Monthly Archives: August 2014

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Israel Kleinberg believes he’s found a weapon that will help the teeth of a child for whom sweets are both a reward and an evening entitlement. The distinguished professor and director of the Division of Translational Oral Biology at Stony Brook has developed a way to tip the scales in favor of the healthy bacteria in the mouth, while making life harder for the bacteria that eats sugars and produces acids that wear away minerals on teeth.

Kleinberg, who has been at Stony Brook for 41 years and is the founding chairman of the Department of Oral Biology and Pathology, discovered that the amino acid arginine, which is present in saliva, reduces acid in the mouth.

At the same time, he searched for a way to rebuild the calcium lost from the acid-producing bacteria. He combined these two ingredients into a product called BasicBites that is available on the Internet.

With two of these small, square chews a day, children can use their body’s own good bacteria to win the battle for teeth health, Kleinberg said.

Mitchell Goldberg, president of Ortek Therapeutics, a Roslyn-based company that is marketing and selling these chews, described the product as “prebiotic,” because it neither kills bacteria like an antibiotic, nor introduces additional bacteria, like a probiotic.

Kleinberg has distinguished himself at Stony Brook in translational research, Maria Ryan, the chair of the Department of Oral Biology and Pathology said.

Indeed, when he first arrived at Stony Brook, Kleinberg worked with Sen. Ken LaValle to create the patent policies for the entire SUNY system, which would help in the discovery of therapies outside the realm of his own research, including Reopro and Xiaflex, according to Ryan, who has known Kleinberg for about three decades.

Earlier this summer in South Africa, Kleinberg received the International Association for Dental Research Distinguished Scientist Award in Research in Dental Caries.

“This is one of the highest honors bestowed by the association to stimulate and recognize outstanding and innovative achievements that have contributed to the basic understanding of the causes and/or prevention of dental caries, commonly known as decay or cavities,” said Ryan. The award is “well-deserved recognition of his work.”

As for his latest creation, Kleinberg, an 84-year-old professor who continues to work five days per week, said BasicBites raise the pH in the mouth. A higher pH is considered more basic, while a lower pH is acidic.

Kleinberg recommends eating these chews slowly and gently twice a day, once before bed and once after breakfast. He suggests spreading it around the teeth with the tongue to push it into areas where cavities might otherwise form. “We picked vulnerable times based on people’s habits, especially kids,” he said.

When people go to bed, their saliva production drops. With less saliva, the bacteria that are getting fed, especially after meals that include carbohydrates and often conclude with sugars, are the acid-producing ones.

The BasicBites, which are chocolate flavored even though they don’t contain actual chocolate, make it tough for the acid-producing bacteria to eat the food leftovers stuck to or around the teeth.

“It’ll give you an extra weapon and an easy thing for you to do,” Kleinberg said. The BasicBites “are part of a program we have where we’re tackling different microflora,” he said.

In the morning after breakfast, the BasicBites, which are manufactured in North Carolina, can help maintain a higher pH for several hours, which means children will only need two a day. If a child has too many of these teeth-protecting chews, Kleinberg said he or she may get diarrhea.

A resident of Smithtown, Kleinberg has been married for 59 years to Constance. The couple have four children and eight grandchildren. Kleinberg shows no signs of slowing down.

“When people know my age, they say, ‘Are you retired?’” Kleinberg laughs. He said he asks them what they do in retirement and they say they do what pleases them. “I happen to be doing stuff that I’m crazy about,” he said.

Kleinberg’s chairman Ryan described him as a “committed academician” who is “extremely productive with his ongoing research.”

Ryan said her 9-year-old son Peter is a big fan of BasicBites and their inventor. Her son “insists on stopping in to Dr. Kleinberg’s office to try his latest flavor of BasicBites.”

 

The Heatherwood Golf Club. File photo by Andrea Moore Paldy

The Port Jefferson Station/Terryville Civic Association will hold a special meeting on Wednesday, Aug. 27, to discuss the proposed housing development for the Heatherwood Golf Club in Terryville.

Doug Partrick, an owner of multifamily housing developer Heatherwood Communities, has proposed a 200-unit retirement community for the golf club, which is at Arrowhead Lane and Nesconset Highway.

