COMING HOME
Laura Gumbus was at West Meadow Beach on April 4 when she spied an osprey and snapped this incredible photo. She writes, ‘I heard the osprey mating call and saw an osprey sitting in a nest. I waited patiently and watched two love birds in flight together and captured this one as it returned to its nest. It was cool to see!’
Send your Photo of the Week to [email protected]
MEET YODEL!
Yodel-Ay-Hee-Hoo! This week’s shelter pet is Yodel, a seven-year-old male Domestic Shorthair who was trapped and brought to the Smithtown Animal Shelter as part of the Trap-Neuter-Release (TNR) program. He earned his name because of the way he “sings” and almost “talks” to people. Sometimes, it even sounds like he says “I love you” when you open a can of food for him! Yodel is a sweet and gentle guy who loves to be petted and loves to get some snuggles. Don’t be fooled by his grumpy face; he’s as happy and friendly as can be.
The Smithtown Animal & Adoption Shelter is located at 410 Middle Country Road, Smithtown. Visitor hours are currently Monday to Saturday from 10 a.m. to 3 p.m. (Sundays and Wednesday evenings by appointment only). For more information, call 631-360-7575 or visit www.townofsmithtownanimalshelter.com.
By Bob Lipinski
The vodka martini was popularized by James Bond movies in which the super spy requested his “vodka martini” be served to him “shaken, not stirred.”
The martini, like many other cocktails’ origins, is shrouded in mystery. One theory suggests that Martinez was the original name of this popular drink, first introduced in 1860 by Professor Jerry Thomas, a bartender in San Francisco’s Occidental Hotel. It was named after nearby Martinez, a local tourist stop for travelers.
The local citizens of Martinez were so convinced that their town was the birthplace of the Martini, they installed a brass plaque to lay claim to that fact. The plaque reads in part, “On this site in 1874, Julio Richelieu, bartender, served up the first martini when a miner came into his saloon with a fistful of nuggets and asked for something special. He was served a Martinez Special.” The drink consisted of 2/3 gin, 1/3 vermouth, a dash of orange bitters, poured over crushed ice and served with an olive.
The first Martinez recipe known in print is the 1884’s “Modern Bartender’s Guide,” by O.H. Byron, which states “same as Manhattan, only you substitute gin for whisky.” In addition, Jerry Thomas’ 1887 “Bartender’s Guide: How to Mix Drinks,” lists a recipe for the Martinez as “one dash bitters, two dashes Maraschino, one pony of Old Tom gin, one wineglass of vermouth,” shaken, strained, and garnished with a lemon slice.
At the Knickerbocker Hotel in Manhattan, in 1912, bartender Martini di Arma di Taggia reportedly served a cocktail he referred to a martini, made of equal parts of gin and dry white vermouth, to John D. Rockefeller.
Other origins of the martini cocktail include the Italian version, which assumes the name comes from Martini & Rossi Vermouth, an indisputable ingredient. The British claim the name originates with the Martini & Henry rifle (used between 1871 and 1891), known for its strong kick.
How and when the name changed from Martinez to Martini remains unclear.
Classic Martini Cocktail
INGREDIENTS:
2 ounces gin or vodka
Dash of dry white vermouth
Garnish: Lemon peel or green olives
DIRECTIONS:
Use a large stainless-steel cocktail shaker. Add plenty of ice cubes, then add the gin or vodka and a dash of vermouth. Either strain the martini into a cocktail glass or pour over ice in an old fashioned glass. Garnish with lemon peel or green olives.
Note: If a pearl cocktail onion is substituted for the lemon peel or green olives, the drink then becomes a “Gibson.”
Bob Lipinski is the author of 10 books, including “101: Everything You Need To Know About Whiskey” and “Italian Wine & Cheese Made Simple” (available on Amazon.com). He consults and conducts training seminars on Wine, Spirits, and Food and is available for speaking engagements. He can be reached at www.boblipinski.com OR [email protected].
By Daniel Dunaief
Grace Mehl had made it onto her first navy ship, passing through a fiercely competitive process in which the U.S. Navy only had openings for two out of 60 women.
