Columns

American Gun Laws

By Daniel Dunaief

Daniel Dunaief

I have an obvious question for the National Rifle Association: Why fight gun control?

Yeah, yeah, I get it. You and many others don’t want a repeal of the Second Amendment, which was written well before the creation of assault weapons that enabled deranged Americans to kill their fellow citizens
at an unfathomable rate.

But don’t gun manufacturers want gun control? After all, wouldn’t it be better to produce a product that stayed out of the wrong hands?

Let’s take a look at the difference between gun manufacturers and car manufacturers. On the one hand, you have companies producing vehicles where safety is a top priority. In addition to meeting the stringent requirements of the law, some car manufacturers add features like a way to block text or phone signals from getting into a car while someone is driving.

Wow, what a concept. The car manufacturers don’t make the phones. People have died doing all kinds of activities with their phones, taking selfies in dangerous locations and not paying attention to their environment in general because they are so focused on their phones.

And yet, some of these car manufacturers are protecting drivers from their own unsafe impulses that could harm them and others — sounds familiar? — by preventing the dangerous combination of phone use and driving. If we buy into the notion that “guns don’t kill people, people kill people,” shouldn’t gun manufacturers make an effort to find out which people are more likely to kill other people, and not sell these destructive weapons to them?

In 1996, three years before the Columbine, Colorado, shooting became one of the first in what has now become a painful and familiar collection of mass murders in locations ranging from schools to houses of worship to malls during back-to-school sales, Congress passed a budget that included the Dickey Amendment, named after U.S. Rep. Jay Dickey (R-Arkansas). That amendment prevented the government from funding research that might lead to the conclusion that gun control was necessary.

Say what? Yeah, but, in light of recent tragedies, a law was passed last year clarifying that the Centers for Disease Control can actually fund research about guns. And, yet, the CDC still can’t lead to any advocacy for gun control.

If guns make most people safer, why don’t gun manufacturers want to know which people, specifically, shouldn’t have a gun? The idea of background checks and red flags are all fine, but they may not be sufficient.

If a virus broke out anywhere in the country that threatened to kill a room full of people in minutes, we would want the CDC not only to understand how to treat those who might have that virus immediately, but also to provide warning signs to others about any symptoms that might lead to an outbreak of that virus.

The CDC is way behind in its research in part because that 1996 amendment effectively dampened any effort to conduct the kind of studies that would lead to a greater understanding of gun violence.

Sure, the Federal Bureau of Investigation could and should find people who might be a threat to society. With the help of the CDC, the FBI might have a better idea of where to look. 

The well-funded NRA, however, would do itself — and society — a huge favor if it put its considerable financial muscle behind an independent effort to understand how to recognize those people who shouldn’t have any kind of gun, let alone an assault rifle capable of mass murder in a minute. The NRA doesn’t even need to call it gun control, just firearms research.

We the people may have a right to own guns, but we also have a right to life, liberty and the pursuit of happiness. Wouldn’t gun control research, supported by the NRA, ensure that we could live our lives without fear of the wrong people owning the wrong guns?

Award winning author and conservationist Carl Safina was the guest speaker at last year's event. Photo by Rita J. Egan
Leah Dunaief

By Leah S. Dunaief

The world has changed for all of us since we entered the 21st century. While our computers didn’t blow up as the millennium turned, the horrific attacks on 9/11 forever, it seems, altered our sense of safety in our country and elsewhere on the globe. The arrival of the internet on desktop computers, the proliferation of cellphones, the rise of social media — they have upended the architecture of our lives.

Change has been no less dramatic in our work lives. For those of us in the news business, the basic business model is disappearing. Once upon a time the publisher brought together talented reporters and editors with an articulate sales staff, and together editorial and advertising were presented to the reader in an attractive format that informed and enriched the community. In the process, the news organization was also enriched, and there were newspapers everywhere. The biggest challenge was beating competitors to the “scoop” and gaining the greater market share of advertisers.

