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Quality of Life

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We know better. So why can’t we do better?

By David Dunaief, M.D.

Dr. David Dunaief

We are continuously inundated with messages about the importance of including fruits and vegetables in our daily diets. In addition to fiber, they include critical nutrients and micronutrients that keep us healthy and reduce our risks of developing chronic diseases.

Despite this, according to a 2022 report by the Centers for Disease Control and Prevention (CDC), an average of 12.3 percent of U.S. adults met the daily requirements for fruit intake, and an even more abysmal 10 percent met vegetable intake recommendations (1). As you might expect, it follows that we are deficient in many key micronutrients (2).

Why do we care? Most chronic diseases, including common killers, such as heart disease, stroke, diabetes and some cancers, can potentially be prevented, modified and even reversed with a focus on nutrients. 

Here’s a stunning statistic: more than 50 percent of American adults have a chronic disease, with 27 percent having more than one (3). This is likely a factor in the slowing pace of life expectancy increases in the U.S., which have plateaued in the past decade and are currently at around 77 years old.

One indicator of nutrient intake that we can measure is carotenoid levels. Carotenoids are nutrients that are incredibly important for tissue and organ health. I measure these regularly, because they give me a sense of whether the patient might lack potentially disease-fighting nutrients. A high nutrient intake dietary approach can resolve the situation and increase both carotenoid and other critical nutrient levels.

Why focus on a high nutrient intake diet?

A high nutrient intake diet focuses on micronutrients, which literally means small nutrients, including antioxidants and phytochemicals — plant nutrients. Micronutrients are bioactive compounds found mostly in foods and in some supplements. While fiber is not considered a micronutrient, it also has significant disease modifying effects. Micronutrients interact with each other in synergistic ways, meaning the sum of them is greater than their parts. Diets that are plant-rich raise the levels of micronutrients considerably in patients.

In a 2017 study that included 73,700 men and women who were participants in the Nurses’ Health Study and the Health Professionals Follow-up Study, participants’ diets were rated over a 12-year period using three established dietary scores: the Alternate Healthy Eating Index–2010 score, the Alternate Mediterranean Diet score, and the Dietary Approaches to Stop Hypertension (DASH) diet score (4).

A 20 percent increase in diet scores, which indicated an improved quality of diet, was significantly associated with a reduction in total mortality of 8 to 17 percent, depending on whether two or three scoring methods were used. Participants who maintained a high-quality diet over a 12-year period reduced their risk of death by 9 to 14 percent more than participants with consistently low diet scores over time. By contrast, worsening diet quality over 12 years was associated with an increase in mortality of 6 to 12 percent. Not surprisingly, longer periods of healthy eating had a greater effect than shorter periods.

This study reinforces the findings of the Greek EPIC trial, a large, prospective cohort study, where the Mediterranean-type diet decreased mortality significantly — the better the compliance, the greater the effect (5). The most powerful dietary components were the fruits, vegetables, nuts, olive oil, legumes and moderate alcohol intake. Low consumption of meat also contributed to the beneficial effects. Dairy and cereals had a neutral or minimal effect.

How can diet improve your quality of life?

Quality of life is as important as longevity. Let’s examine some studies that consider the impact of diet on diseases that may reduce our quality of life as we age.

A study showed olive oil reduces the risk of stroke by 41 percent (6). The authors attribute this effect, at least partially, to oleic acid, a bioactive compound found in olive oil. While olive oil is important, I recommend limiting olive oil to one tablespoon a day. Each tablespoon of olive oil contains 120 calories, all of them fat. If you eat too much of even good fat, it can be counterproductive. The authors commented that the Mediterranean-type diet had only recently been used in trials with neurologic diseases and results suggest benefits in several disorders, such as Alzheimer’s.

In a case-control study that compared those with and without disease, high intake of antioxidants from food was associated with a significant decrease in the risk of early Age-related Macular Degeneration (AMD), the leading cause of blindness in those 55 years or older (7). This was true even when participants had a genetic predisposition for the disease.

There were 2,167 people enrolled in the study with several different genetic variations that made them high risk for AMD. Those with a highest nutrient intake, including B-carotene, zinc, lutein, zeaxanthin, EPA and DHA- substances found in fish, had an inverse relationship with risk of early AMD. Nutrients, thus, may play a role in modifying gene expression. 

