diffusion method with a F‑ion- times of tooth development, this increases the selective electrode (Model 9,609: Orion risk of dental fluorosis. As F is present in Research) coupled to a potentiometer common food and drinks readily available (Model 720A).34 To allow a full recovery on the market, it is important that the F of ionic and ionisable F, this technique content of commercially consumed food and involves acid diffusion in the presence drink products is determined and these data of hexamethyldisiloxane (HMDS). F <0.3 µg/ml disseminated to enable a better understanding standards, ranging from 0.01 to 10 ppm 0.3-0.7 µg/ml of their potential oral health impact. F were used to calibrate the measurement >0.7 µg/ml Among western commercial markets, of F concentration in the samples. The although there has been a sustained increase reliability of the F analytical method was Fluoride concentration (µg/ml) in production and number of soya milk examined by re-analysing 10% (n = 6) of products available for purchase, there are the samples. The validity of method was Fig. 1 Proportional distribution of F limited data on their F content. If soya checked by adding a known amount of F concentration (µg/ml or ppm) for all 52 soya milk samples milk products, readily available in UK (0.5 µg/ml) to 10% (n = 6) of samples and markets, are a significant source of F, then determining F recovery from these samples. it is important for health professionals and Descriptive analysis using Microsoft Excel ml. For the fresh sweetened soya milks public to be aware of this, to help inform was undertaken to report the mean, median (n = 5), the median F concentration was monitoring of F exposure and the provision and range of F concentration for all samples. 0.326 µg/ml and for unsweetened fresh milks of appropriate advice regarding their use, (n = 5) 0.316 µg/ml. For all 28 sweetened especially in children. Thus, the aim of this RESULTS soya milk products, the median (range) F study was to determine the F content of Figure 1 shows the distribution of F concentration was 0.304 (0.015‑0.964) µg/ soya milk products readily available in the concentration for all 52 soya milk samples ml compared with 0.273 (0.040‑0.949) µg/ UK market including fresh and ultra-high analysed in this study; 52% (n = 27) had ml for the 24 unsweetened products. The temperature (UHT) products in addition to a concentration <0.3 µg/ml (<0.3ppm median (range) F concentration of non- sweetened and unsweetened soya milks. F), and 8% of samples (n = 4) had a F organic soya milks was higher for both concentration >0.7 µg/ml (>0.7 ppm F). The sweetened (0.308 [0.015‑0.964] µg/ml) MATERIALS AND METHODS median F concentration of all soya milks was and unsweetened (0.263 [0.066‑0.949] µg/ Preparation of samples 0.293 µg/ml with a range from 0.015 µg/ml ml) products in comparison to organic to 0.964 µg/ml.
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