Her first boss, who was a warrant officer, made his feelings about her presence on the ship known. “I don’t believe women belong on a ship,” he told Mehl in 1980. “I don’t believe they belong in the navy. If you do your job, we’ll get along fine.”
That conversation, however, was among the only ones Mehl, who grew up and now lives in Smithtown, had with people about whether her gender could affect her ability to serve. At the same time, members of the navy sometimes grumbled about the expanding role of women in the armed forces.
“I heard a lot of gruff from older guys talking about having women in the navy,” said Troy Wussow, an enlisted man who served aboard the USS Shenandoah with Mehl after the ship was christened in 1983. “The old salt saw it as problematic.”
Mehl often won over others with her professionalism, talent, and willingness to work.
When he met Mehl, Wussow and others were building an office that they wouldn’t complete by a deadline because supplies hadn’t arrived. When he presented the situation to Mehl, she told them to get lunch. While the others ate, Mehl redesigned the building with the supplies on hand. Wussow was grateful for her solution, which enabled him and the rest of the crew to execute their orders.
“She solved the problem for us, which was an extraordinary beginning,” Wussow said.
Indeed, Mehl also impressed her superiors, rising through the ranks to become one of the first five women to command a navy combatant ship. For 14 years of Mehl’s career, women only joined navy combat ships when they volunteered. In 1994, however, the navy started assigning women to ships the way they had men. The executive officer sent some of those frustrated female navy crew to see Mehl.
“When they walked into my state room and looked at me, they just stopped” being upset, Mehl said. They couldn’t tell Mehl how unfair it was when she had been living that life.
“After they got there, they started to learn that it wasn’t so bad and it was just another job,” she said, “although you were floating around while you were doing it.”
Commanding respect
A graduate of SUNY Binghamton, Mehl, who grew up on a chicken farm, had a desire to get a job that makes a difference and to see the world. Her sister Jane and her college roommate had also joined the military, so she already had examples of women who had gone into the service.
Her father John Albert Mehl had also been in the Army Air Corps during World War II. A tail gunner, the Mehl patriarch had been stationed in England and France and had been on 65 missions. Her sister was an Army nurse.
Despite the army family connection, Mehl entered the navy because she didn’t want her sister to have the ability to boss her around.
“The army wasn’t big enough for both of us,” Mehl said.
Wussow suggested that Mehl had an effective approach with those under her command and with superior officers. Officers either commanded or demanded respect, Wussow suggested. Mehl was in the former category, listening to problems, working with people to solve them, and following and enforcing rules.
Dave Gellene, who was her executive officer when she was the commanding officer of the Gunston Hall, appreciated her naval skills. “She was able to maneuver the ship the best I’ve seen,” he said.
Gellene, who served on active duty in the Navy for 23 years and has been a government civilian for the navy for 15 years, said Mehl maneuvered the ship expertly through all kinds of weather and in densely populated areas where other boats were nearby.
Her ability to control the ship “gained the crew’s confidence,” Gellene said. Even early in Mehl’s tenure as commanding officer, Gellene could tell that the spirit of the ship improved dramatically the day after she took command.
The Bronze Star
The navy awarded Mehl the Bronze Star for her work in 1999, when the armed forces provided support during the humanitarian crisis in the former Yugoslavia.
“I was very proud of the people on the ship,” Mehl said. “I got to wear the Bronze star, but I didn’t earn it: my crew earned it.”
Gellene recalled that the marines who were disembarking for the peacekeeping mission had to get ready each day, only to learn that the mission encountered additional delays.
Mehl, whom Gellene said kept everyone informed of orders and important information, had agreed to play bagpipe music on the day the mission would occur which was “very motivating.”
Mehl and the crew of the Gunston Hall also provided critical assistance in 1999, when an earlier enormous earthquake rocked Turkey, killing over 17,000 people. With Mehl at the helm, the ship tied up at a dock and the crew put up tents for displaced residents.
“The crew would have stayed forever if they could,” Gellene said. “Under her leadership, she kept everyone motivated and focused.”
In a less stressful but important moment for the ship, Gellene also recalled how the Gunston Hall was stationed in North Carolina during the Super Bowl in 1999. Before the widespread use and availability of cell phones, the ship had to face a particular direction to get a good satellite feed to watch the game. Mehl stayed at the helm, keeping the ship at the right angle so the crew could watch the Broncos defeat the Falcons in Super Bowl 33.