Today that simple business plan seems like a fairy tale. According to data in a special section of The New York Times on Sunday, “Over the last 15 years, about 2100 local newspapers — or roughly a quarter of all local newsrooms — have either merged with a competitor or ceased printing …About 6800 local newspapers continue to operate across the country, but many are shells of their former selves, with pared down staffs and coverage areas. About half of the remaining local papers are in small and rural communities, and the vast majority distribute fewer than 15,000 copies of each edition.” 

I could go on with the statistics, but here’s the point: If we don’t embrace change, we get left behind.

Chef Guy Reuge speaks about his latest book, ‘A Chef’s Odyssey,’ at last year’s Cooks, Books & Corks. Photo by Rita J. Egan

So it is that we at Times Beacon Record Newspapers have become TBR News Media, with the addition of a website, Facebook, Instagram, Twitter and YouTube platforms to accommodate the various demands for news and advertising. After all, we work for our customers and we must offer them what they want and need. By the same token, while maintaining those platforms has increased our costs, the revenue they generate is minimal. Further worsening the newspaper situation is the demise of the traditional mom-and-pop retail stores, the previous backbone of so many communities and community newspapers.

So we have changed, as the surviving retailers have changed. We, and they, are now building events into our offerings, much as we used to publish supplements to target specific subjects and advertising niches for our papers. Retailing now includes some aspect of entertainment with their event planning, and publishing companies, whether in print or digital, must also provide entertaining events.

Fortunately for us at TBR, we can make this fit with our mission statement to give back to the community, and indeed to endeavor to strengthen the sense of community where we publish. Since our first year in existence, over 43 years ago, we have held the Man and Woman of the Year event at the Three Village Inn, with the financial help of Stony Brook University and the Lessings, at which we have saluted those who go the extra mile offering their products, services or time to their neighbors in their hometowns.

For the last two years, we have produced and directed films with authentic Revolutionary War narrative at Stony Brook’s Staller Center to share pride in our Long Island history, explaining who we were at the dawn of our country and how we got here.

Coming next on the events list is Cooks, Books and Corks, a community-enriching program that features scrumptious food from some of our local restaurants at stations around the perimeter of a room at the Bates House filled with local authors and their books. We started this last year, and it was such a success that both restaurateurs and authors offered themselves on the spot for the next such gathering. They said they liked “the high tone.”

Therefore, the Second Annual Cooks, Books and Corks will take place in the same bucolic location, in Setauket, on Tuesday evening, Sept. 24, from 6 to 8 p.m. The charge is $50 per person, and the money raised will go toward subsidizing the pay of a journalism intern next summer.

Please mark your calendars and join neighbors and friends at this event to share food for both body and mind. 

Pairing a healthy diet with regular exercise is the best way to prevent heart disease. Stock photo
Taking an active role can reduce your risk significantly

By David Dunaief, M.D.

Dr. David Dunaief

Heart disease is so pervasive that men who are 40 years old have a lifetime risk of 49 percent. In other words, about half of men will be affected by heart disease. The statistics are better for women, but they still have a staggering 32 percent lifetime risk at age 40 (1).

The good news is that heart disease is on the decline due to a number of factors, including better awareness in lay and medical communities, improved medicines, earlier treatment of risk factors and lifestyle modifications. We are headed in the right direction, but we can do better. Heart disease is something that is eminently preventable.

Heart disease risk factors

Risk factors include obesity, high cholesterol, high blood pressure, smoking and diabetes. Unfortunately, both obesity and diabetes are on the rise. For patients with type 2 diabetes, 70 percent die of cardiovascular causes (2). However, high blood pressure, high cholesterol and smoking have declined (3).

Of course, family history also contributes to the risk of heart disease, especially with parents who experienced heart attacks before age 60, according to the Women’s Health Study and the Physician’s Health Study (4). Inactivity and the standard American diet, rich in saturated fat and calories, also contribute to heart disease risk (5). The underlying culprit is atherosclerosis (fatty streaks in the arteries).

Another potential risk factor is a resting heart rate greater than 80 beats per minute (bpm). In one study, healthy men and women had 18 and 10 percent increased risks of dying from a heart attack, respectively, for every increase of 10 bpm over 80 (6). A normal resting heart rate is usually between 60 and 100 bpm. Thus, you don’t have to have a racing heart rate, just one that is high-normal. All of these risk factors can be overcome, even family history.

