Columns

Here we are, Thanksgiving Day, and I’d like to share some things I’m not thankful for. I recognize, of course, all that I do have to be thankful for, but in this moment and in this year it seems fitting to make a not-so-thankful list.

Nicknames: They’ve become ubiquitous. I never liked the nicknames Joe Girardi had for all the Yankees, usually adding a “y” at the end of their last names. Why? Is Gardner too hard to say?

I’m also not a huge fan of the nicknames the president of the only country not in the Paris climate accord has given to all his adversaries and nemeses.

I ask, in all sincerity, does the man occupying the White House who gets to fly on Air Force One have a positive nickname for anyone? Does he, for example, call anyone “Superstar” or “Force of Nature,” or simply “Champ”? Does he think anyone is a “dynamo,” “real winner” or “miracle”? No, I suspect he doesn’t because that might mean that their superpowers would be comparable or, gasp, stronger than his.

Pundits: Everyone on TV, in the comment section of news articles and on the internet seem to know better than everyone else. Some of these pundits seem to be playing a game of mad libs where they change the names, dates and details about their punditry, but their perspectives and their “shame, shame, shame, he’s a bad Democrat/ Republican” outrage get old incredibly quickly. If you have no new thoughts, then don’t pretend to offer something new.

I’d enjoy it if a newscaster said, “And now we’re going to turn to someone that hates Republicans who, no doubt, will offer an oversized portion of outrage.”

Fake news: It’s a convenient label for those who don’t like what they hear. It’s a way to undermine the messenger. I know there are news organizations who play fast and loose with the facts. There are also members of the media who have made a point of blending editorial and news, decrying the lack of moral — or even logical — leadership in Washington. Still, many reporters are eager to find facts and to give people a chance to make decisions for themselves. Ultimately, many journalists are serving society by shining lights in dark corners and by sharing information that informs the public. Without the news, people would need to rely on official sources to tell them their version of the truth. That doesn’t sound very democratic.

Deliciously evil desserts: Around this time of year, cooks in places like The Good Steer make incredible pumpkin pie. Why does it have to taste so good and why can’t I stop at just one or six pieces? Can’t they add string beans or cauliflower to the pie to make it slightly less palatable?

Misspellings and myselfisms: I know that seems incredibly elitist and English-language snobby of me, but I bristle at emails urging me to do something before it’s too late. I would like to reply that it’s “to” late to correct their emails. As for the “myself” problem, I have heard someone say several times in the last few weeks, “If you have a problem, you should talk to Ted or myself.” Really? My problem is that if you took Ted out of that sentence, you’d be suggesting people talk to myself.

Teenage odors: Yes, I know the teenagers are growing, their hormones are surging and they are some of the most active people on Earth. Still, get a group of them in a room, in a car or in any confined space and you might long for the innocent days of diapers and spit-up.

Cranberry Chutney

By Barbara Beltrami

Once Thanksgiving is over and the turkey is just a carcass in a soup pot, and the fixings are just unidentifiable messes in plastic containers, there is still a whole month and beyond in which to take advantage of fresh cranberries, those little ruby-red gems that are in seasonal abundance. Rich in vitamin C, cranberries are not just a life-support system for a sauce. They make a fabulous pie, a delicious chutney and a moist and dense tea loaf — all perfect for holiday entertaining. And …. the tea loaf is an excellent gift from your kitchen as well.

No time to cook now? Buy them anyway and freeze them for the next occasion when you need something special. (They can be frozen for up to a year.) When you scavenge around and find them in the frosty recesses of your freezer right behind the turkey soup that was rejected in favor of a pizza, you’ll be happy to have stashed such a treasure.

Cranberry Walnut Pie

Cranberry Walnut Pie

YIELD: Makes 6 to 8 servings

INGREDIENTS:

Pastry for two-crust 9-inch pie

3 cups cranberries, halved

½ cup walnuts, finely chopped

1 cup raisins

1 cup sugar

2 tablespoons flour

Dash salt

Half a stick of unsalted butter, cut into six pieces

DIRECTIONS: Line a 9-inch pie dish with one pastry crust. In a medium bowl mix together the cranberries, walnuts raisins, sugar, flour and salt and turn into pastry-lined dish and dot evenly with butter. Cut remaining pastry crust into ¾-inch-wide strips and make a lattice across the top of the cranberry mixture. Bake at 425 F for 40 to 50 minutes, until crust is golden and filling is bubbly. Serve warm with vanilla or rum raisin ice cream or whipped cream.

