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Symptoms of diverticular disease include fever and abdominal pain. METRO photo
Focusing on fiber can provide dramatic results

By David Dunaief, M.D.

Dr. David Dunaief

Diverticular disease, or diverticulosis, is a common malady that affects us as we age. Thirty-five percent of U.S. 50-year-olds are affected and, for those over the age of 60, approximately 58 percent are affected (1). The good news is that it is potentially preventable through modest lifestyle changes. Here, I will explain simple ways to reduce your risk, while also debunking a pervasive myth — that fiber, or more specifically nuts and seeds, exacerbates the disease.

What is diverticular disease? 

Diverticular disease is the weakening of the lumen, or wall of the colon, resulting in the formation of pouches or out-pocketing referred to as diverticula. The cause of diverticula may be attributable to pressure from constipation. Its mildest form, diverticulosis may be asymptomatic. 

For those who experience symptoms, they may include fever and abdominal pain, predominantly in the left lower quadrant in Western countries, or the right lower quadrant in Asian countries. It may need to be treated with antibiotics.

Diverticulitis affects 10 to 25 percent of those with diverticulosis. Diverticulitis is inflammation and infection, which may lead to a perforation of the bowel wall. If a rupture occurs, emergency surgery may be required.

Unfortunately, the incidence of diverticulitis is growing. As of 2010, about 200,000 are hospitalized for acute diverticulitis each year, and roughly 70,000 are hospitalized for diverticular bleeding (2). For those between 40 and 49 years old, the incidence of diverticulitis grew 132 percent between 1980 and 2007, the most recent data on this population (3).

How do you prevent diverticular disease and its complications? 

There are a number of modifiable risk factors, including diet composition, including fiber intake, along with weight and physical activity.

In a study that examined lifestyle risk factors for diverticulitis incidences, adhering to a low-risk lifestyle reduced diverticulitis risk almost 75 percent among men (4). The authors defined a low-risk lifestyle as including fewer than four servings of red meat a week, at least 23 grams of fiber a day, two hours of vigorous weekly activity, a body mass index of 18.5–24.9 kg/m2, and no history of smoking. They estimated that a low-risk lifestyle could prevent 50 percent of diverticulitis cases. 

Examining fiber’s effects

In terms of fiber, there was a prospective study published online in the British Medical Journal that extolled the value of fiber in reducing the risk of diverticular disease (5). This was part of the EPIC trial, involving over 47,000 people living in Scotland and England. The study showed a 31 percent reduction in risk in those who were vegetarian. 

But more intriguing, participants who had the highest fiber intake saw a 41 percent reduction in diverticular disease. Those participants in the highest fiber group consumed >25.5 grams per day for women and >26.1 grams per day for men, whereas those in the lowest group consumed fewer than 14 grams per day. Though the difference in fiber between the two groups was small, the reduction in risk was substantial. 

Another study, which analyzed data from the Million Women Study, a large-scale, population-based prospective UK study of middle-aged women, confirmed the correlation between fiber intake and diverticular disease, and further analyzed the impact of different sources of fiber (6). The authors’ findings were that reduction in the risk of diverticular disease was greatest with high intake of cereal and fruit fiber.

Most Americans get about 16 grams of fiber per day. The Institute of Medicine (IOM) recommends daily fiber intake for those <50 years old of 25-26 grams for women and 31-38 grams for men (7). Interestingly, their recommendations are lower for those who are over 50 years old.

Can you imagine what the effect is when people get at least 40 grams of fiber per day? This is what I recommend for my patients. Some foods that contain the most fiber include nuts, seeds, beans and legumes. In a 2009 study, those men who specifically consumed the most nuts and popcorn saw a protective effect from diverticulitis (8).

Obesity’s impact

In the large, prospective male Health Professionals Follow-up Study, body mass index played a significant role, as did waist circumference (9). Those who were obese (BMI >30 kg/m²) had a 78 percent increased risk of diverticulitis and a greater than threefold increased risk of a diverticular bleed compared to those who had a BMI in the normal range of <21 kg/m². For those whose waist circumference was in the highest group, they had a 56 percent increase risk of diverticulitis and a 96 percent increase risk of diverticular bleed. Thus, obesity puts patients at a much higher risk of diverticulosis complications.