Developer Doug Partrick talks about his proposed development for the Heatherwood Golf Club at a recent civic meeting. File photo by Andrea Moore Paldy
Developer Doug Partrick talks about his proposed development for the Heatherwood Golf Club at a recent civic meeting. File photo by Andrea Moore Paldy

His plans for the property include turning the 18-hole golf course into a nine-hole one that would surround two-bedroom rentals — a mixture of ranches, townhouses and apartments. On the 70-acre property, he has said, 45 acres would remain open space.

At a previous civic meeting, residents shared their concerns about an increase in traffic the housing community could bring, as well as drainage and sewage issues. According to representatives at that May meeting, drainage would be handled by constructing ponds and the homes would be linked to a county sewage treatment facility.

The civic association did not take a formal position on the matter at that meeting, but an informal vote showed that most of the people present were against the proposal.

It would require extra approval from the town, as the property is zoned A Residence 5, which allows one housing unit for every 5 acres. This proposal would be more dense, with the 200 units on 25 acres.

The community is invited to discuss the development at the civic’s meeting at the Comsewogue Public Library, from 7 to 9 pm.

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With diabetes, we tend to concentrate on the stabilization of the disease as a whole. This is a good thing. However, there is not enough attention spent on microvascular (small vessel disease) complications of diabetes, specifically diabetic retinopathy, which is an umbrella term. There are at least three different disorders that make up diabetic retinopathy. These are dot and blot hemorrhages, proliferative diabetic retinopathy and diabetic macular edema. The latter two are the most likely disorders to cause vision loss. Our focus for this article will be on diabetic retinopathy as a whole and diabetic macular edema.

Diabetic retinopathy is the No. 1 cause of vision loss in those who are of working age, 25 to 74 years old (1). Risk factors include duration of diabetes, not well-controlled glucose (sugars), type 1 more than type 2, smoking, high blood pressure, kidney disease, pregnancy and high cholesterol (2).

What is diabetic macula edema, also referred to as DME? This disorder is edema, or swelling, due to extracellular fluid accumulating in the macula (3). The macula is a yellowish oval spot in the central portion of the retina — in the inner segment of the back of the eye — and it is sensitive to light. The macula is the region with greatest visual acuity. Hence, when fluid builds up, there is potential loss of vision.

Whew! Did you get all that? If not, to summarize: diabetic macula edema is fluid in the back of the eye that may cause vision loss. DME affects approximately 1 in 25 patients with diabetes according to a recent study (4). However, the results also showed that this number is significantly greater (2.6 times) in blacks compared to non-Hispanic whites. And the highest risk factor for DME was for those with the longest duration of diabetes. Ironically, an oral class of drugs, thiazolidinediones, which includes rosiglitazone (Avandia) and pioglitazone (Actos), used to treat type 2 diabetes may actually increase the risk of DME. However, the results on this are conflicting.

DME is traditionally treated with lasers. But intravitreal (intraocular — within the eye) injections of a medication known as ranibizumab (Lucentis) may be a route that is as effective as laser. Studies suggest that injections alone may be as effective as injections plus laser treatments, though the studies are in no way definitive. Unfortunately, many patients are diagnosed with DME after it has already caused vision loss. If not treated after having DME for a year or more, patients can experience permanent loss of vision (5).

In a cross-sectional study (a type of observational study) using NHANES data from 2005-08, among patients with DME, only 45 percent were told by a physician that the diabetes had affected their eyes (6). Approximately 46 percent of patients reported that they had not been to a diabetic nurse educator, nutritionist or dietician in more than a year — or never. The problem is that the symptoms of vision loss don’t necessarily occur until the latter stages of the disorder. According to the authors, there needs to be an awareness campaign about the importance of getting your eyes examined on an annual basis if you have diabetes. Many patients are unaware of the association between vision loss and diabetes.

According to a study, there is good news in that the percentage of patients reporting visual impairment from 1997 to 2010 decreased (7). However, the absolute number of patients with vision loss has actually continued to grow, but at a lesser rate than diabetes as a disease has grown.

Treatment laser and injection

There seems to be a potential paradigm shift in the making for the treatment of DME. Traditionally, patients had been treated with lasers. The results from a recent randomized controlled trial, the gold standard of studies, showed that intravitreal (delivery directly into the eye) injections with ranibizumab (Lucentis), whether given prompt laser treatments or treatments delayed for at least 24 weeks were equally effective in treating DME (8).