The role of medication

Cholesterol and blood pressure medications have been credited to some extent with reducing the risk of heart disease. The compliance with blood pressure medications has increased over the last 10 years from 33 to 50 percent, according to the American Society of Hypertension.

In terms of lipids, statins have played a key role in primary prevention. Statins are effective at not only lowering lipid levels, including total cholesterol and LDL — the “bad” cholesterol — but also inflammation levels that contribute to the risk of cardiovascular disease. The Jupiter trial showed a 55 percent combined reduction in heart disease, stroke and mortality from cardiovascular disease in healthy patients — those with a slightly elevated level of inflammation and normal cholesterol profile — with statins.

The downside of statins is their side effects. Statins have been shown to increase the risk of diabetes in intensive dosing, compared to moderate dosing (7).

Unfortunately, many on statins also suffer from myopathy (muscle pain). I have a number of patients who have complained of muscle pain and cramps. Their goal when they come to see me is to reduce and ultimately discontinue their statins by following a lifestyle modification plan involving diet and exercise. Lifestyle modification is a powerful ally.

Lifestyle effects

There was significant reduction in mortality from cardiovascular disease with participants who were followed for a very long mean duration of 18 years. The Baltimore Longitudinal Study of Aging, a prospective (forward-looking) study, investigated 501 healthy men and their risk of dying from cardiovascular disease. The authors concluded that those who consumed five servings or more of fruits and vegetables daily with <12 percent saturated fat had a 76 percent reduction in their risk of dying from heart disease compared to those who did not (8). The authors theorized that eating more fruits and vegetables helped to displace saturated fats from the diet. These results are impressive and, to achieve them, they only required a modest change in diet.

The Nurses’ Health Study shows that these results are also seen in women, with lifestyle modification reducing the risk of sudden cardiac death (SCD). Many times, this is the first manifestation of heart disease in women. The authors looked at four parameters of lifestyle modification, including a Mediterranean-type diet, exercise, smoking and body mass index. There was a decrease in SCD that was dose-dependent, meaning the more factors incorporated, the greater the risk reduction. There was as much as a 92 percent decrease in SCD risk when all four parameters were followed (9). Thus, it is possible to almost eliminate the risk of SCD for women with lifestyle modifications.

How do you know that you are reducing your risk of heart disease and how long does it take?

These are good questions. We use cardiac biomarkers, including inflammatory markers like C-reactive protein, blood pressure, cholesterol and body mass index. A cohort study helped answer these questions. It studied both high-risk participants and patients with heart disease. The results showed an improvement in biomarkers, as well as in cognitive function and overall quality of life.

Participants followed extensive lifestyle modification: a plant-based, whole foods diet accompanied by exercise and stress management. The results were statistically significant with all parameters measured. The best part is the results occurred over a very short period to time — three months from the start of the trial (10). Many patients I have seen have had similar results.

Ideally, if patient needs to use medications to treat risk factors for heart disease, it should be for the short term. For some patients, it may be appropriate to use medication and lifestyle changes together; for others, lifestyle modifications may be sufficient, as long as patients take an active role.

(1) Lancet. 1999;353(9147):89. (2) Diabetes Care. 2010 Feb; 33(2):442-449. (3) JAMA. 2005;293(15):1868. (4) Circulation. 2001;104(4):393. (5) Lancet. 2004;364(9438):93. (6) J Epidemiol Community Health. 2010 Feb;64(2):175-181. (7) JAMA. 2011;305(24):2556-2564. (8) J Nutr. March 1, 2005;135(3):556-561. (9) JAMA. 2011 Jul 6;306(1):62-69. (10) Am J Cardiol. 2011;108(4):498-507.

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.         

BALANCE CHALLENGE

Grace Tesoriero of Port Jefferson snapped this balance challenge photo of her daughter Kristen, son-in-law Connor and grandchildren Gracie and Jacob at West Meadow Beach in Stony Brook while they were up visiting from Delaware in July. She writes, ‘I snapped the picture just in time as right after the challenge was no longer balance, but dusting off a lot of sand!’