Increasing physical activity

Physical activity is also important for reducing the risk of diverticular disease, although the exact mechanism is not yet understood. Regardless, the results are impressive. In a large prospective study, those with the greatest amount of exercise were 37 percent less likely to have diverticular disease compared to those with the least amount (10). Jogging and running seemed to have the most benefit. When the authors combined exercise with fiber intake, there was a dramatic 256 percent reduction in diverticular disease risk. 

Thus, if you are focused on preventing diverticular disease and its complications, lifestyle modifications may provide the greatest benefit.

References: 

(1) www.niddk.nih.gov. (2) Clin Gastroenterol Hepatol. 2016; 14(1): 96–103.e1. (3) Gastroenterology. 2019;156(5): 1282-1298. (4) Am J Gastroenterol. 2017; 112: 1868-1876. (5) BMJ. 2011; 343: d4131. (6) Gut. 2014 Sep; 63(9): 1450–1456. (7) Am J Lifestyle Med. 2017 Jan-Feb; 11(1): 80–85. (8) AMA 2008; 300: 907-914. (9) Gastroenterology. 2009;136(1): 115. (10) Gut. 1995;36(2): 276.

Dr. David 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.

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South of the Border Chicken

By Barbara Beltrami

When in doubt — whether company is coming for dinner, whether you have house guests, whether you’ve spent the day at the beach, whether you’re on a staycation, whether it’s just too darn hot to even think of turning on the stove or oven, whether you just can’t do another takeout, or whether you simply cannot think what to make for dinner — throwing some chicken on the grill is the default solution.

If you think of it early enough, you can marinate just about any chicken parts in the fridge while you go about your activities. If you decide too late for that, you can pick up the chicken, raid your herb garden or fridge and create a tasty main dish that’s sure to please even the fussiest guests or family members.

Pollo al Mattone (Chicken Under a Brick)

YIELD: Makes 4 servings

INGREDIENTS: 

2 bricks, wrapped in aluminum foil

One 4-pound chicken

1/4 cup olive oil

1/4 cup dry white wine

4 garlic cloves, chopped

1 1/2 tablespoons chopped rosemary

Freshly squeezed juice from 1/2 lemon

Coarse salt and pepper, to taste

1 teaspoon dried hot red pepper flakes

DIRECTIONS:

Prepare grill to medium, then place bricks on grill to heat up. Remove neck , extra fat, and innards from chicken and discard or save for another use. Place chicken, breast side down on a cutting board and, with poultry shears or a large knife, cut along both sides of spine and remove it. Cut the breast in half lengthwise. Wash chicken in cold water and pat dry with paper towels. 

In a small bowl, combine oil, wine, garlic, rosemary, lemon, salt and pepper and hot pepper flakes. With a pastry brush coat the entire chicken with the mixture. Place chicken halves, skin side down on grill;  place a heated brick on top of each half, close lid and cook for about 10-15 minutes, until skin is crisp and there are dark grill marks\.

Remove bricks, flip the chicken, put bricks back on top and continue to cook  another 10-15 minutes or so, until a meat thermometer inserted at thigh joint reads 170F. Transfer chicken to cutting board and let sit about 5 minutes, then cut into 4 pieces.  Serve with corn on the cob and a tossed salad.

South of the Border Grilled Chicken

YIELD: Makes 4 servings

INGREDIENTS: 

4 skinless boneless chicken breasts

1/4 cup olive oil

2 garlic cloves, minced

2 tablespoons chili powder

2 teaspoons ground cumin

2 teaspoons ground coriander

1 teaspoon paprika

1 tablespoon freshly squeezed lime juice

Coarse salt and pepper to taste

Crushed hot red pepper flakes

Lime wedges

DIRECTIONS:

Butterfly each chicken breast by slicing it almost in half horizontally, then opening it like a book so it lies flat. In a large bowl combine the oil, garlic, chili powder, cumin, coriander, paprika, lime juice, salt and pepper and pepper flakes. Place chicken in bowl and rub it all over with the mixture. Cover and refrigerate 30 minutes. Preheat grill to medium. Use marinade to baste only during first 5 minutes of cooking as it has been in contact with raw chicken and must be thoroughly cooked; grill chicken, turning once, until just turning brown but not dark, about 5-10 minutes per side. Serve immediately with lime wedges, salsa and a salad or cover and refrigerate until ready to serve.

