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According to a recent study, excessive dietary iron intake may increase the risk of age-related macular degeneration. Stock photo
Too much iron can damage the body

By David Dunaief, M.D.

Dr. David Dunaief

Iron is contained in most of the foods that we eat. It is needed for proper functioning of the body and plays an integral role in such processes as DNA synthesis and adenosine triphosphate (ATP) production, which provides energy for cells (1). It is very important to maintain iron homeostasis, or balance.

When we think of iron, we associate it with reducing fatigue and garnering energy. In fact, many of us think of the ironman triathlons — endurance and strength come to mind. If it’s good for us, then the more we get the better. Right? It depends on the circumstances. But for many of us, this presumption is not grounded in reality.

Iron in excess amounts is dangerous. It may contribute to a host of diseases, including diabetes, diabetic retinopathy, age-related macular degeneration (AMD), glaucoma, Parkinson’s disease and even heart disease. These diseases are perpetuated because when we have excess iron it may cause reactive oxygen species, or free radicals, which cause breakdown of DNA and tissues, ironically, the very things that iron homeostasis tends to preserve (2).

So what helps us differentiate between getting enough iron and iron overload? It is a good question and depends on the type of iron we ingest. There are two main types: heme iron and nonheme iron. Dietary heme, or blood, iron primarily comes from red meat and is easily absorbed into the gut. Dietary nonheme iron comes from other sources, such as plants and fortified foods, which are much more difficult sources to absorb. By focusing on the latter source of dietary iron, you may maintain homeostasis, since the gut tends to absorb 1 to 2 mg of iron but also excretes 1 to 2 mg of iron through urine, feces and perspiration.

Not only does it matter what type of iron we consume but also the population that ingests the iron. Age and gender are critical factors. Let me explain. Women of reproductive age, patients who are anemic and children may require more iron. However, iron overload is more likely to occur in men and postmenopausal women because they cannot easily rid the body of excess iron.

Let’s investigate some of the research that shows the effects of iron overload on different chronic diseases.

Impact on diabetes

In a meta-analysis (a group of 16 studies), results showed that both dietary heme iron and elevated iron storage (ferritin) may increase the risk of type 2 diabetes (3). When these ferritin levels were high, the risk of diabetes increased 66 to 129 percent. With heme iron, the group with the highest levels had a 39 percent increased risk of developing diabetes. There were over 45,000 patients in this analysis. You can easily measure ferritin with a simple blood test. Also these levels are modifiable through blood donation and avoidance of heme iron, thus reducing the risk of iron overload.

Diabetic retinopathy

Diabetic retinopathy is a complication of diabetes that occurs when glucose, or sugar, levels are not tightly controlled. It affects the retina, or the back of the eye. Iron excess and its free radicals can have detrimental effects on the retina (4). This is potentially caused by oxidative stress resulting in retinal tissue damage (5).

So how does iron relate to uncontrolled glucose levels? In vitro studies (preliminary lab studies) suggest that high glucose levels may perpetuate the breakdown of heme particles and subsequently raise the level of iron in the eye (6). In fact, those with diabetic retinopathy tend to have iron levels that are 150 percent greater than those without the disease (7). Diets that are plant based and, therefore, nutrient dense are some of the most effective ways to control glucose levels and avoid diabetic retinopathy.

Age-related macular degeneration

Continuing with the theme of retinal damage, excessive dietary iron intake may increase the risk of AMD according to the Melbourne Collaborative Cohort Study (8). AMD is the number one cause of blindness for people 65 and older. People who consumed the most iron from red meat increased their risk of early AMD by 47 percent. However, due to the low incidence of advanced AMD among study participants, the results for this stage were indeterminate.

I have been frequently asked if unprocessed red meat is better than processed meat. Well, this study showed that both types of red meat were associated with an increased risk. This was a large study with over 5,000 participants ranging in age from 58 to 69.

Cardiovascular disease

Though we have made considerable headway in reducing the risk of cardiovascular disease and even deaths from these diseases, there are a number of modifiable risks that need to be addressed. One of these is iron overload. In the Japan Collaborative Cohort, results showed that men who had the highest amount of dietary iron were at a 43 percent increased risk of stroke death, compared to those who ate the least amounts (9). And overall increased risk of cardiovascular disease death, which includes both heart disease and stroke, was increased by 27 percent in men who consumed the most dietary iron. There were over 23,000 Japanese men who were between the ages of 40 to 79 that were involved in this study.

