Tofu is packed with protein.

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Tofu has been a staple in east and southeast Asian cooking for centuries. And in the last 50 years, it's also become a mainstay of vegetarian and vegan eating in the US. Not only is tofu a versatile ingredient (you can use it in everything from stir fries to smoothies), but it's also been credited with a number of health benefits.

Is Tofu Healthy? Here's What Nutritionists Say
Credit: Photo by Polina Tankilevitch from Pexels

What is tofu, exactly?

Tofu, aka bean curd, is made by curdling fresh soy milk then pressing the curds into solid blocks—similar to how traditional dairy cheese is made by curdling and solidifying cow's milk. It can be silken, soft, firm, extra firm, or super firm and can have a soft or crunchy texture depending on how you cook it.

Tofu nutritional facts

According to the US Department of Agriculture, a one-quarter block (or 81 grams) of firm tofu contains 14 grams of protein, 7 grams of fat, 2.3 grams of carbohydrates, 1.9 grams of fiber, and 11 mg of sodium. And that serving provides 117 calories, making it a highly nutrient-dense food.

"Tofu is an excellent source of protein—in fact, it is a rare vegan choice that is a complete source of protein, which means it contains all nine amino acids," certified dietitian nutritionist Tanya Freirich, RD, tells Health. Tofu is also a good source of calcium, magnesium, phosphorus, B vitamins, and iron. Plus, it contains manganese, copper, and zinc.

"As a rich source of lean plant-based protein, it's a nutritious choice for most people, particularly those who have dairy and protein food group restrictions, such as vegans," Summer Yule, RDN, tells Health.

Tofu's health impact

When it comes to specific health benefits of tofu and other soy-based foods, research is ongoing. Here's what we know so far:

Coronary heart disease

The plant estrogens in tofu might help keep your heart healthy. A 2020 study published in the American Heart Association's journal Circulation examined data from more than 200,000 people and found a connection between eating at least one serving of tofu a week and an 18% lower risk of coronary heart disease, compared to those who ate tofu less than once a month.

"Soybeans may be helpful in lowering blood pressure and, consequently, reducing the risk of cardiovascular disease and stroke," adds Freirich.

Cholesterol levels

Tofu is also known to be helpful in lowering LDL (aka, "bad") cholesterol, as well as modestly lowering triglycerides and modestly increasing HDL (aka, "good") cholesterol. A meta-analysis of 46 studies found that soy protein significantly reduced LDL cholesterol by about 3-4% in adults.

Memory and brain health

While there's some evidence to suggest that soy-based foods like tofu might help with cognitive function, such as memory and problem-solving skills, the research isn't clear cut. A 2020 study suggested that equol, a metabolite produced in the gut from consuming soy products, may help reduce the risk for dementia. According to the researchers, those who produced more equol from eating soy products had half the amount of white matter lesions—a risk factor for Alzheimer's disease—as those with lower equol levels. 

Menopause

Soy may have benefits for women going through menopause. Although the researchers didn't look at tofu, a small 2021 study of postmenopausal women found that adding half a cup of another soy-based food, soybeans, to a low-fat, plant-based diet had an 84% reduction in moderate-to-severe hot flashes. And an older analysis of 10 studies found that soy isoflavones (aka, phytoestrogens), which are in tofu, also significantly reduced hot flashes. This is because isoflavones mimic estrogen, Freirich explains.

Osteoporosis

Many studies suggest that the isoflavones in soy also help to prevent bone loss and increase bone mineral density, which makes bones stronger. Bone health is often an issue after menopause, when women lose bone mass due to dropping estrogen levels. But it seems that eating tofu, which is also packed with bone-boosting calcium and vitamin D, could help compensate.

Cancer progression or recurrence

Some studies suggest that regular soy intake may help slow the progression or decrease the recurrence of certain cancers. Men who have prostate cancer may find that eating tofu and other soy-based foods keeps their prostate specific antigen levels low, which means the cancer progresses more slowly, or not at all. But the evidence is conflicting, and one study suggests that eating foods high in certain soy compounds might increase your risk of aggressive prostate cancer.

Meanwhile, there is growing evidence that regular soy intake may decrease breast cancer recurrence. But the evidence isn't strong enough to officially recommend soy to all breast cancer survivors.

The soy controversy

In the 1990s, studies linked the consumption of tofu and other foods containing plant estrogens to cancer, but certified dietitian nutritionist Vanessa Rissetto, RD, co-founder of nutritional coaching group Culina Health, points out that soy foods have been rigorously investigated over the past 25 years for their role in chronic disease prevention and treatment. "Soy may adversely affect some people, but the concerns come mostly from studies on rodents," she tells Health.

More recently, human studies have shown that tofu doesn't contain enough plant estrogens to cause breast cancer. "Both the European Food Safety Authority (EFSA) and North American Menopause Society have found that plant estrogens are not raising the risk of breast cancer," says Freirich. "Of course, research is always ongoing to learn more about how different tissues and different people react to components in our food."

You should speak to your medical provider about your intake of tofu if you take medicines called MAOIs (monoamine oxidase inhibitors), which are sometimes prescribed for anxiety disorders, according to Freirich. One of tofu's amino acids is tyramine, which helps balance blood pressure, and MAOIs block the enzyme that breaks tyramine down. Combining the two could lead to dangerously high blood pressure (known as hypertensive crisis), but that depends on your specific MAOI medication. People may not have to avoid it completely, she says.

Also, according to Freirich, there is some concern regarding soy products and thyroid function for people on thyroid medications. "Speak to your doctor before substantially increasing your intake of soy products," she says. 

Then there's this to keep in mind: Soy is a common food allergen, particularly in young children. According to the American College of Allergy, Asthma & Immunology, allergic reactions first appear in infants and young children under 3, and many outgrow the allergy during childhood.

"When enjoyed in moderation, tofu will be beneficial for most, but it's possible to overdo it even with healthy foods," says Yule. In one "unusual" case, a man who consumed excessive amounts of soy products developed gynecomastia, which is a condition of overdevelopment or enlargement of breast tissue in men or boys.

How to cook tofu

Some prep is required before you cook your tofu. It comes packed in water, so the first step is getting rid of as much liquid as possible. Yule uses a red cheese press but also recommends the old-school method of pressing your tofu between two weighted plates.

To get the best from your tofu, Yule advises against deep-frying or using excessively sugary sauces on it. "It's like a blank canvas for flavor, and one wonderful way to enjoy it is marinated with sesame oil and low-sodium soy sauce then air-fried," she says.

You can also bake, pan-fry, grill, stir fry, or sauté tofu. For an even healthier meal, Freirich recommends filling 50% of your plate with non-starchy vegetables, 25% with a protein like tofu, and 25% with a whole grain like brown rice.

Generally, the variety of tofu determines how it should be cooked for the best results. Medium and soft varieties are ideal for recipes that involve crumbling or mixing, while firm and extra firm varieties are suited for grilling or pan frying. And silken tofu, which is mostly liquid, is best for dips, sauces, and smoothies.

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