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Aquatic exercise can improve balance, strength and mobility. METRO photo
Simple exercises can help

By David Dunaief, M.D.

Dr. David Dunaief

We have had far more ice this winter than snow. Of particular concern is black ice, when a thin ice coating looks innocuously like a simple damp surface. This phenomenon has increased our risk for falling and injuring ourselves. I’ve received quite a few calls this winter from friends and patients who have taken tumbles resulting in broken bones and torn ligaments.

Even without icy steps and walkways, falls can be serious for older patients, where the consequences can be devastating. They can include brain injuries, hip fractures, a decrease in functional ability and a decline in physical and social activities (1). Ultimately, a fall can lead to loss of independence (2).

What increases fall risk?

There are many factors. A personal history of falling in the recent past is the most prevalent. However, there are other significant factors, such as age and medication use. Some medications, like antihypertensive medications, which are used to treat high blood pressure, and psychotropic medications, which are used to treat anxiety, depression and insomnia, are of particular concern. Chronic diseases can also contribute. Circumstances that predispose us to falls also involve weakness in upper and lower body strength, decreased vision, hearing disorders and psychological issues, such as anxiety and depression (3).

Simple ways to reduce fall risk

It is most important to exercise. We mean exercises involving balance, strength, movement, flexibility and endurance, all of which play significant roles in fall prevention (4). The good news is that many of these can be done inside with no equipment or with items found around the home. We will look more closely at the research. 

Nonslip shoes are crucial indoors, and footwear that prevents sliding on winter ice, such as slip-on ice cleats that fit over your shoes, is a must. In the home, inexpensive changes, like securing area rugs, removing other tripping hazards, and adding motion-activated nightlights can also make a big difference.

Does your medication put you at risk?

There are several medications that heighten fall risk. Psychotropic drugs top the list, but what other drugs might have an impact?

A well-designed study showed an increase in fall risk in those who were taking high blood pressure medication (5). Those on moderate doses of blood pressure medication had the greatest risk of serious injuries from falls, a 40 percent increase.

These medications can reduce significantly the risks of cardiovascular disease and events, so physicians need to consider the risk-benefit ratio in older patients before stopping a medication. We also should consider whether lifestyle modifications, which play a significant role in treating this disease, can be substituted for medication (6).

The value of exercise

A meta-analysis showed that exercise significantly reduced the risk of a fall (7). It led to a 37 percent reduction in falls that resulted in injury and a 30 percent reduction in falls requiring medical attention. Even more impressive was a 61 percent reduction in fracture risk.

Remember, the lower the fracture risk, the more likely you are to remain physically independent. The author summarized that exercise not only helps to prevent falls but also fall injuries.

Unfortunately, those who have fallen before, even without injury, often develop a fear that causes them to limit their activities. This leads to a dangerous cycle of reduced balance and increased gait disorders, ultimately resulting in an increased fall risk (8).

What types of exercise are best?

Any consistent exercise program that improves balance, flexibility, and muscle tone and includes core strengthening can help improve your balance. Among those that have been studied, tai chi, yoga and aquatic exercise have all been shown to have benefits in preventing falls and injuries from falls.

A randomized controlled trial showed that those who did an aquatic exercise program had a significant improvement in the risk of falls (9). The aim of the aquatic exercise was to improve balance, strength and mobility. Results showed a reduction in the overall number of falls and a 44 percent decline in the number of exercising patients who fell during the six-month trial, with no change in the control group.

If you don’t have a pool available, tai chi, which requires no equipment, was also shown to reduce both fall risk and fear of falling in older adults (10).

Another pilot study used modified chair yoga classes with a small assisted living population (11). Participants were those over 65 who had experienced a recent fall and had a resulting fear of falling. While the intention was to assess exercise safety, researchers found that participants had less reliance on assistive devices and three of the 16 participants were able to eliminate their use of mobility assistance devices.

Our best line of defense against fall risk is prevention with exercise and reducing slipping opportunities. Should you stop medications? Not necessarily. If you are 65 and older, or if you have arthritis and are at least 45 years old, it may mean reviewing your medication list with your doctor. Before you consider changing your blood pressure medications, review your risk-to-benefit ratio with your physician.