In conclusion, we should focus on avoiding heme iron, especially for men and postmenopausal women. Too much iron creates a plethora of free radicals that damage the body. Therefore, the best way to circumvent the increased risk of chronic diseases with iron overload is prevention. Significantly decreasing red meat consumption and donating blood on a quarterly basis, assuming that one is not anemic, may be the most effective strategies for not falling into the trap of iron overload.

References:

(1) Proc  Natl  Acad  Sci USA. 1997;94:10919-10924. (2) Clin Haematol. 1985;14(1):129. (3) PLoS One. 2012;7(7):e41641. (4) Methods Enzymol. 1990;186:1-85. (5) Rev Endocr Metab Disord. 2008;9(4):315-327. (6) Biophys Chem. 2003;105:743-755. (7) Indian J Ophthalmol. 2004;52:145-148. (8) Am J Epidemiol. 2009;169(7):867-876. (9) J Epidemiol. 2012;22(6):484-493. Epub 2012 Sept 15.

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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Matthew Lerner, far right, with his lab group at Stony Brook University. Photo from Matthew Lerner

By Daniel Dunaief

An actor draws in members of an audience, encouraging them to understand, appreciate and perhaps even become sympathetic to a world created on a stage. The process of creating scenes for the actor, however, can also change his or her world off the stage.

A team of scientists from Vanderbilt University, University of Alabama at Tuscaloosa and Stony Brook University recently received $3 million in funding from the National Institutes of Mental Health for four years to study how participation in a theater production can help people with autism spectrum disorders.

Matthew Lerner. Photo by Graham Chedd from the Alan Alda Center for Communicating Science

“Theater is a venue for learning and gaining skills,” said Matthew Lerner, an assistant professor of psychology, psychiatry and pediatrics at the Department of Psychology at SBU who is leading the Long Island part of a study that will involve about 240 participants from age 10 through 16. “The process of putting on a play with others and being able to successfully produce and perform that has key benefits to learn and practice.”

Called SENSE Theatre (for Social Emotional NeuroScience Endocrinology), the shows were created by the project leader, Blythe Corbett, an associate professor of psychiatry and behavioral sciences and psychology and investigator at Vanderbilt Kennedy Center, who herself performed in stage plays before pursuing her scientific career.

Corbett writes the plays, which have themes she believes are important not only for autism but also for the general public. The topics include acceptance, belonging and diversity and offer a current of core ideas that are “part of having a condition that is unique,” she said. The plays, which typically have about 20 characters, include music and last about 45 minutes.

Tiffany Adams and Jane Goodwin participate in the SENSE Theatre program. Photo by Steve Green, Vanderbilt University

Corbett explained that the experience uses theater as a platform for teaching fundamental areas that could help people with autism spectrum disorders, including reciprocal social communication, flexible thinking and behavior and imagination.

“It also gives [the participants] an opportunity to be exposed to social situations and to engage with others in a safe and supportive environment,” she said. “They can be John today and Henry tomorrow, which allows them to expand their repertoire in a playful, fun way” which, she hopes, might help them assimilate lessons when the program ends.

Corbett has been developing SENSE Theatre for nine years. This specific multisite project will allow her to see how transportable this program is to other locations, where other investigators who have not been involved with this before can employ it with other participants.

The investigators, which include Corbett, Lerner and Susan White at the University of Alabama, will monitor the participants through psychological testing, social interaction and research EEG, or electroencephalography. This is a noninvasive way of monitoring electrical activity in the brain that involves placing electrodes on or below the scalp. The EEG testing takes about 45 minutes.

Participation is free, although members, who go through a screening process, need to contribute to the research program by completing the evaluations.

The theater program has a control study, calling Tackling Teenage Training, in which participants will “address some of the challenges of being a teen,” which include dating and puberty, knowing how to know if somebody likes or doesn’t like you and how to express desires or interests appropriately, Lerner said.

Savannah Bradley participates in the SENSE Theatre program. Photo from Steve Green , Vanderbilt University

Corbett chose to work with Lerner because of considerable overlap in their interests in using performance to provide clinical help for people with autism spectrum disorders. Lerner “has a very strong interest in theater and is able to understand the core approach” to the training and shows as a form of intervention. He is an “engaging, charismatic individual who is extremely hard-working” and is a “really good choice in terms of harnessing his energy and intelligence.”