Cranberry Chutney

Cranberry Chutney

YIELD: Makes 4 to 5 cups

INGREDIENTS:

½ cup cider vinegar

½ cup brown sugar

3 cups fresh whole cranberries

3 fresh pears, peeled, cored and chopped

1 cup drained canned pineapple chunks

1 cup dried figs, chopped

1 red onion, finely chopped

½ cup orange juice

1 tablespoon peeled chopped fresh ginger root

1 tablespoon prepared grainy mustard

1 tablespoon grated orange rind

2 cinnamon sticks

¼ teaspoon ground cloves

Pinch of salt

DIRECTIONS: In a large saucepan, heat vinegar and sugar to boiling point. Lower heat and simmer 5 minutes; add cranberries, pears, pineapple, figs, onion, orange juice, ginger, mustard, orange rind, cinnamon, cloves and salt. Continue to simmer half an hour, until cranberries burst their skins and mixture is thickened. Remove from heat. Cover and refrigerate until ready to use. Serve warm or at room temperature with pork, ham, fowl, game or any soft cheese.

Cranberry-Citrus Tea Loaf

YIELD: Makes one 9- × 5- × 3-inch loaf

INGREDIENTS:

2 cups flour

1 cup sugar

1½ teaspoons baking powder

1 teaspoon salt

½ teaspoon baking soda

1 egg, well beaten

½ cup grapefruit or orange juice

2 tablespoons vegetable, canola or sunflower oil

¼ cup Grand Marnier liqueur

1 cup fresh cranberries, coarsely chopped

½ cup chopped fresh pecans

1 teaspoon grated orange zest

1 teaspoon vanilla extract

¼ teaspoon orange extract

DIRECTIONS: Preheat oven to 350 F. Grease and flour a 9- × 5- × 3-inch loaf pan. Sift together the dry ingredients, then add the egg, juice, oil and liqueur. Stir to combine. Add cranberries, nuts, zest and extracts; mix thoroughly but do not overmix. Spread batter evenly in prepared loaf pan. Bake 50 minutes to one hour, until cake tester inserted in middle comes out clean. Cool 15 to 20 minutes; remove from pan when ready to serve. Serve with hot tea, coffee or chocolate with butter, orange sorbet, butter pecan or vanilla ice cr

This Thanksgiving, offer healthy dessert options like dairy-free pumpkin pudding, above, or fruit salad.
Eating well can set the table for a year of well-being

By David Dunaief, M.D.

Dr. David Dunaief

Many of us give thanks for our health on Thanksgiving. Well, let’s follow through with this theme. While eating healthy may be furthest from our minds during the holidays, it is so important.

Instead of making Thanksgiving a holiday of regret, eating foods that cause weight gain, fatigue and that increase your risk for chronic diseases, you can reverse this trend while maintaining the traditional theme of what it means to enjoy a festive meal.

What can we do to turn Thanksgiving into a bonanza of good health? Phytochemicals (plant nutrients) called carotenoids have antioxidant and anti-inflammatory activity and are found mostly in fruits and vegetables. Carotenoids make up a family of more than 600 different substances, such as beta-carotene, alpha-carotene, lutein, zeaxanthin, lycopene and beta-cryptoxanthin (1).

Carotenoids help to prevent and potentially reverse diseases, such as breast cancer; amyotrophic lateral sclerosis, also known as Lou Gehrig’s disease; age-related macular degeneration; and cardiovascular disease — heart disease and stroke. Foods that contain these substances are orange, yellow and red vegetables and fruits and dark green leafy vegetables. Examples include sweet potato, acorn squash, summer squash, spaghetti squash, green beans, carrots, cooked pumpkin, spinach, kale, papayas, tangerines, tomatoes and Brussels sprouts.

Let’s look at the evidence.

Breast cancer effect

We know that breast cancer risk is high among women, especially on Long Island. An American woman has an average risk of 12.4 percent for getting breast cancer (2). Therefore, we need to do everything within reason to reduce risk.

