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The path to improved health: Your body needs vitamins and minerals, known as micronutrients, to nourish and keep it healthy and to reduce risk for chronic diseases. Getting them through food ensures that your body can absorb them properly.
Increasing food quality makes a difference

By David Dunaief, M.D.

Dr. David Dunaief

Hunger is only one reason we eat. There are many psychological and physiological factors that influence our eating behavior, including addictions, lack of sleep, stress, environment, hormones and others. This can make weight management or weight loss for the majority who are overweight or obese — approximately 75 percent of the U.S. adult population — very difficult to achieve (1).

Since calorie counts have been required on some municipalities’ menus, we would expect that consumers would be making better choices. Unfortunately, studies of the results have been mostly abysmal. Nutrition labeling either doesn’t alter behavior or encourages higher calorie purchases, according to most studies (2, 3).

Does this mean we are doomed to acquiesce to temptation? Actually, no: It is not solely about will power. Changing diet composition is more important.

What can be done to improve the situation? In my clinical experience, increasing the quality of food has a tremendous impact. Foods that are the most micronutrient dense, such as plant-based foods, rather than those that are solely focused on macronutrient density, such as protein, carbohydrates and fats, tend to be the most satisfying. In a week to a few months, one of the first things patients notice is a significant reduction in their cravings. But don’t take my word for it. Let’s look at the evidence.

Effect of refined carbohydrates

By this point, many of us know that refined carbohydrates are not beneficial. Well, there is a randomized controlled trial (RCT), the gold standard of studies, with results that show refined carbohydrates may cause food addiction (4). There are certain sections of the brain involved in cravings and reward that are affected by high-glycemic (sugar) foods, as shown by MRI scans of participants.

The participants consumed a 500-calorie shake with either a high-glycemic index or with a low-glycemic index. The participants were blinded (unaware) as to which type they were drinking. The ones who drank the high-glycemic shake had higher levels of glucose in their blood initially, followed by a significant decline in glucose levels and increased hunger four hours later. In fact, the region of the brain that is related to addiction, the nucleus accumbens, showed a spike in activity with the high-glycemic intake.

According to the authors, this effect may occur regardless of the number or quantity of calories consumed. Granted, this was a very small study, but it was well designed. High-glycemic foods include carbohydrates, such as white flour, sugar and white potatoes. The conclusion: Everyone, but especially those trying to lose weight, should avoid refined carbohydrates. The composition of calories matters.

Comparing macronutrients

We tend to focus on macronutrients when looking at diets. These include protein, carbohydrates and fats, but are these the elements that have the most impact on weight loss? In a RCT, when comparing different macronutrient combinations, there was very little difference among groups, nor was there much success in helping obese patients reduce their weight (5, 6). In fact, only 15 percent of patients achieved a 10 percent reduction in weight after two years.

The four different macronutrient diet combinations involved an overall calorie restriction. In addition, each combination had either high protein, high fat; average protein, high fat; high protein, low fat; or low protein, low fat. Carbohydrates ranged from low to moderate (35 percent) in the first group to high (65 percent) in the last group. This was another relatively well-designed study, involving 811 participants with an average BMI of 33 kg/m², which is defined as obesity (at least 30 kg/m²). Again, focusing primarily on macronutrient levels and calorie counts did very little to improve results.

Impact of obesity

In an epidemiological study looking at National Health and Nutrition Examination Survey data, results demonstrate that those who are overweight and obese tend to be lacking in micronutrients (7). The authors surmise that it may have to do with the change in metabolic activity associated with more fat tissue. These micronutrients include carotenoids, such as lutein, zeaxanthin, beta-carotene, alpha-carotene and beta-cryptoxanthin, as well as vitamin B12, folate and vitamins C, E and D.

However, it does not mean this population should take supplements to make up for the lack of micronutrients. Quite the contrary, micronutrients from supplements are not the same as those from foods. Overweight and obese patients may need some supplements, but first find out if your levels are low, and then see if changing your diet might raise these levels. With a few exceptions, such as vitamin D and potentially B12, most micronutrient levels can be raised without supplementation. Please ask your doctor.

Steroid levels

It may seem like there are numerous factors influencing weight loss, but the good news is that once people lose weight, they may be able to continue to keep the weight off. In a prospective (forward-looking) study, results show that once obese patients lose the weight, the levels of cortisol metabolite excretion decreases significantly (8).