Indeed, Lerner and Karen Levine, a licensed psychologist and the co-author of “Treatment Planning for Children with Autism Spectrum Disorders,” developed a model in 2004 for youths with disabilities to work on social skills called Spotlight, which utilized techniques of theater games and dramatic training. Spotlight is a program of Northeast Arc, a human services organization founded in 1954 and based in Massachusetts.

The Spotlight efforts started with nine students and has expanded to include hundreds of families each year.

In early high school, Lerner met someone who would change his life. He was having dinner with the family of a friend of his younger sister’s when he noticed a boy, Ben, playing on his own in another room. Lerner asked if he could play with Ben, who was 2 at the time and was running a car back and forth across the top of a toy playhouse.

Lerner mirrored what Ben did. “He looked at me curiously and kept doing what he was doing,” Lerner recalled. “I followed him around for over two hours.”

A scene from a performance by SENSE Theatre. Photo by Steve Green, Vanderbilt University

Up to that point in his life, Lerner thought the experience with Ben was “the most fascinating two hours of my life.” He had made a connection in which he “loved the joy and challenge of trying to meet him where he was, rather than behave in a way that was consistent with what the world expected.”

Lerner studied philosophy and music at Wesleyan University. After earning his doctorate at the University of Virginia, where his dissertation explored why youths with autism experience social problems, Lerner worked at the University of Chicago and then moved to SBU in 2013.

A native of Swampscott, Massachusetts, Lerner lives in Port Jefferson with his wife Chelsea Finn, a pediatric nurse practitioner in the Stony Brook Hospital Emergency Room and a nurse practitioner at SV Pediatrics in Patchogue. The couple has a 4-year-old son Everett and a 6-month-old son Sawyer.

Lerner is looking for people who would like to participate in the study. They can reach out to him by phone at 631-632-7857 or by email at [email protected]. The first set of students will begin working in the SENSE Theatre program this spring and summer.

Corbett said the participants aren’t the only ones who benefit from the program.

“The overwhelming sentiment from those who come to see the performance is that it changes their perception of what it means to have autism,” Corbett said. After the show, some of the audience members “ask who are the children with autism.”

Parents of the actors are pleasantly surprised by the things their children are able to do, which exceed their expectations. “In one of our previous studies, parents reported that their stress went down” during the program, she said, “which appeared to be in response to the child participating in intervention.”

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Pictured from left, author Virginia McCaffrey, Allyson Konczynin, Bob Scollon, Will Konczynin and Brian Ehlers. Photo from Virginia Ehlers

Reviewed by Melissa Arnold

Virginia McCaffrey, an 11th-grade special education teacher at Ward Melville High School in Setauket, has brought her childhood memories to life with an imaginative new book for kids. “Chased by a Bear,” McCaffrey’s first book, honors the memory of her late grandmother, Jean Scollon, who loved telling her grandchildren vivid bedtime stories. I recently reached out to McCaffrey to ask her about her newest venture.

Tell me a little bit about yourself.

Ward Melville High School special education teacher Virginia McCaffrey is pictured with the children’s book “Chased by a Bear” she authored. Photo courtesy of Three Village school district

I am one of five children, one girl with four brothers. I was born in Lake Ronkonkoma and our family moved to Setauket when I was in ninth grade. I loved growing up in a big family as there was never a dull moment. As a child, I never really dreamed of becoming a writer, although I did think of it occasionally, not sure what direction I should take. The answer only came to me at the passing of my grandmother, Jean Scollon, three years ago.

Why did you decide to write a children’s book specifically?

My grandmother was such a large part of our lives. My own children knew her well and have always loved hearing stories of the terrific times my brothers, cousins and I had with her as we were growing up.

One night I was telling them about our many sleepovers at Nany and Grandad’s house. The four of us would climb onto the bed in the guest room at the end of the hall, then Nany would squeeze in with us to tell us a story before going to sleep. As I grow older, I fondly remember taking turns adding to the story, but specifically remember thinking that Nany had an incredible imagination. She always seemed to be coming up with great scenes, characters and situations, as well as games for us to play.

After sharing these stories with my own children and sending them off to bed, I decided to sit down and write a “Nany-type” story for them. At first, it was meant to simply be for them, but the more I worked on it, I began to dream of sharing the story of this wonderful grandmother with other children and turning it into a book; I found a way to honor my grandmother and share her with others.

How did your family respond when you told them you had an idea for a book?

I didn’t tell the family about my project until it was complete and I could present it to my grandfather, Bob Scollon, at a family dinner.  The only exception was my mother, who was sworn to secrecy. It was probably the hardest secret I have ever had to keep.