Curried Grilled Chicken

YIELD: Makes 4 servings

INGREDIENTS:

3 tablespoons olive oil

2 tablespoons prepared mustard

2 tablespoons warm honey

1 tablespoon curry powder

Salt and freshly ground pepper to taste

1 small onion, minced

1 garlic clove, minced

1/2 teaspoon cinnamon

4 boneless chicken thighs

1/4 cup fresh cilantro leaves, chopped

DIRECTIONS:

Preheat grill to medium. In a large bowl combine oil, mustard, honey, curry powder, salt and pepper, onion, garlic, and cinnamon. Place chicken thighs in bowl and toss to coat evenly with mixture. Place chicken on grill and baste with marinade only during first 5 minutes as it has been in contact with raw chicken and must be thoroughly cooked. Grill, turning once, until cooked through and meat thermometer inserted in thickest part of thigh reads 170 F. Sprinkle cilantro  over chicken and serve immediately with rice and grilled peaches.

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“All politics is local.” This expression rings truer today than ever before. 

The Framers of the U.S. Constitution envisioned a system of federalism for the United States — one in which the national government was assigned a select number of well-defined powers, with all other powers not delegated by the Constitution reserved to the states. Over the course of American history, however, more and more powers have been delegated to the federal government.

Right now, we are witnessing a turning point in a century-long power struggle between the federal government and the states. Democratic presidents such as Woodrow Wilson, Franklin Delano Roosevelt and Lyndon B. Johnson incrementally augmented the size of the federal government and expanded the scope of its powers. After a century of concentrating power in Washington, the U.S. Supreme Court is now undoing that legacy, returning decision-making authority to lower levels of government. 

Two recent SCOTUS opinions have dramatically altered the balance of power in this country. The court ruled in Dobbs v.  Jackson Women’s Health Organization that the Constitution does not confer a right to abortion. In New York State Rifle & Pistol Association Inc. v. Bruen, the court overruled New York State’s proper-cause licensing requirement for concealed carry of a handgun, making it harder for New York and other states to regulate concealed carry. 

The one interconnecting theme of both of these decisions is that the federal government is yielding much of its power to the states, putting greater pressure on state and local governments to make decisions on behalf of the people. 

No longer are the days of FDR, who saw the federal government as the vehicle to drive the national economy with his New Deal. No longer are the days of LBJ, whose Great Society program sought to eliminate poverty and racial disparities using the federal government as its engine. In this post-Roe America, the power of the federal government is waning, taken out of its hands and placed in the hands of the states.

There are some possible benefits to the decentralization of federal power. For starters, this may reduce voter polarization and division in the United States. With fewer decision-making powers, the stakes will be reduced for congressional and presidential elections. While national security and interstate commerce will always be the domain of the federal government, a host of domestic issues may soon return to the states, meaning state and local elections may soon carry much greater weight.

As power shifts away from the federal government and into our backyards, local residents must maintain an active interest in their state and local legislatures as these bodies will be deciding upon the issues that matter the most. Citizens can — and should — stay informed by reading their local newspapers, where information on these matters is most accessible. And they should remember to write letters to the editor because this remains a tried-and-true method to reach and persuade one’s fellow citizens.

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Markus Seeliger, third from left, with members of his lab, from left, Terrence Jiang. Aziz Rangwala, Ian Outhwaite, Victoria Mingione,YiTing Paung, and Hannah Philipose. Photo from Markus Seeliger

By Daniel Dunaief

When a dart hits the center of a target, the contestant often gets excited and adds points to a score. But what if that well-placed dart slipped off the board before someone could count the points, rendering such an accurate throw ineffective?

With some cases of cancer treatments, that’s what may be happening, particularly when a disease develops a mutation that causes a relapse. Indeed, people who have chronic myeloid leukemia typically receive a treatment called Imatinib, or Gleevac.

The drug works, hitting a target called a kinase, which this white blood cell cancer needs to cause its cells to continue to divide uncontrollably. Patients, however, develop a mutation called N368S, which reduces the effectiveness of the drug.

While mutations typically make it more difficult for a drug to bind to its target, that’s not what’s happening with this specific mutation. Like the dart hitting the center of a board, the drug continues to reach its target.

Instead, in a model of drug resistance several scientists have developed, the mutation causes the drug to decouple.