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

Stock photo

By Elof Axel Carlson

Elof Axel Carlson

Wishful thinking is part of our lives. As a guide to our hopes, it often is realized and that might mean a happy marriage, a successful occupation and a healthy mind and body.  

But reality often thwarts these ideals and desires. This may be through our faults as well as by bad luck. Scientists hope for success when exploring the unknown, but they are taught not to trust wishful thinking.

In my fields of genetics and biology I have witnessed wishful thinking when science is applied to practical ends. The tobacco industry used wishful thinking for over 50 years, denying that tobacco smoke caused cancers, emphysema and heart disease. They blamed instead an unhealthy lifestyle, an unhealthy work environment or stress itself.  

Similarly, nuclear reactor companies used wishful thinking (and still do) to minimize or deny hazards of radiation except at very high doses of exposure. Most geneticists use a linear relation of dose received to gene mutations produced. They have based this on dozens of peer-reviewed publications. Wishful thinking by those who deny harm to a population from low doses of radiation include a belief that at worst small doses of radiation lead to resistance of radiation or that small doses of radiation are negated by strengthening the immune system to repair any damage done to the DNA.  

In our generation wishful thinking has appeared in discussions of severe and more numerous instances of climate change. Here, opponents of ecological response by international treaty argue that such changes are just normal responses to Earth’s cycles of warming and cooling leading to ice ages or long arid climate or that unpredictable ocean currents might shift and bring about these changing weather patterns.  

Critics of government regulations downplay the discharge of waste into rivers, lakes and oceans, and they use wishful thinking in their arguments, claiming “nature repairs itself” whether it is chopped down forests, over farmed land, open pit mining, fracking for natural gas or lands saturated with pesticides and herbicides. They call scientists raising alarm “tree huggers.”  

It would be a wonderful world if everything we did had no harmful long-lasting unintended consequences of what we do. Wishful thinking saves money and effort to prevent toxic products from entering the environment. It allows abusers to create erosion from bad practices clearing land for agriculture. It allows the discharging of massive quantities of carbon dioxide, believing a dwindling ecosystem will sop up the atmospheric carbon dioxide, producing luxuriant plant growth with massive emissions of oxygen. 

What scientists know is that environments are more complex, and we can disturb it with bad consequences for both local and global environments. The needs of 7 billion people can create substantial changes to Earth and we (thanks to wishful thinking) tend to be unaware or choose to deny such bad outcomes.   

Elof Axel Carlson is a distinguished teaching professor emeritus in the Department of Biochemistry and Cell Biology at Stony Brook University.

Stock photo

By Nancy Marr

In July 2015, New York State Chief Judge Jonathan Lippman made permanent the Commission to Expand Access to Civil Legal Services in New York. To measure the impact of the justice gap on vulnerable litigants and others, a task force had been created in 2010 to assess the extent and nature of the state’s civil legal services crisis. 

It held public hearings with civil legal providers, law firms, law schools and other stakeholders statewide and determined that the chronic lack of  free and low-cost legal assistance has led to a crisis in the courts, reflected by the ever-rising number of unrepresented litigants in these cases whose incomes are too low to pay for legal representation (a low-income family of four in New York State earns about 125 percent of the poverty level of $25,750).   

The mission of the commission is to ensure access to justice for all by using every resource, including self-help services, pro bono programs, technological tools and adequate funding (now $100 million of dedicated state funds annually for civil legal services throughout New York State). In order to add more pro bono attorneys, the commission amended the Rules of Professional Conduct to recommend an increase of annual pro bono hours for lawyers and for law school graduates seeking admission to the New York State bar from 10 to 50.   

The commission sought a site for a local pilot in which a strategic action plan could be developed; its goal would be providing effective assistance to all the persons in need and its success could then inform similar efforts in communities statewide. 

Looking at Suffolk County it found significant assets: a supportive judiciary, engaged providers, an active bar association and an involved law school that provides a variety of legal clinics for residents and trainings for legal service providers are significant assets. 

