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Mediterranean diet. Pexels photo
Diet plays a large role in quality of life as we age

By David Dunaief, M.D.

Dr. David Dunaief

What if I told you that approximately 85 percent of the U.S. population is malnourished, regardless of socioeconomic status and, in many cases, despite being overweight or obese (1)? The definition of malnourished is insufficient nutrition, which in the U.S. results from low levels of much-needed nutrients. Sadly, the standard American diet is very low in nutrients, so many have at least moderate malnutrition.

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). 

Here’s a stunning statistic: more than 50 percent of American adults have a chronic disease, with 27 percent having more than one (2). 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.

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. A high nutrient intake dietary approach can resolve the situation and increase, among others, carotenoid levels.

Benefits of high nutrient intake

A high nutrient intake diet 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 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 (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.

Improving 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 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), 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 improve life expectancy and, on an individual level, improve our quality of life.

References: 

(1) dietaryguidelines.gov. (2) cdc.gov. (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. 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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Asian Style Green Beans. METRO photo

By Barbara Beltrami

If you think this column is going to be about that ubiquitous traditional casserole made with green beans, cream of mushroom soup and French fried onion rings, it’s not. It’s going to be about fresh green beans, aka string beans, young and slender and just off the vine because green beans, like so many other veggies, just taste so different, so much better when they’re fresh picked, and now is the season to take advantage of that. 

You can make them part of a Ligurian pasta dish with potatoes and basil or you can just douse them with lemon juice and olive oil or toss them into a salade Nicoise. You can do the old standby, green beans almandine, or an Asian stir-fry. Or you can try them sautéed with cherry tomatoes, or with hazelnuts and citrus zest or dipped in batter and fried, or even left raw and dunked in your favorite dip.

Pasta with Pesto, Green Beans and Potatoes

YIELD: Makes 8 servings as first course, 4 servings as main course.

INGREDIENTS: 

2 1/3 cups packed fresh basil leaves

1/3 cup pignoli nuts

2 garlic cloves, peeled and chopped

1/2 cup or more extra virgin olive oil

1/2 cup or more freshly grated Parmesan cheese

Salt and freshly ground pepper to taste

1/2 pound potatoes, peeled and quartered

1/2 pound fresh green beans, trimmed and cut into one-inch lengths

1 pound spaghetti or linguine

DIRECTIONS:

In the bowl of an electric food processor, combine the basil, pignoli nuts, garlic, oil, cheese, and salt and pepper; process, scraping bowl often, until a smooth consistency is achieved. To a large pot of boiling salted water add the potatoes and cook until they are not quite al dente, about 5 to 8 minutes; add green beans and continue cooking until potatoes are tender and beans are bright green and tender, about another 5 to 10 minutes. With a slotted spoon, remove potatoes and beans and set aside to keep warm; when potatoes are cool enough to handle, cut them into one-inch cubes. To the potato and green bean water add the pasta and cook according to package directions; drain, transfer to large bowl, add vegetables and pesto and toss to coat thoroughly.  (If mixture seems too dry, add a little of the cooking water to it.) Serve hot with a tomato and onion salad.

Asian Style Green Beans

YIELD: Makes 4 servings

INGREDIENTS: 

2 tablespoons soy sauce

2 tablespoons hoisin sauce

2 tablespoons chunky peanut butter

1/4 teaspoon hot red pepper flakes

2 tablespoons peanut oil 

2 tablespoons chopped shallot

2 teaspoons minced peeled fresh ginger root

1 pound fresh green beans, trimmed

2 tablespoons sliced scallions

2 tablespoons chopped fresh cilantro leaves

DIRECTIONS:

In a small bowl, combine the soy sauce, hoisin sauce, peanut butter and hot pepper flakes. In a large skillet heat oil over medium heat, then add shallot and ginger and, stirring frequently, saute about two minutes, until tender and a little crisp; add green beans and stirring frequently, saute until al dente; add sauce, toss to coat thoroughly, top with scallions and cilantro and serve hot with grilled fish and rice.

Beer Batter-Fried Green Beans

YIELD: Makes 4 to 6 servings

INGREDIENTS: 

1 cup beer

1 cup flour

Salt and freshly ground pepper to taste

Vegetable oil for frying

1 pound green beans, trimmed

DIRECTIONS:

In a medium bowl, whisk together the beer, flour, salt ad pepper. In a large skillet, heat oil over medium-high heat to 375 F. When oil is ready, dip the beans in the batter, let excess oil drip off, then being careful to avoid getting spattered, gently drop the beans into the oil; fry in batches, and when they are golden brown and crisp, after about 5 to 8 minutes, with a slotted spoon remove them to drain on paper towels. Serve hot or warm with margaritas or dry white wine.