“You could imagine the morale boost,” Gellene said.
Current contributions
Mehl has established numerous connections to the Long Island community. Having given talks to students in elementary and high schools, she said people know her as “the Navy lady.”
She volunteers with Vietnam Veterans of America, is on the Board of Directors of the United Veterans Beacon House, and serves on Veterans Court.
Mehl also earned a certification as Eastern Apicultural Society Master Beekeeper and is the Education Director of the Long Island Beekeepers club.
Looking back on her service, Mehl believes she did something important during her two decades in the navy.
“I feel like I opened a door for women to be able to follow in the path that I broke for them,” she said. “I feel that we have come a long way in the military.
By Daniel Dunaief
Ideally, doctors would like to know about health threats or dangers such as diseases or chronic conditions before they threaten a person’s quality of life or expected lifespan.
On a larger scale, politicians and planners would also like to gauge how people are doing, looking for markers or signs that something may be threatening the health or safety of a community.
Researchers in computer science at Stony Brook University have been designing artificial intelligence programs that explore the language used in social media posts as gauges of mental health.
Recently, lead author Matthew Matero, a PhD student in Computer Science at Stony Brook; senior author H. Andrew Schwartz, Associate Professor in Computer Science at Stony Brook; National Institute on Drug Abuse data scientist Salvatore Giorgi; Lyle H. Ungar, Professor of Computer and Information Science at the University of Pennsylvania; and Brenda Curtis, Assistant Professor of Psychology at the University of Pennsylvania published a study in the journal Nature Digital Medicine in which they used the language in social media posts to predict community rates of opioid-related deaths in the next year.
By looking at changes in language from 2011 to 2017 in 357 counties, Schwartz and his colleagues built a model named TrOP (Transformer for Opioid Prediction) with a high degree of accuracy in predicting the community rates of opioid deaths in the following year.
“This is the first time we’ve forecast what’s going to happen next year,” Schwartz said. The model is “much stronger than other information that’s available” such as income, unemployment, education rates, housing, and demographics.
To be sure, Schwartz cautioned that this artificial intelligence model, which uses some of the same underlying techniques as the oft-discussed chatGPT in coming up with a model of ordered data, would still need further testing before planners or politicians could use it to mitigate the opioid crisis.
“We hope to see [this model] replicated in newer years of data before we would want to go to policy makers with it,” he said.
Schwartz also suggested that this research, which looked at the overall language use in a community, wasn’t focused on finding characteristics of individuals at risk, but, rather at the overall opioid death risks to a community.
Schwartz used the self-reported location in Twitter profiles to look at representation of a community.
The data from the model, which required at least 100 active accounts each with at least 30 posts, have proven remarkably effective in their predictions and hold out the potential not only of encouraging enforcement or remediation to help communities, but also of indicating what programs are reducing mortality. Their model forecast the death rates of those communities with about a 3 percent error.
Both directions
Schwartz explained that the program effectively predicted positive and negative changes in opioid deaths.
On the positive side, Schwartz said language that reflected a reduction in opioid mortality included references to future social events, vacation, travel and discussions about the future.
Looking forward to travel can be a “signal of prosperity and having adventures in life,” Schwartz said. Talking about tomorrow was also predictive. Such positive signals could also reflect on community programs designed to counteract the effect of the opioid epidemic, offering a way of predicting how effective different efforts might be in helping various communities.
On the negative side, language patterns that preceded increases in opioid deaths included mentions of despair and boredom.
Within community changes
Other drug and opioid-related studies have involved characterizing what distinguishes people from different backgrounds, such as educational and income levels.
Language use varies in different communities, as words like “great” and phrases like “isn’t that special” can be regional and context specific.
To control for these differences, Schwartz, Matero and Giorgi created an artificial intelligence program that made no assumptions about what language was associated with increases or decreases. It tested whether the AI model could find language that predicted the future reliably, by testing against data the model had never seen before.
By monitoring social media in these specific locales over time, the researchers can search for language changes within the community.
Scientists can explore the word and phrases communities used relative to the ones used by those same communities in the past.