In fact, some in the delayed group, 56 patients or about half, never even required laser treatments at all. Unfortunately, intravitreal injections may be used as frequently as every four weeks. Though in practice, ophthalmologists generally are able to inject patients with the drug less frequently. However, the advantage of receiving prompt laser treatments along with the injections was a reduction in the median number of injections by four over a five-year period.

Increased risk with diabetes drugs

You would think that drugs to treat type 2 diabetes would prevent DME from occurring as well. However, in the THIN trial, a retrospective (backward-looking) study, a class of diabetes drugs, thiazolidinediones, including Avandia and Actos, actually increased the occurrence of DME compared to those who did not use these oral medications (9). Those receiving these drugs had a 1.3 percent incidence of DME at year one, whereas those who did not had a 0.2 percent incidence. This incidence was persistent through the 10 years of follow-up. To make matters worse, those who received both thiazolidinediones and insulin had an even greater incidence of DME. There were 103,000 diabetes patients reviewed in this trial. It was unclear whether the drugs, because they were second line treatments, or the severity of the diabetes itself may have caused these findings.

This is in contrast to a previous
ACCORD eye substudy, a cross-sectional analysis, which did not show an association between thiazolidinediones and DME (10). This study involved review of 3,473 participants who had photographs taken of the fundus (the back of the eye).

What does this ultimately mean? Both of these studies were not without weaknesses. It was not clear how long the patients had been using the thiazolidinediones in either study or whether their sugars were controlled and to what degree. The researchers were also unable to control for all other possible confounding factors (11). Thus, there needs to be a prospective trial done to sort out these results.

Diet

The risk of progression of diabetic retinopathy was significantly lower with intensive blood sugar controls using medications, one of the few highlights of the ACCORD trial (12). Medication-induced intensive blood sugar control also resulted in more increased mortality and no significant change in cardiovascular events. But an inference can be made: a nutrient-dense, plant-based diet that intensively controls blood sugar is likely to decrease the risk of diabetic retinopathy complications (13) (14).

The best way to avoid diabetic retinopathy is obviously to prevent diabetes. Barring that, it’s to have sugars well controlled. If you or someone you know has diabetes, it is imperative that they get a yearly eye exam from an ophthalmologist so that DME and diabetic retinopathy, in general, is detected as early as possible, before permanent vision loss can occur. It is especially important for those diabetes patients who are taking the oral diabetes class thiazolidinediones, which include rosiglitazone (Avandia) and pioglitazone (Actos).

References:

(1) Diabetes Care. 2014;37 (Supplement 1):S14-S80. (2) JAMA. 2010;304:649-656. (3) www.uptodate.com. (4) JAMA Ophthalmol online. 2014 Aug. 14. (5) www.aao.org/ppp. (6) JAMA Ophthalmol. 2014;132:168-173. (7) Morb Mortal Wkly Rep. 2011;60:1549-1553. (8) ASRS. Presented 2014 Aug. 11. (9) Arch Intern Med. 2012;172:1005-1011. (10) Arch Ophthalmol. 2010 March;128:312-318. (11) Arch Intern Med. 2012;172:1011-1013. (12) www.nei.nih.gov. (13) OJPM. 2012;2:364-371. (14) Am J Clin Nutr. 2009;89:1588S-1596S.

Dr. Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, go to medicalcompassmd.com.

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One of the leaders on a high-powered team, Joel Hurowitz recently helped win a $1.4 million bid to build something that will eventually take a one-way journey far from home. Their device will need to withstand temperatures as low as 200 degrees below Fahrenheit.

Hurowitz, a research associate professor at Stony Brook, and a team that includes members from Stony Brook and the Jet Propulsion Laboratory, are creating one of seven instruments that will journey aboard the Mars 2020 rover mission. The group beat out 57 other proposals to win a grant from the National Aeronautics and Space Administration to construct their Planetary Instrument for X-ray Lithochemistry, which will be bolted onto the turret at the end of the rover’s arm.

“The thing that we’re really excited about is that, for the first time, we can link the texture of a rock to its geochemistry,” said Hurowitz, who is the deputy principal investigator on the project.