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METRO photo

By Jennifer B. Cona, Esq.

Jennifer B. Cona, Esq.

All trusts are not created equally; there are many different types of trusts used for a variety of purposes, such as asset protection planning, financial management, probate avoidance and tax planning. Two common types of trusts in estate and asset protection planning are revocable and irrevocable trusts.

A revocable trust is a trust where you, the trust creator, reserve the right to revoke or change the trust at any time. If properly structured and funded, a revocable trust can be helpful in avoiding probate and allowing for easier management of assets in the event of incapacity. If you own homes in more than one state, it may make sense to place your out-of-state property in a revocable trust to avoid the need for probate in two states. Beware, however, that a revocable trust offers no asset protection. For Medicaid purposes, all of the assets in a revocable trust are considered available and may have to be spent down on the costs of care.

The better option for most older adults is an irrevocable trust. This type of trust cannot be revoked or changed by you alone, but can be with the consent of the trust beneficiaries. The benefit of making a trust irrevocable is that it can be structured as a Medicaid asset protection trust.

An irrevocable trust set up for asset protection purposes can hold almost any type of asset, including your home, bank accounts, and investments. You cannot have access to the principal of the trust, but you can retain the right to receive the income (dividends and interest). After five years have passed, the assets held in the trust are protected with respect to Medicaid. You would not have to spend down those assets on the cost of care; they are protected and will be inherited by your beneficiaries.

By properly planning ahead, your assets can be maintained for quality-of-life items and ultimately left to your heirs. But creating the trust is only the first step. The trust also must be funded, meaning assets must be transferred or re-titled into the name of the trust. For example, bank and brokerage accounts need to be retitled in the name of the trust. When transferring real property to a trust, you will need to sign a new deed naming the trust as the owner of the property.

For many families in the metro NY area, their most valuable asset is their home. As such, we often transfer title to the home to the irrevocable asset protection trust in order to protect its value. You can still sell your home, purchase a new property, keep your real estate tax exemptions, and no one can sell your house without your consent. Other assets can be placed in a trust for asset protection purposes as well, such as investment accounts, bank accounts, mutual funds, and life insurance. 

With the escalating cost of healthcare, it is more important than ever for older adults to protect the assets they worked their whole lives to save from a sudden healthcare crisis. An irrevocable trust is an important tool in that asset protection plan. 

Be sure your Elder Law and Estate Planning attorney understands the extent of your assets and listens carefully to your concerns and goals so that together you can create a customized trust, estate and elder law plan.

Jennifer B. Cona, Esq. is the Founder and Managing Partner of Cona Elder Law located in Melville and Port Jefferson. The law firm concentrates in asset protection, estate planning, Medicaid benefits, probate and special needs planning. For information, visit www.conaelderlaw.com.

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Scott Martella served as communications director for Suffolk County Executive Steve Bellone. Photo from Facebook

Join Suffolk County Executive Steve Bellone on Wednesday, Aug. 3, between 10 a.m. and 4 p.m. for a blood drive in honor of Scott Martella. Martella was a dedicated public servant who impacted thousands of lives across Long Island. The goal is to help thousands more by donating blood to combat the critical blood shortage. 

There will be four donation sites across Suffolk County: H. Lee Dennison Building Plaza, 100 Veterans Memorial Highway, Hauppauge; DSS MacArthur Building Cafeteria; Suffolk County Fire Academy, Room K, 103 East Ave., Yaphank; and the Riverhead County Center Cafeteria, 300 Center Drive Riverhead. . Please join the effort and donate! To schedule an appointment, call 888-933-2566.

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Cake Fairyland ribbon cutting

On July 6th, Councilmember Jonathan Kornreich was on-hand to celebrate the grand opening and ribbon cutting of Cake Fairyland in the Coventry Commons Center at 1320 Stony Brook Road in Stony Brook. The new business specializes in pastries, puffs, cakes, coffee, tea, slushies, milk shakes and more. 

“I had the pleasure of attending a most delicious ribbon cutting for the grand opening of Cake Fairyland. Despite the name, they are much more than just a bakery: they also serve a wide variety of beverages and other treats and have plenty of seating to sit and relax with friends or do some work with a cup of coffee or bubble tea,” said Councilmember Kornreich said, 

“I was amazed at the beauty and craftsmanship of their offerings. Joined by Assemblyman Steve Englebright and a large number of family and friends, we sampled their fantastic treats and celebrated the latest exciting new business to open in Three Village. Congratulations and best wishes to Rachel and the whole staff, and thanks for making life a little bit sweeter in Stony Brook,” he said.