“We don’t make any assumptions about what words mean” in a local context, Schwartz said. He can control for language differences among communities by focusing on language differences within a community.
Schwartz recognized that fine refinements to the model in various communities could enhance the predictive ability of the program.
“If we could fully account for differences in cultural, ethnic and other variables about a community, we should be able to increase the ability to predict what’s going to happen next year,” he said.
With its dependence on online language data, the model was less effective in communities where the number of social media posts is lower. “We had the largest error in communities with the lowest rates of posting,” Schwartz explained. On the opposite side, “we were the most accurate in communities with the highest amounts” of postings or data.
Broader considerations
While parents, teachers and others sometimes urge friends and their children to limit their time on social media because of concerns about its effects on people, a potential positive is that these postings might offer general data about a community’s mental health. The study didn’t delve into individual level solutions, but these scientists and others have work that suggests this is possible.
As for his future work, Schwartz said he planned to use this technique and paradigm in other contexts. He is focusing on using artificial intelligence for a better understanding of mental health.
“We hope to take this method and apply it to other outcomes, such as depression rates, alcohol use disorder rates,” post traumatic stress disorder and other conditions, Schwartz said. “A big part of the direction in my lab is trying to focus on creating AI methods that focus on time based predictions.”
By Daniel Dunaief
I don’t know if teeter-totters exist anymore. Remember them? Two people sit on opposite ends of a board, with a support in the middle. They start at the same height, facing each other, with legs extended. One person pushes up while the other bends his or her legs and gets closer to the ground. The one on the bottom pushes off, while the one on the top heads toward the ground.
The image seems like an apt simile for conversations.
You see, one person talks, while the other listens, and then, the listener becomes the speaker and the speaker the listener. Such simple descriptions don’t work in group dialogue.
In one-on-one conversations, these interactions sometimes involve prolonged periods when one person is on the ground, and the other is stuck in the air, waiting for the speaker to stop talking so he or she can come to the ground and share some thoughts and reactions.
I have had numerous experiences where it seems the teeter-totter gets stuck in one position, much more often than not with me dangling in the air. Yes, I am a decent listener. No, I don’t hear or register everything my wife or anyone else tells me. I do, however, have an ability to listen to a meandering story that includes many detours, recitations of facts that aren’t germane to the main thread of the story, and to self editing. To wit:
“It was a Tuesday that I lost my dog.”
“No, wait, it was a Wednesday and it wasn’t my dog, it was my cat.”
“No, no, it was a Tuesday, and it was neither my dog nor my cat, but it was my car keys. The point is that I lost something before I found it. That was also the day I got a new job.”
Somewhere along the lines, I wonder what happened to the fine art of conversational teeter-tottering, with a predictable and relaxing back-and-forth rhythm.
The stories from another person continue, with one bleeding into the next one so endlessly that I feel like I’m listening to excerpts from several different books on tape.
As I listen, I wonder what my role is. Clearly, the other person doesn’t want or need to hear much from me.
I sometimes wish there were a swimmer’s clock behind the person’s head, which would allow me to time the minutes between sounds like “uh huh,” and “oh yeah,” and “really? no way! That’s terrible/wonderful/amazing/ridiculous!”
It’s the Mad Libs version of listening to the same story, or a variation of that story, while throwing in the appropriate, or sufficiently irreverent, adjective.
I raise my eyebrows periodically in response to the tone of the person’s voice, going through lists of chores in my head, wondering who didn’t give this person a chance to speak when he or she was younger.
An actual pause periodically arrives. My toes dig happily into the welcome sand beneath me, reveling in the auditory opening.
I don’t want to wait too long to say something, because people aren’t always comfortable with quiet, which can restart an ongoing monologue.
After I express an idea, or sometimes just a phrase, I feel my body ascending back into space. Wait, did I not make it clear that I wasn’t done? How am I dangling above the ground again?
Suspended in mid-air, I suppose I could consider those moments as the equivalent of listening to a bird singing a repetitive tune echoing among the eaves.
Perhaps in the future, we can create a verbal shorthand when we feel we’ve lost conversational balance. Maybe, we can just say “teeter-totter” when we need to speak.