Why is this important? Cortisol is a glucocorticoid, which means it raises the level of glucose and is involved in mediating visceral or belly fat. This type of fat has been thought to coat internal organs, such as the liver, and result in nonalcoholic fatty liver disease. Decreasing the level of cortisol metabolite may also result in a lower propensity toward insulin resistance and may decrease the risk of cardiovascular mortality. This is an encouraging preliminary, yet small, study involving women.

Therefore, controlling or losing weight is not solely about willpower. Don’t use the calories on a menu as your sole criteria to determine what to eat; even if you choose lower calories, it may not get you to your goal. While calories may have an impact, the nutrient density of the food may be more important. Thus, those foods high in micronutrients may also play a significant role in reducing cravings, ultimately helping to manage weight.

References: (1) www.cdc.gov. (2) Am J Pub Health 2013 Sep 1;103(9):1604-1609. (3) Am J Prev Med.2011 Oct;41(4):434–438. (4) Am J Clin Nutr Online 2013;Jun 26. (5) N Engl J Med 2009 Feb 26;360:859. (6) N Engl J Med 2009 Feb 26;360:923. (7) Medscape General Medicine. 2006;8(4):59. (8) Clin Endocrinol.2013;78(5):700-705.

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

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A letter to the editor of your local newspaper will reach members of the public as well as your legislator.

By Nancy Marr

As we debated whether or not to support a New York State constitutional convention on Election Day, we considered the only other way change is possible — through the state legislature itself. If our legislators do not choose to make the changes, change cannot happen.

One example is the New York State election system. For many years, the League of Women Voters and other “good government” groups have worked together to convince legislators that our election system needs major improvements. Concern about the very low number of New Yorkers who actually vote has led us to lobby to remove some of the roadblocks to registering and voting.

Although there are no charges of voter suppression in our state, the state constitution prohibits early voting and stipulates that you can change your party designation only prior to the previous year’s election. Access to absentee ballots is very limited. The state requires that we have a full-face ballot, resulting in a ballot that is difficult to read. Counties cannot make any of these changes, so we have turned to the state legislature for action, with no results.

What is the most effective way to bring about change? The Legislature can change these constitutional roadblocks but will have to pass the legislation in two consecutive years and then present it to the voters for approval. To advocate for change, we have to start with our individual assembly member or senator regarding one important issue, for instance, a no-excuse absentee ballot.

How can we convince our legislators to support legislation to allow state residents to vote by absentee ballot without requiring a specific reason? Currently voters must state that they will be out of the county, that they are ill or disabled, are in a veterans hospital, in jail or prison or that they are primary caretakers of a person who is ill or disabled. If you believe that it would benefit all voters if they could vote by absentee ballot for any reason — if they are busy on Election Day, or if they have no transportation — how can you communicate this most effectively?

If we hope to see a change enacted this year, we will have to reach our state legislators by March (or earlier) in order to have the issue considered in the April budget. Start by locating your assembly member or senator and his or her contact details. Check in the league’s Directory of Public Officials at https://www.lwv-suffolkcounty.org/files/DPO2017_3.pdf or go to the website of the Board of Elections at www.suffolkvotes.com to identify your district and legislators.

Call to make an appointment at your legislator’s local office. Explain who you are or who you represent (if you belong to an organization you will be representing) and explain that you want to discuss no-excuse absentee voting because you think it will increase the turnout in your district (which is also your legislator’s district). Try to arrange for two or three persons who agree with you to attend as well. Including a young person can add a new perspective to your presentation.

Before you visit, find out about the legislator: voting record, committee assignments and leadership positions in the legislature, and any bills he or she sponsored that you support. (This information is available on legislators’ websites.) Decide with your companions what you will say, and who will say it. It is helpful for one of the visitors to agree to be the leader or spokesperson, another to be the recorder, and the others to have specific points to add.

Introduce yourselves to the legislator and present your concern about the low turnout in the voting district. Give any statistics that you have to back up your concern. If the legislator is not equally concerned, you and your colleagues may want to talk about why you think it is important that people feel involved in election issues.

Be sure to watch the clock. Knowing ahead how much time the legislator has agreed to spend with you, the leader should allot an appropriate amount of time for each issue and keep everyone on the subject. Record the legislator’s response. If you anticipate printing any part of the interview, you are obligated to get the legislator’s permission and specific conditions under which it may be printed.

Be sure and write a follow-up thank you after the visit. This gives you the opportunity to underscore some of the points made or answer any questions you were asked.

Other ways to express yourselves to legislators are by phone, letter or social media. A letter to the editor of your local newspaper will reach members of the public as well as your legislator. Rallies often are effective ways to make your opinions known and to show support for them. You may be able to arrange a public information meeting to discuss the issue and its significance. Invite your legislator to speak. Even if not concerned about low voter turnout, you could invite him or her to speak along with a representative who would present the opposite point of view.