Up to now, the equipment NASA has sent to Mars has analyzed rocks by looking at pieces in a 4- or 5-centimeter circle, which is about the size of the top of a soda can. Such a large field of view, even from an average distance of 140 million miles away, makes it difficult to determine “which ingredients go with which parts of the rock,” Hurowitz said.

Their new instrument will scan the rock in hundred micron steps, which is about the width of a human hair. This is also the size of clues at which small living organisms, or microbes, might leave their mark on rocks. This will allow for a more complete analysis of Martian rocks, helping NASA choose which rocks to bring back to Earth in the late 2020s.

The rock analysis will also likely give scientists a better understanding of the history of conditions on Mars over the last three or four billion years. Scientists generally believe that Mars had an early period ­— four billion years or so ago — when it had water on its surface, although some researchers believe that water was more like ice, while others suspect it may have had oceans, lakes and rivers.

Something changed dramatically, causing Mars to dry out, become nearly water free and get much colder. “While this big picture model is generally true, we’re finding deposits of water-born sediments in places that are younger than we might have predicted,” Hurowitz said, which is “out of sequence in general with this framework.”

When NASA sought designs for this instrument, Hurowitz and a team led by Abigail Allwood at Jet Propulsion Laboratory built two prototypes, one of which was used to gather data in the Pilbara region, which is in the northwestern part of Australia.

The Mars 2020 mission will include several other instruments, including: SHERLOC, which will seek evidence of organic compounds in rocks and soils, and MOXIE, which will attempt to produce oxygen from Martian carbon dioxide.

While Hurowitz is developing a device that will never return, he himself has come back to a place he called home when he was a graduate student in Stony Brook in Scott McLennan’s lab. After a seven year absence in which he worked at JPL, Hurowitz rejoined Stony Brook last year.

McLennan appreciates the talents of his former Ph.D. student. Hurowitz “has all the attributes of an outstanding scientist and educator,” McLennan said. He has “exceptional laboratory skills, having designed and built experimental labs at Stony Brook and JPL.” McLennan said Hurowitz is recognized in the field for research that combined lab and Mars mission data to gain a better understanding of how the surface of Mars weathered over geological time.

A professor in the Department of Geosciences, McLennan believes Hurowitz, who will become an assistant professor in a few weeks, is a considerable asset.

He “will create really unique and great opportunities for training Stony Brook graduate and undergraduate students to be the next generation of planetary scientists,” McLennan said.

Hurowitz and his wife Tanya, an assistant principal at an elementary school on the South Shore, recently bought a home in Stony Brook, where they plan to raise their two young sons.

As Hurowitz and Allwood prepared their NASA bid, Hurowitz felt that “this will all be worth it when we’re standing on a sunny beach in Florida, watching the rocket lift off with our families next to us and the instrument team beside us.”

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BNL’s rising star Haupt helps create complex camera

When Justine Haupt was a teenager, her mother had a camera that wasn’t working. “I can fix it,” Justine said. Her mother, Lorraine Labate, who recently became a substitute teacher’s assistant for BOCES, was skeptical. “It doesn’t work anyway,” she urged. “Can I have it?” Her mother found that logic hard to refute, so she gave the camera she didn’t expect to work again to her daughter.

Haupt discovered an electrical problem that prevented the film-advance motor from functioning and fixed it. That early curiosity came in handy for Haupt, who started out as an intern five years ago and is now a design engineer in the Instrumentation Division at Brookhaven National Laboratory. She is working on a camera that will have the largest lens and the largest sensor/detector array ever built.

Haupt is a part of a team that is developing the Large Synoptic Survey Telescope, which will allow astronomers to study dark matter, dark energy and asteroids that threaten to collide with Earth.

The LSST is a long-term project that includes numerous scientists at BNL, as well as other parts of the world. Ultimately, the camera for the LSST, which will find a home in Cerro Pachon in Chile at 8,800 feet, is expected to open its shutters for the first time in 2019 and will start its scientific survey around 2022.

Haupt earned distinction for her work this year, as Mouser Electronics and Design News named her the 2014 Rising Engineering Star. “She is exceptional in her engineering talent,” said Paul O’Connor, who is the head of the Instrumentation Group. “She also has a lot of outside interests, which I thought would be appealing” to the magazine.

Those interests include serving as a director-at-large for the Custer Institute in Southold, which is the oldest public observatory on Long Island. Haupt “did a lot of work with the instrumentation there,” O’Connor said. Her background in optics has been “very helpful” to his department at BNL, O’Connor said.