Pratyush Tiwary with this year’s US top 20 students who are going to the international chemistry olympiad. Photo from Toward

A team of experimental and computational researchers including Markus Seeliger, Associate Professor of Pharmacological Sciences at Stony Brook University, and Pratyush Tiwary, Associate Professor in the Department of Chemistry & Biochemistry at the University of Maryland, published two research papers explaining a process that may also affect the way mutations enable resistance to other drugs.

Seeliger described how different disease-associated mutations bind to Gleevac in a paper published in the Proceedings of the National Academy of Sciences. 

Working with scientists at Memorial Sloan Kettering Cancer Center and Goethe University in Frankfurt, Germany, Seeliger used nuclear magnetic resonance spectroscopy, or NMR. The researchers showed how the drug bound to its target and then released.

Understanding the way diseases like cancer develop such resistance could affect drug discovery, giving pharmaceutical companies another way to prepare for changes diseases make that reduce the effectiveness of treatments.

A ‘hot paper’

Tiwary published research in which Seeliger was a coauthor in late April in the journal Angewandte Chemie that the publication labeled a “hot paper” for its implications in the field. Tiwary developed a way to simulate the kinetic processes that enable the mutated kinases to release the drug.

Tiwary created an artificial intelligence model that extended the time he analyzed the drug-protein interaction from milliseconds all the way out to thousands of seconds.

“Even within the simulation world, if you can quantitatively predict a binding affinity, that’s amazing,” Seeliger said. “It’s extremely hard to calculate kinetics, and he got that right.”

Tiwary, who started talking with Seeliger about five years ago and has been actively collaborating for about three years, uses experimental data to inform the dynamics that affect his simulations.

Seeliger “had done the experiments of the dissociation rates beforehand, but did not have a way to explain why they were what they were,” Tiwary explained in an email. “Our simulations gave him insights into why this was the case and … insight into how to think about drugs that might dissociate further.”

Drug discovery

Tiwary hopes the work enables researchers to look at structural and kinetic intermediates in reactions, which could provide clues about drug design and delivery. While he worked with a single mutation, he said he could conduct such an analysis on alterations that affect drug interactions in other diseases.

He wrote that the computations, while expensive, were not prohibitive. He used the equivalent of 16 independent 64 CPUs for one to two weeks. He suggested that computing advances could cut this down by a factor of 10, which would enable the exploration of different mutations.

“The methods are now so easy to automate that we could run many, many simulations in parallel,” Tiwary explained. Machine learning makes the automation possible.

Given what he’s learned, Tiwary hopes to contribute to future drug begin that addresses mutation or resistance to treatment in other cancers. He also plans to continue to work with Seeliger to address other questions.

Next steps

Seeliger said he plans to extend this work beyond the realm of this specific type of cancer.

He will explore “how common these kinetic mutations are in other systems, other diseases and other kinases,” Seeliger said.

He would also like to understand whether other proteins in the cell help with the release of drugs or, alternatively, prevent the release of drugs from their target. The cell could have “other accessory proteins that help kick out the drug from the receptor,” Seeliger said.

The concept of drug resistance time comes from infectious disease, where microbes develop numerous mutations.

Seeliger, who is originally from Hanover, Germany, said he enjoys seeing details in any scene, even outside work, that others might not notice. 

He described how he was driving with postdoctoral fellows in Colorado when he spotted a moose. While the group stopped to take a picture, he noticed that the moose had an ear tag, which is something others didn’t immediately notice.

As for the research collaboration, Seeliger is pleased with the findings and the potential of the ongoing collaboration between experimental and computational biologists.

“The computational paper, aside from using interesting new methodology, describes why things are happening the way they are on a molecular level,” he said.

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Pixabay photo

By Daniel Dunaief

Daniel Dunaief

I read bumper stickers, buttons, fortune cookies and messages on T-shirts. They are a form of poetry that captures a moment, an approach, an attitude, and a message in fewer words than some of the soupier birthday cards.

Like birthday cards, sometimes these messages work, are amusing, evoke a reaction, or make me laugh for intentional and unintentional reasons.

In the modern world, in which so many interactions seem less than optimal or contrary to the intentions, I have some suggested messages that reflect the current state of customer service and civility, or lack thereof.

— Please don’t interrupt. I’m in the middle of looking busy. When I started working many years ago, someone told me to balance between looking busy and being under control. She suggested I walk quickly and purposefully, even if just to the bathroom, to suggest that I’m too busy to tackle something new that might involve lots of administrative work.