References:

(1) MMWR. 2014; 63(17):379-383. (2) J Gerontol A Biol Sci Med Sci. 1998;53(2):M112. (3) JAMA. 1995;273(17):1348. (4) Cochrane Database Syst Rev. 2012;9:CD007146. (5) JAMA Intern Med. 2014 Apr;174(4):588-595. (6) JAMA Intern Med. 2014;174(4):577-587. (7) BMJ. 2013;347:f6234. (8) Age Ageing. 1997 May;26(3):189-193. (9) Menopause. 2013;20(10):1012-1019. (10) Mater Sociomed. 2018 Mar; 30(1): 38–42. (11) Int J Yoga. 2012 Jul-Dec; 5(2): 146–150.

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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WINTER SUNSETS RULE

William Honor snapped this stunning photo of Stony Brook Harbor at sunset on Jan. 30. Did you know that sunsets are actually more vivid in the winter? It’s all science! The Earth spins closer to the sun in winter, and the angle the sun takes setting makes sunset colors last a bit longer. Humidity is also lower in the winter, and the air is cleaner, causing purer colors to be splashed across the sky.

Send your Photo of the Week to [email protected]

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Fresh Bing Cherry Upside-Down Cake

By Heidi Sutton

The month of February has a few important events to celebrate. In the United States, one such event is Presidents’ Day, which this year will be observed on Monday, February 20. Presidents’ Day honors both George Washington and Abraham Lincoln, two influential presidents who were born in February.

Some may recall a legend about George Washington and a cherry tree, as it’s one of the most popular tales tied to the nation’s first president. 

The original story has a young George receiving a hatchet as a gift when he is six years old. Young George ends up using it to cut into his father’s cherry tree. After discovering the damage, George’s father confronts him. Rather than lie, George admits to his wrongdoing. George’s father commends him for his honesty, indicating that honesty has more value than a cherry tree.

While no one is suggesting to cut down a cherry tree this month in honor of George Washington, the value of this tale and lesson can be celebrated symbolically with this tasty recipe for “Fresh Bing Cherry Upside-Down Cake” courtesy of The California Cherry Board.

Fresh Bing Cherry Upside-Down Cake

YIELD: Serves 8

INGREDIENTS:

Fruit Layer:

4 tablespoons unsalted butter

3⁄4 cup firmly packed light brown sugar

2 tablespoons pineapple juice

1⁄2 pound (about 2 cups) Bing cherries, rinsed, pitted and halved

1⁄4 fresh pineapple, peeled, cored and cut into 1/2-inch chunks (you will need 8-10)

Cake:

1⁄2 cup (1 cube) unsalted butter, softened

3⁄4 cup sugar

2 eggs

2 teaspoons vanilla

11⁄2 cups flour

2  teaspoons baking powder

1⁄4 teaspoon salt

2⁄3 cup whole milk

Whipped cream topping (optional)

DIRECTIONS:

Preheat oven to 350 F. Lightly butter or spray with non-stick spray, a 9-inch standard round cake pan.

For the fruit layer, melt the butter in a wide skillet, add the sugar, and stir until it is melted and begins to bubble. Whisk in the pineapple juice, stirring until smooth. Pour this mixture into the bottom of the prepared pan.

In the bottom of the prepared cake pan, arrange the cherries cut side down in a circle, pressing down lightly to adhere. Add a second circle of cherries inside of the first ring. Place pineapple chunks in a circle inside of the cherry rings and another circle of pineapple chunks, if there is room. Place a cherry half (or halves) to fill in the center of the cake.

For the cake, beat the butter with the sugar until fluffy. Beat in the eggs, one at a time, and the vanilla until smooth. Mix the flour with the baking powder and salt. Add the flour alternately with the milk, mixing until just combined. Pour batter over fruit and spread evenly.

Bake for 40 to 45 minutes until golden brown, and a toothpick inserted in the center comes out clean. Let stand 5 minutes and invert onto a sheet pan. Drizzle any lingering caramel over top. Cut into slices and serve topped with whipped cream, if desired. 

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METRO photo

By Shannon L. Malone, Esq.

Shannon L. Malone, Esq.

