Nicholas D. Kristof/The New York Times
An Armenian doctor showing chest x-rays used to track a patient’s tuberculosis that has been resistant to drug therapy.
Fred R. Conrad/The New York Times
Nicholas D. Kristof
Garik Hakobyan, 34, an artist, carries an ailment, XDR-TB, an incurable form of tuberculosis.
Yerevan, Armenia, The New York Times, December 7, 2008, by Nicholas D. Kristof — As if you didn’t have enough to worry about … consider the deadly, infectious and highly portable disease sitting in the lungs of a charming young man here, Garik Hakobyan. In effect, he’s a time bomb.
Mr. Hakobyan, 34, an artist, carries an ailment that stars in the nightmares of public health experts — XDR-TB, the scariest form of tuberculosis. It doesn’t respond to conventional treatments and is often incurable.
XDR-TB could spread to your neighborhood because it isn’t being aggressively addressed now, before it rages out of control. It’s being nurtured by global complacency.
When doctors here in Armenia said they would introduce me to XDR patients, I figured we would all be swathed in protective clothing and chat in muffled voices in a secure ward of a hospital. Instead, they simply led me outside to a public park, where Mr. Hakobyan sat on a bench with me.
“It’s pretty safe outside, because his coughs are dispersed,” one doctor explained, “but you wouldn’t want to be in a room or vehicle with him.” Then I asked Mr. Hakobyan how he had gotten to the park.
“A public bus,” he said.
He saw my look and added: “I have to take buses. I don’t have my own Lincoln Continental.” To his great credit, Mr. Hakobyan is trying to minimize his contact with others and doesn’t date, but he inevitably ends up mixing with people.
Afterward, I asked one of his doctors if Mr. Hakobyan could have spread his lethal infection to other bus passengers. “Yes,” she said thoughtfully. “There was one study that found that a single TB patient can infect 14 other people in the course of a single bus ride.”
Americans don’t think much about TB, just as we didn’t think much of AIDS in the 1980s. But drug-resistant TB is spreading — half a million cases a year already — and in a world connected by jet planes and constant flows of migrants and tourists, the risk is that our myopia will catch up with us.
Barack Obama’s administration should ensure it isn’t complacent about TB in the way that Ronald Reagan was about AIDS. Reagan didn’t let the word AIDS pass his lips publicly until he was into his second term, and this inattention allowed the disease to spread far more than necessary. That’s not a mistake the Obama administration should make with tuberculosis.
One-third of the world’s population is infected with TB, and some 1.5 million people die annually of it. That’s more than die of malaria or any infectious disease save AIDS.
“TB is a huge problem,” said Tadataka Yamada, president of global health programs for the Bill and Melinda Gates Foundation. “It’s a problem that in some ways has been suppressed. We often don’t talk about it.”
Ineffective treatment has led to multi-drug resistant forms, or MDR-TB. Scarier still is XDR-TB, which stands for extensively drug resistant TB. That is what Mr. Hakobyan has. There were only 83 cases of XDR-TB reported in the United States from 1993 to 2007, but it could strike with a vengeance.
“We always think we live in a protected world because of modern medicines and the like,” Dr. Yamada said. “But if we get a big problem with XDR, we could be in a situation like we had in the 19th century when we didn’t have good treatments.”
If we were facing an equivalent military threat capable of killing untold numbers of Americans, there might be presidential commissions and tens of billions of dollars in appropriations, not to mention magazine cover stories. But with public health threats, we all drop the ball.
Because of this complacency about TB, there hasn’t been enough investment in treatments and diagnostics, although some new medication is on the horizon.
“Amazingly, the most widely used TB diagnostic is a 19th-century one, and it’s as lousy as you might imagine,” said Dr. Paul Farmer, the Harvard public health expert whose Partners in Health organization was among the first to call attention to the dangers of drug-resistant TB.
