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Yearly Archives: 2015

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Danny Bullis stops in his tracks to maneuver around an opponent and go to goal for Mount Sinai. File photo by Bill Landon

After playing his freshman year at St. Anthony’s, Danny Bullis transferred back to Mount Sinai, and he and his team couldn’t be happier with his decision.

Harold Drumm, the Mount Sinai boys’ lacrosse head coach, first saw the now college-bound attackman when he was in sixth grade, playing on a club team.

“We knew he was going to be a special player,” he said. “He was really good and you could see it even at that age. He just really understood the game and we were excited for him to come on up.”

Drumm would have pulled Bullis up to the varsity level when he was a freshman, but the attack decided to try out St. Anthony’s and upon transferring back to Mount Sinai his sophomore year, made the varsity team.

“He was the quarterback of the offense for the last three years,” Drumm said. “This year he really came into his own and became the talented and determined player that we knew he could become.”

The team went 8-8 his first year on the team, where Bullis scored 21 goals and added 27 assists. In his junior year, the Mustangs went 9-6 and the attack tallied 22 goals and 39 assists.

“We haven’t really had a player like Danny since I’ve been the head coach here,” Drumm said. “We had a couple of really good players in the past when you needed a goal or an assist or were waiting for something to happen, but we never had a player of his caliber to give the ball and to create something.”

Danny Bullis celebrates the Suffolk County win with his Mount Sinai teammates. File photo by Bill Landon
Danny Bullis celebrates the Suffolk County win with his Mount Sinai teammates. File photo by Bill Landon

Bullis excelled his senior year, exceeding his sophomore and junior marks by scoring 45 goals and 37 assists.

His second-to-last goal of this past
season was the most important one of his career.

With 3:41 left in the Suffolk County Class B title game, in front of a large crowd at Stony Brook University’s LaValle Stadium, Bullis scored the game-winning goal to help the Mustangs edge out Sayville, 8-7.

“I can’t even describe the feeling.” Bullis said of scoring the final goal of the game. “It was one of the best feelings I’ve ever had.”

Bullis scored two goals and added two assists in the Mustangs’ first county-title win in years.

“He was definitely very dedicated and worked hard,” Drumm said of Bullis. “He had the lacrosse ability and he worked real hard in the weight room this last off-season, got a lot stronger, and that made a big difference for him his senior year. I wish I had a Danny ever year.”

The attack is now St. Joseph’s University-bound, and Taylor Wray, the men’s head coach, is thrilled to welcome his new player to the team.

“He’s a huge addition to our team,” the head coach said. “He’s got a terrific skill set, he has an old-school attackman — two-handed, great vision, speed, he’s a feed first kind of player, and he can do a little bit of everything. He can turn the corner and score, shoot the ball pretty well from the outside and he’s a very well-rounded player.”

Wray is hoping that Bullis can compete for time right away and said he believes he has all the tools to do so.

“We are expecting big things from him over the course of his career,” he said. “From a program standpoint, to have a player of Danny’s caliber and skill set on attack, and to have a character guy who puts the team first, is something that gives you a major piece to work with for many years.”

Although initially a baseball player, it seems that switching to lacrosse was another move in the right direction for Bullis, who was unanimously voted an All-American and the Attackman of the Year for Division II.

“It’s one of my greatest accomplishments,” Bullis said of the All-American nod. “Not as great as the county title, though,” he added, laughing.

According to Drumm, St. Joseph’s is a budding lacrosse program that he thinks is a perfect fit for Bullis. For the player’s mother, Janine, she’s just excited to see how far her son has come in the sport.

“The older he got the more he practiced and the more he strived to become the player that he is,” she said. “I’m so proud of how far he’s come. It’s something that I never expected. I don’t even have the words to describe how exciting it is as a parent to watch the progress of not only Danny, but the entire team.”

Bullis said he plans to take a lot of what Drumm taught him with him to college, and he’s hoping it will make him successful at the next level.