Maximum impact results from many constituents visiting and communicating with their legislators. Many factors will affect the legislator’s response. Those who are now in office may be reluctant to expand the voting base to the benefit of possible opponents. New York State has representatives from counties that differ widely in their goals and interests. Upstate and downstate representatives are often in opposition because they face different challenges. In a later article we will discuss the political dilemma posed by the downstate/upstate differences and the differences between members of the same party in New York State government.

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

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Above, a Greenland shark with the parasite copepod Ommatokoita elongata on its eye. The parasite destroys the corneal tissue, rendering the shark partially blind. Stock photo

By Elof Axel Carlson

I was reading an article on the Greenland shark, Somniosus microcephalus, and I thought of my only other encounter with a shark (other than a slab on my dinner plate). That was when I was getting my bachelor’s at NYU and taking comparative anatomy.

One organism we dissected was the dogfish shark, Squalus acanthias. The sharks have no bones. They have a skeleton made of cartilage. The difficult challenge for my classmates and me was dissecting the inner ear within the cartilaginous capsule encasing it. I learned to respect surgeons, especially those working on the ears (like correcting otosclerosis of its calcareous deposits without breaking the coated set of bones that normally help us hear).

I learned that most sharks give birth to live young (puppies) rather than depositing eggs. Sex for sharks is a bit of a contortion act since the male (usually smaller than the female) uses one of its modified tail fins in lieu of a penis to inseminate a female. I also learned that they are quite ancient in the evolutionary scale, dominating the seas in the mid-Devonian era (about 390 million years ago) before the bony fishes out did them in adaptability.

That brings us back to S. microcephalus, which translates from its Latin name to an insulting “sluggish shark with a tiny head.” As its common name implies, these fish are located mostly in the Arctic circle and are spared an endangered species status as they are toxic to humans (and other predators) because they accumulate trimethylamine oxide in their tissues.

Inuits and others who live in that frosty region have learned to treat and ferment the fish so it is not as toxic; but even as a delicacy for the adventurous, it is not a popular item for those who catch fish for a living.

The sharks grow very slowly (less than half an inch a year) and swim at a leisurely pace of about one foot per hour. In addition to accumulating the toxic trimethylamine oxide, they also accumulate large amounts of urea in their tissues, which also contributes to their unsavory reputation among gourmets.

To make matters worse, the Greenland sharks are pretty ugly because they have luminescent parasites (copepod Ommatokoita elongata) that attach to their eyelids and use this to attract prey to their mouths. Although an opportunistic predator with much of their diet being decayed meat from drowned tetrapods and dead fish — they can swallow the floating carcass of a caribou — the sharks have been known to ambush and eat sleeping seals.

So why would such a revolting creature be attractive to research biologists? The answer is surprising. Greenland sharks are the longest lived vertebrates, living to be about 392 (272-512) years from radioactive carbon dating of crystals that are deposited in lenses of their eyes, which are layered like onions. They become sexually mature at about age 150 and attain a full mature adult size of 18 to 21 feet in length.

There is an irony to some of life’s winners of desired traits. Want to live as long as a Greenland shark? OK, make yourself toxic and marinate in urea. Try visiting your relatives at a speedy swimming rate of one foot per hour. Want to be cancer free no matter how old you get? OK, be like a naked mole rat (if you like subterranean life and ant hill type living).

We admire diversity among the millions of species of living things; but in addition to the instructive lessons of life (“Go to the ant thou sluggard”), we can find irony and humor in the knowledge we gain.

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

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Alexander Krasnitz. Photo by Gina Motis?CSHL

By Daniel Dunaief

Seeing into the future is one of the most challenging, and potentially rewarding, elements of studying cancer. How, scientists and doctors want to know, can they take what evidence they have —through a collection of physical signs and molecular signatures — and determine what will be?

Researchers working on a range of cancers have come up with markers to divide specific types of cancers to suggest the likely course of a disease.

With prostate cancer, the medical community uses a combination of the prostate-specific antigen (PSA), magnetic resonance imagining (MRI) and biopsy results, which are summarized as the Gleason score, to diagnose the likely outcome of the disease. This analysis offers probable courses for developing symptoms.

Cold Spring Harbor Laboratory Professor Michael Wigler and Associate Professor Alexander Krasnitz recently published an article in the journal Cancer Research of a promising study of eight patients that suggests a way of using molecular signatures to determine whether a prostate is likely to contain cells that will threaten a patient’s health or whether the cells are in a quieter phase.

