Love nuts? Keep indulging

Q: My father loved peanuts and cashews, and my mother was a fan of macadamia nuts. They were told they should avoid nuts because of their high fat content. Lately, though, I have heard that nuts are heart healthy. Is that true?

A: It is. The results of the Women’s Health Initiative, including more than 100,000 postmenopausal women, show that substituting nuts for meat, dairy products and eggs results in fewer deaths from heart disease (Journal of the American Heart Association, February 2021). Plant protein in general was associated with lower mortality in this study.

Apparently, one way that nuts influence health is through their impact on intestinal microbes. A Mediterranean diet focused on high-fiber plants, legumes, vegetables, fruits and nuts encourages beneficial bacteria (Nutrients, February 2021).

Q: My libido had dropped to zero after menopause. A new doctor prescribed testosterone cream specially formulated by a compounding pharmacy.

I was like a teenage boy until I found the right dose! It doesn’t take much. My bone density is excellent, and I now have an active sex life.

A: TRT (testosterone replacement therapy) is quite controversial. The Food and Drug Administration cautions that “prescription testosterone products are approved only for men who have low testosterone levels caused by certain medical conditions.”

A review in the journal U.S. Pharmacist (Aug. 19, 2019) reports that “TRT has been shown to be effective for improving libido, sexual desire, arousal, sexual frequency and sexual satisfaction in women.” The long-term effects of this off-label use have not been wellstudied, though, and safe dosing guidelines are not well-established.