January 24, 2007

Health in a Nutshell

I don’t usually eat nuts because I’ve heard they’re very high in fat. But my friends—who are kind of “health nuts” when it comes to their eating habits—tell me that they’re good for me. Whom do I believe?

The word “nut” is not always complimentary. Consider the usage in the following: a “loose nut” (as in “at the wheel”), the “nutty professor,” “going nuts,” and “health nut.” Despite its colloquial abusage, the role of nuts in nutrition is more valuable than its inclusion in the first three letters of the word!

The seeds of plants that grow enclosed in a shell of woody fiber, nuts have long been highly prized as sources of protein, fat, and multiple trace elements. The Persian walnut (often called the English walnut), pecans, almonds, cashews, Brazils, and pistachios are well-known nuts. But hazelnuts (or filberts) and macadamias have become much better known in recent years. Peanuts are actually not true nuts, but are from the legume family. Yet they share many of the attributes of nuts. Coconuts, on the other hand, do not rise to the high status enjoyed by the others. In the Philippines, the “pili nut” is a prized nut. The sapucaia is a tropical nut that grows in the Amazon basin, and has been called the “paradise nut.”

Apart from their value as a source of energy and protein, nuts have recently been recognized as one of nature’s healthful encapsulations.

When Ellen White included nuts as part of the healthful foods God has given, she opened herself to criticisms leveled at nuts. Many persons promoting “low fat” or “no fat” diets looked askance at nuts.

2007 1503 page28It was extremely interesting to read the first conclusive data taken from an analysis of the Adventist Health Study1 published by Gary Fraser, et al., in 1992. The study showed that frequent nut consumption led to lower risk of coronary heart disease. The following year Joan Sabate, a coauthor of the first paper, published findings on the effects of walnuts on serum lipid levels and blood pressure in healthy young men. This research opened the door to a whole raft of research that continues to the present.2 All current evidence confirms that a person consuming approximately one ounce of nuts some five times per week has only half the risk of nonfatal coronary heart disease. Even as people age the beneficial effect of nuts is retained.3

Researchers at Harvard, following the nurses in the famous nurses’ study, have also confirmed the findings of the Loma Linda researchers.4

Nuts consistently lower the bad LDL cholesterols (low density lipoprotein cholesterols) that play a major role in heart attacks. Nuts are high in unsaturated fatty acids, which can be expected to lower blood cholesterols. But the modest reduction in blood cholesterol predicted by the consumption of 1-1.5 ounces of nuts does not account for the 40-50 percent reduction in coronary heart disease risk demonstrated in these studies. There must be other factors at work.

Many use flaxseed oil as an addition to their diet for the Omega-3 fats they contain. In a recent visit to Saskatchewan, Canada, I listened to research that showed complete ground flaxseeds had a more salutary effect than the oil alone, probably because of the lignans found in the seeds. Nuts will similarly be found to have many other contents that have beneficial effects rather than just their oils. For example: magnesium, selenium, and other trace elements are found in nuts.

As with all things, balance is important. It is possible to take excessive quantities of even good things. Perhaps in the enthusiasm for nuts, we should offer a word of caution in that excessive calories will make one gain weight. However, there is a study in which an extra 350 calories were added daily to the diet in the form of nuts. In this study the group eating the extra nuts did not gain any extra weight.

Another feature of importance with nuts is that they should be fresh. Nuts that become rancid should not be eaten. Certain molds can grow on nuts and form aflatoxin, which is known to play a role in the development of some cancers. Some nuts can also be contaminated by bacteria.

Another serious concern for some individuals relates to the potential for allergy that exists with nuts. Persons allergic to one nut may find mixed nuts a hazard. Even if the mix does not contain their particular allergen, factories may process several types of nuts, which could contaminate the mix. Confectionaries may also contain nuts. Care needs to be taken by persons with a true allergy to nuts.

Taking the data we have currently, there is no doubt that a lot of health is encapsulated in a nutshell. We recommend that people make nuts a regular part of their diet.

So, go on, be a health nut!


For the past 20 years I have had low back pain that varies from mild to severe. I am nervous about becoming addicted to pain killers. Any advice?

Back pain is one of the most miserable and common afflictions of humankind. It is, however, much more common in those more sedentary populations.

Back pain can be thought of as (1) that which relates to the mechanics of the back (i.e., the multiple little joints and muscles supporting the back), and (2) the large group of disorders relating to nerve pressure. The latter is often a result of a prolapsing (slippage) of the disc between the vertebrae, so that the disk pushes on a nerve. When pressure is put on a nerve, the pain often “radiates” or spreads to areas supplied by the nerve.

Traditionally bed rest, pain killers, and even traction have been used. However, a much underutilized approach is exercise. Support of the spine involves more muscles than is often imagined. Most of us are aware of the back muscles between the vertebrae of the chest and pelvis, and think of these as the “back” muscles. The vertebral column is also supported by muscles that run in front of the spinal column. These muscles are strengthened by abdominal-strengthening exercises.

Such exercise must be entered into cautiously, especially when beginning. Sit-ups are probably too aggressive a place to begin. Lying on one’s back with flexed knees, and then a half sit-up—consisting of raising the head and shoulders—may be a place to begin. A physical therapist is the person to show you a set of exercises for your back.

Some people promote herbal remedies. Three of the common ones—devil’s claw, white willow bark, and cayenne pepper—were found to be more effective than controls in several studies. Devil’s claw had the best effects. These herbs were not compared with prescription or over-the-counter pain relievers, such as ibuprofen, in most of these studies. So whether they are the success story some would like them to be is not clear. We need to remember, though, that herbal remedies are still “drug” therapies.

Chiropractic therapy has been used for back pain, and up to 40 percent of back pain sufferers use chiropractic treatments. Studies have shown some relief, but not as effectively as physical therapy and pain killers.

People with traumatic injuries will require specific and individual therapies.

Overall, most back pain sufferers would benefit by the addition of a well-supervised physical therapy program.

1Archives of Internal Medicine, 152:1416-1424; 1992b.
2New England Journal of Medicine, 328:603-607; 1993.
3Fraser & Shavlik, Annals of Epidemiology, 7:375-382; 1997b.
4Hu, F. B., et al., British Medical Journal, 317:1341-1345; 1998.

Allan R. Handysides, M.B., Ch.B., FRCPC, FRCSC, FACOG, is director of the General Conference Health Ministries Department; Peter N. Landless, M.B., B.Ch., M.Med., F.C.P.(SA), F.A.C.C., is ICPA executive director and associate director of Health Ministries.

Send your questions to: Ask the Doctors, Adventist Review, 12501 Old Columbia Pike, Silver Spring, Maryland, 20904. Or you may send your questions via e-mail to [email protected] . While this column is provided as a service to our readers, Drs. Landless and Handysides unfortunately cannot enter into personal and private communication with our readers. We recommend that you consult with your personal physician on all matters of your health.