In a meta-analysis (a group of eight prospective or forward-looking studies), results show that women who were in the second to fifth quintile blood levels of carotenoids, such as alpha-carotene, beta-carotene and lutein and zeaxanthin, had significantly reduced risk of developing breast cancer (3).

Thus, there was an inverse relationship between carotenoid levels and breast cancer risk. Even modest amounts of carotenoids can have a resounding effect in potentially preventing breast cancer.

Amyotrophic lateral sclerosis: Lou Gehrig’s disease

ALS is a disabling and feared disease. Unfortunately, there are no effective treatments for reversing this disease. Therefore, we need to work double time in trying to prevent its occurrence.

In a meta-analysis of five prestigious observational studies, including The Nurses’ Health Study and the Health Professionals Follow-Up Study, results showed that people with the greatest amount of carotenoids in their blood from foods like spinach, kale and carrots had a decreased risk of developing ALS and/or delaying the onset of the disease (4). This study involved over 1 million people with more than 1,000 who developed ALS.

Those who were in the highest carotenoid level quintile had a 25 percent reduction in risk, compared to those in the lowest quintile. This difference was even greater for those who had high carotenoid levels and did not smoke, a 35 percent reduction. According to the authors, the beneficial effects may be due to antioxidant activity and more efficient function of the power source of the cell: the mitochondria. This is a good way to prevent a horrible disease while improving your overall health.

Positive effects of healthy eating

Despite the knowledge that healthy eating has long-term positive effects, there are several obstacles to healthy eating. Two critical factors are presentation and perception.

Presentation is glorious for traditional dishes, like turkey, gravy and stuffing with lots of butter and creamy sauces. However, vegetables are usually prepared in either an unappetizing way — steamed to the point of no return, so they cannot compete with the main course — or smothered in cheese, negating their benefits, but clearing our consciences.

Many consider Thanksgiving a time to indulge and not think about the repercussions. Plant-based foods like whole grains, leafy greens and fruits are relegated to side dishes or afterthoughts. Why is it so important to change our mindsets? Believe it or not, there are significant short-term consequences of gorging ourselves.

Not surprisingly, people tend to gain weight from Thanksgiving to New Year. This is when most gain the predominant amount of weight for the entire year. However, people do not lose the weight they gain during this time (5). If you can fend off weight gain during the holidays, just think of the possibilities for the rest of the year.

Heart attack risk: Even in the short term

Also, if you are obese and sedentary, you may already have heart disease. Overeating at a single meal increases your risk of heart attack over the near term, according to the American Heart Association (6). However, with a little Thanksgiving planning, you can reap significant benefits. What strategies should you employ for the best outcomes?

• Make healthy, plant-based dishes part of the main course. I am not suggesting that you forgo signature dishes, but add to tradition by making mouthwatering vegetable-based dishes for the holiday.

• Improve the presentation of vegetable dishes. Most people don’t like grilled chicken without any seasoning. Why should vegetables be different? In my family, we make sauces for vegetables, like a peanut sauce using mostly rice vinegar and infusing a teaspoon of toasted sesame oil. Good resources for appealing dishes can be found at www.PCRM.org, www.DrFuhrman.com, www.EatingWell.com, www.wholefoodsmarket.com and many other resources.

• Replace refined grains. A study in the American Journal of Clinical Nutrition, showed that replacing wheat or refined grains with whole wheat and whole grains significantly reduced central fat, or fat around the belly (7). Not only did participants lose subcutaneous fat found just below the skin but also visceral adipose tissue, the fat that lines organs and causes chronic diseases such as cancer. For even better results, consider substituting finely chopped cauliflower for rice or other starches.

• Create a healthy environment. Instead of putting out creamy dips, processed crackers and candies as snacks prior to the meal, put out whole grain brown rice crackers, baby carrots, cherry tomatoes and healthy dips like hummus and salsa. Help people choose wisely.

• Offer healthy dessert options. Options might include dairy-free pumpkin pudding and fruit salad.

The goal should be to increase your nutrient-dense choices and decrease your empty-calorie foods. You don’t have to be perfect, but improvements during this time period have a tremendous impact — they set the tone for the new year and put you on a path to success. Why not turn this holiday into an opportunity to de-stress, rest and reverse or prevent chronic disease by consuming plenty of carotenoid-containing foods.