The third most common cancer among Americans, prostate cancer kills an average of 21,000 men each year. Doctors and their patients face difficult decisions after a prostate cancer diagnosis.

“A major challenge is to determine which prostate cancers have aggressive potential and therefore merit treatment,” Herbert Lepor, a professor and Maritin Spatz Chair of Urology at the NYU Langone Medical Center School of Medicine, explained in an email. A collaborator on the study, Lepor provided a clinical perspective and shared patient samples.

A conversation with a doctor after such a diagnosis may include a discussion about how the cancer is not likely to pose an immediate risk to a patient’s life, Krasnitz explained. In that case, doctors do not recommend surgery, which might cause other problems, such as incontinence.

Doctors typically recommend active surveillance to monitor the disease for signs of progression. Some patients, however, make their own decisions, electing to have surgery. The Gleason score, which is typically 3, 4 or 5, can’t provide “meaningful information regarding aggressiveness of the disease,” Lepor explained. “The unique genetic profile of a cancer cell should have infinite more prognostic capability.”

Wigler and Krasnitz, who have been collaborating since Krasnitz arrived at CSHL in 2005, use several hundred single cells from biopsy cores. The research group, which Krasnitz described as a large team including research investigator Joan Alexander and computational science manager Jude Kendall, look for cells with a profile that contains the same irregularities.

“If you take two cells and their irregularities are highly coincident, then perhaps these two cells are sisters or cousins,” Krasnitz explained in an email. “If they are less coincident, then the two cells are more like very distant relatives. We looked for, and sometimes found, multiple cells with many coincident irregularities. This was our evidence for a clonal population.”

By looking at how many biopsy cores contain clonal cells, and then determining how far these clonal cells have spread out through the prostate, the researchers gave these patient samples a score. In this group, these scores, determined before any intervention, closely tracked a detailed analysis after surgery.

“We get a high correlation” between their new score and a more definitive diagnosis that comes after surgery, Krasnitz said. “Our molecular score follows the final verdict from the pathology more closely than the pathological score at diagnosis from the biopsy.”

Wigler, Krasnitz, Lepor and other researchers plan to continue to expand their work at Langone to explore the connection between their score and the course of the disease. Lepor explained that he has been collaborating with Wigler and Krasnitz for five years and suggested this is “an exceptional opportunity since it bridges one of the strongest clinical programs with a strong interest in science (NYU Urology) and a world-class research program interested in clinical care (CSHL).

The research team has submitted a grant to the National Institutes of Health and hopes to expand their studies and provide “compelling evidence” that single-cell genomic mapping “will provide an unmet need defining aggressiveness of prostate cancers,” Lepor said.

While Krasnitz is encouraged by the results so far, he said the team has work ahead of them to turn this kind of analysis into a diagnostic tool physicians can use with their patients.

Realistically, it could take another five years before this score contributes to clinical decision-making, Krasnitz predicted. “You can’t do it overnight,” he cautioned. When this test offers specific signals about the likely outcome for a patient, a researcher would likely need to wait several years as the patient goes on active surveillance to see whether the score has predictive value for the disease in a larger population.

Krasnitz has a sense of urgency to produce such a test because there is “no point in delaying something that potentially looks promising and that one day might well be a part of a clinical practice.”

The work that led to their article took three or four years to complete. The study required technical improvements in the way the researchers processed DNA from single cells. They also had to develop algorithmic improvements that allowed them to use copy number variation to determine clonal structure. The scientists tapped into a wealth of information they gained by taking cells from several locations within the prostate.

Krasnitz was born in Kiev, now part of the Ukraine, and grew up in the former Soviet Union. A resident of Huntington, he lives with his wife Lea, who produces documentaries, including “Maria — The Russian Empress” on Dagmar of Denmark, who was also known as Maria, mother of Nicholas II, the last Romanov czar who was overthrown in 1917. As for his work with Wigler, Krasnitz is excited about the possibilities. “It’s very encouraging,” he said. “We look forward to a continuation of this.”

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Scott Kelly and Amiko Kauderer.Photo by Stephanie Stoll/ NASA
Astronaut Scott Kelly’s girlfriend recounts a year apart

By Daniel Dunaief

One night, her leg drifted to his side of the bed, where she often snuggled up so close that she nearly pushed him off the bed. The cold woke her up. After that, she stayed away until he returned from his perch, circling 249 miles above the Earth for a record-breaking year.