“Coach Drumm is one of my favorite coaches,” he said. “Training with him throughout the last few years has made me not only a lot better of a player, but a better person. He taught me hard work will outwork talent when talent’s not working hard, and I’m never going to give up.”

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Brigit DiPrimo is a new assistant principal at Comsewogue High School. Photo by Victoria Espinoza

Comsewogue High School has completed its search for a new assistant principal.

The board of education approved Brigit DiPrimo for a four-year probationary period during a business meeting on Monday night, filling a gap caused by recent shifts in the administration.

“I’m thrilled; this feels like a home away from home,” DiPrimo said in an interview after the meeting. “I’m very excited to get started.”

The Three Village resident previously worked as a principal in Amagansett and before that was an assistant principal at W.S. Mount Elementary School in Stony Brook.

The Comsewogue school district has undergone several administrative changes this year, with the two part-time deans at the middle and high schools being replaced with full-time assistant principals, and DiPrimo’s arrival completes the shift in staff.

Board members had already chosen social studies teacher and former dean James Hilbert to become the new assistant principal at John F. Kennedy Middle School, joining the other assistant principal there, Theresa Etts. At the high school, DiPrimo will work alongside fellow assistant principal Jinu Mathews — the pair of them replacing longtime dean Bill Bodkin, who has retired, and Robert Pearl, an assistant principal and special education teacher who recently left to become principal at Norwood Elementary School.

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Supreme Court judge throws out lawsuit against Shoreham solar project

The DeLalio Sod Farm in Shoreham, where a solar panel facility is in the works. File photo by Erika Karp

Brookhaven Town reached the trifecta of adopting renewable energy codes when it embraced Suffolk County’s model solar code last week.

After previously adopting the county’s geothermal and wind energy codes, the Brookhaven Town Board approved the one for solar, which will permit solar energy production facilities by planning board special permit in the town’s industrial zones. According to Suffolk County Planning Commission Chairman Dave Calone, the town is the first in the county to adopt all three model codes.

“Brookhaven is the place where renewable energy is moving forward,” Calone said prior to a public hearing on the matter on Aug. 6.

Deputy Town Attorney Beth Reilly said the code applies to the town’s industrial districts, L Industrial 1, light industry; L Industrial 2, heavy industry; and L Industrial 4. Permitted uses in light industry include banks, agricultural or nursery uses, places of worship, day cares, health clubs, manufacturing within a building, offices and warehouse spaces, while uses in heavy industry include manufacturing of asphalt, cement fertilizers, and chemicals; junkyards; farmers markets and stockyards. L4 districts deal solely with the generation, transmission and distribution of electrical energy.

“The intent of this section [is] to provide adequate safeguards for the location, siting and operation of solar production facilities,” the code states.

The day before the Town Board’s adoption, a state Supreme Court judge dismissed a lawsuit against the town, its planning board and zoning board of appeals that sought to overturn the town’s approvals for a solar-energy production facility in Shoreham.

Eight Shoreham residents listed under the community group Shoreham Wading River Advocates for Justice filed the lawsuit in November against the town entities, along with sPower, a renewable energy company based in Utah and California, and utilities PSEG Long Island and the Long Island Power Authority. sPower has an agreement to sell power generated at a future 50,000-solar panel facility, located on the DeLalio Sod Farm, to PSEG. Many residents who live near the farm have advocated against it, saying the project is too large for a residential area.

Calone said he believes the new solar code, which outlines where the solar arrays should be located, will lead to new projects being welcomed to communities.

The total coverage of solar panels cannot exceed 60 percent of the lot area and freestanding panels cannot reach more than 20 feet above the ground, according to the code, which also adds buffer and setback restrictions. In addition, the code outlines design standards for the solar panels.

Supervisor Ed Romaine (R) thanked Calone and Councilmembers Valerie Cartright (D-Port Jefferson Station), Jane Bonner (C-Rocky Point) and Connie Kepert (D-Middle Island), who worked with the county on the code.