— Yes, I am talking to you. Those of you old enough to have seen the Robert De Niro film “Raging Bull” will understand this one instantly. This message captures the prevalence of confrontations.

— I have no idea what’s good. I don’t eat here. Diners often ask waiters and waitresses, “what’s good.” More often than not, they tell people what’s popular dishes or their specials. The subtext here is that some of them don’t, can’t or wouldn’t eat where you’re eating, especially after spending considerable time in the kitchen.

— Everything and nothing is special today. Keeping with the dining theme, while blending in some grade inflation, waiters could provide something philosophical for their diners to consume.

— I believe in building suspense. The assignment, the job, or even the entree may be later than someone wanted. This message could suggest the tardiness was deliberate and was designed to enhance appreciation and add drama. So, you’re welcome.

— Sure, you can ask. I like the buttons people wear at Yankees games that encourage fans to ask a question. On a day when these customer service professionals are feeling tired or hung over, they could don messages that encourage people to move along or to figure out how to drive home to Pennsylvania from the Bronx on their own.

— How can I appear to help you? Life is all about optics. Yes, we should be helping and yes, people are paid to help each other, in person, on phone and on the Internet. Sometimes, the person (or artificial intelligence programs) that is offering assistance isn’t delivering much.

— I brought my own questions, thanks. I would love it if a politician wore this button to a debate. On one level, it could suggest the candidate has questions that are hopefully substantive for his or her opponent. On the other, it could be an honest way of acknowledging the disconnect between a question about the environment and an answer about the person’s commitment to family.

— What can you do for me? This is a way of turning the tables, literally, on a hostile or inappropriate customer. It also discourages people from asking too much of someone who is not eager to deliver.

— Is there anything else I can’t do for you? I’ve been on numerous calls with people who haven’t done anything, particularly when dealing with traveling details, who then ask if there’s anything else they can help me with. When they haven’t helped me with the first question, it’s hard to imagine they can help with a second. A more honest message might suggest that they also anticipate not being able to provide any help with a second problem or question.

— What did you get me for my birthday? People often want, or expect, something, even from strangers, on their birthday. They don’t often consider that the person from whom they expect service, help or extra treatment had a birthday they likely missed.

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Catch a free screening of 'Encanto' in Port Jefferson or St. James this week.
PROGRAMS

Summer Drop-In Workshop

The Heckscher Museum in Huntington will offer Summer Drop-In workshops all summer. Photo from Heckscher Museum

Join the Heckscher Museum of Art, 2 Prime Ave., Huntington for a Summer Drop-In Workshop every Thursday through Aug. 18 including July 7 and 14 from 10:30 to 11:30 a.m. Create fun works of art in a variety of materials inspired by artwork in the Museum’s Collection and exhibitions. Each week’s project will be exciting and different. Programs will be held both in the Museum and in Heckscher Park. Fee is $10 per child, adults free, payable at the door. (Fee includes all art supplies and general admission to the museum.) Call 380-3230 for more information.

Pop-Up Saturday

The Ward Melville Heritage Organization kicks off its Pop-Up Saturdays at the Stony Brook Village Center’s Inner Court, 97 Main Street, Stony Brook Village on July 9 with a magic show by Magic of Amore from 2 to 3 p.m. Fast-paced & original, this one-of-a-kind performance combines magic, illusion, comedy, and music with lots of audience participation. Rain date is the following day. Free. Call 751-2244 for further details.

Family Concert

Darlene Graham & The Shades of Green Band will present a free family concert at the Huntington Summer Arts Festival at Heckscher Park’s Chapin Rainbow Stage, 2 Prime Ave., Huntington on July 12 at 7 p.m. filled with play time, dancing, bubbles, freeze dance, snuggle time, and songs geared toward family time and imagination. Bring seating. Visit www.huntingtonarts.org.

Stars & Stripes Crafts

In perfect timing with the Fourth of July, the Whaling Museum, 301 Main St., Cold Spring Harbor offers Stars & Strips crafts Tuesdays to Sundays from 1 to 4 p.m. through July 10. Explore the museum’s exhibits and then help yourself to red, white, and blue crafts in the workshop. ​Free with admission fee of $6 adults, $5 kids/seniors. Call 367-3418.