Amiko Kauderer, who works for NASA, has been dating astronaut Scott Kelly for years. Indeed, she had been through a six-month separation when he traveled to the International Space Station in 2011. This time, however, Kelly was gone for a year, conducting a range of experiments, including one in which he grew flowers in space. He also took samples of his own blood, which NASA will use to compare to his identical twin brother Mark to track the effects of extended time in space on his body. The information Kelly collected will help NASA prepare for future missions deeper into space, including to Mars.

Kelly’s journey, and his NASA career, ended on March 1, 2016, a year after jetting away from Kauderer and his two daughters from a previous marriage for an extraordinary journey that covered 144 million miles, or more than the distance from Earth to the sun.

Kelly recently published an in-depth book about his life before and after his historic mission titled “Endurance: A Year in Space, a Lifetime of Discovery.” Kauderer has her own story to tell about their prolonged separation. When asked about the time apart, both of them acknowledge that the challenges are no different from the ones people face when a spouse is on active deployment with the military.

During their separation, Kelly and Kauderer spoke regularly, including by videoconference. In an early videoconference, Kelly took Kauderer on a tour of his orbiting home, where he circled Earth 5,440 times. “I’ve seen it,” Kauderer recalled, as he drifted from room to room, using his toes to push off and float to the next destination. When he entered a room, Kelly asked her to guess where he was. “I know where you’re at,” she laughed. “You’re in the gym.”

While he was beaming images of his life in space, Kauderer returned the favor with video of their home in Houston, Texas. She took him outside, where he could see the pool. She knew he loved the water. When they were on these calls, Kelly focused on Kauderer as well as on areas around the house that he could see from space that needed attention. He saw that the refrigerator water filter light was on, indicating it was time for a new one. He told her, “You need to change the filter,” she recalled. She enjoyed the observation because “those kinds of moments felt like he was home.”

Kauderer recalled an experience where she was on a video conference with Kelly while she cooked a pizza, something he couldn’t eat during his journey. He asked her to show it to him when she was taking it out of the oven and then told her the pizza wasn’t done and she needed to stick it back in the oven for another few moments. “Him being from New Jersey and me being from China Spring, Texas, I’m not going to argue with the New Jersey guy on how to make a pizza,” she recalled. That, too, felt more like normal.

Kauderer didn’t dwell on the dangers of his trip, even though she had considerable information about his schedule and his daily assignments. Knowing “her man,” as she puts it, well also helped her recognize the early signs of trouble for him from afar. Once, when they began a conversation, she heard an aggressiveness and frustration in his voice. She told him to check the carbon dioxide levels, which were above normal.

The most stressful moment for her was when he went on the first of his three space walks. “I had seen how hard he worked,” she said “I knew all the behind-the-scenes stuff, even the things that are not as fun and [are] painful. I was extremely excited that he was finally going to do this.”

She said she knew he’d be fine as soon as he got back inside. While he was gone, she forgot what it felt like to have physical contact with Kelly. “The one thing you can not replicate is human touch,” she said. “There does come a time when you forget what that person feels like, what it feels like to get a hug.” The moment of realization is “sad,” although she said she always knew there was an end point.

Indeed, when his journey was almost over, Kelly sent her a list of the things he wanted and craved back on Earth, including green Gatorade, strawberries and salad. She didn’t have any similar such lists for him. “You tend to put your own needs aside,” she said. “You focus on everything for him. I didn’t think about what I wanted.”

At first, she felt an urgency to make sure he adapted to his return, which was no small task. In addition to getting him to doctors’ appointments, she helped him deal with a painful rash that developed after an extended time when gravity didn’t push clothing against his skin. He also had swelling in his legs. When she massaged his feet, she couldn’t feel his ankle bones. At the beginning, it was “disgusting,” she said. “I knew they weren’t his feet.” She said he was “in such a fog” after his return. Physically, he was back, but the pain, particularly in his feet, was difficult for him.

Kauderer felt limited in what she could do for herself. “When he came home, I didn’t have any me-time,” she said. She went to the door to go for a run and Kelly asked her where she was going. She told him she needed to get out for 20 minutes to take a run. “That’s all I need,” she said. “He was like, ‘OK.’”

Kelly’s life has returned to a new normal, as he travels to promote his book. Kauderer said the distance apart brought them closer together. At night, she said she has returned to moving over to his side of the bed, which is warmer than it was during his absence. “When he was back, I went back to pushing him off the bed again,” she said.