“The one thing that is so beneficial is getting uniform code that can apply to all 10 towns so there is no guessing,” Romaine said. “It isn’t different from one town to another. It makes it simple for alternative energy to move forward.”

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A friend of mine recently shopped for a dishwasher with son, age 8. He checked out all the specifications from one to the next, examining the price, checking out the Energy Star rating and comparing the colors to the other appliances in his kitchen.

The salesman gave the father and son team an overview of all the features. When my friend asked about the energy efficiency, the salesman suggested he could get one with a particular rating, but it was not that big of a deal.

My friend’s son insisted, “Hey, it protects the environment. You need to tell people that when they’re buying it.”

My friend does energy research, where he tries to find the most efficient way to produce energy, although not for dishwashers necessarily. He spends his days designing, developing and refining plans to reduce greenhouse gas emissions while keeping down the cost of supplying the energy.

When he told me this story, he said he realized that his son, who didn’t always seem to pay attention to what his father said, was listening.

When our kids were young, my wife and I used to say, “The recorder is on.” That was a reminder that we might be venturing into conversational areas that weren’t appropriate for our children or that we might want to avoid saltier language.

Did treading lightly around difficult subjects and avoiding curses help our children at all? Well, we’d like to think so, at least back then. Still, the way we speak to, about or in front of our children matters.

That brings me to the recent Republican presidential debate at the home of the Cleveland Cavaliers, and near the Rock and Roll Hall of Fame. There was a candidate, Donald Trump, who made some pejorative comments about a moderator for the debate, Megyn Kelly of Fox News. He continued to go on the attack, even suggesting that Kelly should apologize to him for her tough questions.

Even in the moment, when challenged by a woman about his perspective on women, he insisted, with some effective humor, that he didn’t have time for political correctness and that he wasn’t referring to all women, only one, with whom he has an ongoing public feud.

But wait, a politician, who wants to be the leader of our country and of the free world, doesn’t have time for political correctness? Yeah, I get it, he’s barnstorming around the country, full of bluster and self-importance, blending entertainment and outrage in one big, hairy ball.

What happened to the notion of nuanced negotiations? Shouldn’t our leaders demonstrate the kind of statesmanship that enables them to discuss important matters with the leaders of other nations, without running the risk of alienating them and damaging our negotiating position?

Maybe Trump, the latest guy running for president, has a corollary to President Theodore Roosevelt’s “speak softly and carry a big stick” ideology. Perhaps he believes he’ll be more effective if he speaks loudly and brashly and carries a big stick.

Whatever his philosophy, it seems like the manner in which he delivers his messages isn’t exactly what we might like from a role model for our country and for the world.

Does attacking the moderator of a debate in which he’s trying to demonstrate his leadership skills underscore his effectiveness as a leader?

Perhaps Trump, and we, might want to consider the lessons we teach. If he was in a store buying a dishwasher with a younger relative, would he really want the next generation to insult the salesman and then demand an apology?

Whatever, Cleveland was rocking and the rest of the United States watched in record numbers.

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From left, Dana Bush, Michael Giordano, James D. Schultz, Frank Gilleece, Amanda Geraci and Sue Anne Dennehy in a scene from ‘The Pied Piper’ at Theatre Three. Photo by Sari Feldman/Franklin Inc.

Currently in production on the Mainstage, Theatre Three’s Children’s Theatre brings us a kinder, gentler musical version of the classic fairy tale “The Pied Piper.” Written by Jeffrey E. Sanzel and Kevin F. Story and adapted from “The Pied Piper of Hamelin” by the Brothers Grimm, it tells the tale of a town that has a bit of a rodent problem. Millions of rats, some the size of toasters, have taken over every nook and cranny. Even the cats are afraid of the rats!

The mayor decrees that anyone who can come up with a successful plan to rid the town of the rats will receive 100 gold pieces. A mysterious stranger appears and convinces the mayor to pay him 974 gold pieces. With a handshake and a promise, a deal is made and the Pied Piper lures the rats away by playing his magical flute. When the mayor has a change of heart and refuses to pay the full amount, the piper seeks revenge by placing the children under a magical spell and leading them out of the town and into a mountain.

