Love nuts? Keep indulging. They’re great for your heart
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.
Q: I want to thank you for your story about whether to take blood pressure medications in the morning or at bedtime. I’ve been taking BP meds for about 20 years.
In January, I visited my doctor about another problem, and he became concerned about my blood pressure. He wanted me to monitor it every day for a month and check back in.
During that month, I read your article. I’d been taking my meds with breakfast, and I decided to change that.
The effect was quite remarkable. My systolic pressure dropped from about 145 to 135. (Those
are averages of about 70 readings before the switch and 21 readings after the switch.)
I’ve had serious side effects from BP meds in the past and I was apprehensive that my doctor would change my meds. Lately, I’ve been on amlodipine and HCTZ, and the side effects seem minimal. Yesterday, my doctor decided to not to make any changes and I want to thank you for that.
A: We are glad to hear that this is working for you. Research shows that people taking their blood pressure pills in the evening had better BP control and were less likely to have heart attacks or strokes (Sleep Medicine Reviews, Jan. 23, 2021).
An important exception: People with glaucoma should not follow this schedule. In addition, people taking diuretics may find that bedtime pills result in more frequent overnight bathroom trips.