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Above, Scott Kelly, right, with his twin brother Mark. Photo by Robert Markowitz

By Daniel Dunaief

Dear readers,

Each week, in the Power of Three, Times Beacon Record News Media highlights the efforts of dedicated scientists at Stony Brook University, Cold Spring Harbor Lab and Brookhaven National Lab. This week, we will feature astronaut Scott Kelly, who set an American record for consecutive days in space.

Kelly not only conducted research on flowers and performed space walks while orbiting the Earth, he also became his own living laboratory, taking blood samples to compare to his twin brother Mark. Some day, the pioneering studies from the twins may turn the dream of a trip to Mars and beyond into a reality.

He had a spectacular view for close to a year, watching 16 sunrises and sunsets each day aboard the International Space Station. He even pretended to catch a pass thrown by television host Stephen Colbert from over 249 miles away.

A view of Earth aboard the ISS. Photo by Scott Kelly

Astronaut Scott Kelly set an American record for consecutive days in space, floating from one part of the multinational station to another for 340 days. During that journey, in which Kelly traveled over 143 million miles with cosmonaut Mikhail Kornienko, the New Jersey native conducted numerous experiments, including on himself. NASA plans to use the information gained from Kelly’s mission to design future extended trips into space, including any future journey to Mars.

Kelly, who returned to Earth in March of 2016, recently published a book titled “Endurance: A Year in Space, a Lifetime of Discovery” (Knopf), in which he shared a long journey from underachieving high school student to celebrated astronaut.

“There are things about the experience that are absolutely amazing,” he said, “but, then, at the same time, the things that make everything amazing also make other things more difficult.” For starters, moving from a Soyuz rocket to the space station isn’t as simple as stepping out of a car and opening another door. When the rocket attaches to the station, it can take hours to equalize the pressure. In a film or documentary of life in space, “You can’t show 11 hours of docking or six hours of preparation to go out on a space walk,” Kelly said.

Once aboard, the astronaut, who had lived on the space station on an earlier six-month mission, said he had to adapt to the logistics of meals in space. Gravity doesn’t hold the astronauts on a chair or their food on a plate. For close to a year, he couldn’t relax his body while eating, which meant that he felt like he was standing and balancing during meals.

Scott Kelly and Mark Kelly in 1967. Photo from Scott Kelly

Kelly said the transition from life on Earth to the station, and then back again, requires adjustments. One of the most significant scientific efforts he was a part of originated from a conversation Kelly had with a NASA scientist, asking him what he should say if a reporter asked if NASA was comparing the changes in his body to those of his identical twin brother Mark. The NASA scientist then asked if he and his brother, who is a retired astronaut, would consider participating in such an effort. Thus, the NASA Twins Study was born.

Before his mission, Kelly got several small tattoos on his body, to make sure he was drawing blood from the same place each time. Scientists have spent over a year examining changes in his genes. While more results will be published next year, the work so far shows an uptick in the methylation of Scott’s DNA. That means he potentially had more signals that can turn on or off genes.

Additionally, Scott’s telomeres, which protect the ends of DNA strands, were longer during the same period than those of his Earth-bound twin. Also, Scott returned from space closer to two inches taller than his brother because the discs in Scott’s spinal column weren’t compressed by gravity. That difference didn’t last long, however, as his spine returned to normal after he came back to Earth.

While life aboard the space station included movies like “50 Shades of Grey” in Russian and books like “The Right Stuff” by Thomas Wolfe, which Kelly said inspired him to become an astronaut, it also involved unusual environmental challenges.

Scott Kelly. Photo from NASA

As part of his training, Kelly needed to recognize any of the symptoms of carbon dioxide buildup in his system. His girlfriend Amiko Kauderer provided some necessary observations during one particular conversation. Within seconds of speaking with him, Kauderer told him to stop talking to her and check the carbon dioxide levels. She quickly had diagnosed that the carbon dioxide levels, while not dangerously high, were above Kelly’s comfort level.

Kelly explained that the routine in space doesn’t leave much time for relaxation or down time. “You have one day on the weekend when you’re off,” he said. “You can arrange your workweek such that you’re taking advantage of that. You still have stuff like cleaning the space station and you still have to exercise and organize the living environment.”

Indeed, astronauts need to exercise aboard the station or risk losing bone mass and encountering muscular atrophy during their missions. In addition to stretching his body, Kelly expanded the typical limits of his responsibility for some scientific experiments.

As he chronicled in his book, he was following a protocol for growing zinnias. When the flowers weren’t flourishing, Kelly asked NASA if he could take over the decision-making process, which NASA approved. “The satisfaction came more from the idea that it was an experiment that we were making the decisions on and controlling,” he said.