In Armenia, the only program for drug-resistant TB, overseen by Doctors Without Borders, can accept only 15 percent of the patients who need it. And the drugs often are unable to help them.
“After two years of treatment with toxic drugs, less than half of such chronic TB patients are cured, and that’s very demoralizing,” noted Stobdan Kalon, the medical coordinator for Doctors Without Borders here. And anyone who thinks that drug-resistant TB will stay in places like Armenia is in denial. If it isn’t defused, Mr. Hakobyan’s XDR time bomb could send shrapnel flying into your neighborhood.
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Photographs at www.xdrtb.org
Extensively drug-resistant tuberculosis
Extensively drug-resistant tuberculosis (XDR-TB) is a form of TB caused by bacteria that is resistant to the most effective anti-TB drugs. It has emerged from the mismanagement of multidrug-resistant TB (MDR-TB) and once created, can spread from one person to another.
One in three people in the world is infected with TB bacteria. Only when the bacteria become active do people become ill with TB. Bacteria become active as a result of anything that can reduce the person’s immunity, such as HIV, advancing age, or some medical conditions. TB can usually be treated with a course of four standard, or first-line, anti-TB drugs. If these drugs are misused or mismanaged, multidrug-resistant TB (MDR-TB) can develop. MDR-TB takes longer to treat with second-line drugs, which are more expensive and have more side-effects. XDR-TB can develop when these second-line drugs are also misused or mismanaged and therefore also become ineffective.
XDR-TB raises concerns of a future TB epidemic with restricted treatment options, and jeopardizes the major gains made in TB control and progress on reducing TB deaths among people living with HIV/AIDS. It is therefore vital that TB control is managed properly and new tools developed to prevent, treat and diagnose the disease.
The true scale of XDR-TB is unknown as many countries lack the necessary equipment and capacity to accurately diagnose it. It is estimated however that there are around 40,000 cases per year. As of June 2008, 49 countries have confirmed cases of XDR-TB.
Definition of XDR-TB
XDR-TB is defined as TB that has developed resistance to at least rifampicin and isoniazid (resistance to these first line anti-TB drugs defines Multi-drug-resistant tuberculosis, or MDR-TB), as well as to any member of the quinolone family and at least one of the following second-line anti-TB injectable drugs: kanamycin, capreomycin, or amikacin. This definition of XDR-TB was agreed by the WHO Global Task Force on XDR-TB in October 2006. The earlier definition of XDR-TB as MDR-TB that is also resistant to three or more of the six classes of second-line drugs, is no longer used, but may be referred to in older publications.
Like other forms of TB, XDR-TB is spread through the air. When a person with infectious TB coughs, sneezes, talks or spits, they propel TB germs, known as bacilli, into the air. A person needs only to inhale a small number of these to be infected. People infected with TB bacilli will not necessarily become sick with the disease. The immune system “walls off” the TB bacilli which, protected by a thick waxy coat, can lie dormant for years.
The spread of TB bacteria depends on factors such as the number and concentration of infectious people in any one place together with the presence of people with a higher risk of being infected (such as those with HIV/AIDS). The risk of becoming infected increases the longer the time that a previously uninfected person spends in the same room as the infectious case. The risk of spread increases where there is a high concentration of TB bacteria, such as can occur in closed environments like overcrowded houses, hospitals or prisons. The risk will be further increased if ventilation is poor. The risk of spread will be reduced and eventually eliminated if infectious patients receive proper treatment.
Successful diagnosis of XDR-TB depends on the patient’s access to quality health-care services. If TB bacteria are found in the sputum, the diagnosis of TB can be made in a day or two, but this finding will not be able to distinguish between drug-susceptible and drug-resistant TB. To evaluate drug susceptibility, the bacteria need to be cultivated and tested in a suitable laboratory. Final diagnosis in this way for TB, and especially for XDR-TB, may take from 6 to 16 weeks.To the time needed for diagnosis, new tools for rapid TB diagnosis are urgently needed.