Haupt works with software she taught herself to use that allows her to print out three-dimensional images of her designs, O’Connor said. She can start with a concept in the morning and provide a finished product by the end of the day and has kept the department’s two three dimensional printers “running practically 24/7,” he added.

Haupt is specifically involved with optical, mechanical and thermal design for testing and prototyping a raft tower module. When 21 of these RTMs come together, that will form the final sensor array in the camera ­— or, as she puts it, the film.

There are portions of this raft that require precise mechanical alignment to preserve the image quality. The entire object lives in a vacuum because the sensors require low temperatures. The electronics, however, generate heat, so the thermal and mechanics have to be stable for the digital film part of the telescope to function without wearing down. Haupt said anything that’s put in the vacuum with the sensors has to be cleaned meticulously and handled carefully.

While Haupt’s role is in the creation of the telescope, she, like O’Connor, plans to follow the discoveries this tool will enable scientists to make in the world of astronomy and physics. “That’s part of why I look forward to coming to work,” she said. “I’m working on the instrument that we think will lead to the discovery of the mystery of dark matter. I will definitely be watching it closely.”

A Rocky Point High School graduate and current Rocky Point resident, Haupt has not only spent time thinking about the stars and helping create an instrument that will enable their study, but has also logged hours closer to them than many of her neighbors on the land-locked Long Island.

Until the last few years, she owned a 1947 Stinson Voyager, a single engine plane. She worked on the avionics for the plane.

Haupt’s grandfather, Daniel Labate, was a welder and had a machine shop in his basement. When Haupt was 5 or 6, her grandfather taught her how to use a lathe. He also showed her how to solder and got her involved with model railroads.

After they saw her success with a camera, Haupt’s parents gave her electronics that were no longer functioning, like VCRs. “I built up a big camera collection,” she recalled.

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Calling them as she sees them has stirred up some trouble for Heather Lynch. An ecologist at Stony Brook, Lynch recently shared her estimate of the global population of the Adelie penguin, which waddles, feeds, and raises its young in the Antarctic.

The Adelie – pronounced ah deli – are considerably more numerous than previous estimates. Considered an indicator of climate change in the Antarctic because they respond to local conditions around the colony, the two and a half foot flightless water fowl number about 3.79 million breeding pairs, which is 53% higher than earlier figures.

“The losses” in some penguin populations “are more than offset by the gains we’re picking up on the continental part,” Lynch said.

Lynch has received some frustrated emails from conservationists that suggest the results may not be consistent with the messages they are sending.

“Our willingness to report on these findings makes some conservationists uncomfortable because there is a tendency in the media and with readers to conflate population gains with a rejection of climate change, or even as a benefit of climate change,” she said. The evidence, and the use of that information, doesn’t invalidate the notion of global warming or make the penguin, an animated hero in movies and an attraction to families at the Central Park Zoo, any less important or worth studying.

“Climate change is occurring in Antarctica: the shifts we have documented in the Adelie populations speaks to the ecological changes now under way due to climate change,” she said.

Looking closely at the numbers, Lynch said the population of this type of penguin, which has a white ring around the eye, long black tail and white chest that gives the bird its tuxedo appearance, has decreased on the Antarctic peninsula, amid a reduction in the population of one of their primary food sources, krill, in the Western Antarctic Peninsula. Those declines, however, have been more than counterbalanced by greater penguin population on the continent, where these birds may have found more places to breed and where there has been a decline in the toothfish, a competitor that also eats krill.

Lynch said the study of the Adelie penguins is a “complex story” and will require further study to identify the causes of these changes.

Indeed, Lynch and her collaborator on the penguin population project, Michelle LaRue, a research associate at the University of Minnesota in the Earth Sciences Department, surveyed these birds to provide information that might help policy makers with fisheries management. They didn’t intend their study to ruffle feathers in the conservation community.

“Pinning down the distribution [of Adelie penguins] is one piece of a larger puzzle to determine sustainable krill catch limits,” Lynch said. LaRue and Lynch spent about 10 months pouring over satellite images. The satellites were not able to pick up the image of these waddling birds, but they were able to provide a map of their guano, or droppings. The color of their droppings is usually reddish.