To say my family was surprised is an understatement. They appeared to be completely shocked. All four of my brothers told me how proud they were, my nieces and nephews all asked if they could share it with their classes, and my grandfather was speechless. He immediately sat down and read the book cover to cover while the rest of the family chatted about how surprised they were. Their reactions made keeping it a secret for so long all worth it.   

What is the book about?

The cover of Virginia McCaffrey’s first book.

“Chased by a Bear” is the story of four young children and the magical adventure their grandmother is able to make them a part of through her bedtime stories. No one but the five of them know where Nany’s stories take them each week during their sleepovers, making the adventure so much more special for them. They find themselves in a dangerous situation but use teamwork to resolve the problem.

Why did you choose a story about a bear for your first book?

I chose to use a bear story for the book because so many of Nany’s stories involved a bear in the woods. It was her favorite theme to her stories. Looking back I think those were always my favorite ones to hear.

Are the children in the story based on real-life people?

My younger brother (Brian Ehlers), two cousins (Allyson and William Konczynin) and I are the youngest of seven grandchildren and the characters in the book.

What was the publication process like?

Once I decided to write the children’s book, the process took about 18 months to complete. I decided to self-publish, and ultimately took the advice of my illustrator as to which company to use. The result was a very smooth process.

How did you find an illustrator?

I found the most challenging effort was to find an illustrator to capture the characters in the book: my grandparents, cousins, brother and myself. After a great deal of research online, I found an illustrator whose artwork not only connected with the personalities and descriptions of all of us but was exactly what I would hope for in a children’s book. Robin Bayer’s style is so uplifting and colorful. She made my story come to life. I sent her pictures of the four of us as children, as well as pictures of Nany and Grandad. She totally captured the look I wanted.

What was it like seeing the illustrations and receiving the first copy of the book?

When the first sketches were sent to me, I found it incredible how someone who didn’t know us as children and never had the opportunity to meet Nany was able to read a story I wrote and look at pictures I sent and completely capture my childhood and my vision of how my book should look. The story seemed to come to life more and more as additional illustrations were created and color was added to the pages.

When I received the first copy of the completed book to proof, I was in love with it. Once the book went public, friends sent me pictures of their children reading my book. I’ve saved every picture they’ve sent. I love hearing what their children and grandchildren think of the story.

What is the target age for the book?

The book was written on a second- or third-grade reading level. However, it was intended to appeal to many ages as it can be read aloud. 

What do your students think?

My students have expressed excitement at the idea of their teacher writing and publishing a book. They make me feel proud when they mention it. Recently, I was invited to read to the class of one of my daughters. The students had many questions about the writing process and becoming an author. It was wonderful to see the awe and excitement on their faces.

Do you plan to write any more books?

I would love to see this turn into a series of Nany Bedtime Stories … and maybe even let the rest of my family have some input.

“Chased by a Bear” is available for purchase on Amazon.com.

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Above, the museum’s George Washington portrait. Image from Vanderbilt Museum
Visitors invited to take part in museum ‘treasure hunt’

From Feb. 17 to 25 including Presidents Day, Monday, Feb. 19, visitors to the Vanderbilt Museum in Centerport can view a framed oil portrait of George Washington, originally thought to have been created by the renowned American portraitist Gilbert Stuart. Stuart was widely considered one of America’s foremost portrait artists, producing portraits of more than 1,000 people, including the first six presidents of the United States. Stuart painted a number of Washington portraits. The most celebrated is known as the “Lansdowne” portrait (1796), and one large-scale version of it hangs in the East Room of the White House.

The artist’s best-known work is an unfinished portrait of Washington begun in 1796 and sometimes called “The Athenaeum.” This image of Washington’s head and shoulders is a familiar one to Americans — it has appeared for more than a century on the U.S. one-dollar bill.

The Vanderbilt’s Washington portrait, found in the basement of the Suffolk County Welfare Department in Yaphank, was restored and presented to the Vanderbilt Museum in 1951. While the artist did not sign the work, a specialist reported that year that the painting was an authentic Gilbert Stuart. In 1981, however, two curators from the Metropolitan Museum of Art studied the portrait and advised the board of trustees that the work was not created by Stuart. As a result, the portrait, oil on panel and measuring 21.25 by 33.5 inches, is described in the archival records as “After Gilbert Stuart.”