The principles of treatment for MDR-TB and for XDR-TB are the same. Treatment requires extensive chemotherapy for up to two years. Second-line drugs are more toxic than the standard anti-TB regimen and can cause a range of serious side-effects including hepatitis, depression and hallucinations. Patients are often hospitalized for long periods, in isolation. In addition, second-line drugs are extremely expensive compared with the cost of drugs for standard TB treatment.
XDR-TB is associated with a much higher mortality rate than MDR-TB, because of a reduced number of effective treatment options.Despite early fears that this strain of TB was untreatable, recent studies have shown that XDR-TB can be treated through the use of aggressive regimens. A study in the Tomsk oblast of Russia, reported that 14 out of 29 (48.3%) patients with XDR-TB successfully completed treatment.
Successful outcomes depend on a number of factors including the extent of the drug resistance, the severity of the disease and whether the patient’s immune system is compromised. It also depends on access to laboratories that can provide early and accurate diagnosis so that effective treatment is provided as soon as possible. Effective treatment requires that all six classes of second-line drugs are available to clinicians who have special expertise in treating such cases.
Countries can prevent XDR-TB by ensuring that the work of their national TB control programmes, and all practitioners working with people with TB, is carried out according to the International Standards for TB Care. These emphasize providing proper diagnosis and treatment to all TB patients, including those with drug-resistant TB; assuring regular, timely supplies of all anti-TB drugs; proper management of anti-TB drugs and providing support to patients to maximize adherence to prescribed regimens; caring for XDR-TB cases in a centre with proper ventilation, and minimizing contact with other patients, particularly those with HIV, especially in the early stages before treatment has had a chance to reduce the infectiousness. Also an effective disease control infrastructure is necessary for the prevention of XDR tuberculosis. Increased funding for research, and strengthened laboratory facilities are much required. Immediate detection through drug susceptibility testing’s are vital, when trying to stop the spread of XDR tuberculosis.
The BCG vaccine prevents severe forms of TB in children, such as TB meningitis. It would be expected that BCG would have the same effect in preventing severe forms of TB in children, even if they were exposed to XDR-TB, but it may be less effective in preventing pulmonary TB in adults, the most common and most infectious form of TB. The effect of BCG against XDR-TB would therefore likely be very limited. New vaccines are urgently needed, and WHO and members of the Stop TB Partnership are actively working on new vaccines.
Can radiation from cell phones affect the memory? (Credit: iStockphoto/Karen Town)
ScienceDaily, December 5, 2008 — Can radiation from cell phones affect the memory? Yes — at least it appears to do so in rat experiments conducted at the
Division of Neurosurgery, Lund University, in Sweden. Henrietta Nittby studied rats that were exposed to mobile phone radiation for two hours a week for more than a year. These rats had poorer results on a memory test than rats that had not been exposed to radiation.
The memory test consisted of releasing the rats in a box with four objects mounted in it. These objects were different on the two occasions, and the placement of the objects was different from one time to the other.
The actual test trial was the third occasion. This time the rats encountered two of the objects from the first and two of the objects from the second occasion. The control rats spent more time exploring the objects from the first occasion, which were more interesting since the rats had not seen them for some time. The experiment rats, on the other
Henrietta Nittby and her, supervisor Professor Leif Salford, believe that the findings may be related to the team’s earlier findings, that is, that microwave radiation from cell phones can affect the so-called blood-brain barrier. This is a barrier that protects the brain by preventing substances circulating in the blood from penetrating into the brain tissue and damaging nerve cells. Leif Salford and his associates have previously found that albumin, a protein that functions as a transport molecule in the blood, leaks into brain tissue when laboratory animals are exposed to mobile phone radiation.
The research team also found certain nerve damage in the form of damaged nerve cells in the cerebral cortex and in the hippocampus, the memory center of the brain. Albumin leakage occurs directly after radiation, while the nerve damage occurs only later, after four to eight weeks. Moreover, they have discovered alterations in the activity of a large number of genes, not in individual genes but in groups that are functionally related.