With six talented adult actors at the helm, the cast also includes 45 young actors from the theater’s summer Dramatic Academy workshop who portray the children of Hamelin. Frank Gilleece plays Mayor Bruce Armbuckle who does whatever his wife, Mrs. Hilda Arbuckle, played by Sue Anne Dennehy, tells him to do, which includes going back on his word. James D. Schultz plays the bumbling Police Chief Henry Kahnstible and his wife, Mrs. Natasha Kahnstible, is played with aplomb by Amanda Geraci. Dana Bush as Mrs. Lavinia Brewster, the richest woman in town, is terrific.

However, it is the amazing Michael Giordano as the Pied Piper who steals the show. Making his entrance toward the end of the first act, he commands the stage with his wonderful rendition of “I Can Rid You of the Rats.” The audience is entranced as he sings and dances and performs his signature one-handed cartwheel.

While all the young actors did a fine job, special mention should be made of Jamie Terlecki, as Lydia, the lone child left behind. A bright future awaits her on the theater stage.

Accompanied on piano by Steve McCoy, the songs are playful and fun. Choreography by Sari Feldman is top notch, especially with “Hope Springs Eternal” and “The Blame,” as are the costumes, designed by Amanda Geraci.

Sanzel and Story’s play goes beyond the traditional tale of the Pied Piper with messages about keeping your word, cheating, forgiveness and, for the parents, that children are more valuable than gold. And that is the real magic behind this wonderful production.

Meet the cast in the lobby after the show and take a selfie. Next on the agenda is “Squawk: The Live Bird Show” on Aug. 23, a brand new musical titled “Alice’s Wonderland Adventures” from Oct. 3 to 30 and a Halloween Party for ages 4 and up on Oct. 24.

Theatre Three, 412 Main St., Port Jefferson will present “The Pied Piper” on Aug. 7, 8, 14 and 15 at 11 a.m. and Aug. 8 and 15 at 2 p.m. Tickets are only $10 each. For more information, call 631-928-9100 or visit www.theatrethree.com.

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By Matthew Kearns, DVM

“Ooooooh … those itchy ears. My dog or cat is constantly scratching or shaking its head. I feel terrible for them and it sometimes keeps me up at night. My vet calls it an ear infection. It clears up on the medication but once finished it keeps coming back. Why does this happen?”

That is the million dollar question (actually, I’m sure millions of dollars are spent on ear infections every year).  To call every dog or cat that comes in with itchy ears an ear infection is misleading. 

These pets have otitis externa, and “otitis externa” literally means inflammation (not infection) of the external ear canal. Although we veterinarians commonly dispense medications with antibiotics and antifungals in them, the bacteria and yeast we are treating are considered natural flora (in the ear canal at all times in lower numbers).

So why do we get “flora gone wild”?  Usually some other primary trigger is involved and the infection is secondary overgrowth. Examples are parasitic infections (ear mites), pets that swim or get baths and get water (and shampoo) in their ears, ear tumors (both benign polyps and cancerous tumors) etc.  However, the most common cause of recurrent otitis externa is allergies. I consulted with a veterinary dermatologist, and she estimated that between 80 and 90 percent of all recurrent otitis externa in dogs is related to allergies. 

To understand why an allergy would cause such problems in the canine and feline ear canal we first have to describe the anatomy. Unlike a human ear canal, which has a shorter external component in a horizontal direction only, the canine and feline external ear canal is much longer and has both a vertical and horizontal component. Therefore, there is a much greater distance from the opening of the ear canal to the ear drum. This shape and extra distance plays a critical role in otitis externa.

Also, the healthy ear canal is lined with three types of cells: epithelial cells (those similar to skin), ceruminous cells and apocrine cells (cells that produce earwax).  Just like the epithelial cells of the skin, these cells will be replaced every few days. The new cells push the old (dead) cells out to the entrance of the canal, and the small amount of earwax produced in the healthy ear migrates out with the dead epithelial cells.