The business is open daily from 10 a.m. to 9 p.m. For more information, call 631-675-0581.

Pictured with the staff of Cake Fairyland are (center left to right) New York State Assemblyman Steve Engelbright; Cake Fairyland owner Rachel Ching and Brookhaven Town Councilmember Jonathan Kornreich.

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Get ready for a night of laughter! Theatre Three, 412 Main Street in Port Jefferson, will host a Friday Night Face-Off on the Second Stage on July 29 at 10:30 p.m. Friday Night Face Off is Long Island’s longest running Improv Comedy Show. Using audience suggestions, FNFO pits two teams of improvisers against each other in an all-out championship!! Think “Whose Line Is It, Anyway?” on about a dozen Redbulls and completely uncensored!

Beer, wine and other refreshments will be served and there is never a drink minimum. Recommended for audiences 16 and up, due to adult content. Tickets are $15 at the door only.

For more information, call 631-928-9100 or visit www.theatrethree.com.

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Pictured from left,beach stewards Roberta Fabiano and Frank Fountain; Councilmember Kornreich and Nicole Pocchiare, Town of Brookhaven Environmental Educator. Photo from Town of Brookhaven

On July 19, Councilmember Jonathan Kornreich was at West Meadow Beach in Stony Brook to announce PSEG Long Island’s installation of an Osprey platform disk atop a utility pole on Trustees Road. 

The platform was installed to accommodate a pair of ospreys that chose the pole to build a nest upon but constantly caused a disruption of electric service. 

“The story of the osprey nest at the West Meadow Nature Preserve proves the adage that you can’t fight Mother Nature,” said Councilmember Kornreich. 

“The first few attempts at nest building by this pair of ospreys resulted in blown fuses on the pole, and PSEGLI made several attempts to introduce elements of “hostile architecture” to discourage them from further attempts. The ospreys’ persistence paid off, and finally PSEGLI decided to install a raised platform on top of the pole which would permit the birds to safely build their structure without damaging the electrical service. The nest has been rebuilt and we look forward to this breeding pair’s return to West Meadow after their migration,” he said. 

“It is so important that we find the balance between our use of the land and the preservation of this beautiful coast. To enjoy but also protect areas with unique ecology like that of West Meadow Beach and Creek. The installation of this platform for the Osprey’s Nest is a perfect example of how we can be more understanding and appreciative of the natural space we share. Let it be an inspiration for a trend of positive impact,” said Nicole Pocchiare, Town of Brookhaven Environmental Educator.

Many people assisted in the effort to maintain the nest in its present location, including Peter Fontaine, Town of Brookhaven Division of Environmental Protection Senior Analyst; John Turner, Town of Brookhaven Division of Environmental Protection Senior Analyst; Elaine Maas, Board of Directors, Four Harbors Audubon Society; and Lisanne Altmann and the installation crew from PSEG Lonf Island. 

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The cast of 'Puss-In-Boots' at Theatre Three. Photo by Peter Lanscombe/Theatre Three Productions, Inc.
A scene from 'Puss-In-Boots' at Theatre Three. Photo by Peter Lanscombe/Theatre Three Productions, Inc.
A scene from 'Puss-In-Boots' at Theatre Three. Photo by Peter Lanscombe/Theatre Three Productions, Inc.
A scene from 'Puss-In-Boots' at Theatre Three. Photo by Peter Lanscombe/Theatre Three Productions, Inc.
A scene from 'Puss-In-Boots' at Theatre Three. Photo by Peter Lanscombe/Theatre Three Productions, Inc.
A scene from 'Puss-In-Boots' at Theatre Three. Photo by Peter Lanscombe/Theatre Three Productions, Inc.
A scene from 'Puss-In-Boots' at Theatre Three. Photo by Peter Lanscombe/Theatre Three Productions, Inc.
A scene from 'Puss-In-Boots' at Theatre Three. Photo by Peter Lanscombe/Theatre Three Productions, Inc.
A scene from 'Puss-In-Boots' at Theatre Three. Photo by Peter Lanscombe/Theatre Three Productions, Inc.