“We now see that things happen to the brains of lab animals after cell phone radiation. The next step is to try to understand why this happens,” says Henrietta Nittby.
She has a cell phone herself, but never holds it to her ear, using hands-free equipment instead.
Hydroponics — a method of cultivating plants in water instead of soil — could bring farming into cities.
Agriculture Goes Urban and High-Tech
CNN.COM, December 8, 2008 — Terry Fujimoto sees the future of agriculture in the exposed roots of the leafy greens he and his students grow in thin streams of water at a campus greenhouse.
The program run by the California State Polytechnic University agriculture professor is part of a growing effort to use hydroponics — a method of cultivating plants in water instead of soil — to bring farming into cities, where consumers are concentrated.
Because hydroponic farming requires less water and less land than traditional field farming, Fujimoto and researchers-turned-growers in other U.S. cities see it as ideal to bring agriculture to apartment buildings, rooftops and vacant lots.
“The goal here is to look at growing food crops in small spaces,” he said.
Long a niche technology existing in the shadow of conventional growing methods, hydroponics is getting a second look from university researchers and public health advocates.
Supporters point to the environmental cost of trucking produce from farms to cities, the loss of wilderness for farmland to feed a growing world population, and the risk of bacteria along extensive, insecure food chains as reasons for establishing urban hydroponic farms.
However, the expense of setting up the high-tech farms on pricey city land and providing enough year-round heat and light could present some insurmountable obstacles.
“These are university theories,” said Jim Prevor, editor of Produce Business magazine. “They’re not mapped to things that actually exist.”
The roots of hydroponically produced fruits and vegetables can dangle in direct contact with water or be set in growing media such as sponges or shredded coconut shells. Most commercial operations pump water through sophisticated sensors that automatically adjust nutrient and acidity levels in the water.
Hydroponics are generally used for fast-growing, high-value crops such as lettuces and tomatoes that can be produced year-round in heated, well-lit greenhouses. So far, production is not large enough for the U.S. Department of Agriculture to track.
The country’s largest hydroponic greenhouse is Eurofresh Inc.’s 274-acre operation in southeastern Arizona, where more than 200 million pounds of tomatoes were produced in 2007. Most large-scale commercial operations are in the arid Southwest, where water-efficiency is prized, or the sometimes frigid Northeast, where the method can be used year-round in heated greenhouses.
The technology has benefited from nearly three decades of NASA research aimed at sustaining astronauts in places with even less green space than a typical U.S. city.
Hydroponics also bears the dubious distinction of being a growing method for marijuana.
Fujimoto said one of his research assistants got a call from the FBI after using a credit card to buy nutrients for the campus greenhouse at a hydroponic-supply store.
There’s clearly nothing illicit going on at the greenhouse, where thin streams of water pass silently though dozens of long white plastic tubes arranged in rows across chest-high stands. Rose-shaded lettuce leaves, pale-green stalks of bok-choy and sprigs of basil poke from the holes in the tubes.
Fujimoto aims to prepare his students to operate the urban hydroponic businesses that he thinks will gain importance in the future. They sell their lettuces, peppers, tomatoes and other produce to an on-campus grocery store and at a farmers market.
In Ohio, the ProMedica Health System network of clinics used a Toledo hospital roof to grow more than 200 pounds of vegetables in stacked buckets filled with a ground coconut shell potting medium. The tomatoes, peppers, green beans and leafy greens were served to patients and donated to a nearby food shelter, hospital spokeswoman Stephanie Cihon said.
When the project resumes in the spring, the hospital plans to expand into at least two community centers in economically depressed central Toledo, where fresh produce is hard to come by.
“From the health-care perspective, the more we can increase people’s lifestyle changes and encourage them to eat better, it’s going to impact our services greatly,” Cihon said.