References: (1) Crit Rev Food Sci Nutr 2010;50(8):728–760. (2) SEER Cancer Statistics Review, 1975–2009, National Cancer Institute. (3) J Natl Cancer Inst 2012;104(24):1905-1916. (4) Ann Neurol 2013;73:236–245. (5) N Engl J Med 2000; 342:861-867. (6) www.heart.org. (7) Am J Clin Nutr 2010 Nov;92(5):1165-71Givi.

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, visit www.medicalcompassmd.com or consult your personal physician.

Wyatt

MEET WYATT! Fun loving, sharp, loyal and true to the breed. That’s why Wyatt, a 1-year-old blue heeler mix, is TBR News Media’s shelter pet of the week. Rescued from a high-kill shelter in Texas, this handsome boy is currently up for adoption at Kent Animal Shelter and comes neutered, microchipped and up to date on all his vaccines. Wyatt would love to go home with you for the holidays. Kent Animal Shelter is located at 2259 River Road in Calverton. For more information on Wyatt and other adoptable pets at Kent, please call 631-727-5731 or visit www.kentanimalshelter.com.

The word 'fondue' comes from the French word 'fonder,' meaning 'to melt.'

By Bob Lipinski

“Cheese complements a good meal and supplements a bad one.” — E. Briffault, French gastronome

Bob Lipinski

As the weather turns colder and days become shorter, thoughts of sitting around a roaring fire come to mind. Although freshly roasted chestnuts and large mugs of mulled wine or even hot chocolate satisfy, I enjoy dipping some crusty bread into a pot of melted cheese. Not just any cheese, but one that is flavored with kirsch (cherry brandy), garlic, white wine and seasonings. I’m talking fondue, a true Swiss tradition.

The word “fondue” comes from the French word “fondre,” meaning “to melt.” There are several kinds of fondue including the traditional cheese one and a meat fondue known as fondue bourguignonne from Burgundy, France, where cubes of raw beef are threaded on skewers, then dipped in bubbling hot oil for several minutes prior to being eaten with various dipping sauces.

Then there is a dessert fondue featuring chocolate, cream and liqueurs heated until melted, then used to coat pieces of cake or fruit.

When selecting wines to pair with fondue, choose fairly neutral dry white wines with good acidity, while avoiding oaky ones. My recommended white wines include a Swiss Fendant (Chasselas grape) or Neuchâtel; French Chablis or Muscadet; Grüner Veltliner, sauvignon blanc or dry Riesling. Choose red wines with little tannin and oak in favor of wines like Beaujolais, grenache, grignolino, and pinot noir.

The following fondue recipe is a modification of the original I enjoyed while in Switzerland. Although the recipe calls for the traditional Emmental or Gruyère cheese, you can also try Appenzeller, Beaufort or Comté and any combination of these cheeses.

Cheese Fondue

The word ‘fondue’ comes from the French word ‘fonder,’ meaning ‘to melt.’

INGREDIENTS:

3 cloves garlic, pressed

1 pound Emmental or Gruyère cheese, grated (not chopped)

1 teaspoon butter

½ cup dry white wine (see above recommendations)

¹/3 cup kirsch (cherry brandy, NOT “flavored” brandy)

1 teaspoon cornstarch

Nutmeg for dusting

Salt and white pepper to taste

¹⁄₈ teaspoon bicarbonate of soda

DIRECTIONS: In an earthenware pot, rub the sides and bottom with garlic (add to pot), then add cheese, butter, white wine, kirsch (in which the cornstarch has been dissolved) and nutmeg. Place the pot over medium heat and stir with a wooden spoon. If the cheese forms into a thick mass, continue to stir and it will be re-absorbed. As the mixture continues to bubble, adjust flavor with salt and pepper, then add the bicarbonate of soda, which will make the fondue lighter. Now the fondue is ready to enjoy. Take cubes of crusty French or Italian bread; fasten onto foot-long, three-pronged, metal fondue forks and dip into the fondue for a moment or so before popping it into your mouth. Now enjoy a glass of some good Swiss wine!

Bob Lipinski, a local author, has written 10 books, including “101: Everything You Need to Know About Whiskey” and “Italian Wine & Cheese Made Simple,” available on Amazon.com. He conducts training seminars on wine, spirit and food and is available for speaking engagements. He can be reached at www.boblipinski.com or bkjm@hotmail.com.