Magic of Amore

Sunken Meadow State Park, Sunken Meadow Parkway, Kings Park presents the Magic of Amore on July 10 at 2 p.m. Part of Long Island State Parks Summer Entertainment, this magic show will amaze and astound no matter your age! Colorful handkerchiefs turn to magic canes and objects materialize out of thin air. BYO chairs or blanket. $10 vehicle use fee. Call 269-4333.

Nature T’s 

Sunken Meadow State Park, Sunken Meadow Parkway, Kings Park presents a Tiny Tots program, Nature T’s, on July 14 from 10:30 to 11:30 a.m. Children ages 3 to 5 and their parents will connect with nature through short walks, animal visitors, and crafts. Bring your own t-shirt for a nature craft. $4 per child. To register visit Eventbrite.com and search #NatureEdventure.

Toothy Tuesdays

Drop by the Whaling Museum, 301 Main St., Cold Spring Harbor on Tuesdays in July for Toothy Tuesday, a shark tooth excavation workshop, from 2 to 4 p.m. Design and create a necklace or keychain featuring your fossil treasure. Admission + $10 participant. Call 367-3418 for more information.

Movies

‘Encanto’

The Village of Port Jefferson kicks off its Movies on the Harbor series with a screening of Disney’s Encanto at Harborfront Park, 101-A East Broadway, Port Jefferson on Tuesday, July 12 at dusk. Bring seating. Rain date is the next evening. Free. For more information, visit www.portjeff.com or call 631-473-4724.

‘Spider-Man’

The Town of Huntington presents a free drive-in movie screening of Spider-Man at Crab Meadow Beach, Waterview Street W., Fort Salonga on Wednesday, July 13 starting at 8:30 p.m. For more information, call 631-351-3089 or visit www.huntingtonny.gov

‘Encanto’

St. James Chamber of Commerce invites the community to Deepwells Farm County Park, 497 Route 25A, St. James for a screening of Disney’s Encanto on the great lawn  on Thursday, July 14 at dusk. Come early at 7 p.m. for fun and and games. Bring seating.  Rain date is July 21. Call 631-584-8510 for further details.

Theater

Disney’s ‘The Little Mermaid’

The Smithtown Center for the Performing Arts, 2 E. Main St., Smithtown presents Disney’s The Little Mermaid from July 2 to July 24. Based on one of Hans Christian Andersen’s most beloved stories and the classic animated film, Disney’s The Little Mermaid is a hauntingly beautiful love story for the ages. Ariel, King Triton’s youngest daughter, wishes to pursue the human Prince Eric in the world above, bargaining with the evil sea witch, Ursula, to trade her tail for legs. But the bargain is not what it seems, and Ariel needs the help of her colorful friends, Flounder the fish, Scuttle the seagull and Sebastian the crab to restore order under the sea. All seats are $25. To order, visit www.smithtownpac.org.

‘Puss-In-Boots’

Join Theatre Three, 412 Main St., Port Jefferson for a hilarious musical re-telling of Puss-In-Boots, the tale of a boy and his ingenious feline, from July 8 to July 30 with a special sensory sensitive performance on July 10. When Christopher inherits his father’s clever cat, he sets out on an adventure that takes him to the palace of King Vexmus and beyond and learns that faith comes from within. $10 per person. To order, call 928-9100 or visit www.theatrethree.com.

‘Elephant & Piggie’s ‘We’re in a Play!’

The Smithtown Center for the Performing Art presents Mo Willems’ Elephant & Piggie’s ‘We’re in Play! outdoors on the grounds of the Smithtown Historical Society. 239 E. Main St., Smithtown from July 9 to July 29. An elephant named Gerald and a pig named Piggie are best, best, “bestus” friends, but Gerald worries that something could go wrong that would end their friendship. Piggie is not worried at all. She’s even happier and more excited than usual. That’s because she and Gerald are invited to a party hosted by the Squirrelles, three singing squirrels who love to have a good time. And so begins a day when anything is possible. Tickets are $18 per person. To order, visit www.smithtownpac.org.