Guests can also view a facsimile of a letter President Abraham Lincoln wrote to Fernando Wood, then mayor of New York City. President Lincoln wrote the letter to Wood on May 4, 1861 — two months to the day following his inauguration as president and less than one month after the start of the Civil War.

Wood (1812–1881), who built a successful shipping enterprise in New York City, served several terms in Congress and was mayor of New York for two terms, 1854–58 and 1860–62. He reached out to Lincoln shortly after the Fort Sumter attack, offering him whatever military services he, as mayor, could provide. Lincoln’s reply to Wood was in gratitude for his offer of assistance.

Excerpt:

“In the midst of my various and numerous other duties I shall consider in what way I can make your services at once available to the country, and agreeable to you —

Your Obt. [Obedient] Servant   

A. Lincoln”

Now a part of William K. Vanderbilt II’s extensive archives, the letter will be on display in the Memorial Wing, outside the Sudan Trophy Room.

Stephanie Gress, the Vanderbilt Museum’s director of curatorial affairs, said, “We do not know how this letter came to be in Mr. Vanderbilt’s possession. Perhaps it was originally the property of his great-grandfather, Cornelius Vanderbilt, who was an acquaintance of Mayor Wood, and it was passed down through the Vanderbilt family.”

Visitors can also take part in a museum “treasure hunt.” The Vanderbilt curatorial department has created an intriguing list of treasures and clues to “the presidential, the regal and the royal” on display at the museum. Guests of all ages are invited to explore the galleries and discover them. Laminated copies of the treasure list will be available for guest use.

The Suffolk County Vanderbilt Museum is located at 180 Little Neck Road in Centerport. Directions and updated details on programs and events are available at www.vanderbiltmuseum.org. For further information, call 631-854-5579.

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Rapunzel. Photo courtesy of Kent Animal Shelter

MEET RAPUNZEL!

Just look at those beautiful brown eyes! This is Rapunzel, an adorable 2½-month-old Catahoula/hound mix from South Carolina, now waiting for a furever home at Kent Animal Shelter. How is it that this gorgeous gal couldn’t find herself a home down south? No worries, Rapunzel — New Yorkers are going to be fighting over you! Rapunzel has already spent some time with cats and would do well sharing a home with them. She is also spayed, microchipped and up to date on all her vaccines. Will you be her Valentine?

Kent Animal Shelter is located at 2259 River Road in Calverton. For more information on Rapunzel and other adoptable pets at Kent, visit www.kentanimalshelter.com or call 631-727-5731.

Update: Rapunzel has been adopted!

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Raspberry-Chocolate Linzer Cookies

By Barbara Beltrami

There’s no day like Valentine’s Day to conjure up sweet talk, sweet sentiments in sweet cards and everlasting promises of eternal love and/or imminent romance. Those who subscribe to its traditions take them very seriously. Those who do not scoff at what they call the holiday created by the greeting card industry. Norman Rockwell-ish as it may be, there is something sweet about the old-fashioned image of a man holding a sumptuous bouquet of red roses and presenting a huge heart-shaped box of chocolates to his sweetheart.

Which brings me to another thing. No matter how Valentine’s Day is observed, or not observed, like any holiday, it provides an excuse for capitulating to that sweet tooth in all of us, that secret valentine of the appetite.

Raspberry-Chocolate Linzer Cookies

Raspberry-Chocolate Linzer CookiesYIELD: Makes three dozen cookies.

INGREDIENTS:

2¹/₃ cups flour

1 teaspoon baking powder

½ teaspoon salt

1½ sticks unsalted butter at room temp.

1 cup sugar

2 eggs

1 teaspoon vanilla extract

¼ teaspoon almond extract

2 cups chocolate chips, melted over boiling water

Raspberry jam

Confectioners’ sugar

DIRECTIONS:

In a medium bowl, sift together the flour, baking powder and salt. In a large bowl, cream the butter and sugar until light and fluffy. Beat in the eggs, one at a time; add the extracts and beat to thoroughly combine. With the mixer on low speed, gradually beat the dry mixture into the wet one. Gather the dough into two even pieces, enclose in plastic wrap and refrigerate until firm and solid.

When ready to bake, preheat oven to 350 F. On a flour-dusted board roll out one piece of the dough to ¹⁄8-inch thickness and using approximately a 2½-inch heart-shaped cookie cutter, cut out cookies and place on cookie sheet. Re-roll any scraps to form solid pieces for more cookies. Repeat procedure using second half of dough, except this time use a 1-inch round or heart-shaped cutter.