However, if the lining of the ear canal becomes inflamed, it narrows due to swelling and excessive earwax is produced. This not only overwhelms the ability to clear the wax, it also leads to a warm, dark and moist environment and allows the normal bacteria and yeast to overgrow and a true ear infection is produced.

This will clear up with medication but, if your pet is exposed to the same trigger, it will come back again. Certain breeds such as Labrador retrievers, golden retrievers, cocker spaniels, shar-peis and many others may have complicating factors such as hair in the ear canal, floppy ears, narrow ear canals or a combination of these things. Now, this does not mean that every member of these breeds is guaranteed to have chronic ear infections, rather it means that if you have a member of these breeds and they have even low-grade allergies the ears can spiral out of control quickly.

In my next article I will describe how to manage chronic or recurrent otitis externa.

Dr. Kearns has been in practice for 16 years and is pictured with his son, Matthew, and his dog, Jasmine.

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Maria Raheel, instructor at LISUP, strikes a pose on the board. Photos by Michael Chinnici

By Lisa Steuer

While surfing on Long Island is not extremely common, stand up paddleboarding is more popular than ever in the warmer months — and the good news is that you don’t need to be experienced to get started.

Long Island SUP is just one of the local companies with introductory classes featuring certified instructors, rentals, tours and even fitness classes on the paddleboard. In operation for the last 10 years, LISUP offers paddle boarding on Fire Island and in Smithtown and Patchogue.

Owner and instructor Joe Funaro was a surfer and a life guard, and also does windsurfing and kitesurfing — so getting into paddle boarding was a natural progression for him, he said.

“Surfing on Long Island is very difficult because the weather conditions have to be perfect to surf – it has to be a north wind at low tide,” said Funaro. “Stand up paddleboard surfing, because there is a paddle, enables you to surf smaller waves.”

At LISUP, first-timers typically start with the introduction to stand up paddle boarding class before coming back to rent boards and venture out on their own. In addition, like many other paddleboarding companies, LISUP also offers yoga/paddle fitness classes. More and more yogis are taking their practice to the paddleboard and the water because it creates more instability, making your core work harder.

“We call it yoga fusion because we are fusing both disciplines… so there are a lot of Pilates moves in it, there’s a lot of yoga in it, and then there’s core strength,” said Funaro.

Paddleboarding itself is not too difficult to learn – it’s harder to understand the wind direction, said Funaro. On the North Shore, for example, the wind is pushing you away from the beach toward Connecticut, while on the South Shore, the wind is pushing you in toward shore.

And while injuries are not too common, it’s important to be aware of your environment when paddleboarding and to look out for boats. If a boat creates a wake, “that wake is similar to somebody running through a stop sign; you’re not expecting that,” he said.

Plus, another way to ensure a safer paddleboarding experience is to simply go to a place like LISUP that has certified instructors and areas they already use for paddle boarding, rather than attempting to go out by yourself. “We have our locations to rent the boards because those areas we know best as far as what’s under the water,” he said.

The popularity of paddleboarding continues to grow, and there are also more long-distance races popping up, said Funaro, who has done a race around Manhattan. He has also paddled to Connecticut and Fire Island among others, and also offers paddling tours to those places as well, in addition to sunset paddling.

LISUP offers paddle boarding until October. For more information, visit www.longisland-sup.com.

Get on board
In addition to LISUP, here are a few more local stand up paddleboard companies:

  • Step Into Liquid Stand Up Paddle Board Long Island: Cold Spring Harbor. Contact: 516-302-6852.
  • Epic Paddle Boarding: Various locations. More information: www.epicpaddleboarding.com.
  • Huntington Stand Up Paddle Board: Huntington Harbor. More information: www.huntingtonsup.com.

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Sea bass will continue to remain on the North Shore in August. Above, Angelo Peluso and Adrian Mason show off their catches. Photo from Angelo Peluso

By Angelo Peluso

As we move into late summer, fishing has hit peak strides throughout the entirety of the Long Island Sound. Despite the sweltering heat that often accompanies August, the eighth month of the year contains National Smile Week, and if you play your fishing cards right you just might smile broadly while finding some of the best local fish of the year.