In a New York City schools program run by Cornell University, students grow lettuce on a school roof and sell it for $1.50 a head to the Gristedes chain of supermarkets.
Cornell agriculturist Philson Warner, who designed the program’s hydroponics system, said his students harvest hundreds of heads of lettuce a week from an area smaller than five standard parking spaces by using a special nutrient-rich solution instead of water.
The numbers have some researchers imagining a future when enough produce to feed entire cities is grown in multistory buildings sandwiched between office towers and other structures.
Columbia University environmental health science professor Dickson Despommier, who champions the concept under the banner of his Vertical Farm Project, said he has been consulting with officials in China and the Middle East who are considering multistory indoor farms.
He is also shopping his concept to engineering teams in hopes of having a prototype built as he seeks funding.
“Most of us live in cities,” he said. “As long as you’re going to live there, you might as well grow your food there.”
ATLANTA, Georgia CNN.com, December 5, 2008 — On the Sunday before Thanksgiving, Barb Lighthall was walking into church when her feet slipped out from under her and she hit her head on the parking lot’s black ice.
Barb Lighthall had to wait a week to see her regular doctor after a head injury sent her to the ER.
“You know how most people break their fall with their hands? I broke my fall with my head,” says Lighthall.
An ambulance took her to the emergency room, where she was prescribed pain pills, discharged, and told to check in with her regular doctor in the next three days.
But that would prove impossible. When Lighthall called her internist the next day, the appointment secretary said the doctor wouldn’t be able to see her for another week.
“I told them I’d take a cancellation, I’d do anything, but they said she was all booked up,” says Lighthall, who lives in Munnsville, New York. “So I spent the week of Thanksgiving dizzy. When I walked from my bed to the bathroom, I hit every piece of furniture and every wall in between.”
When Lighthall did finally get in to see her physician the next week, she was prescribed medicine to treat the dizziness, and felt much better.
“It would have made my Thanksgiving week a whole lot better if I’d gotten in to see her earlier,” she says.
“I really screwed up. I should have pushed for an earlier appointment,” she adds. “I’d advise anyone who needs an appointment quickly to never give up.”
According to a 2007 Commonwealth Fund report, only 30 percent of patients who needed care were able to get a same-day appointment. So here are some insider tips from doctors about how to get an appointment when you really need one.
1. Find your doctor’s e-mail address
This will require some Internet sleuthing, but it could be worth it.
· In Depth: Empowered Patient
“This is a true story,” says Dr. Indu Subaiya, co-founder of a health care forum called Health 2.0.
“A friend of mine needed to get his wife into a doctor at UCSF for back pain. All the secretaries told them it would be weeks for an appointment. They found the e-mail address of one doctor who seemed like a good fit and just wrote him a personal note explaining the urgency. He responded at 11 p.m., and she was in to see him the first thing in the morning the next day.”
2. Give TMI (too much information)
Be specific about what’s wrong. For example, Dr. Paul Konowitz, an ear, nose, and throat surgeon in Quincy, Massachusetts, says his receptionist might not make time in his schedule to see someone with a sore throat. “But if he said he had a sore throat and it felt like his throat was closing, this might indicate a more serious issue,”
Your goal is to get the person on the other end of the phone to feel sorry for you, Konowitz advises on HealthAngle, a health information Web site where he’s the medical director.
“Let them feel your pain; you want them to have sympathy for you and your sense of urgency.”
3. Ask to speak to the manager
The person answering the phone is often the lowest person on the totem pole. Ask to speak to the office manager or the nurse in charge, who might have the authority to squeeze you in. Leave a voice mail if you don’t get a real person.
“Be polite but persistent,” says Dr. John Santa, director of the Consumer Reports Health Ratings Center.
4. Call first thing in the morning
Place your call the minute the office opens, and you’ll greatly improve your chances of getting an appointment.