Bake cookies for approximately nine minutes and remove from oven just as they start to brown. With spatula, remove from cookie sheet and place on rack. When cookies are cooled and crispy, spread a level half teaspoon of melted chocolate on each large cookie; top with a level half teaspoon jam and carefully place another cookie on top. Dust tops with confectioners’ sugar and place on tiered or flat cookie plate. Serve with coffee, tea, milk, hot chocolate or dessert wine and, of course, love.

Chocolate Mousse

Chocolate Mousse

YIELD: Makes 8 servings

INGREDIENTS:

4 ounces unsweetened chocolate

¾ cup sugar

¼ cup water

5 eggs, separated

1 teaspoon vanilla extract

DIRECTIONS:

In the top of a double boiler combine the chocolate, sugar and water, stirring occasionally; heat until the chocolate is melted. Beating hard after each addition, while the double boiler is still over the heat, add the egg yolks, one at a time. Remove mixture from over the hot water and set aside to cool while you beat the egg whites until stiff. In a large bowl, gently fold the egg whites and vanilla into the chocolate mixture. Distribute the mousse evenly among  eight sorbet or wine glasses and refrigerate covered overnight or at least 10 to 12 hours. Serve with whipped cream, fresh strawberries and delicate wafer cookies.

Cherry Sauce

Cherry Sauce

YIELD: Makes 2½ cups.

INGREDIENTS:

1 pound sweet fresh or frozen and defrosted cherries, pitted

½ cup water

¹⁄₃ to ½ cup light corn syrup (depending on tartness of cherries)

1 tablespoon cornstarch

Fresh squeezed lemon juice, to taste

Kirsch liqueur, to taste

DIRECTIONS:

In a small saucepan, over medium heat, combine the cherries, half the water and the corn syrup and bring to a boil. With a wire whisk, stirring constantly, blend the cornstarch and remaining water with the cherry mixture. Over medium heat, cook until clear, about one minute. Add lemon juice and kirsch. Serve warm over vanilla or chocolate ice cream, sponge cake, angel cake, pound cake or cheesecake.

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Photo from RBCC

Resurrection Byzantine Catholic Church, located at the corner of Edgewater and Mayflower avenues in Smithtown, invites the community to take part in its 7th annual Traditional Ukrainian Easter Egg (Pysanky) workshop on March 11 and 18 from 1 to 3 p.m.

The two-day workshop, which will take place in the church’s Social Hall, is open to all levels of experience. Learn and complete your first egg, discover new patterns and tips or show your skills and enjoy the company. Bring your dyes and tools or start fresh with a new kit, available for an additional fee. Each participant must bring a candle in a holder, pencils and a roll of paper towels.

The two-day class fee is $20. Advance registration is required by calling Joanne at 631-332-1449 or email [email protected]. Deadline to register is Feb. 18.

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YOUR MAJESTY

Jay Gao of Stony Brook captured this stunning image on the morning of Jan. 30 using a Nikon 5500 camera. He writes, ‘It was snowing heavily this morning. While shooting the cardinal taking  shelter under the bush in my backyard, a white-throated sparrow flew into  view and I fired the camera instantly.’

Send your Photo of the Week to [email protected].

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Andrew Murano as Will Shakespeare in a scene from ‘Shakespeare in Love’. Photo by Danielle Nigro

By Heidi Sutton

In perfect timing with Valentine’s Day, the Smithtown Center for the Performing Arts continues its 2017-18 season with the romantic comedy, “Shakespeare in Love.” The play, based on the 1998 award-winning film about William Shakespeare written by Marc Norman and Tom Stoppard and starring Gwyneth Paltrow and Joseph Fiennes, was adapted for the stage by Lee Hall in 2014 and has been making the rounds in playhouses ever since. Last weekend it opened on the Mainstage complete with mistaken identities, disguises, a sword fight and a dog.

Regarded by many as the greatest writer in the English language and the foremost dramatist of his time, Shakespeare was thought to have written more than 30 plays and more than 100 sonnets. Or did he? That is the question. Rumors and conspiracy theories have circulated for years. Now the Bard himself is in the spotlight as the story follows his journey and inspiration in writing one of his greatest masterpieces, ultimately proving that sometimes it does take a village.

Kenneth Washington directs a large cast of 22 plus Baby Jack as Spot the dog in this love letter to Shakespeare.