August brings many surprises along the North Shore of Long Island. Many anglers take time off during the often scorching days of late summer, relenting to the call of the beach and BBQs. But succumbing to the myth of the dog days is a big mistake. August brings with it numerous and exciting fishing opportunities. The cool depths of the Long Island Sound and abundant bait can keep fishing vibrant and at times hectic. This is especially true of the central regions of the Sound where, striped bass, bluefish, fluke, porgies and seas bass can be caught with a high degree of regularity.

Water quality in the Long Island Sound is at its finest along the central portions of the North Shore. The month, named in honor of Augustus Caesar, also brings with it the strong possibility of visitations by some highly anticipated pelagic species: Atlantic bonito, little tunny and Spanish mackerel. With conducive bait and water conditions, those highly coveted light tackle gamesters should show in numbers sufficient to warrant expanded time on the water. All significant recreational species are in season and several ocean-roaming species visit local waters.

Summer flounder, also called fluke, have been in abundance and will continue to be caught through to the season’s end on Sept.  21.  Although it appears at times that anglers need to weed through dozens upon dozens of undersized fluke and sea robins to be rewarded with a limit of keeper summer flounder, bigger fish are still around and patience pays dividends. August usually also witnesses some of the largest striped bass catches of the season. Nighttime moon tides and drifted eels will typically relinquish some of the finer specimens of bass. While some of the largest bass will succumb to large natural baits, casting artificial lures early and late in the day will yield bass.

All the other popular summer game fish species will also continue to remain along the North Shore: bluefish, scup and sea bass. Bluefish have been prolific, but beginning in July, larger pods of marauding “choppers” began moving inshore to feast on snappers. That predation pattern should continue through August and into the fall. This is a great time to cast large top-water plugs to snag what just might be the largest bluefish of the year. Porgy, aka scup, fishing is now as hot as the weather. There are lots of these tasty scup around, but finding the jumbo porgies will take some searching in deeper water. At this time of year, smaller scup can be found well inshore and often well within reach of shore anglers fishing around jetties, rock groins, boulders and other structures. Porgies are the most democratic fish that swim in the Sound, and they can be caught by just about anyone who fishes for them. If you’d like a little different kind of fun with porgies, try feeding them small artificial baits. Scent-infused plastic lures work wonders on porgies, as do small flies. Sea bass will also present themselves this month.  To date, there have been some impressive catches of quality sea bass, and those results should continue for the remainder of the season. Deep water structure is the key to this form of bass fishing. So get out there and have a great, safe month on the water. The fish will be waiting.

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Downed trees were a common sight along Route 25A in the Setauket- East Setauket and Stony Brook areas. Photo by Rohma Abbas

The winds have subsided, but Setauket and Stony Brook still have a lot of debris to clean up since last week’s brutal storm sent the North Shore for a spin.

An early morning windstorm made its way through the area early last Tuesday morning, toppling trees and downing power lines. The electricity has since been restored, a spokesman for PSEG Long Island said, and the utility has been providing more than 600 workers to ensure all temporary repairs are made permanent. Most roads have been cleared of fallen trees, and the town has been moving nearly 1,000 cubic yards of material a day amid cleanup efforts.

But there is still a ways to go.

Brookhaven Highway Superintendent Dan Losquadro (R) said it could take another two to three weeks for Setauket and Stony Brook to be declared 100 percent passable. In the immediate aftermath of the storm, Losquadro said his team buddied up with utility PSEG to help remove trees from roadways while grappling with fallen utility poles and electric wires. Now, he said it’s all about following through on the stragglers.

“This week, we’ve been bringing crews in an hour early each day to continue the debris removal process,” he said in a phone interview this week. “While we have shifted skeleton crews back out to their respective districts, a vast majority of my assets are still deployed in this area doing debris removal.”