“Doctors will often have a few slots saved throughout the day for same day appointments. They fill up fast, so call ASAP in the morning,” advises Dr. Delia Chiaramonte, an internist in Maryland. “Don’t wait to see if you feel better. You can always cancel it.”
5. Go a little crazy
Another true story: One of Konowitz’s patients, who was worried she had throat cancer, actually called a local TV station to complain when she couldn’t get in to see him on short notice. Someone at the station called the public relations folks at the hospital where he works, who called him.
“I was really embarrassed — and shocked! I saw the patient immediately,” Konowitz says, adding that the receptionist had never told him, or his nurses, about this patient’s desperation. “Physicians can’t really know who is out there looking to be seen, which is why the patients often have to take matters into their own hands.”
When all else fails, Konowitz advises that you just go to the doctor’s office and plunk yourself in the waiting room.
“You may find a sympathetic receptionist, medical assistant or nurse who will discuss your situation with your doctor, who then might agree to see you,” he says.
The Brassica family is a group of winter-favorite veggies that includes broccoli, brussels sprouts, cauliflower, and cabbage. They’re slightly bitter, but that’s because you can actually taste their colon-cancer-fighting compounds called isothiocyanates.
Colon Cancer Blockers
Research shows that the isothiocyanates in Brassica veggies may actively block potential carcinogens, putting the kibosh on not only colorectal cancer but prostate cancer cells as well. Brassica vegetables are also a good source of folic acid, phenolics, carotenoids, selenium, and vitamin C. About 1 in 3 cancers may be related to what people eat.
Golden-Crusted Brussel Sprouts
A couple of shopping tips: look for Brussel sprouts that are on the small size and tightly closed. The tiny ones cook through quickly, whereas larger ones tend to brown on the outside long before the insides are done. When the weather is mild, finish them with a lighter, salty cheese, like Parmesan, but if it’s stormy and cold, opt for a heavier, more melty cheese, like a regular or smoked Gouda (or gruyere). Try not to overcook them, and eat them as soon as they come of the stove if at all possible.
Golden-Crusted Brussel Sprouts Recipe
Cut the Brussels sprouts in half and cook until deliciously tender inside and perfectly brown and crusted on the outside. Finished them off with cheese and some toasted nuts – delicious!
24 small brussels sprouts
1 tablespoon extra-virgin olive oil, plus more for rubbing
fine-grain sea salt and freshly ground black pepper
¼ to 1 cup (to your taste) grated cheese of your choice
1 cup of sliced almonds (toast to your taste) or chopped walnuts
Wash the Brussels sprouts well. Trim the stem ends and remove any raggy outer leaves. Cut in half from stem to top and gently rub each half with olive oil, keeping it intact (or just toss them in a bowl with a glug of olive oil).
Heat 1 tablespoon of olive oil in your largest skillet over medium heat. Don’t overheat the skillet, or the outsides of the Brussels sprouts will cook too quickly. Place the Brussel sprouts in the pan flat side down (single-layer), sprinkle with a couple pinches of salt, cover, and cook for roughly 5 minutes; the bottoms of the sprouts should show a hint of browning. Cut into or taste one of the sprouts to gauge whether they’re tender throughout. If not, cover and cook for a few more minutes.
Once, just tender, uncover, turn up the heat, and cook until the flat sides are deep brown and caramelized. Use a metal spatula to toss them once or twice to get some browning on the rounded side. Season with more salt, a few grinds of pepper, and a dusting of grated cheese.
Sprinkle with toasted almonds, or chopped walnuts, to taste.
While you might be able to get away with keeping a platter of these warm in the oven for a few minutes, they are exponentially tastier if popped in your mouth immediately.