While it is mandatory in New York State for all motor vehicle owners to have liability insurance to cover damages from automobile accidents, a surprising number of owners do not have such coverage. This is in spite of the fact that it is a violation of the New York Vehicle and Traffic Law to drive any motor vehicle in our state without insurance.

So what can you do when you suffer serious injuries as a result of an automobile accident caused by an uninsured motorist? The first thing to do is protect yourself before the accident even happens by including adequate Uninsured Motorist (UM) coverage in your own automobile insurance policy. How does this help? When it is determined that the motorist who caused your accident has no insurance, you may make a claim with your own insurance company under the UM coverage provision in your own insurance policy. This coverage is also mandatory in New York State.

To be clear, UM coverage protects you if the driver who caused the accident and resultant injuries is uninsured. Like SUM coverage (Supplemental Uninsured Motorist), you have the option of purchasing almost any amount of coverage you desire to be included in your insurance policy. 

While the minimum required UM coverage in New York State is $25,000.00 (the same minimum coverage required for both SUM and liability coverage), this amount may be totally insufficient to compensate you for any serious injuries you sustain. Thus, purchasing as much UM (and SUM) coverage as feasible is very important. Interestingly, the cost of such insurance protection is relatively modest. 

However, in this atmosphere when insurance companies are advertising lower rates than any rival can offer, it is important for you to make sure your agent or insurance company adequately protects you.

How does it work?

Let’s look at an example of how and why this coverage works and can protect you. Assume you are badly injured in an automobile accident caused by an uninsured owner/driver. This injury may result in a severe condition or even partial or permanent disability. If you have only $25,000.00 in UM insurance, that is all you can recover from insurance for your injuries. It follows that if you have $50,000.00, $100,000.00 or whatever amount in coverage, that it is the total amount you can recover from insurance. 

While you do have the right to obtain a judgment after trial against the actual owner and/or driver of the uninsured vehicle, that could take years and the uninsured driver and/or owner is usually judgment proof (or they would have made sure they obtained liability insurance).

Thus, just as in SUM coverage which protects against underinsured vehicles, the higher the amount of uninsured motorist coverage you have under your own automobile insurance policy, the more protected you are if injured by an uninsured vehicle. We have seen too many clients who were seriously injured by an uninsured driver, but were unable to be fully compensated for those injuries due to insufficient UM coverage. It is therefore very important to discuss the amount of such insurance you have with your broker or insurance carrier.

Shannon L. Malone, Esq. is an Associate Attorney at Glynn Mercep Purcell and Morrison LLP in Setauket. She graduated from Touro Law, where she wrote and served as an editor of the Touro Law Review. Ms. Malone is a proud Stony Brook University alumna.

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Louis Jordan's Typany Five, New York, N.Y., between 1946 and 1948. William P. Gottlieb/Wikimedia Commons

Black History Month is celebrated throughout February, and for more than 50 years, has provided an outlet for people to remember and reflect upon African American history.

We see many examples of Black history right here on Long Island. Though not fully understood or preserved, the examples feature most prominently in the field of entertainment.

How many readers are aware of the Red Rooster club on Route 25 between Gordon Heights and Coram with its national Black celebrities and advertising a “complete floor show every night” through the late 1940s? How many can recount the contributions made by the Celebrity Club in Freeport in the 1950s and ‘60s, when R&B and soul reigned supreme? 

Then there was East Setauket’s own Paula Jean’s club, where not only could one enjoy the top national and local blues artists at the turn of the new millennium but also the most authentic Cajun or Creole cuisine this side of New Orleans and south Louisiana.

Never heard of these clubs and their place in the Black hierarchy? That’s all the more reason why measures should be taken by the state, counties, towns and villages to recognize these sites with heritage plaques. These important and historic local institutions should be studied in local history classes from K-12, community colleges and universities.

In years to come, the investment of time and resources will be paid off in the form of enhanced Long Island artistic recognition, increased tourist traffic and greater cross-cultural understanding.

Today, the local club tradition is continued in honor of many top Black jazz legends at Tom Manuel’s The Jazz Loft in Stony Brook in live performances and at its museum which features pioneering stars such as Louis Jordan — arguably the inspiration for rock ‘n’ roll music — and balladeer Arthur Prysock. 