UNCOMMON BEAUTY Gerard Romano of Port Jefferson Station captured this image at Satterly Landing Park in Mount Sinai. He writes, ‘I stopped by the area to see my friends fishing and I noticed how nice the common reeds looked when the sun shined at a 45 degree angle so I framed the abandoned shack across the harbor with them.’

Send your Photo of the Week to leisure@tbrnewspapers.com.

Minghua Zhang

By Daniel Dunaief

Minghua Zhang spent a sabbatical year in China trying to improve climate models, which included analyzing errors of current models.

A professor at the School of Marine and Atmospheric Sciences at Stony Brook University, Zhang focused on the Southern Great Plains of the United States. He explored how the current models did not accurately simulate convection, which created a warm and dry bias.

In convection, heat and moisture get carried upward. The models account for summer rainfall but do not calculate the organizational structure of the convective systems, which led them to simulate insufficient precipitation.

By adding in the new information, Zhang predicts in recent research published in the scientific journal, Nature Communications, that the projected warming in the region would be 20 percent less than previously thought. Precipitation, meanwhile, would be about the same as it is today, instead of the drying that was previously anticipated.

“The resolution of the models is not high enough to predict the change of the convection with a high degree of precision,” Zhang explained in an email.

He suggested that using 10 times the specificity of model calculations, he expects a clearer picture of the likely climate by the end of the 21st century. This is like looking through binoculars at a nondescript moving shape in the distance. By adding focal power to the lens, the image can become sharper and clearer.

The climate is a big picture view of trends over the course of many years. That is distinct from weather, which involves day-to-day variations and which meteorologists describe each morning and evening with colorful images of cold and warm fronts on local maps.

“You have many things you can’t see and now you have better binoculars,” he suggested. “This tiny thing in the binoculars can make a bigger impact. What we see is that these [variables] actually matter.”

Zhang suggested that a climate model that better accounts for summer rainfall still includes higher temperatures in this sensitive region. “The warming is going to be there and will be significant,” he said. If carbon dioxide emissions continue at their current rate, the warming will still be about five degrees by the end of the century, he suggested. That, he predicted, will still have a significant impact on agriculture.

Edmund Chang, a professor at the School of Marine and Atmospheric Sciences at Stony Brook who was not involved in this study, said this research addresses “a specific bias of the model that needs to be taken care of.” He added that researchers know that the “models are not perfect” and suggested that the “scientific and climate modeling community is trying to refine and improve” these tools.

Chang agreed that the refinement “doesn’t change the fact that we still project a large increase in the temperatures over the central United States.”

The Southern Great Plains region has some unique elements that make climate predictions challenging. It has considerable organized convection, which increases the occurrence of tornadoes. There’s also a large coupling between the soil moisture and the clouds, which means that whatever happens on the land has feedback for the atmosphere.

Zhang said his research focus is on climate simulation modeling. He knew the models had problems simulating convective events, which is why he started exploring this specific region. “The way the models are constructed, the granules are not small enough,” he said.

Chang expected that this work would “spur more research on trying to understand this mechanism. Model developers will need to try to find out how to improve the physical model.”

Zhang has been working for the last two years with scientists from Tsinghua University in China, which included his time on sabbatical. “When you are on sabbatical, you have more time to really think about problems,” he said.

Chang added that sabbaticals can provide some time to focus on specific scientific questions. During a typical semester that includes administrative responsibilities and teaching, professors “are very busy,” He said. “We really don’t have an extended period of time to focus on one project. The sabbatical gives us a chance to focus.”

Zhang hopes this study “motivates people to think about how to improve their models in describing” other climate systems.

One of the many challenges scientists like Zhang face in developing these climate models is that their computers are still not powerful enough to resolve elements like clouds, which not only dot the landscape and provide shade during the summer but also send the sun’s energy back into space.

The system he’s studying is “chaotic by nature,” which makes accounting for elements that change regularly challenging. He suggested that these studies were akin to the butterfly effect. Scientists have suggested that someone who went back in time and committed a seemingly trivial act, like killing a single butterfly, might return to his familiar time and surroundings to discover profound changes.

While that’s an exaggeration, that’s still the kind of system he said researchers are confronting as they try to account for, and weigh, climate defining factors. That’s why he’s looking for statistical, or probabilistic, predictions that are averaged over time periods.