Suffolk’s challenges include its geography, the highest number of veterans in the state, a high percentage of homeless persons and many unaccompanied minors. A substantial  percentage of the population speaks a language other than English at home. 

Because the needs of many community members were still unmet, Suffolk was selected as a pilot. The gaps in legal services in Suffolk County are largest in three areas: family law, immigration and re-entry of veterans and formerly incarcerated individuals. Housing and health care also loom high in need for legal help. 

With funding from the Public Welfare Association, under the leadership of Administrative Judge C. Randall Hinrichs, Suffolk County launched its program with the Suffolk Planning Group, including civil legal aid providers, the judiciary, the Suffolk County Bar and Touro Law Center. Prior to starting the program, they held listening sessions, attended by 70 of the community organizations that are points of entry for people seeking help. 

Despite the number of service providers, many recognized that they were unfamiliar with each other’s services and that gaps exist that present opportunities for community integration and resource awareness. Training will be provided for these organizations and nonlawyer volunteers on how to make effective referrals. Recognizing the importance of talking to people in their own language, and at their level, these organizations can provide assistance to people in need that can prevent the escalation of issues into court matters. 

To publicize the legal resources that exist in Suffolk, and make it easier to navigate the system, the Suffolk Planning Group is soon to launch a website that would include offerings of the many legal service providers and advocacy groups. The two centers for help are Brentwood Public Library, 34 Second Ave., Brentwood, and Middle Country Public Library, 575 Middle Country Road, Selden. Suffolk residents may call 631-822-3272 for appointments with attorneys who provide advice in areas of law to persons in need. Informational materials are available at the centers, as well as training videos. 

The intersections between individuals and the civil justice system are complex. As we begin to break down barriers, we can enable everyone to access the information and effective assistance they need, and in a form they can use. With an integrated system where communities are empowered; courts participate and support access to justice initiatives; and legal service providers are dedicated to serving those in need, the provision of effective assistance will help people improve their lives. 

To view copies of the Community Legal Help Project information flyers in English and in Spanish, visit http://www.lwv-suffolkcounty.org/TakeAction.html.

Nancy Marr is first vice president of the League of Women Voters of Suffolk County, a nonprofit, nonpartisan organization that encourages the informed and active participation of citizens in government and influences public policy through education and advocacy. For more information, visit www.lwv-suffolkcounty.org or call 631-862-6860.

Honeydew melons are a versatile treat and can be used as an ingredient in salads, side dishes, entrees and even drinks. Stock photo

By Barbara Beltrami

I have found that honeydew melons can often be a rather dicey proposition. I frequently think I’ve picked out a promising one only to get it home where it languishes and never ripens. Or it does ripen but the result is a flavorless disappointment. 

Well, that’s no way to start a food column, is it? Let me start over on a more positive note.  

When a honeydew is good, it’s very good. When it’s perfectly ripened, it is an explosion of mouth-watering fruit worthy of its name. On its own, it sings of summer. With other ingredients it’s a perfect foil for salty or slightly bitter flavors. And it’s such a pretty color; just looking at it is enough to cool one off. 

So, if you’re good at picking out melons, or if you’re lucky enough to find a winner, try some of these honeydew recipes.

Honeydew Salad with Honey-Citrus Dressing

YIELD: Makes 4 servings

INGREDIENTS:

1 avocado, diced

Freshly squeezed juice of half a lemon

½ ripe honeydew melon, diced

2 cups baby arugula

4 red radishes, scrubbed and sliced thin

2 tablespoons extra virgin olive oil

1 tablespoon honey

1½ tablespoons lime or orange juice

Salt and freshly ground pepper to taste

4 slices prosciutto, torn into small pieces

DIRECTIONS:

In a large bowl toss the avocado with the freshly squeezed lemon juice to thoroughly coat.  Add honeydew, arugula and radishes; toss again and set aside. In a small bowl whisk together olive oil, honey, lime or orange juice, salt and pepper. When ready to serve, toss with melon mixture; sprinkle prosciutto on top and serve immediately with prosecco and breadsticks.