Though many Americans are malnourished, nutrients that are effective and available can improve our outcomes. With a focus on a high nutrient intake diet, we can improve life expectancy and, on an individual level, improve our quality of life.

References:

(1) cdc.gov. Morb Mortal Wkly Rep 2022;71:1–9. (2) cdc.gov/nutritionreport (3) cdc.gov. (4) N Engl J Med 2017; 377:143-153. (5) BMJ. 2009;338:b2337. (6) Neurology June 15, 2011. (7) Arch Ophthalmol. 2011;129(6):758-766.

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 or consult your personal physician.

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Pixabay photo

Over the summer, dozens of nonprofits and organizations hosted beach and park cleanups across Long Island. 

People came together with their trash bags in hand to pick up debris and trash. Families made days out of it, grabbing dinner afterward with the kids. Couples turned it into a bonding experience. 

While it’s inspirational and helpful for members of the community to work together to clean up the communities in which we live, shouldn’t the town government take the lead with these efforts?

To that end, the road along Route 25A in Setauket has eyesores that detract from the beauty and safety of our community, including several dead trees, overgrown gardens, leaves and debris. Street lights that protect pedestrians and help drivers navigate the area are dimming, making them less useful as we approach days with less sunlight.

Long Islanders receive and appreciate the return on investment from their taxes, particularly when roads are cleared after a storm or when children receive excellent educations from public schools. Given the tax bill, however, shouldn’t the town be able to use some of that money for upkeep?

The community doesn’t police itself and shouldn’t need to clean up accumulating messes or detritus from trees or other vegetative growth. Residents can, and should, dispose of their own trash. Landlords should also take responsibility for the space outside their residences.

As for those public places the village, town or county oversees, those responsible for upkeep on those properties should step up their game. 

We appreciate the work the municipalities do, particularly under difficult circumstances and, at times, with limited resources. We are also grateful to the go-getters whose efforts enhance the beauty of the communities we share.

At the same time, we need our elected officials and people with authority to take action to remove these dead trees, fix dim lights and remove garbage by the side of the road. The effort they put in now will save money and aggravation later, as well as improve the local environment.

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Diet may also affect quality of life as we age

By David Dunaief, M.D.

Dr. David Dunaief

Here’s a stunning statistic: 60 percent of American adults have a chronic disease, with 40 percent of adults having more than one (1). This is likely a factor in the slowing pace of life expectancy increases in the U.S., which have plateaued in the past decade at around 78.8 years old (2).

Most chronic diseases, including common killers, such as heart disease, stroke, diabetes and some cancers, can potentially be prevented, modified and even reversed with a focus on nutrients, according to the Centers for Disease Control and Prevention (CDC). 

The truth is that many Americans are malnourished. How could that be, when so many are overweight or obese? We are not a developing country, where access to healthy food is more challenging. Still, malnourishment is common at all levels of socioeconomic class. The definition of malnourished is insufficient nutrition, which in the U.S. results from low levels of much-needed nutrients.

I regularly test patients’ carotenoid levels. Carotenoids are nutrients that are incredibly important for tissue and organ health. They are measurable and give the practitioner a sense of whether the patient may lack potentially disease-fighting nutrients. Testing is often covered if the patient is diagnosed with moderate malnutrition. Because the standard American diet is very low in nutrients, classifying a patient with moderate malnutrition can be appropriate. A high nutrient intake approach can rectify the situation and increase, among others, carotenoid levels.

High nutrient intake

A high nutrient intake is an approach that focuses on micronutrients, which literally means small nutrients, including antioxidants and phytochemicals -— plant nutrients. Micronutrients are bioactive compounds found mostly in foods and some supplements. While fiber is not considered a micronutrient, it also has significant disease modifying effects. Micronutrients interact with each other in synergistic ways, meaning the sum is greater than the parts. Diets that are plant-rich raise the levels of micronutrients considerably in patients.

In a 2017 study that included 73,700 men and women who were participants in the Nurses’ Health Study and the Health Professionals Follow-up Study, participants’ diets were rated over a 12-year period using three established dietary scores: the Alternate Healthy Eating Index–2010 score, the Alternate Mediterranean Diet score, and the Dietary Approaches to Stop Hypertension (DASH) diet score (3).