The United States, China and the European Union are all pursuing more powerful computers for these kinds of applications, Zhang said.

Zhang, who is the editor-in-chief of the Journal of Geophysical Research: Atmospheres, has been involved in an advisory capacity with the United States Department of Energy in developing these models. A

s for this specific effort, Zhang said he was pleased that the paper pointed out a research direction to refine models for climate in this area. “What we see is that these things [including convection] actually matter,” he said. “That’s the main contribution of this paper.”

Lifestyle modifications, particularly switching to plant-based diets, are effective tools in reversing diabetes.
Antioxidants in foods may reduce diabetes risk

By David Dunaief, M.D.

Type 2 diabetes continues to be an epidemic that is monopolizing health care budgets. According to the Centers for Disease Control and Prevention, the incidence of diabetes has tripled in the last 20 years (1). We need a plan to prevent the disease and to reverse its course.

In medicine, our arsenal of drug therapies has grown considerably, but there are unpleasant side effects. Drugs have even been shown to reduce cardiovascular disease in diabetes patients, which is the number one reason that patients die.

However, there is nothing potentially more powerful with beneficial side effects than lifestyle modifications, especially diet and exercise. And when it comes to reversal, lifestyle modifications are the only potential source.

Two large observational studies, the Adventist Health Study 2 and the EPIC trial, have shown the considerable prevention abilities of diet. In terms of reversal, several studies with a plant-based diet, including one run by Dr. Neal Barnard and another that I published with Dr. Joel Fuhrman, indicate its efficacy. These are backed up by additional anecdotal stories from my clinical experience over an 11-year period.

Let’s look at the research.

Prevention of diabetes with diet

Lifestyle modifications, particularly switching to plant-based diets, are effective tools in reversing diabetes.

A recently published prospective study of the E3N EPIC trial showed considerable benefit from the antioxidant capacity of foods including fruits, vegetables and tea (2). Those who consumed the highest quintile of antioxidants reduced their diabetes risk 39 percent compared to the lowest quintile. After adjusting for weight loss, there was still a statistically significant 27 percent reduction. Interestingly, fruits had the greatest impact with a 23 percent decrease in risk, and vegetables followed with a 19 percent decrease.

This study serves two purposes: one, it shows that antioxidant capacity is important in food; and two, it demonstrates that fruit actually has beneficial effects for those at risk of diabetes. This was not solely a plant-based diet or a vegan or vegetarian diet. This is an impressive effect considering that people may have been eating many other items that may not have been beneficial in addition to fruits and vegetables.

Study participants were 64,223 women who did not have diabetes or cardiovascular disease at the beginning of the study. One of the major weakness of this trial is that the food frequency questionnaire was only used at the study’s start. This means we have to assume people continued to eat the same way throughout the study.

In the Adventist Health Study, the results of a plant-based diet were very powerful. This showed significant effects and, unlike the EPIC trial, compared people who were trying to eat healthy with those who ate either a vegan or vegetarian plant-based diet. Results showed that those who ate a vegan plant-based diet and those who ate a lacto-ovo vegetarian diet were at 62 and 38 percent, respectively, lower risk of developing diabetes than those who were eating a health-conscious omnivore diet (3). This study reaffirms how a plant-based diet is so important when it comes to preventing diabetes.

There were 15,200 men and 26,187 women in this study, and the results were as impressive in both blacks and nonblacks.

Reversal of diabetes with diet

A randomized controlled trial, considered the gold standard of trials, used drug therapy to reduce HbA1C to near nondiabetes levels; however, they could not achieve this before multiple deaths occurred (4). The reason, the researchers surmise, was polypharmacy, or too many drugs.

Fortunately, this is not the case with lifestyle modifications. In one randomized controlled trial, Barnard compared a low-fat vegan diet to the American Diabetes Association diet at the time. The results showed that with a low-fat vegan diet, HbA1C was reduced significantly more than with the ADA diet (5). This trial included 49 patients on the low-fat vegan diet and 50 patients on the ADA diet. The trial duration was 74 weeks. This trial, though small, does show substantial benefit with a low-fat vegan diet.

The benefits of a plant-based diet have been known for many decades. In a 1979 study on diabetes, results showed that insulin was significantly reduced by more than half on a high carbohydrate, high-plant fiber diet (HCF) compared to a control diet (6). This effect was seen in approximately 2.5 weeks.