Losquadro said the trucks were moving quickly to remove debris and bring it to his department’s Setauket yard to be handled. And he credited a big chunk of his team’s efficiency since the winds came barreling through on his emergency management preparedness.

“We had a plan set up with [the] waste management [department] that they would move their big grinder — the one at the Brookhaven landfill — to an area where we would stage material out of,” he said. “Now, we only have to handle the materials once.”

In prior storms, Losquadro said the town moved waste materials two to three times before they hit a landfill, which slowed down the recovery process and ended up costing more money. But the new plan has made cleaning up more efficient.

On a financial note, Losquadro said the storm will undoubtedly put a dent in his overall budget but his team would remain vigilant in tracking all costs and seeking reimbursement from the state, or the Federal Emergency Management Agency, when the recovery efforts conclude.

“It will be a significant number,” he said. “There’s no two ways about it. It’s a fact that that area was hit harder by this storm than it was hit by [Hurricane] Sandy.”

The highway superintendent said the hardest-hit areas in Setauket and Stony Brook should be able to fully put the storm behind them in a matter of two weeks or so.

“The fact that this was a localized event did allow me to pour many more assets into a smaller area to get the recovery done faster,” he said. “It also allowed PSEG to do the same thing. I, myself, could not be happier with the organization of my operation.”

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There is some thought that obesity may be reaching a plateau. Is this true? It depends on how the data is analyzed. According to one recent study, yes; it is plateaued when looking at short, two-year periods from 2003 to 2011 (1).

However, another, more recently published, study shows a picture that is not as positive (2). The study’s authors believe obesity has not plateaued; when looking over a longer period of time, statistics say that obesity has reached a new milestone.

There are now more obese patients in the United States, 67.6 million, compared to those who are overweight, 65.2 million. This is based on a study that reviewed data from the National Health and Nutrition Examination Survey (NHANES). These results were in adults over the age of 25. This should be an eye-opener. In fact, the researchers go even further to estimate that from the 1988-1994 survey to the 2007-2012 survey NHANES data show that 8 percent more women and 12 percent more men became overweight or obese.

Unfortunately, according to one study, the probability is not very good for someone to go from obese to “normal” weight in terms of body mass index (3). In this observational trial, results show that an obese man has a 0.5 percent chance of achieving normal weight, while a woman has a slightly better chance, 1 percent. This study used data from the UK Clinical Practice Datalink. The data were still not great for men and women trying to achieve at least 5 percent weight loss, but better than the prior data. Patients who were more obese actually had an easier time losing 5 percent of their body weight.

What are two major problems with being obese? One, obesity is a disease in and of itself, as noted by the American Medical Association in 2013 (4). Two, obesity is associated with — and is even potentially a significant contributor to — many chronic diseases such as cardiovascular disease (heart disease and stroke), high blood pressure, high cholesterol, atrial fibrillation, diabetes, cancer, cognitive decline and dementia. When I attended the 28th Blackburn Course in Obesity Medicine in June 2015 at Harvard Medical School, a panel of experts noted that there are over 180 chronic diseases associated with obesity. In this article, we will focus on one significant multifaceted disease, cancer.

Watch out for cancer

One of the more unpredictable diseases to treat is cancer. What are the risk factors? Beyond family history, and personal history, obesity seems to be important. In fact, obesity may be a direct contributor to 4 percent of cancer in men and 7 percent of cancer in women (5). This translates into 84,000 cases per year (6). On top of these stunning statistics, there is about a 50 percent increased risk of death associated with cancer patients who are obese compared to those with normal BMIs (7).

What about with breast cancer?

The story may be surprising and disappointing. According to an analysis of the Women’s Health Initiative, those who were obese had increased risks of invasive breast cancer and of death once the diagnosis was made (8). The severity of the breast cancer and its complications were directly related to the severity of the obesity. There was a 58 percent increased risk of advanced breast cancer in those with a BMI of greater than 35 kg/m2 versus those with normal BMI of <25 kg/m2. And this obese group also had a strong association with estrogen-receptor-positive breast cancer.

