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Nuts Prevent Heart Attacks

cholesterol to help prevent heart attacks (Archives of Internal Medicine, May 10, 2010). Eating an average of 2.5 ounces of nuts per day lowers total cholesterol 5.1 percent, LDL (the bad cholesterol) 7.4 percent, and triglycerides 10.2 percent. It even lowers Lp(a), a genetic component of cholesterol that increases risk for strokes and heart attacks in young people. The more nuts a person eats, the lower the cholesterol. Those with the highest bad LDL cholesterol had the greatest lowering when they ate nuts.

An earlier review of five large epidemiologic studies and 11 clinical studies showed that eating nuts reduces risk for heart attacks (Nutrition Reviews, May 8, 2001). The most improvement came from eating two ounces (four tablespoons) of nuts five or more times a week. Eating an ounce of nuts more than five times a week can result in a 25 to 39 percent reduction in heart attack risk.

Nuts are a rich source of monounsaturated fatty acids. Before the bad LDL cholesterol can form plaques in arteries, it must be converted to oxidized LDL. LDL formed from monounsaturated fat is highly resistant to oxidation, so the LDL is less likely to be converted to its form that damages arteries. The nuts in these studies included almonds, brazil nuts, cashews, hazelnuts, macadamia nuts, pecans, pistachios, walnuts, and peanuts. Among Americans, peanuts account for approximately half of all nuts consumed.


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Dear Dr. Mirkin: Should average bicycle riders ride with their heads as low as possible, as racers do?

Probably not. A study from Trinity College in Dublin, Ireland shows that "aerodynamic position" (with the head down near the handlebars) causes bicycle riders to tire earlier when they ride fast (European Journal of Applied Physiology, March 2010 and January 2006). Researchers compared how quickly cyclists tired during high-intensity cycling at constant speed in upright and supine postures. During the fatigue tests, riders performed a 10-second all-out effort followed by riding at a fast speed for 50 seconds. They repeated the all-out, 10-second bursts every minute until they couldn't go fast any more. Riding supine caused a drop in power and fatigue earlier than riding upright.

Riding bent over can reduce lung capacity in cyclists who have not trained in an aero position and adapted to it. The limiting factor in how fast a person can ride is the time it takes to move oxygen from the air you breathe into your muscles. If your lung volume is diminished, you take in less oxygen and tire earlier.

Then why do virtually all bicycle racers try to ride lower and lower? Because air resistance slows you down and the lower and narrower you ride, the less air pushes against your body. When you pedal on level ground with no wind blowing, 60 percent of your energy is directed to overcome air resistance against your body. Ed Pavelka, a world-class endurance bicycle racer, says: "The fastest speeds in cycling are obtained on aero bikes with the handlebar well below the height of the saddle. Fatigue is caused by the duration and intensity of effort, and reducing the work you have to do against air resistance is more important than anything else."

If you are not a bicycle racer, you will probably be more comfortable and ride longer if you don't try to get as low as possible. To receive Ed Pavelka's free weekly newsletter, with great information for racers and recreational riders, go to


Dear Dr. Mirkin: Does taking fish oil or olive oil improve endurance?

We have no data to show that it does. Olive and fish oils offered no advantage to people on a ten day endurance training program (The British Journal of Nutrition, April 2010). Tests used were Vo2max (maximal amount of oxygen taken in), time to exhaustion at 80 percent of maximum effort, oxidation of food, and incremental insulin usage.


Recipe of the Week:

Quick Hummus

You'll find lots of recipes and helpful tips in The Good Food Book - it's FREE

June 21st, 2013
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About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
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