Since this was the first time researchers used satellite images, the comparison to earlier data, providing the 53% increase, creates some room for interpretation.“We were using published information,” said LaRue, which included “the information on hand at the time,” but didn’t tap into the views afforded by satellite images.

Indeed, Lynch and LaRue plan to revisit this number in about five years, using the same method to compare the change in the number of penguins.

“We could have caught them on a high year,” LaRue said. “The next time, it could be lower or vice versa. This represents a base line from which we can make better and more accurate management decisions and learn about the species.”

Lynch and LaRue have collaborated for close to four years. Lynch is a “brilliant quantitative ecologist,” LaRue said. “When you’re in the field, you go, go, go.”

After a full day of trudging through three feet of snow to collect information about penguins, Lynch took more pictures of the colonies all the way up until the last call to return to the ship, LaRue described.

Lynch said she sees her role as providing data regardless of the result. “I want to be the trusted umpire,” she said. “I limit my comments to what the data are telling us.” At this point, she said, the data are telling her what is happening. The next step is to figure out why.

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Running at any pace for 5 to 10 minutes has significant benefits

When asked what was more important, longevity or healthy aging (quality of life), more people choose the latter. Why would you want to live a long life, but be miserable? Well, it turns out the two components are not mutually exclusive. I would like you to ponder the possibility of a third choice, “all of the above.” Would you change your answer and, instead of making a difficult choice between the first two, choose the third?

I frequently use the example of Jack LaLanne, a man best known for popularizing fitness. He followed and preached a healthy lifestyle, which included diet and exercise. He was quite a motivator for many and ahead of his time. He died at the ripe old age of 96.

This brings me to my next point, which is that the number of 90-year-olds is growing by leaps and bounds. According to the National Institutes of Health, those who were more than 90 years old increased by 2.5 times over a 30-year period from 1980 to 2010 (1). This group is among what researchers refer to as the “oldest-old,” which includes those age 85 and older.

What do these patients have in common? According to one study, they tend to have fewer chronic morbidities or diseases. Thus, they tend to have a better quality of life with a greater physical functioning and mental acuity (2).

In a recent study of centenarians, genetics played a significant role. Characteristics of this group were that they tended to be healthy and then die rapidly, without prolonged suffering (3).

Another benchmark is the amount of health care dollars spent in their last few years. Statistics show that the amount spent for those who were in their 60s and 70s was significantly higher, three times as much, as for centenarians in their last two years (4).

Factors that predict one’s ability to reach this exclusive club may involve both genetics and lifestyle choices. One group of people in the U.S. who lives longer lives on average than most is Seventh-day Adventists. We will explore why this might be the case and what lifestyle factors could increase our potential to maximize our healthy longevity. Exercise and diet may be key components of this answer. Now that we have set the tone, let’s look at the research.

Exercise

For all those who don’t have time to exercise or don’t want to spend the time, this next study is for you. We are told time and time again to exercise. But how much do we need, and how can we get the best quality? In a recent study, the results showed that 5 to 10 minutes of daily running, regardless of the pace, can have a significant impact on lifespan by decreasing cardiovascular mortality and all-cause mortality (5).

Amazingly, even if participants ran less than six miles per week at a pace slower than 10-minute miles, and even if they ran only one to two days a week, there was still a decrease in mortality compared to nonrunners. Here is the kicker: those who ran for this very short of amount of time potentially added three years to their lifespan. There were 55,137 participants ranging in age from 18 to 100 years old.

An accompanying editorial to this study noted that more than 50 percent of people in the United States do not meet the current recommendation of at least 30 minutes of moderate exercise per day (6). Thus, this recent study suggests an easier target that may still provide significant benefits.

Diet

A long-standing paradigm is that we need to eat sufficient animal protein. However, there have been cracks developing in this façade of late, especially as it relates to longevity. In a recent observational study using NHANES III data, results show that those who ate a high-protein diet (greater 20 percent from protein) had a twofold increased risk of all-cause mortality, a four times increased risk of cancer mortality and a four times increased risk of dying from diabetes (7). This was over a considerable duration of 18 years and involved almost 7,000 participants ranging in age at the start of the study from 50 to 65.

However, this did not hold true if the protein source was from plants. In fact, a high-protein plant diet may reduce the risks, not increase them. The reason for this effect, according to the authors, is that animal protein may increase insulin growth factor-1 and growth hormones that have detrimental effects on the body.