Honeydew Sorbet with Candied Ginger

Honeydew Sorbet

YIELD: Makes about 3½ cups

INGREDIENTS:

½ cup sugar

½ cup water

4 cups diced ripe honeydew melon

¼ to 1/3 cup candied ginger, finely chopped

DIRECTIONS:

In a small saucepan over medium heat, cook sugar and water until sugar is completely dissolved, about 5 minutes. Set aside to cool. Measure out ¾ cup; reserve and refrigerate any extra for later use. Puree melon in a blender or food processor until very smooth. Measure out 2½ cups. Cover and refrigerate any extra puree for another use. Combine sugar syrup, melon puree and chopped ginger in bowl of ice cream maker and process according to manufacturer’s directions. Transfer to freezer container, cover and freeze for at least two hours. Serve with ginger snaps.

Shrimp and Lobster Salad in Honeydew Bowls

YIELD: Serves 2

INGREDIENTS:

1 cup chopped cooked shrimp

1 cup chopped cooked lobster meat

¼ cup minced celery

¼ cup minced green bell pepper

 1/3 cup mayonnaise

1 tablespoon freshly squeezed lemon juice

1 tablespoon chopped fresh dill or tarragon

¼ teaspoon celery seed

Salt and freshly ground pepper to taste

1 small ripe honeydew, halved and seeded

DIRECTIONS:

In a medium bowl, combine the shrimp, lobster, celery, green pepper, mayonnaise, lemon juice, dill or tarragon, celery seed, salt and pepper; mix thoroughly and scoop into hollowed out honeydew halves. Cover with plastic wrap and chill for one hour before serving.

Kedar Kirane Photo from SBU

By Daniel Dunaief

Some day, a collection of soldiers in the Army may be sleeping in a bunker near an explosion. Their lives may depend on the ability of their bunker to crack, rather than fracture and collapse.

Kedar Kirane, an assistant professor in the Department of Mechanical Engineering at Stony Brook University, recently received a $359,000 grant from the Army Research Office’s Young Investigator Program to develop a computational model to predict the fracturing behavior of woven textile composites under dynamic loading, such as blasts and other impact loads.

In his work, Kirane hopes to develop a model for how composite materials fracture.

Kedar Kirane. Photo courtesy of Mechanical Engineering/Stony Brook University

Ralph Anthenien, the division chief for mechanical sciences in the U.S. Army Research Office, described the process of granting these awards as “very selective.”

The program supports “innovative breakthroughs,” he said. Part of the charter is to fund “high risk research, which won’t have a 100 percent chance of success,” but could provide a way forward for research.

Ultimately, the hope in the work the Army funds is to “protect soldier’s lives and protect Army systems,” Anthenien continued. The research should “make everything for the Army better.”

Kirane suggested that this research could also have implications in civilian life, such as to predict automotive crashworthiness. While it’s possible to consider fractures and cracks at the atomic scale, he said he is focusing on the macro level because the structures he is studying are so large.

“If you start looking at the atomic scale, it would be impossible because we don’t have the kind of computing power we would need” to convert that into buildings, bridges or other structures, Kirane said.

He is exploring the rates of loading for these fiber composite materials and would like to understand how these objects hold up in response to a blast or a projectile hitting it, as opposed to a more gradual progression of stressors.

Kirane will not conduct any of the laboratory work that explores the fracturing and reaction of the materials. Instead, he will use public data to calibrate and verify his model. The grant supports only the development of the model, not the performance of any physical experiments.

While materials are manufactured with different procedures, he is focused on how the materials fracture, crack and branch. The work is “more of a fundamental study rather than an applied study for a particular material,” he said.

One of the areas of focus in Kirane’s research involves analyzing the branching of cracks during fracture. As the cracks branch, they multiply, causing the material to break into multiple pieces.

The speed at which load builds on an object determines its reaction. A slow buildup typically causes one crack to form, while a more rapid load can cause a single crack that can branch and rebranch to produce multiple cracks.