By Leah S. Dunaief
As I drive along the local roads, the sight of the bright yellow forsythia, the symphony of pink cherry blossoms, dogwood and magnolia and the yellow daffodils waving” hello” uplift my spirits and bring me joy. Yes, it’s spring, glorious spring! And the weather could not be more cooperative. We have been able to shed our heavy jackets, sweaters and such, and even give our air conditioners a brief trial run when the temperature hit the high 80s and stayed there for a couple of days. Best of all, we know this splendor is early, and the beautiful season, when Nature festoons the earth, is just beginning.
At one and the same time, the news about human activities blackens the world. Every day, yes every day, we wake up to the news of more mass shootings, more homicides. Because a teenage boy rings the bell of the wrong house on his errand to pick up his younger siblings, he is then shot to death. Because a car full of teenage girls pulls into the wrong driveway, shots are fired at the vehicle as it is trying to back out and one young woman is killed. Because yet another unarmed young man tries to run away from the police at a traffic stop, he deserves to be murdered.
What is happening to our country?
These horrors are occurring because people are afraid. Unless he has cognitive issues, why would an 84-year-old man answer his door with a gun? Why would someone inside a house shoot at a car that just entered the driveway unless they were terrified for themselves. This is more than a mental health issue, which might be blamed for shooting up employees in a bank. This is about cold, petrifying fear.
Thank heavens that Nature goes about her business transforming the earth into a paradise because we humans need something to offset the hell we are creating. People are asked if they are afraid for their children to go to school. To school, which was always the safest place to get children off the streets. Now more than three quarters of the parents say, “Yes.” And so do more than half of the children in elementary school and middle school. Never mind COVID-19 and inflation. They are passing, or will eventually. But the violence that we are living with? That just seems to be getting worse.
What can we do? We know that bad things happen when good people do nothing. But how can we improve our society?
One answer, I believe, is to turn to family and community. Strong family support and a tight-knit community offer security that is close at hand. Parents who let their children feel the love, who set standards and limits, who teach values by example and talk to their children about fears, who are there when most needed — these actions go a long way toward offering meaningful response to a frightening world.
For us adults, meeting the neighbors and creating a Neighborhood Watch for mutual protection is both a safety and social advantage. Participating in one of the many local non-profits, from Rotary to the civic associations and PTAs in the schools to the historical societies to actually running for office can strengthen a sense of belonging and empowerment.
And then there is kindness. I’m not sure how one goes about teaching kindness except by practicing it. Kindness offsets bullying, it makes both the giver and receiver feel noticed and valued. Who has time to visit a sick neighbor? But then, we all have time to hold the door open for the person behind us, and for that person to thank the door holder, or to let the car waiting to join the line of traffic enter in front of us and in return see a thank-you wave.
And there is always Nature for respite. A walk in the park or along a beach can be restorative. Nature, too, can be violent, but storms pass. With effort and focus, perhaps human storms can, too.
By Heidi Sutton
Imagine an old-fashioned dessert that is reminiscent of a simpler time … an airy, buttery vanilla cake with a beautiful caramelized brown sugar topping sweetened with pineapple rings and maraschino cherries. Of course I’m referring to the classic Pineapple Upside Down Cake, the bright flavored spring and summer dessert perfect for casual family dinners and special occasions.
The cake became popular in the United States in the mid-1920s after Dole Pineapple Company sponsored a contest for pineapple recipes and received over 2,500 submissions. The winner was a Pineapple Upside-Down Cake recipe submitted by Mrs. Robert Davis from Norfolk, Virginia. Dole published the recipe in an advertisement, which increased the cake’s popularity.
In honor of National Pineapple Upside Down Cake Day on April 20, here is a recipe for the retro classic dessert that is as delicious today as it was decades ago. The directions call for a large cast-iron skillet. However, you can use any non-stick baking round pan. The cake can be served warm or cold.
Pineapple Upside Down Cake
YIELD: Makes 8 servings
INGREDIENTS:
2/3 cup margarine, divided
2/3 cup packed brown sugar, divided
1 can (20 ounces) Dole Pineapple Slices
10 maraschino cherries
3/4 cup granulated sugar, divided
2 eggs, separated
1 teaspoon grated lemon peel
1 teaspoon lemon juice
1 teaspoon vanilla extract
1 1/2 cups all-purpose flour
1 3/4 teaspoons baking powder
1/4 teaspoon salt
1/2 cup sour cream
DIRECTIONS:
Heat oven to 350° F. In 10-inch cast-iron skillet, melt 1/3 cup margarine. Remove from heat. Add brown sugar and stir until blended.