Typically, he reported what he saw to NASA, and scientists back on Earth came up with a plan that they sent to Kelly. While they required considerable effort, the astronaut also took satisfaction in the three space walks he conducted during his journey. As with the movie “Gravity,” Kelly recognized the danger that orbiting space debris, even small pieces, could pose for the space station and him. “You could get hit with something that would not only put a hole in your visor, but would put a hole in your head,” he said.

Kelly didn’t bother watching out for such objects when he’s outside the station because he’d “never see it coming at you at 17,000 miles an hour.” As for what he could see from space, Kelly watched wildfires in California and Hurricane Patricia, which was a storm off the coast of Oman. In addition to information NASA might take from his mission that could inform decisions about future missions, Kelly hopes people view his experience, and his success, as a model for them.

“There’s a lot of opportunities for redemption in the United States,” Kelly said. “It’s not the preferred or easy path, but it is a path, especially in this country.”

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Sparkling wines can be red, white or rosé (pink) and dry, off-dry, semisweet or even sweet.

By Bob Lipinski

Bob Lipinski

The expression, “All that bubbles is not champagne,” might be overplayed, but it is true. Sparkling wines are made throughout the world in virtually every country that makes wine, and most countries have a local name for their “bubbly.” However, the term “champagne” is properly given to the sparkling wines made in the Champagne region of France. Sparkling wines made in the U.S. must provide a geographic term such as New York, American, or California before the word “Champagne.”

A sparkling wine is an effervescent wine (contains bubbles) resulting from the secondary fermentation of wine within a closed container (bottle or tank). Sparkling wines are made globally from a multitude of different grapes and grape blends. Sparkling wines can be red, white or rosé (pink) and dry, off-dry, semisweet or even sweet. Prices also range from inexpensive to very expensive, sometimes costing hundreds of dollars per bottle.

Some recently tasted sparkling wines that should satisfy anyone’s taste are:

Codorníu Cuvée Clásico “Cava Brut,” Spain (blend of macabeo, parellada and xarel-lo grapes): Fine pin-point bubbles with a bouquet of green apples, lemon and brioche. Dry, clean and crispy in the mouth with a pleasing aftertaste of almonds. Fabulous with fried calamari.

Codorníu Anna Blanc de Blancs, Brut Reserva, Spain (blend of chardonnay, parellada, xarel-lo and macabeo grapes): Delicately flavored, elegant and beautifully balanced with a nice creamy mouthfeel and a lively, fruity-spicy aftertaste. Raw oysters with a hint of mignonette sauce pairs well.

2016 Montesel Conegliano Valdobbiadene Prosecco Superiore, DOCG, Brut, Italy: A top-of-the-line dry prosecco, which has a fruity bouquet of apples, citrus and fennel. Flavors of ginger, stone fruit and anise round out this beauty. Did anyone say dark chocolate with some fresh raspberries!

Philippe Deval Brut Crémant de Loire, AOC Loire Valley, France (blend of chenin blanc and chardonnay grapes): A flowery aroma of apple cider, citrus, nuts and peaches. Dry and lemony with ripe melon flavors and almond aftertaste. Serve with a fruit-based sauce over pork.

Cococciola Brut Spumante, Abruzzo, Italy: Cococciola is a white grape variety grown in the Abruzzo (some in Apulia) region since the early 1900s and used mostly for blending. This is the first sparkling wine I have seen from the grape variety and it is amazing! Pale straw colored with a perfumed aroma of apricots, honeysuckle, lychee and wild flowers. Flavors of citrus and orange, with hints of sage and toasted almonds. The aftertaste begs for another glass (or bottle)! Pair this with some panettone, light fruit tarts or a bowl of strawberries with whipped cream.

By the way … the first recorded production of a bottle-fermented sparkling wine occurred as early as 1531 at the Abbey of Saint-Hilaire at Limoux in southern France, more than a century before Dom Pérignon arrived at Hautvillers.

Bob Lipinski, a local author, has written 10 books, including “101: Everything You Need to Know About Whiskey” and “Italian Wine & Cheese Made Simple,” available on Amazon.com. He conducts training seminars on wine, spirit and food and is available for speaking engagements. He can be reached at www.boblipinski.com or [email protected].

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Chip is looking for her furever home. Photo from Kent Animal Shelter

MEET CHIP! Chip is an 8-month-old domestic short-haired female who has the best personality and loves to be around people. She has a sweet and playful nature, so she would be good in any home. Chip is very loving and purrs almost instantly when you pet her. She is up to date on all her shots, spayed and microchipped. Also she is free for the month of December! Come meet this sweetheart today! Kent Animal Shelter is located at 2259 River Road in Calverton. For more information on Chip and other adoptable pets at Kent, visit www.kentanimalshelter.com or call 631-727-5731.