“Being able to model this is complicated,” Kirane said. “The more it fractures, the more energy it can dissipate.” Ultimately, he would like his model to provide the Army with an idea of how much load a structure can withstand before the developing defects compromises its integrity.

In other projects, Kirane’s work will try to extrapolate from studies of smaller objects up to much larger manufactured structures. Ideally, he’d gain a better understanding of how to extend the information up to the scale at which people live.

He starts with objects that are of various dimensions, at 10 by 10 millimeters and then doubles and quadruples the size to determine the effect on their resilience and strength. There are mechanics-based scaling laws to extrapolate the structure strength to larger sizes, Kirane explained. It depends on the material and its fracturing behavior.

“That is the use of having a model: you can do some experiments in the lab, develop the model, calibrate it, use the model to predict the response and the scaling correctly,” he said.

Kirane explained that he usually tries to get data from a published journal, especially from sources where he knows the principal investigators produce reliable research. 

Indeed, sometimes the models can suggest problems with the data.“There is some back and forth” between the bench researchers and the scientific modelers, he said.

Kirane, who joined Stony Brook two years ago, has two doctoral students in his lab, one master’s student and several undergraduates. 

A resident of Westbury, he commutes about an hour back and forth. He enjoys visiting Jones Beach and appreciates the proximity to New York City. 

Raised in Pune, India, Kirane speaks English, Hindi and Marathi, which is his native language. During his schooling, which was in English, he not only pursued his interest in science but also played a percussion instrument called the tabla and was a gymnast. He says he can’t do any of the gymnastics routines from his youth today, although he does practice yoga and his gymnastics training helps. 

As for his future work, he hopes to start collaborating with scientists at Brookhaven National Laboratory, where he’d like to conduct some research at the National Synchrotron Light Source II. He’d like to understand how rocks fracture at the atomic scales.

In his own life, Kirane said he doesn’t recognize failures but sees any result that falls short of his hopes or expectations as a learning opportunity. “If something doesn’t go as planned, it’s an opportunity to retry,” he explained.

Indeed, in Kirane’s research, scientists call the process of fracturing “failure,” but that judgment depends on the context. When structures are “supposed to be sacrificial and dissipate energy by fracturing,” he said, then that “fracturing is good and not equal to failure.”

 

Helios

MEET HELIOS!

This week’s shelter pet is Helios, a 6-month-old potcake rescued from the Bahamas. 

This ray of sunshine is a fun little fella who would love nothing more than to have a home of his own. He loves to go for walks with our volunteers, and enjoys being petted and loved on!  

He’s just an all around nice little dog, weighing approximately 27 pounds; however, he still has a little bit of growing to do. This sweet boy comes neutered, microchipped and is up to date on all his vaccines.

Kent Animal Shelter is located at 2259 River Road in Calverton. The adoption center is open seven days a week from 10 a.m. to 4 p.m. For more information on Helios and other adoptable pets at Kent, call 631-727-5731 or visit www.kentanimalshelter.com.

Yoga can be an effective way to increase bone density. Photo from Metro
Overtreatment and undertreatment of osteopenia and osteoporosis are common

By David Dunaief, M.D.

Dr. David Dunaief

As we get older, bone fractures can have potentially life-altering or life-ending consequences. Osteoporosis is a silent disease where there is bone loss, weakening of the bones and small deleterious changes in the architecture of the bone over time that may result in fractures with serious consequences (1). It affects millions of patients, most commonly postmenopausal women.

One way to measure osteoporosis is with a dual-energy X-ray absorptiometry (DXA) scan for bone mineral density. Osteopenia is a slightly milder form that may be a precursor to osteoporosis. However, we should not rely on the DXA scan alone; risk factors are important, such as a family or personal history of fractures as we age. The Fracture Risk Assessment Tool (FRAX) is more thorough for determining the 10-year fracture risk. Those who have a risk of fracture that is 3 percent or more should consider treatment with medications. A link to the FRAX tool can be found at www.shef.ac.uk/FRAX.