Skillet Brussel Sprouts
Skillet Brussel Sprouts (quick, easy, delicious)
Canola or Olive oil (spray can)
2 1/2 lbs Brussel Sprouts – cut in half
2 T. unsalted butter
2 T. light brown sugar
1/4 cup maple syrup
2 T. cider vinegar
Optional: Use 1 cup sliced shallots, sauté for a few minutes in canola or olice oil and set aside
In a large non-stick skillet spray the bottom with vegetable oil. Just cover the bottom no need to have any depth. When the oil is shimmering, toss in the Brussel Sprouts to cover the pan, season with some salt and pepper. Let the Brussel Sprouts stay over the high heat for about 2 minutes. This should really brown some of them. After about 2 minutes, give the pan a shake and toss around the sprouts. Add the shallots to pan.
Add the the butter and brown sugar and lower the temperature to a medium high heat. Stir until the butter and sugar is melted. Add the maple syrup to the skillet and continue to cook over a medium high heat, stirring occasionally for about 6-7 minutes. The sprouts should start to really get browned. After this, add the cider vinegar and stir in for about another 30 seconds.
Done. A real sweet treat. Might be good with some dried cranberries tossed in.
Brussel Sprouts are good with grilled lamb or pork chops with apples and pomegranate seeds. Slice 4 Granny Smith apples (cut in rings). Brown them in the same pan you’re going to make the lamb or pork chops in. Then add 3 T. honey mixed with 3 T. sherry vinegar until it boiled down with the apples. When it’s done, toss in about 2 cups of pomegranate seeds. And put this aside. Now grilled the chops in the same pan. Put the chops on a serving plate, re-warm the apples in the pan and pour them over the chops.
Brussel Sprouts For Sale in Ontario, Canada
Go a Little Nuts at Holiday Parties This Year
Whether you’re a health nut or just a nut lover, you’ve probably heard that these hard-shelled seeds help keep your weight and cholesterol down, cancer at bay, and your heart, well, hardy. But do you know your filberts from your macadamias, your walnuts from your almonds — healthwise, that is? Just in time for all those nut bowls and party platters, here are the specific benefits of each. Think small handfuls, though, not mindless munching. As nutritious as they are, nuts pack 160 to 200 calories per ounce!
1. Coping with holiday stress? Reach for the almonds.
Crunching down 24 of them will give you 35% of your daily value of vitamin E, which is quickly depleted when you’re under pressure. (Eat ’em with the skin on to get the biggest dose!) You’ll also score some calcium, magnesium, and riboflavin.
2. Not crazy about Brazil nuts?
Eat one anyway. That’s all it takes — one a day — to completely meet your body’s need for the antioxidant mineral selenium. You’ll also be munching down some complete protein (Brazil nuts have all the essential amino acids in one neat package) and zinc (think immunity boosting, and more stress relief) while minimizing its one drawback: saturated fat (5 grams in 6 to 8 of these big nuts).
3. What’s with the buzz around walnuts?
Omega-3 fatty acids is what. You can meet your daily value for these hard-to-get health protectors in about 14 halves (1 ounce). Walnuts are also stuffed with disease-fighting antioxidants: In a study of nearly 100 plant foods, they ranked #2 in antioxidant content (rosehips — hardly party fare — came in first).
4. Feeling moody? Hunt out the filberts — aka hazelnuts.
These slightly smoky, buttery nuts are packed with mood-stabilizing tryptophan; 20% of the RDA is in every ounce (about 20 hazelnuts).
5. Peanuts aren’t really nuts.
They’re legumes (bio-cousins to peas, lentils, and beans). Never mind. They’re rich in three key B vitamins — folate, niacin, and riboflavin — so you can lose the guilt at happy hour. And ounce for ounce, they pack the same protein punch as beef (7 grams), minus the saturated fat. Wow.
6. Need an excuse to go for the macadamia nuts?
They win the prize for having the most monounsaturated fats — the good ones, which lower bad LDL cholesterol. Just one ounce (10 to 12 of these creamy white treats) has 17 grams of the heart-healthy stuff. Plus, they’re a good source of thiamin, a B vitamin that helps keep your muscles, nerves, and GI system humming.