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As you become more active, Santa, you’ll find that you have more energy all year round, not just on Christmas Eve.

By David Dunaief, M.D.

Dr. David Dunaief

Dear Santa,

This time of year, people around the world are no doubt sending you lists of things they want through emails, blogs, tweets and old-fashioned letters. In the spirit of giving, I’d like to offer you — and maybe your reindeer — some advice.

Let’s face it: You aren’t exactly the model of good health. Think about the example you’re setting for all those people whose faces light up when they imagine you shimmying down their chimneys. You have what I’d describe as an abnormally high BMI (body mass index). To put it bluntly, you’re not just fat, you’re obese. Since you are a role model to millions, this sends the wrong message.

We already have an epidemic of overweight kids, leading to an ever increasing number of type 2 diabetics at younger and younger ages. According to the Centers for Disease Control and Prevention, as of 2015, more than 100 million U.S. adults are living with diabetes or prediabetes. It complicates the issue that approximately two-thirds of the U.S. population is overweight and/or obese. This is just one of many reasons we need you as a shining beacon of health.

Obesity has a much higher risk of shortening a person’s life span, not to mention quality of life and self-image. The most dangerous type of obesity is an increase in visceral adipose tissue, which means central belly fat. An easy way to tell if someone is too rotund is if a waistline, measured from the navel, is greater than or equal to 40 inches for a man, and is greater than or equal to 35 inches for a woman. The chances of diseases such as pancreatic cancer, breast cancer, liver cancer and heart disease increase dramatically with this increased fat.

Santa, here is a chance for you to lead by example (and, maybe, by summer, to fit into those skinny jeans you hide in the back of your closet). Think of the advantages to you of being slimmer and trimmer. For one thing, Santa, you would be so much more efficient if you were fit. Studies show that with a plant-based diet, focusing on fruits and vegetables, people can reverse atherosclerosis, clogging of the arteries.

The importance of a good diet not only helps you lose weight but avoid strokes, heart attacks, peripheral vascular diseases, etc. But you don’t have to be vegetarian; you just have to increase your fruits, vegetables and whole-grain foods significantly. With a simple change, like eating a handful of raw nuts a day, you can reduce your risk of heart disease by half. Santa, future generations need you. Losing weight will also change your center of gravity, so your belly doesn’t pull you forward. This will make it easier for you to keep your balance on those steep, icy rooftops.

Exercise will help, as well. Maybe for the first continent or so, you might want to consider walking or jogging alongside the sleigh. As you exercise, you’ll start to tighten your abs and slowly see fat disappear from your midsection, reducing risk and practicing preventive medicine. Your fans everywhere leave you cookies and milk when you deliver presents. It’s a tough cycle to break, but break it you must. You — and your fans — need to see a healthier Santa. You might let slip that the modern Santa enjoys fruits, especially berries, and veggies, with an emphasis on cruciferous veggies like broccoli florets dipped in humus, which have substantial antioxidant qualities and can help reverse disease.

As for your loyal fans, you could place fitness videos under the tree. In fact, you and your elves could make workout videos for those of us who need them, and we could follow along as you showed us “12 Days of Workouts with Santa and Friends.” Who knows, you might become a modern version of Jane Fonda or Richard Simmons or even the next Shaun T!

How about giving athletic equipment, such as baseball gloves, footballs and basketballs, instead of video games? You could even give wearable devices that track step counts and bike routes or stuff gift certificates for dance lessons into people’s stockings. These might influence the recipients to be more active.

By doing all this, you might also have the kind of energy that will make it easier for you to steal a base or two in this season’s North Pole Athletic League’s Softball Team. The elves don’t even bother holding you on base anymore, do they?

As you become more active, you’ll find that you have more energy all year round, not just on Christmas Eve. If you start soon, Santa, maybe by next year, you’ll find yourself parking the sleigh farther away and skipping from chimney to chimney.

The benefits of a healthier Santa will ripple across the world. Think about something much closer to home, even. Your reindeer won’t have to work so hard. You might also fit extra presents in your sleigh. And Santa, you will be sending kids and adults the world over the right message about taking control of their health through nutrition and exercise. That’s the best gift you could give!

Wishing you good health in the new year,

David

P.S. I could really use a new baseball bat, if you have a little extra room in your sleigh.

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

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