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Health Questions & Answers #61 ~ [Issue 0205-4]  Wellness Weekly
 Feb 23, 2005 21:08 PST 

Q & A #1:
What exactly is tofu?

Made from soybean curd, tofu is rich in protein. It is a cheese-like
food made by curdling fresh soymilk. The curds are pressed into cakes
and textures vary from soft to firm depending on how much water is
extracted during processing. It also has no cholesterol and is easily
digestible. Tofu varieties include "cotton" and "silk," firm and
soft, respectively. Tofu was first made in China approximately 2000
years ago. Some people use tofu in place of sour cream, yogurt, or
mayonnaise in dips, spreads, and salad dressings.

Q & A #2:
Is tofu / soy good for me?

Most likely you have heard that eating soy, because it is high in
protein, is healthy. Some nutrition experts believe that soy is the
best form of protein you can get, while others are indifferent, and
still others say that soy should be avoided at all cost. You can find
all kinds varying opinions about soy on the internet. A series of
articles on the negatives of soy can be found at:

Q & A #3:
I am 50, female, fairly healthy, and I try to eat sensibly. Should I
be taking a folic acid supplement?

To answer your question we need to ask you another question - what do
you mean by "eat sensibly"? Middle-aged and older adults should take
in about 400 micrograms of folate daily. Unless you are eating plenty
of "cruciferous" vegetables (e.g. cabbage, kale, radishes, broccoli,
Brussels sprouts), chili peppers, and/or milk, you may not be getting
enough folate to keep your homocysteine at a healthy low level. In
this case, either change direction with your diet, or take a daily
multivitamin with enough folate in it. A good alternative is to eat a
cold breakfast cereal which is fortified to contain adequate amounts
of the usual vitamins and minerals. Low folate and/or riboflavin
intake can lead to an elevated homocysteine level, and this in turn
is linked with an increased risk of heart disease and/or mental
decline. Recently, it has been found that high folate intake is
accompanied by a decreased risk of developing high blood pressure. It
is believed that folate has important beneficial effects on the inner
lining cell layer of blood vessels (the endothelium), and this delays
the development of atherosclerosis, the most common degenerative
arterial disease.

Q & A #4:
I have heard that the PSA test is often wrong - sometimes it is
positive when you do not have cancer, and other times it is negative
and you do have cancer. Is the test any good?

Serum prostate-specific antigen (PSA) has been used for screening for
prostate cancer for many years. It was originally hoped that, with
further use, its accuracy would be improved. But a new study has
provided more questions than answers. In this study, prostate
biopsies revealed cancer in as many as 27% of men with a PSA level
between 3 and 4 ng/ml - values hitherto considered "normal". 7% of
men with values below 2.5 ng/ml were found to have cancer. However,
it was not possible to say if the cancers found in these men were, in
fact, aggressive, or if they would have merely smoldered until the
person died of something else. Many small prostate cancers diagnosed
on biopsy are really quite benign. Another study has shown that PSA
levels correlate best with the actual weight of the prostate gland -
whether this is due to cancer or benign prostatic hypertrophy (BPH or
"prostatism"). The true value of PSA determinations has been found to
lie in the rate at which they increase over time. Thus if the rate of
increase in men with cancer that was removed by prostatectomy were
greater than 2 ng/ml per year, the 5-year mortality rate was 5%; if
the rate of increase was lower than 2 ng/ml per year, the mortality
over 5 years was 0.3%. Clearly you should discuss this with your
urologist, so that the actual value of your PSA test (if you have
one) can be assessed in relation to the results of your digital
rectal exam and any symptoms you may have.
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