Drain pineapple slices; reserve 2 tablespoons syrup. Arrange pineapple slices in sugar mixture. Place cherry in center of each slice.
Beat remaining 1/3 cup margarine with 1/2 cup granulated sugar until light and fluffy. Beat in egg yolks, lemon peel, lemon juice and vanilla. Combine flour, baking powder and salt. Blend into creamed mixture alternately with sour cream and reserved pineapple syrup.
Beat egg whites to soft peaks. Gradually beat in remaining 1/4 cup granulated sugar to make stiff meringue. Fold into batter. Pour over pineapple in skillet.
Bake 35 minutes, or until toothpick inserted comes out clean. Let stand 10 minutes, then invert onto serving plate.
By Michael Christodoulou
It’s almost Earth Day, when people around the world focus on ways of protecting and preserving the environment. And the lessons from this occasion can be applied to other areas of life — such as investing.
Here are some themes to consider:
Sustainability – From an environmental perspective, sustainability encompasses a range of issues, such as using natural resources wisely. As an investor, you, too, need to protect your resources.
So, for example, to sustain a long-term investment strategy, you won’t want to dip into your retirement accounts, such as your IRA and 401(k), to pay for major home or car repairs or other unexpected, costly bills before retirement.
You can help prevent this by building an emergency fund containing several months’ worth of living expenses, with the money kept in a liquid, low-risk account. And once you’re retired, you need to sustain your portfolio so it can help provide income for many years. For that to happen, you’ll need to maintain a withdrawal rate that doesn’t deplete your investments too soon.
Growth potential – Many people plant trees to celebrate Earth Day, with the hope that, as the trees grow, they’ll contribute to cleaner air. When you invest, you also need growth potential if you’re going to achieve your goals, including a comfortable retirement.
So, your portfolio will need a reasonable percentage of growth-oriented vehicles, such as stocks and stock-based mutual funds or exchange-traded funds (ETFs). Yet, you do need to be aware that these investments can lose value, especially during downturns in the financial markets. You can help reduce the impact of market turbulence on your holdings by also owning other types of investments, such as bonds, government securities and certificates of deposit (CDs).
While these investments can also lose value, they are typically less volatile than stocks and stock-based mutual funds and ETFs. The appropriate percentage of growth and fixed-income investments in your portfolio depends on your risk tolerance, time horizon and long-term objectives.
Avoidance of “toxins” – At some Earth Day events, you can learn about positive behaviors such as disposing of toxic items safely. And in the investment world, you’ll also want to avoid toxic activities, such as chasing “hot” stocks that aren’t appropriate for your needs, or trading investments so frequently that you run up commissions and taxes or jumping out of the markets altogether when there’s a temporary decline.
Consolidation – Getting rid of clutter and unnecessary possessions is another lesson some people take away from Earth Day. All of us, when we look around our homes, could probably find many duplicate items — do we really need two blenders or three brooms or five staplers? When you invest, it’s also surprisingly easy to pick up “clutter” in the form of multiple accounts. You might have an IRA with one financial company and brokerage accounts with two or three others.
If you were to consolidate these accounts with one provider, you might reduce correspondence — even if it is online — and possibly even lower the fees you pay. But perhaps more important, by consolidating these accounts at one place, possibly with the guidance of a financial professional who knows your needs and goals, you may find it easier to follow a single, unified investment strategy.
Earth Day only happens once a year — but it may provide lessons for investors that can last a lifetime.
Michael Christodoulou, ChFC®, AAMS®, CRPC®, CRPS® is a Financial Advisor for Edward Jones in Stony Brook. Member SIPC.
By David Dunaief, M.D.
Your kidneys are workhorses; they perform an array of critical functions for you. Primarily, they filter waste and fluid from your body and maintain your blood’s health. They also help control your blood pressure, make red blood cells and vitamin D, and control your body’s acid levels.