Join Theatre Three, 412 Main St., Port Jefferson for one of its last two performances of “Puss-In-Boots,” a hilarious musical re-telling of a boy and his ingenious feline on July 29 and July 30 at 11 a.m. 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 631-928-9100 or visit www.theatrethree.com.

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Photo from Stony Brook Medicine
Ranked Top 10 in the State

Stony Brook University Hospital (SBUH) has been recognized as a Best Hospital for 2022-23 by U.S. News & World Report, ranking in the top 50 nationally for Urology, Diabetes and Endocrinology. SBUH also climbed to a No. 9 ranking overall in New York State out of more than 155 hospitals statewide, up from No. 10 in the state last year.

SBUH ranked No. 41 nationally out of 1491 peer hospitals in Urology, which is in the top 3 percent. In Diabetes and Endocrinology, SBUH ranked No. 50 nationally out of 764 peer hospitals, which is in the top 7 percent.

“I’m delighted that Stony Brook Medicine continues to garner national recognition,” said Hal Paz, MD, Executive Vice President of Health Sciences and Chief Executive Officer, Stony Brook University Medicine. “U.S. News & World Report Best Hospital rankings is a national benchmark of quality and a metric that consumers rely on when seeking care. This ranking is the latest illustration of our never-ending commitment to delivering a quality patient experience and demonstrates the range of top-caliber expertise in our healthcare system.”

A total of 4,515 hospitals across 15 specialties and 20 procedures and conditions were evaluated by U.S. News. Of these hospitals, 1,895 met volume criteria in at least one specialty, and only 164 hospitals in the United States performed well enough to be nationally ranked in at least one specialty. The state ranking reflects the highest performing hospitals in the state across multiple areas of care.

“Achieving these Best Hospital national and state rankings speaks volumes about the quality of care our patients receive at Stony Brook University Hospital,” said Carol Gomes, MS, FACHE, CPHQ, Chief Executive Officer at Stony Brook University Hospital. “Whether it is for routine or complex care, the commitment of our faculty and staff is evident at all levels, at all times.”

U.S. News evaluated each hospital’s performance using a variety of measures such as survival rates, complication rates, patient experience and level of nursing care. The Best Hospitals methodology factors in data from the Centers for Medicare & Medicaid Services, American Hospital Association, professional organizations and medical specialists.

In addition to national rankings in Urology, Diabetes and Endocrinology, SBUH earned a “high performing” rating in the specialty of Neurology and Neurosurgery and in 12 procedures and conditions. These include: colon cancer surgery, lung cancer surgery, uterine cancer surgery, ovarian cancer surgery, prostate cancer surgery, heart attack, heart bypass surgery, heart failure, diabetes, kidney failure, stroke, maternity care (uncomplicated pregnancy), hip replacement, chronic obstructive pulmonary disease (COPD) and pneumonia.

These accolades follow on the heels of SBUH being named one of America’s 100 Best Hospitals™ for the past four years by Healthgrades – the only hospital on Long Island to receive the distinction for four consecutive years. Only four hospitals in New York State were named among America’s 100 Best Hospitals™ this year. For 2022, Stony Brook was also named by Healthgrades as one of America’s 50 Best Hospitals for Cardiac Surgery™; and one of America’s 100 Best Hospitals for Coronary Intervention™ (seven consecutive years), Cardiac Care (eight consecutive years), and Stroke Care (seven consecutive years).

“Recognition at this level from both U.S. News and Healthgrades does not come easy,” said Gomes. “Such an achievement requires years of hard work, dedication, collaboration and a steadfast commitment to continuously improving quality of care.”

For more information about Stony Brook Urology, click here.

For more information about Stony Brook Diabetes and Endocrinology, click here.

For more information about Stony Brook Heart Institute, click here.

For more information about Stony Brook Neurosciences Institute, click here.

About Stony Brook University Hospital:

Stony Brook University Hospital (SBUH) is Long Island’s premier academic health center. With 624 beds, SBUH serves as the region’s only tertiary care center and Regional Trauma Center, and is home to the Stony Brook University Heart Institute, Stony Brook University Cancer Center, Stony Brook Children’s Hospital and Stony Brook University Neurosciences Institute. SBUH also encompasses Suffolk County’s only Level 4 Regional Perinatal Center, state-designated AIDS Center, state-designated Comprehensive Psychiatric Emergency Program, state-designated Burn Center, the Christopher Pendergast ALS Center of Excellence, and Kidney Transplant Center. It is home of the nation’s first Pediatric Multiple Sclerosis Center. To learn more, visitwww.stonybrookmedicine.edu/sbuh.

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