Andrew Murano and Katie Ferretti in a scene from ‘Shakespeare in Love’. Photo by Danielle Nigro

 

Andrew Murano tackles the role of Will Shakespeare, a young playwright who is suffering from writer’s block. Deep in debt and constantly being upstaged by his rival Kit Marlowe (Evan Donnellan) he struggles to complete his latest play, a comedy titled “Romeo and Ethel, the Pirate’s Daughter,” which he has promised to two theater owners, Henslowe (Michael Newman) and Burbage (Doug Vandewinckel).

When Shakespeare meets Viola de Lesseps (Katie Ferretti), the daughter of a rich merchant betrothed to another, their forbidden love affair becomes the inspiration for much of the dialogue written for the play, which slowly evolves to become the romantic tragedy of “Romeo and Juliet.” His greatest admirer (she can recite every one of his plays by heart), Viola disguises herself as a man and lands the lead role of Romeo, further inspiring the playwright to begin work on “Twelfth Night” at the end of the second act. “Are you my actor or my muse?” Shakespeare asks her. “I am both but I should be neither,” she replies. Will someone discover her secret? Will Shakespeare steal her heart?

The talented group of actors, many of whom are regulars at the Smithtown venue, seem quite at ease blending a play within a play with backstage antics and onstage dramas. Murano and Ferretti are perfectly cast as the show’s forbidden lovers, reciting Shakespeare with skill and passion. The production is also enhanced by its supporting cast including Christine Boehm as the dog-loving Queen Elizabeth and Camile Arnone as Viola’s nurse. Special mention should be made of Evan Donnellan who, although he is only in a few scenes, leaves the audience wanting more.

A scene from ‘Shakespeare in Love’. Photo by Danielle Nigro

Set in the 1500s, the play’s Renaissance-era world is beautifully enhanced with period costumes by Chakira Doherty and the simple but functional set by Timothy Golebiewski serves as both castle with a balcony and an Elizabethean theater. The musical score, directed by Melissa Coyle, further elevates the show, especially during a dance in the castle where Shakespeare firsts lays eyes on his muse Viola.

Throughout the play, Shakespeare is told that all an audience wants is comedy along with love … and a bit with a dog and in that aspect “Shakespeare in Love” delivers. Recommended for mature audiences, running time is approximately two hours and 30 minutes, including one 15-minute intermission.

The Smithtown Center for the Performing Arts, 2 E. Main St., Smithtown will present “Shakespeare in Love” through March 4. The season continues with “Mamma Mia” from March 24 to April 29 and “Dreamgirls” from May 12 to June 17. Tickets are $35 adults, $32 seniors and $20 students. To order, call 631-724-3700 or visit www.smithtownpac.org.

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A recent study suggests that drinking diet soda may increase the risk of heart disease. Stock photo
Simple dietary changes can improve outcomes

By David Dunaief, M.D.

Dr. David Dunaief

Cardiovascular disease is anything but boring; what we know about it is constantly evolving. New information comes along all the time, which on the whole is a good thing. Even though cardiovascular disease has been on the decline, it is still the number one killer of Americans, responsible for almost 30 percent of deaths per year (1). However, not all studies nor all analyses on the topic are created equal. Therefore, I thought it apropos to present a quiz on cardiovascular disease myths and truths.

Without further ado, here is a challenge to your cardiovascular disease IQ. The questions below are either true or false. The answers and evidence are provided after.

1) Saturated fat is good for us, but processed foods and trans fats are unhealthy.

2) Fish oil supplements help reduce the risk of cardiovascular disease and mortality.

3) Fiber has significant beneficial effects on heart disease prevention.

4) Unlike sugary sodas and drinks, diet soda is most likely not a contributor to this disease.

5) Vitamin D deficiency may contribute to cardiovascular disease.

Now that was not so difficult. Or was it? The answers are as follows: 1-F, 2-F, 3-T, 4-F and 5-T. So, how did you do? Regardless of whether you know the answers, the reasons are even more important to know. Let’s look at the evidence.

Saturated fat

Most of the medical community has been under the impression that saturated fat is not good for us. We need to limit the amount we ingest to no more than 10 percent of our diet. But is this true? The results of a published meta-analysis (a group of 72 randomized clinical trials and observational studies) would upend this paradigm (2).

While saturated fat did not decrease the risk of cardiovascular disease, it did not significantly increase the risk either. Also, results showed that trans fats increase risk. Of course, trans fats are a processed fat, so this is something that most of us would agree upon. And in the clinical trials portion of the meta-analysis, omega-3 and omega-6 polyunsaturated fats did not significantly reduce the risk of cardiovascular disease.

