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Isoflavones have a structure like animal estrogens, such as estradiol-17, and exhibit affinity for estrogen receptors, classifying them as phytoestrogens with both estrogenic and anti-estrogenic effects (Sakthivelu et al., 2008)

Some guidelines advocate for universal testing to prevent chronicity and guide allergen avoidance, while others favor a more selective approach, recognizing the practical limitations of testing for every single patient, including accessibility, cost, and its variable impact on treatment outcomes [5, 7, 40,41,42,43,44]

Circulating acylated ghrelin responses in RCTs 8 RCTs [44, 46, 47, 50, 52,53,54, 60] were included in the meta-analysis, comprising 13 independent intervention groups (2 CR and 11 EX only, no CREX group), and involving a total of 288 participants (Fig

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