‘Junie B. Jones The Musical’

Children’s theater continues at the John W. Engeman Theater, 250 Main St., Northport with Junie B. Jones The Musical from July 23 to Aug. 28. Sneak a peek into the “Top-Secret Personal Beeswax Journal” of the outspoken and lovable Junie B. Jones! Based on the top selling children’s book series, this upbeat musical follows the spunky Junie as she navigates through the ups and downs of her first day of 1st grade. All seats are $20. To order, call 261-2900 or visit www.engemantheater.com.

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Stock photo

By Leah S. Dunaief

Leah Dunaief

“Are you worried about what’s going to happen to our country?”

This question was posed to me by a younger person I know. He was clearly worried by current events, and with good reason. Our nation is facing a number of serious problems, and, in fact, so is most of the rest of the world.

His question made me think back to some of the chaotic times I remember. Polarization is a painful word being used to describe the United States today, but there were other times in my short lifetime when our country was seriously divided.

I have an early memory of signs hanging in our apartment house elevator. “Impeach Truman,” they urged. I don’t think I knew what they meant, but people on the streets were heatedly saying the same thing. I knew Truman was president, but I certainly did not know anything about impeachment, and I had never before heard of Douglas McArthur, who had been relieved of his command in the Far East for disagreeing with Truman over Korean War tactics. That was a time of polarization, and tensions were high, even in my neighborhood of New York City. The Chicago Tribune editorialized, “The American nation has never been in greater danger.”

Our country moved on.

Everyone who was alive in the 60s well remembers the torments of that decade. Both Kennedy and Martin Luther King were assassinated, civil rights legislation drove friends apart, the Vietnam War caused endless demonstrations and riots, and the Democratic National Convention in Chicago in 1968 was a frightful militarized spectacle epitomizing the nation’s divisions and chaos. It seemed our nation was being torn apart. People wondered if the country would survive.

Our country moved on.

There was Watergate in the 70s and a president of the United States was forced to resign. There were long lines at the gas pumps and wild inflation with stagnation and American hostages in Iran.

Our country moved on.

You get the point. Severe problems have always periodically challenged America, our stability and our way of life. There have been those with evil intent and there have been true heroes. We have been challenged regularly, we have come together and we have moved on.

July 4th, we celebrated our independence, and the flag that belongs to all of us. In our small town America, up and down the Island, we paraded together, fire departments and police departments, conservatives and liberals, Blacks and whites and Latinos and Asians, gay and straight, lifers and choicers. We did so as Americans, proud of our nation despite its many faults, recognizing that we can make our country better even as we cheer the exceptionalism that makes immigrants risk and sometimes lose their lives to get here.

If you read through the Declaration of Independence, as I did this past weekend, you will see the values that bind us together. We must not lose, in the struggles to find our way forward today, the respect in the ending sentence:

“And for the support of this Declaration, with a firm reliance on the protection of divine Providence, we mutually pledge to each other our Lives, our Fortunes and our sacred Honor.”

Let us then start our healing not by putting power over country but by pledging to each other our sacred Honor. That will help unite us, to truly hear each other, and together we can move on. We always have, and together, we always will.

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King James. Photo from Smithtown Animal Shelter

MEET KING JAMES!

This week’s featured shelter pet is King James, a handsome rooster who was found as a stray and never claimed. He is now up for adoption at the Smithtown Animal Shelter.

James is a stunning big boy who adores treats. He will follow at a distance and cluck away, begging for his favorite goodies.  James is  quite vocal when he is happy and comfortable.  He seems to be very social with other animals and has a curious and independent spirit. 

James is a decent flyer for a chicken and will need an enclosed coop as that curiosity does get the better of him. He is a good boy, but the shelter does not have the facilities to keep him safe and happy long term. Their wish is to see him in a home with some girls to keep him company and a family that appreciates how sweet he can be.

The Smithtown Animal & Adoption Shelter is located at 410 Middle Country Road, Smithtown. Visitor hours are currently Monday to Saturday from 10 a.m. to 3 p.m. (Sundays and Wednesday evenings by appointment only). For more information, call 631-360-7575 or visit www.townofsmithtownanimalshelter.com.

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In the U.S., 24.4 million people over the age of 40 have cataracts. Pixabay photo
Reducing oxidative stress with diet may lower risk

By David Dunaief, M.D.

Dr. David Dunaief

The likelihood we will have cataracts that affect our vision increases as we age, but we can take an active role in preventing them. 

A cataract is an opacity or cloudiness of the lens in the eye, which decreases vision over time as it progresses. Typically, it’s caused by oxidative stress, and it’s common for both eyes to be affected.