When your kidney function degrades, it can lead to hypertension or cardiovascular problems and it may require dialysis or a kidney transplant in later stages. For the best outcomes, it’s critical to identify chronic kidney disease (CKD) early and adopt techniques to stop its advance. However, of the estimated 37 million U.S. adults who have CKD, as many as 9 in 10 are not aware they have it (1).
One of the challenges with identifying early-stage CKD is that symptoms are not obvious and can be overlooked. Among them are high blood pressure, hand or feet swelling, urinary tract infections, and blood in your urine (2).
Fortunately, there are simple tests, such as a basic metabolic panel and a urinalysis, that will indicate whether you may have mild CKD. These indices for kidney function include an estimated glomerular filtration rate (eGFR), creatinine level and protein in the urine. eGFR is a calculation and, while the other two indices have varying ranges, depending on the laboratory used, a patient with an eGFR of 30 to 59 is considered to have mild disease. The eGFR and the kidney function are inversely related, meaning as eGFR declines, the severity of CKD increases.
What can be done to stem early-stage CKD, before complications occur? There are several studies that have looked at lifestyle modifications and their impacts on its prevention, treatment and reversal.
How do other medical issues affect your kidneys?
Among the greatest risks for your kidneys are uncontrolled diseases and medical disorders, such as diabetes and hypertension (1). If you have – or are at risk for – diabetes, be sure to control your blood sugar levels to limit kidney damage. Similarly, if you currently have hypertension, controlling it will put less stress on your kidneys.
For these diseases, it’s crucial that you have your kidney function tested at least once a year.
In addition, obesity and smoking have been identified as risk factors and can be managed by making lifestyle changes to reduce your risk.
Can diet help protect your kidneys?
Fruits and vegetables may play a role in helping patients with CKD. In a one-year study with 77 patients, results showed that fruits and vegetables work as well as sodium bicarbonate in improving kidney function by reducing metabolic acidosis levels (3).
What is the significance of metabolic acidosis? It means that body fluids become acidic, and it is associated with CKD. The authors concluded that both sodium bicarbonate and a diet including fruits and vegetables were renoprotective, helping to protect the kidneys from further damage in patients with CKD. Alkali diets are primarily plant-based, although not necessarily vegetarian or vegan. Animal products tend to cause an acidic environment.
In the Nurses’ Health Study, results show that animal fat, red meat and sodium all negatively impact kidney function (4). The risk of protein in the urine, a potential indicator of CKD, increased by 72 percent in those participants who consumed the highest amounts of animal fat compared to the lowest, and by 51 percent in those who ate red meat at least twice a week. With higher amounts of sodium, there was a 52 percent increased risk of having lower levels of eGFR.
The most interesting part with sodium was that the difference between higher mean consumption and the lower mean consumption was not that large, 2.4 grams compared to 1.7 grams. In other words, a difference of approximately a quarter-teaspoon of sodium was responsible for the decrease in kidney function.
The National Kidney Foundation recommends diets that are higher in fruit and vegetable content and lower in animal protein, including the Dietary Approaches to Stop Hypertension (DASH) diet and plant-based diets (5).
In my practice, when CKD patients follow a vegetable-rich, nutrient-dense diet, there are substantial improvements in kidney functioning. For instance, for one patient, his baseline eGFR was 54. After one month of lifestyle modifications, his eGFR improved by 9 points to 63, which is a return to “normal” functioning of the kidney. Note that this is anecdotal, not a study.
What are our takeaways?
It is important to have your kidney function checked with mainstream tests. If the levels are low, you should address the issue through medications and lifestyle modifications to manage and reverse early-stage CKD. If you have common risk factors, such as diabetes, smoking, obesity or high blood pressure, or if you are over 60 years old, talk to your doctor about testing.
Don’t wait until symptoms and complications occur. In my experience, it is much easier to treat and reverse a disease in its earlier stages, and CKD is no exception.
References:
(1) CDC.gov. (2) kidneyfund.org. (3) Clin J Am Soc Nephrol. 2013;8:371-381. (4) Clin J Am Soc Nephrol. 2010; 5:836-843. (5) kidney.org.
Dr. David Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, visit www.medicalcompassmd.com or consult your personal physician.
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