However, those who lost weight did not reduce their risk of breast cancer during the study. There were 67,000 postmenopausal women between the ages of 50 and 79 involved in this prospective (forward-looking) study. The researchers do not know why patients who lost weight did not reduce their risk profile for cancer and suggest the need for further studies. This does not imply that lifestyle changes do not have beneficial impact on breast cancer.

Why might this be the case with cancer and obesity?

We find that fat is not an inert or static substance, far from it. Fat contains adipokines, cell-signaling (communicating) proteins that ultimately may release inflammatory factors in those who have excessive fat. Inflammation increases the risk of tumor development and growth (9).

What can we do?

There is a potentially simple step that obese cancer patients may be able to take — the addition of vitamin D. In a recent study in older overweight women, those who lost weight and received vitamin D supplementation were more likely to reduce inflammatory factor IL-6 than those who had weight loss without supplementation (10). This was only the case if the women were vitamin D insufficient. This means blood levels were between 10 and 32 ng/mL to receive vitamin D.

Interestingly, it has been suggested that overweight patients are more likely to have low levels of vitamin D, since it gets sequestered in the fat cells and, thus, may reduce its bioavailability. Weight loss helps reduce inflammation, but the authors also surmise that it may also help release sequestered vitamin D. The duration of this randomized controlled trial, the gold standard of studies, was one year, involving 218 postmenopausal women with a mean age of 59. All of the women were placed on lifestyle modifications involving diet and exercise. The treatment group received 2,000 IU of vitamin D3 daily. Those women who received vitamin D3 and lost 5 to 10 percent of body weight reduced their inflammation more than those in the vitamin D group who did not lose weight.

What does medicine have to offer?

There are a host of options ranging from lifestyle modifications to medications to medical devices to bariatric surgery. Recently, the FDA approved two medical devices that are intragastric (stomach) balloons (11). The balloons are filled with 500 mL of saline after inserting them in the stomach via upper endoscopy. They need to be removed after six months, but they give the sense of being satiated more easily and help with weight loss. One, the ReShape Dual Balloon, is intended to go hand-in-hand with diet and exercise. It is meant for obese patients with a BMI of 30-40 kg/m2 and a comorbidity, such as diabetes, who have failed to lose weight through diet and exercise. In a randomized controlled trial involving 326 obese patients, those who received the balloon insertion lost an average of 14.3 lb in six months, compared 7.2 lb for those who underwent a sham operation.

Lifestyle modifications

In an ode to lifestyle modifications, a recent study of type 2 diabetes patients showed that diet helped reduce weight, while exercise helped maintain weight loss for five years. In this trial, 53 percent of patients who had initially lost 23 lb (9 percent of body weight) over 12 weeks and maintained it over one year were able to continue to maintain this weight loss and preserve muscle mass through diet and exercise over five years (12). They also benefited from a reduction in cardiovascular risk factors. In the initial 12-week period, the patients’ HbA1C was reduced from 7.5 to 6.5 percent, along with a 50 percent reduction in medications.

We know that obesity is overwhelming. It’s difficult to lose weight and even harder to reach a normal weight; however, the benefits far outweigh the risks of remaining obese. Lifestyle modifications are a must that should be discussed with your doctor. In addition, there are a range of procedures available to either help jumpstart the process, accelerate progress or to help maintain your desired weight. Choose wisely with the help of your physician.

References:

(1) JAMA 2014;311:806-814. (2) JAMA Intern Med 2015;175(8):1412-1413. (3) Am J Public Health 2015;105(9):e54-9. (4) ama-assn.org. (6) cancer.gov/cancertopics/factsheet/risk/obesity. (7) N Engl J Med 2003;348:1625-1638. (8) JAMA Oncol online June 11, 2015. (9) Clin Endocrinol 2015;83(2):147-156. (10) Cancer Prev Res 8(7):1-8. 2015 (11) fda.gov (12) ADA 2015 Abstract 58-OR.

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

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