Cataracts affect a substantial portion of the U.S. population. In the U.S., 24.4 million people over the age of 40 were afflicted, according to statistics gathered by the National Eye Institute of the National Institutes of Health (1). This number is expected to increase approximately 61 percent by the year 2030.

Cataract prevalence varies considerably by gender, with 61 percent of cases being women, and by race; 80 percent of those affected are white. There are many modifiable risk factors including diet, smoking, sunlight exposure, chronic diseases (such as diabetes and metabolic syndrome), steroid use, and physical inactivity. Here, we will focus on the dietary factor.

Impact of meat consumption on cataract risk

Diet has been shown to have substantial effect on the risk reduction for cataracts (2). One of the most expansive studies on cataract formation and diet was the Oxford (UK) group, with 27,670 participants, of the European Prospective Investigation into Cancer and Nutrition (EPIC) trial. Participants completed food frequency questionnaires between 1993 and 1999. Then, they were checked for cataracts between 2008 and 2009.

There was an inverse relationship between the amount of meat consumed and cataract risk. In other words, those who ate a great amount of meat were at higher risk of cataracts. “Meat” included red meat, fowl and pork. These results followed what we call a dose-response curve. 

Compared to high meat eaters, every other group demonstrated a significant risk reduction as you progressed along a spectrum that included low meat eaters (15 percent reduction), fish eaters (21 percent reduction), vegetarians (30 percent reduction) and finally vegans (40 percent reduction). 

There really was not that much difference in meat consumption between high meat eaters, those having at least 3.5 ounces, and low meat eaters, those having less than 1.7 ounces a day, yet there was a substantial decline in cataracts. This suggests that you can realize a meaningful effect by simply reducing or replacing your average meat intake, rather than eliminating meat from your diet.

In my clinical experience, I’ve had several patients experience reversal of their cataracts after they transitioned to a nutrient-dense, plant-based diet. I didn’t think this was possible, but anecdotally, this is a very positive outcome and was confirmed by their ophthalmologists.

Do antioxidants have an effect?

Oxidative stress is one of the major contributors to the development of cataracts. In a review article that looked at 70 different trials for the development of cataract and/or maculopathies, such as age-related macular degeneration, the authors concluded antioxidants, which are micronutrients found in foods, play an integral part in eye disease prevention (3).

The authors go on to say that a diet rich in fruits and vegetables, as well as lifestyle modification with cessation of smoking and treatment of obesity at an early age, help to reduce the risk of cataracts. Thus, you are never too young or too old to take steps to prevent cataracts.

Among antioxidants studied that have shown positive effects is citrus. The Blue Mountains Eye Study found that participants who had the highest dietary intake of vitamin C reduced their 10-year risk for nuclear cataracts (4).

Cataract surgery

The only effective way to treat cataracts is with surgery; the most typical type is phacoemulsification. Ophthalmologists remove the opaque lens and replace it with a synthetic intraocular lens. This is done as an outpatient procedure and usually takes approximately 30 minutes. Fortunately, there is a very high success rate for this surgery. So why is it important to avoid cataracts if surgery can remedy them?

There are always potential risks with invasive procedures, such as infection, even though the chances of complications are low. However, more importantly, there is a greater than fivefold risk of developing late-stage age-related macular degeneration (AMD) after cataract surgery (5). This is wet AMD, which can cause significant vision loss. These results come from a meta-analysis (group of studies) looking at more than 6,000 patients.

It has been hypothesized that the surgery may induce inflammatory changes and the development of leaky blood vessels in the retina of the eye. However, because this meta-analysis was based on observational studies, it is not clear whether undiagnosed AMD may have existed prior to the cataract surgery, since they have similar underlying causes related to oxidative stress.

Therefore, if you can reduce the risk of cataracts through diet and other lifestyle modifications, plus avoid the potential consequences of cataract surgery, all while reducing the risk of chronic diseases, why not choose the win-win scenario?

References: 

(1) nei.nih.gov. (2) Am J Clin Nutr. 2011 May; 93(5):1128-1135. (3) Exp Eye Res. 2007; 84: 229-245. (4) Am J Clin Nutr. 2008 Jun; 87(6):1899-1305. (5) Ophthalmology. 2003; 110(10):1960.

Dr. David 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.

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