Interestingly, those who are over the age of 65 may benefit from more animal protein in reducing the risk of cancer. However, there was a significantly increased risk of diabetes mortality across all age groups eating a high animal protein diet. The researchers therefore concluded that lower animal protein may be wise at least during middle age.

The Adventists Health Study 2 trial reinforced this data. It looked at Seventh-day Adventists, a group whose emphasis is on a plant-based diet, and found that those who ate animal protein up to once a week had a significantly reduced risk of dying over the next six years compared to those who were more frequent meat eaters (8). This was an observational trial with over 73,000 participants and a median age of 57 years old.

Inflammation

You may have heard the phrase that inflammation is the basis for more than 80 percent of chronic disease. But how can we quantify this into something tangible? In the Whitehall II study, a specific marker for inflammation was measured, interleukin-6. The study showed that higher levels did not bode well for participants’ longevity (9). In fact, if participants had elevated IL-6 (>2.0 ng/L) at both baseline and at the end of the 10-year follow-up period, their probability of healthy aging decreased by almost half.

The takeaway from this study is that IL-6 is a relatively common biomarker for inflammation that can be measured with a simple blood test offered by most major laboratories. This study involved 3,044 participants over the age of 35 who did not have a stroke, heart attack or cancer at the beginning of the study.

The bottom line is that, although genetics is important for longevity, so too are lifestyle choices. A small amount of exercise, specifically running, can lead to a substantial increase in healthy lifespan. While calories are not equal, protein from plants may trump protein from animal sources in reducing the risk of mortality from all-cause, diabetes and heart disease.

This does not necessarily mean that one needs to be a vegetarian to see the benefits. IL-6 may be a useful marker for inflammation, which could help predict healthy or unhealthy outcomes. Thus, why not have a discussion with your doctor about testing to see if you have an elevated IL-6? Lifestyle modifications may be able to reduce these levels.

References:

(1) nia.nih.gov. (2) J Am Geriatr Soc. 2009;57:432-440. (3) Future of Genomic Medicine (FoGM) VII. Presented March 7, 2014. (4) CDC.gov. (5) J Am Coll Cardiol. 2014;64:472-481. (6) J Am Coll Cardiol. 2014;64:482-484. (7) Cell Metab. 2014;19:407-417. (8) JAMA Intern Med. 2013;173:1230-1238. (9) CMAJ. 2013;185:E763-E770.

Dr. Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management.  For further information, go to medicalcompassmd.com and/or consult your personal physician.

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By Linda M. Toga, Esq.

The Facts: My mother died recently. She and my brother, who is my only sibling, had not spoken to each other in over a decade. In her Will, my mother disinherited my brother. On the beneficiary designation form for her IRA, my mother named my father, who predeceased my mother, as the sole beneficiary. She did not name any contingent beneficiaries.

The Question: Under the circumstances, is my brother entitled to a share of the IRA despite the provisions of the Will?

The Answer: How the funds in an IRA are distributed upon the death of the account holder is governed by the beneficiary designation form associated with the account. If there are no living beneficiaries named, the funds in the IRA effectively become an estate asset and they will be distributed in same manner as the rest of the decedent’s estate. If the decedent died with a Will, the terms of the Will will dictate how the funds are distributed. If the decedent died intestate (without a Will), the intestacy statute that dictates who inherits a decedent’s assets will control.

Since your father was the only beneficiary named on the beneficiary designation form, and he predeceased your mother, the funds in the IRA are now estate assets. If your mother had died without a Will, your brother would be entitled to one-half of your mother’s entire estate, including the funds that had been in the IRA. However, since your mother had a Will, the terms of the Will control. That means that your brother is not entitled to any of the estate assets.

Interestingly, if your mother had named you and your brother as contingent beneficiaries on her IRA, your brother would be entitled to a share of the funds in the IRA despite the fact that he was explicitly disinherited in your mother’s Will. This fact highlights the importance of considering all of your assets when engaging in estate planning, including but not limited to jointly held property and accounts, retirement plans and life insurance policies, so that your estate plan is comprehensive and consistent. Inconsistencies could result in a costly will contest.

Linda M. Toga, Esq. provides legal services in the areas of litigation, estate planning and real estate from her East Setauket office.

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