A 20 percent increase in diet scores (indicating an improved quality of diet) was significantly associated with a reduction in total mortality of 8 to 17 percent, depending on whether two or three scoring methods were used. Participants who maintained a high-quality diet over a 12-year period reduced their risk of death by 9 to 14 percent than participants with consistently low diet scores over time. By contrast, worsening diet quality over 12 years was associated with an increase in mortality of 6 to 12 percent. Not surprisingly, longer periods of healthy eating had a greater effect than shorter periods.

This study reinforces the findings of the Greek EPIC trial, a large prospective (forward-looking) cohort study, where the Mediterranean-type diet decreased mortality significantly – the better the compliance, the greater the effect (4). The most powerful dietary components were the fruits, vegetables, nuts, olive oil, legumes and moderate alcohol intake. Low consumption of meat also contributed to the beneficial effects. Dairy and cereals had a neutral or minimal effect.

Quality of life

Quality of life is also important, though. Let’s examine some studies that examine the impact of diet on diseases that may reduce our quality of life as we age.

A study showed olive oil reduces the risk of stroke by 41 percent (5). The authors attribute this effect at least partially to oleic acid, a bioactive compound found in olive oil. While olive oil is important, I recommend limiting olive oil to one tablespoon a day. There are 120 calories per tablespoon of olive oil, all of them fat. If you eat too much, even of good fat, it defeats the purpose. The authors commented that the Mediterranean-type diet had only recently been used in trials with neurologic diseases and results suggest benefits in several disorders, such as Alzheimer’s. 

In a case-control (compare those with and without disease) study, high intake of antioxidants from food is associated with a significant decrease in the risk of early Age-related Macular Degeneration (AMD), even when participants had a genetic predisposition for the disease (6). AMD is the leading cause of blindness in those 55 years or older. There were 2,167 people enrolled in the study with several different genetic variations that made them high risk for AMD. Those with a highest nutrient intake, including B-carotene, zinc, lutein, zeaxanthin, EPA and DHA- substances found in fish, had an inverse relationship with risk of early AMD. Nutrients, thus, may play a role in modifying gene expression. 

Though many Americans are malnourished, nutrients that are effective and available can alter this predicament. Hopefully, with a focus on a high nutrient intake, we can re-ignite the pace of increased life expectancy and, on an individual level, improve our quality of life.

References:

(1) cdc.gov. (2) macrotrends.net. (3) N Engl J Med 2017; 377:143-153. (4) BMJ. 2009;338:b2337. (5) Neurology June 15, 2011. (6) Arch Ophthalmol. 2011;129(6):758-766.

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.       

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Tracy Kosciuk hopes to take incumbent Valerie Cartright's seat for Council District 1 in Brookhaven.

Valerie Cartright (D-Port Jefferson Station) is running for her fourth term as Brookhaven Town councilwoman in District 1. Her challenger is one of her neighbors, Tracy Kosciuk.

Cartright sat down with the TBR News Media editorial staff Oct. 25 to talk about her accomplishments and initiatives, while Kosciuk, a registered nurse at St. Charles Hospital, answered questions via email due to being on a trip to Albany. The nurse is a local union president who travels to the state capital to lobby for improved working conditions.

“There are several projects that have been in the planning stages for years — stagnated by red tape.
— Tracy Kosciuk

 

Kosciuk said if elected to the Town Council she plans to continue working as a nurse and promises she would give town issues the same 24/7 attention she gives to her nurses, as she recognizes the council position is a full-time job.

“I am a multitasker, ask any of my nurses, friends or family — I work with commitment to the task and get the job done,” Kosciuk said.

She said the primary reason she is running this year is the frustration people feel when one doesn’t fulfill the obligations of their job. The nurse and union leader said she is also a wife and a mother, who cares for a sick parent. A firm believer in time management, she said she will make the necessary adjustments to her life “to guarantee to my constituents a much better degree of responsiveness and dedication to my office than what they are currently receiving.”

Cartright said being a councilwoman is a full-time job, and because of that while she maintains her license to practice law, she only handles two or three cases annually. She said she spends the majority of her time in Town Hall meeting with various departments, dealing with constituents’ issues and meeting with residents at her mobile offices or in people’s homes. She said there are also community events to attend and meetings with civic groups and chambers of commerce.