Most of us have been prompted all our lives to consume calcium for strong bones. In fact, the National Osteoporosis Foundation recommends that we get 1,000 to 1,200 mg per day of calcium from diet and supplements if we are over age 50, although recommendations vary by sex and age (2). However, research suggests that calcium for osteoporosis prevention may not be as helpful as we thought.

The current treatment paradox

Depending on the population, we could be overtreating or undertreating osteoporosis. In the elderly population that has been diagnosed with osteoporosis, there is undertreatment. One study showed that only 28 percent of patients who are candidates for osteoporosis drugs are taking the medication within the first year of diagnosis (3). The reason most were reluctant was that they had experienced a recent gastrointestinal event and did not want to induce another with osteoporosis medications, such as bisphosphonates. The data were taken from Medicare records of patients who were at least age 66.

On the other hand, as many as 66 percent of the women receiving osteoporosis medications may not have needed it, according to a retrospective study (4). This is the overtreatment population, with half these patients younger, between the ages of 40 and 64, and without any risk factors to indicate the need for a DXA scan. This younger population included many who had osteopenia, not osteoporosis.

Do we all need calcium?

Calcium has always been the forefront of prevention and treatment of osteoporosis. However, two studies would have us question this approach. Results of one meta-analysis of 59 randomized controlled trials showed that dietary calcium and calcium supplements with or without vitamin D did increase the bone density significantly in most places in the body, including the femoral neck, spine and hip (5). Yet the changes were so small that they would not have much clinical benefit in terms of fracture prevention.

Another meta-analysis of 44 observational dietary trials and 26 randomized controlled trials did not show a benefit with dietary or supplemental calcium with or without vitamin D (6). There was a slight reduction in nonsignificant vertebral fractures, but not in other places, such as the hip and forearm. Dietary calcium and supplements disappointed in these two trials.

Does this mean calcium is not useful? Not so fast!

In some individual studies that were part of the meta-analyses, the researchers mentioned that dairy, specifically milk, was the dietary source on record, and we know milk is not necessarily good for bones. But in many of the studies, the researcher did not differentiate between the sources of dietary calcium. This is a very important nuance. Calcium from animal products may increase inflammation and the acidity of the body and may actually leach calcium from the bone, while calcium from vegetable-rich, nutrient-dense sources may be better absorbed, providing more of an alkaline and anti-inflammatory approach.

What can be done to improve the situation?

Yoga has become more prevalent and part of mainstream exercise. This is a good trend since this type of exercise may have a big impact on prevention and treatment of osteoporosis. In a small pilot study of 18 participants, the results showed that those who practiced yoga had an increase in their spine and hip bone density compared to those who did not (7).

The researchers were encouraged by these results, so they performed another study. The results showed that 12 minutes of yoga daily or every other day significantly increased the bone density from the start of the study in both the spine and femur, the thigh bone (8). There was also an increase in hip bone density, but this was not significant. The strength of the study includes its 10-year duration; however, this trial did not include a control group. Also, while 741 participants started the trial, only 227 finished. Of those, 202 were women. 

Significantly, prior to the study there were 109 fractures in the participants, most of whom had osteoporosis or osteopenia, but none had yoga-related fractures by the end of the trial. The “side effects” of yoga included improved mobility, posture, strength and a reduction in anxiety. The researchers provided a road map of specific beneficial poses. Before starting any exercise program, consult your physician.

The moral of the story is that exercise is beneficial. Yoga may be another simple addition to this exercise regimen. Calcium may be good or bad, depending on its dietary source. Be cautious with supplemental calcium; it does have side effects, including kidney stones, cardiovascular events and gastrointestinal symptoms, and consult with your doctor to assess whether you might be in an overtreatment or undertreatment group when it comes to medication.

References:

(1) uptodate.com. (2) nof.org. (3) Clin Interv Aging. 2015;10:1813-1824. (4) JAMA Intern Med. online Jan. 4, 2016. (5) BMJ 2015; 351:h4183. (6) BMJ 2015; 351:h4580. (7) Top Geriatr Rehabil. 2009; 25(3); 244-250. (8) Top Geriatr Rehabil. 2016; 32(2); 81-87.

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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