Involving 20 men with type 2 diabetes who had a mean duration with diabetes of 8 years, patients were started on the control diet for seven days and then switched to the HCF diet for 16 days. This showed reversal with diet over a short period of time and reduction in medication. Thus, diet does not only have an insidious (slow) effect, but it also has an acute (immediate) effect on diseases. Of course, insulin was the gold standard of treatment at the time.

More recently, in a retrospective (backward-looking) case series with 13 men and women with type 2 diabetes, results showed that HbA1C was reduced from a mean of 8.2 to 5.8 percent over a seven-month period (7). This was an impressive 2.4 percent reduction in HbA1C, and 62 percent of patients reached normal sugar levels.

At baseline, patients were on an average of four medications, including diabetes medications. By seven months, they were able to reduce this to one medication while significantly decreasing their HbA1C. In addition, their blood pressure and triglycerides improved. These patients were following a nutrient-dense, plant-based diet. This study was performed by myself and Fuhrman using patients in his practice. The study’s weaknesses were that there was no control arm and that it was retrospective. But this does imply that there is potential for diabetes reversal.

In my clinical practice, I have seen many diabetes patients successfully reverse their disease. Let me share one anecdotal story. A 55-year-old diabetes male Caucasian patient told me that no relative had lived past 57 because they died from diabetes complications. He is currently 60 years old or, as he likes to put it, “three years past expiration date.”

When he first came to see me, he was on four diabetes medications, including insulin, plus a statin. He is no longer on any of these medications. These results were seen in only two months. He did lose weight, but at a much slower pace than the metabolic changes that took place in his body. This anecdotal story is inspirational and reinforces the research above.

In conclusion, while medications are important for the treatment of diabetes, nothing seems to trump lifestyle modifications. Diet, especially, can play both prevention and reversal roles. Even fruit plays a significant role in reducing the incidence of diabetes. Regardless of family history, as demonstrated by my patient, these results can be achieved. Whether or not you are on medications, if you have diabetes, lifestyle modifications should be adopted to get optimal results.

References: (1) CDC.gov. (2) Diabetologia online Nov. 9, 2017. (3) Nutr. Metab Cardiovsc Dis. 2013;23(4):292-299. (4) N Engl J Med. 2008;358:2545-2559. (5) Am J Clin Nutr. 2009 May; 89(5): 1588S–1596S. (6) Am J Clin Nutr 1979 32: 2312-2321. (7) Open J Prev Med. 2012 2(3), 364-371.

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, visit www.medicalcompassmd.com or consult your personal physician.

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Joe Biden has written a book called, “Promise Me, Dad: A Year of Hope, Hardship, and Purpose,” about one year in his life. A memoir, it deals in part with the illness and death of his elder son, Beau, from brain cancer at the age of 46. I have not read the book. It just came out this past Tuesday, Nov. 14. But the coincidence of the book’s release on the day my husband died at a similarly young age exactly 30 years ago from cancer has connected me to Biden. I know what he went through — the shock, the pain, the hope, the heartbreak, the grief and the end that ultimately comes crashing down into silence. Then he faced the absolute necessity of having to pick up and function because life moves on with every passing day. And we must move on with it because there is no respite for the living.

Biden also writes about his difficult decision not to run for president in the 2016 election and about the foreign crises in Iraq, the Ukraine and Central America as part of his workload during that one year.

“I wanted to write precisely about the crises and dilemmas I faced as they intersected in the moment,” Biden told Philip Galanes in an interview with The New York Times. “I wanted to show that in the ebb and flow of life, nothing is totally separable.”

I know that Biden was lucky to have those other facets to deal with, just as I was lucky to have a huge challenge almost immediately after my husband’s death.

Two of my sons were away in college, the third was a high school senior and the newspaper was being challenged by the Communications Workers of America to unionize. A reporter on my staff, who had already made his mark by unionizing the teaching assistants at Stony Brook University, brought the union to my door. He turned his attention to our hometown newspaper, despite the fact that there wasn’t a community newspaper in all of New York state that had a union. Shoestring budgets and multitask jobs preclude coordinated decision making with a union. The CWA was attracted, I guess, because it represented new territory to conquer. The only problem was that community newspapers are not flush with profits and do not have large staffs to join a union. Nonetheless, we had to fight them off for six months, as they handed out pamphlets with all sorts of painful charges to get our staff worked up against the company. The climax came with an appearance before the National Labor Relations Board in a room without air conditioning in Brooklyn on a hot June day. The pickings were turning out to be pretty lean for the CWA, and they backed off.