“I’m very much a hands-on person,” she said. “I’m visual. I need to see what it is that the constituents are talking about.”

Cartright said she and her staff handle an average of 3,000 to 3,500 calls on a yearly basis and receive more requests via email. The issues can vary from a pothole in front of someone’s house to drainage problems to a resident asking for help with National Grid to get their lights turned back on. She encourages people to call her in addition to the department or entity responsible as she said she considers herself an advocate for her constituents.

Both candidates are focused on local issues, including revitalization in the district.

Kosciuk said she believes one of the largest issues facing the town is “the prevalence of illegal housing and also buildings that are referred to as ‘zombie homes.’” While she believes Supervisor Ed Romaine (R) and other town councilpersons have been addressing the issue, she said in Council District 1, based on her walking through the communities and talking to residents, that it hasn’t been sufficiently addressed.

“As I have said many times, these illegal housing conditions are a magnet for crime, drugs and an undesirable element that our communities and neighborhoods can do without,” the nurse said.

Cartright, who bought a zombie home when she moved to Port Jeff Station from Queens 14 years ago, said she encourages residents to alert her office about homes they believe may be abandoned or if there are drug issues.

For the past few years, Cartright has been working on revitalization projects for the Route 25A corridor in the Three Village area and to create a walkable downtown hub in Port Jefferson Station between the train tracks and Route 347.

“I look forward to tackling the remaining quality of life issues,” she said.

“We did that because a community member felt comfortable enough and was willing to say, ‘Valerie, can you help?’”

— Valerie Cartright

Regarding the PJS plan, she has met with the two major landowners to discuss recommended density and site plans. She is also working with Suffolk County to create a sewer district in the area. With the Three Village 25A corridor plan, she said the work is more about historical architectural continuity, something that residents showed a concern for during visioning meetings she spearheaded.

Kosciuk, on her website, stated she would continue with current revitalization projects and help small business owners succeed, calling them the cornerstone of the community.

“There are several projects that have been in the planning stages for years — stagnated by red tape,” she said.

“It is to our benefit that these projects are completed in order to revive our community and provide a much-needed ‘face-lift’ for our district,” Kosciuk said.

The incumbent said the process can be long at times due to the need for land-use plans before work truly begins.

When it comes to quality of life issues, Cartright is currently working to allow town vehicles to provide transportation for those who are looking to enter temporary housing or clinics. The initiative was inspired by a couple who the councilwoman said she waited three hours with after they agreed to go into temporary housing. The cab was a third party hired by the county, but there was miscommunication that left her and the couple stranded. She is currently working with a task force to deal with homeless issues that includes the Port Jefferson Station/Terryville Civic Association and Port Jeff village officials. She said the group has spent six months gathering information.

“There are a lot of misconceptions, in my opinion, as to where the root of all of this is coming from,” she said.

Both candidates hope to tackle the drug crisis in the area.

Kosciuk, who has been a nurse for more than 30 years, called it a problem of epic proportions

“It is essential to work with area hospitals and treatment centers to establish a more comprehensive discharge plan for patients suffering from this disease,” she said, adding the importance of providing resources to educate residents on the dangers of illicit drugs.

Cartright helped to form a community-based drug prevention coalition that holds education events, which will also include vaping cessation workshops for teenagers. The councilwoman said she hopes the workshops will be an alternative to students being suspended from school. The coalition was formed after Sal Pitti, president of the Port Jefferson Station/Terryville Civic Association, approached her saying he identified money from the federal government.

“We did that because a community member felt comfortable enough and was willing to say, ‘Valerie, can you help?’ and I believe government is supposed to help people and not hinder initiatives,” she said.

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Suffolk County Police Commissioner Tim Sini speaks about new police cameras at each of the seven precincts during a press conference in Greenlawn. Photo by Kyle Barr

By Kyle Barr

Be careful what actions you take, because the police are watching.

Suffolk County Police Department officials announced the implementation of 12 overt surveillance cameras throughout the county July 10, in an effort to deter crime.

The pilot program began in October 2016 with the implementation of a single camera in both the 1st and 2nd precincts. Suffolk County Police Commissioner Timothy Sini said that cameras were installed in the five other precincts early June.

