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DEAR DR. ROACH: I have seen numerous articles extolling the advantages of eating nuts because they are a good fat. I often have wondered if it matters whether the nuts are raw or roasted. Would you please explain the difference and the impact on one’s health? – D.O.
ANSWER: Scientists believe that nuts are healthy for us based on three different types of evidence. One is called “epidemiological” – people who eat nuts live longer and have less heart disease than people who don’t eat nuts. This suggests nuts are good for you, but it’s not definitive. People who eat nuts may do other healthy things, which could be the real reason they live longer (this is called “confounding”).
A second line of evidence comes from watching what happens to factors we believe are related to disease. People who add a reasonable amount of nuts to their diet often have improvements in their cholesterol levels. They also help some people lose a few pounds, possibly because the fat and protein in nuts makes them more filling than the (often processed) starches many people eat. This also is not definitive, because there are treatments that lower cholesterol but don’t make people live longer or improve health.
The third is evidence from a large, interventional study on diet. A group of people were randomly assigned to either add more nuts to their diet, or to make no change (or some other change) in their diet. At least one study showed that when people changed their diet to include more nuts and seeds (but also more fruits and vegetables, more healthy oils, like olive oil, and less meat), they had fewer heart attacks than the group that did not change their diet. This evidence is strong, but it’s not clear whether it’s one change in the diet (just nuts) or all the changes in the diet that are responsible for the observed benefit.
In none of these kinds of studies were raw nuts compared against roasted. However, the composition of the fats does not change in nuts and seeds when roasted, and most experts believe it does not make a difference. So, I recommend partaking in nuts however you like them best.
Just one serving a day (30 grams or an ounce) makes a difference. They are quite high in calories, so it’s wise not to overdo it. If you don’t like nuts (and obviously for those allergic), not eating them is not a major risk for developing heart disease.
DEAR DR. ROACH: You have mentioned diseases of the blood marrow before, but what does the bone marrow actually do? – T.S.B.
ANSWER: The main job of the bone marrow is to produce the different blood cells: red blood cells to carry oxygen; white blood cells to fight infection and cancers; and platelets to stop bleeding. Diseases of the bone marrow can cause problems by making something abnormal (such as leukemia cells), but also by failing at its job and not making what it is supposed to. Low red cell counts lead to anemia; low white cell counts increase risk of infection; and low platelet counts contribute to abnormal bleeding.
Bone marrow diseases sometimes can be treated directly, but often treatment involves replacing blood products, and possibly using growth factors to make the bone marrow work better.
Dr. Roach regrets he is unable to answer individual letters, but he will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu.
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