Throughout the ordeal, I was wildly angry. I wasn’t getting a chance to grieve. Each day I had to rush to the parapets to defend the honor and integrity of the newspaper against what was to me a ridiculously unequal battle. I barely gave any attention to my grieving son who was still at home, nor did I have a chance to pour out my own grief somewhere in a quiet corner. But I did realize how fortunate I was in those who came to my defense. We had absolutely no money to hire a labor lawyer, and we had no idea how to respond. But the newly retired union leader of the Long Island Rail Road came into my office and offered his help.

Harold Pryor was the man who had terrified Gov. Nelson Rockefeller (R) during contract talks by calling wildcat strikes from his totally loyal followers, directing them to abandon the trains at the nearest station during rush hour. Pryor was living in the area and teaching at Stony Brook University. When he found out what was happening to our newspaper, he thought it was not only unfair but also idiotic. He came to advise me through the thicket of union maneuverings, and he brought with him an experienced lawyer to defend us during the hearing.

It was a script worthy of a movie. Here was this feared union leader facing off against one of the largest unions for the sake of a peanut of a newspaper. Jimmy Stewart would have played his part in the spirit of “It’s a Wonderful Life.” And thanks to his aid, we emerged unscathed.

Only after it was all over did I realize that life had thrown me a life preserver, much as it had for Biden, and therefore we hadn’t drowned in our grief.

We rarely get anything completely right the first time. I’m not just saying that because I’m a second child. I idolize my older brother. In fact, I’m fond of my younger brother, too.

We need practice. When we’re young, we take a few steps and we fall hard. Fortunately, at that age, we’re practically made of plastic, bouncing off the nearby floor as if it were a downy soft trampoline. As we age, the floor gets harder.

With each figurative step through life, we make adjustments, learn on the fly and revise our approach.

We recently visited a few colleges with our daughter. The cheerful school representatives were selling us on the idea that their classes were great, the students they admitted were incredible and the opportunities were extraordinary.

One theme that stuck out, especially after several schools presented it as if unique, was that they made students uncomfortable. They wanted to challenge their undergraduates to reach outside their comfort zone. They wanted eager students to fall down and, in so doing, learn to get back up.

This idea of falling is part of the charm of enjoying the ride. We listen to elementary school music concerts in which someone plays a few notes after the conductors arms have stopped moving, we nod encouragement when the young person on stage says a few of the wrong words in a speech, and we suggest to our kids that they’ll spell “because” correctly the next time.

The country may have forgotten that our strutting president, who has been in the public eye for so long, has never been a politician. He’s definitely outside his comfort zone, acting like a president when he hasn’t even been, to borrow a phrase from him, “elected dog catcher.”

People pounce on every mistake, every breach of protocol and every misstatement, ready to tar and feather him for saying or writing something that probably would play better on a fictionalized reality TV show than it does for him as president of the United States.

He’s so eager to be a part of every story and to expand his brand — something he’s been doing reflexively for years — that he doesn’t appear to take the time to recognize or
acknowledge mistakes.

I know how it is to say, “my bad.” Many people consider admitting a mistake some sign of weakness, instead of a reflection of strength and self awareness. Erring, as the saying goes, is human.

You don’t get many free passes when you’re president. You either learn or you don’t, you either unify or you don’t, and you either say or do the right thing, or you don’t.

Still, it seems to me that he might endear himself to more people, and win higher ratings, if he took a few extra seconds to think about whether he might write or respond to something in a different way. He doesn’t seem burdened by the kind of reflection that allows for his own second thoughts to enter the discussion.

People are eager to rip him apart each day, but let’s remember something his handlers and cohorts seem to embrace regularly: He gets angry when people point out that he’s fallen down. Maybe he can meet us halfway, by learning to take an extra second to edit his thoughts or speech. When he takes a few steps without falling, we can breathe a sigh of relief, the way parents do when they’re no longer bending over to protect their children from bumping their heads on nearby coffee tables.

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