Two of these cameras were positioned in Huntington Town, with one displayed on top of a telephone pole outside a small shopping center at the corner of Rockne Street and Broadway in Greenlawn.

“We want people to know about it.” Sini said of the camera program. “Local government is doing everything in their power to increase the quality of life in our communities.”

Suffolk County Legislator William “Doc” Spencer (D-Centerport) said that the town is dealing with the impact of several recent crimes, specifically recent shootings in Greenlawn that are “all too fresh in our minds.”

“These incidents of crime take away the feeling of safety,” Spencer said. “We will not tolerate violence in our community. These cameras put criminals on notice to say, ‘Don’t come here.’”

The cameras are full color and full motion, and can be accessed remotely through any officer or SCPD official that has access to Wi-Fi. The camera equipment was purchased for about $130,000 in a program funded by SCPD asset forfeiture dollars. However, the plan for a new real-time crime center, part of which will be to monitor the overt security cameras, will be created using SCPD’s normal operating budget.

The cameras are additions to a surveillance system that includes a number of license-plate readers along intersections and hidden cameras placed in areas such as local public parks.

“While the discreet cameras catch crime, the overt cameras do the same but they deter crime as well,” Sini said.

SCPD officials said that depending on community feedback, the cameras could be moved into different positions or to different areas.

On the topic of privacy, Sini responded that people should not expect privacy in a public space.

“The message we want to send is think twice before doing something illegal — think twice before doing something that demotes the quality of life for our residents, because we are watching,” Sini said.

Several nearby residents were happy to have the new camera system in their community.

“It’s a blessing,” said Greenlawn resident Earline Robinson about the implementation of the camera. She said she was concerned about crime, including gang activity, in the area and especially those of several shootings that happened in the community just in the past month.

President of Greenlawn Civic Association, Dick Holmes, said he had high expectations for the cameras and the police department.

“I think it’s a great idea,” he said. “We’ll see what it does and I guess we’ll see how it goes from there.”

The cameras are meant to be hung from telephone poles and are colored bright white and wrapped with a blue stripe that reads “police.” The camera positioned outside the shopping center in Greenlawn looks down at a strip that has been the site of a number of crimes, including several robberies.

One Stop Deli owner Mohammad Afzaal said that in the nine years he’s owned his store, it had been raided four times. Once, robbers broke into the safe behind the counter, and several times he had walked in to find the store in disarray. From those robberies, he estimates he lost about $11,000.

“Sometimes my camera doesn’t work,” Afzaal said, pointing to the camera hanging in the corner of his store. “But the camera out there, it will work.”

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Brookhaven Town wants to limit the number of cars allowed per house. Photo by Elana Glowatz

Long Island is infamous for its numerous layers of government, and sometimes those layers try to legislate too much of our lives.

An underlying misconception about what truly affects “quality of life” is forcing our elected officials to pitch laws that are more knee-jerk reactions and overregulation than appropriate responses. We are seeing it in several North Shore communities, like in Brookhaven Town this week.

As part of the town’s fight against overcrowded and illegal rental houses — many of them inhabited by students in the neighborhoods around Stony Brook University — officials want to limit the number of allowed vehicles per bedroom in a house, to help them track the number of people living in a home.

But elected leaders are reacting based upon unrealistic expectations of what “quality of life” should mean to the average Long Islander.

Telling a homeowner how many vehicles they can have, based on the number of bedrooms in a home, is drawing a dangerous line in the sand. What would that do to the basic Brookhaven nuclear family with four older kids, sharing two bedrooms? What would that do to the average car collector? Let’s also not forget about a different — but relevant — issue on Long Island: It’s difficult to even get around out here without a vehicle because of shoddy public transportation. And now we are going to limit the number of cars a family home can possess?

There are already provisions in place to penalize irresponsible neighbors who make too much noise, don’t properly dispose of trash or park on lawns — true quality of life issues. Cracking down on vehicle ownership is beyond the pale, especially if everyone is parked legally. If we cannot use existing provisions to track or police rentals, perhaps they are not enough of a nuisance for us to get involved.

Neighborhoods change. People build. People leave. New people with new personalities come in. These things happen, and it isn’t the job of our county or town officials to make regulations in an attempt to control that.

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