Does this mean that we can go back to eating saturated fats with impunity? Well, there were weaknesses and flaws with this study. The authors only looked at the one dimension of fat. Their comparison was based on the upper-third of intake of one type of fat versus the lower-third of intake of the same type of fat (whether it was saturated fat or a type of unsaturated fat). It did not consider whether saturated fat was substituted with refined grains or unsaturated fatty acids. Also, what was the source of saturated fats, animal or plant, and did these sources also contain unsaturated fats as well, like olive oil or nuts which contain good fats?

Therefore, there are many unanswered questions and potentially several significant flaws with this study.

The meta-analysis also does not differentiate among plant or animal saturated fat sources. But in one that does, the researchers found saturated fats from animal sources increased cholesterol and the risk of cardiovascular disease (3). Also in another study, specifically using unsaturated fats in place of saturated fat reduced the risk of this disease (4, 5).

Fish oil

There is a whole industry built around fish oil and reducing the risk of cardiovascular disease. Yet the data don’t seem to confirm this theory. In the age-related eye disease study 2 (AREDS2), unfortunately, 1 gram of fish oil (long-chain omega-3 fatty acids) daily did not demonstrate any benefit in the prevention of cardiovascular disease nor its resultant mortality (6). This study was done over a five-year period in the elderly with macular degeneration. The cardiovascular primary end point was a tangential portion of the ophthalmic AREDS2. This does not mean that fish, itself, falls into that same category, but for now there does not seem to be a need to take fish oil supplements for heart disease, except potentially for those with very high triglycerides. Fish oil, at best, is controversial; at worst, it has no benefit with cardiovascular disease.

Fiber

We know that fiber tends to be important for a number of diseases, and cardiovascular disease does not appear to be an exception. In a meta-analysis involving 22 observational studies, the results showed a linear relationship between fiber intake and decreased risk for developing cardiovascular disease (7). In other words, for every 7 grams of fiber consumed, there was a 9 percent reduced risk in developing the disease. It did not matter the source of the fiber from plant foods; vegetables, grains and fruit all decreased the risk of cardiovascular disease. This did not involve supplemental fiber, like that found in Fiber One or Metamucil. To give you an idea about how easy it is to get a significant amount of fiber, one cup of lentils has 15.6 grams of fiber, one cup of raspberries or green peas has almost 9 grams, and one medium-size apple has 4.4 grams. Americans are sorely deficient in fiber (8).

Diet soda

A presentation at the American College of Cardiology examined the Women’s Health Initiative: The study suggests that diet soda may increase the risk of heart disease (9). In those drinking two or more cans per day, defined as 12 ounces per can, there was a 30 percent increased risk of a cardiovascular event, such as a stroke or heart attack, but an even greater risk of cardiovascular mortality, 50 percent, over 10 years. These results took into account confounding factors like smoking, diabetes, high blood pressure and obesity. This study involved over 56,000 postmenopausal women for almost a nine-year duration.

Vitamin D

The results of an observational study in the elderly suggest that vitamin D deficiency may be associated with cardiovascular disease risk. The study showed that those whose vitamin D levels were low had increased inflammation, demonstrated by elevated biomarkers including C-reactive protein (CRP) (10). This biomarker is related to inflammation of the heart, though it is not as specific as one would hope.

Beware in regards to saturated fat. If a study looks like an outlier or too good to be true, then probably it is. I would not run out and get a cheeseburger just yet. However, study after study has shown benefit with fiber. So if you want to reduce the risk of cardiovascular disease, consume as much whole food fiber as possible. Also, since we live in the Northeast, consider taking at least 1000 IUs of vitamin D daily. This is a simple way to help thwart the risk of the number one killer.

References:

(1) hhs.gov. (2) Ann Intern Med. 2014;160(6):398-406. (3) JAMA 1986;256(20):2623. (4) Am J Clin Nutr. 2009;99(5):1425-1432. (5) Cochrane Database Syst Rev. 2012:5;CD002137. (6) JAMA Intern Med. Online March 17, 2014. (7) BMJ 2013; 347:f6879. (8) Am J Med. 2013 Dec;126(12):1059-67.e1-4. (9) ACC Scientific Sessions 2014; Abstract 917-905. (10) J Clin Endocrinol Metab online February 24, 2014.

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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