The recently opened Long Island Music Hall of Fame is located on the site of the Dogwood Hollow Amphitheater behind Stony Brook Village Center. It was the place to be for international acts such as Duke Ellington and Louis Armstrong until 1970.

Like The Jazz Loft, LIMHOF is another institution preserving the music history of artists and entertainers of all colors and stripes. Both organizations should be supported and patronized by local residents and tourists alike. But more recognition through plaques and other landmarks should be offered by our municipalities, as is done with music trails in Mississippi and Louisiana.

Months celebrating specific cultures such as Black History Month, Hispanic Heritage Month, Asian Pacific Heritage Month and more, are all helpful for reminding us that our country is what it is today thanks to people of all walks of life. Recognizing our accomplishments shouldn’t be confined to just four weeks out of the year.

Let’s think of better ways to share the stories of people from all walks of life, those who accomplished greatly whether in music, politics, the armed forces or other fields. Let us remember and honor their legacy by putting those ideas into practice. Here on Long Island, there is diversity in history from which we can learn so much for our future benefit and enlightenment.

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METRO photo

By Daniel Dunaief

Daniel Dunaief

What says hello nonverbally more than a wave? I’m surprised nonhuman animals don’t do it more often. It’s efficient, requires minimal energy most of the time and can be as subtle as a lifted finger or as dramatic as a full-body wave signaling to someone at the top of the Eiffel Tower.

People wave to me frequently, particularly when I’m walking my dog. I suspect many of them are really waving to my dog. He is cuter, more charming and more personable than I am. Sure, I’m happy to engage in a conversation about the weather, the latest “Big Game,” my kids, or someone else’s family, but my dog is prepared to throw his head into someone’s knees as long as they pet him and assure him he’s wonderful.

Back to waving — I think the gesture merits categories, along with a short explanation.

— The-wave-or-maybe-not moment: We’ve all been there. Someone we kind of know or with whom we might want to interact appears to wave at us. Is that for me, we wonder? We consider swiveling our heads to check, but we’re not owls. We raise our hand tentatively. When we realize the more popular person behind us is the wave target, we awkwardly run our fingers through our hair. Great recovery, we mutter to ourselves.

— The “here-but-don’t-really-want-to-be” wave. Remember back when you were in high school, and your homeroom teacher took attendance? He or she would go down the list and when your name came up, you pulled your wrist back as casually as possible and pointed your fingers to the fluorescent lighting on the ceiling? It’s a wave and acknowledgment devoid of any enthusiasm.

— The “tickle the piano keys” wave. After lifting their wrists, some people wiggle their fingers next to their heads, as if they are tapping an imaginary musical instrument to send a visual and auditory greeting.

— The eraser wave. This can either be an enthusiastic or an unenthusiastic gesture. With this wave, people keep their fingers together and brush back and forth, as if they have an eraser in their hand and are removing an incorrect answer from the blackboard. This kind of wave can be an Eeyore greeting from the Winnie the Pooh series, in which he sighs and shares a burden with a deflated wave. With a head tilt, an affectionate smile, and faster side-to-side motion, this kind of wave can also signal a responsive and more enthusiastic greeting.

— The stiff-fingered-salute. Often offered by older men, this isn’t a wave so much as it is a signal that the person sees you, but does not intend to encourage any kind of dialog or further gesturing. It’s a nonverbal stop sign, telling you that he’s coming through, he sees you, and he would prefer that you keep whatever eye contact you’re going to make to a minimum. In fact, if you need to look at something, look at his flat and indifferent hand.

— The tree-swaying-in-a-blustery-wind wave. Yes, this is one of those moments when people are so thrilled to see you that they raise their arms over their heads and wave quickly back and forth. They may even catch some air. People waving this way don’t care what others think and, more importantly, want to share how excited they are to see you. This kind of wave transitions into a full-body hug.

— Finally, to end on the opposite end of the spectrum from where we began, there’s the wave from someone you might otherwise want to ignore. That wave says, “I’m over here, I see you, but you’re not responding.” It has the same characteristics as the excited greeting, except that it adds the need for acknowledgment. If you’re embarrassed, that may be a bonus.

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METRO photo

By Leah S. Dunaief

Leah Dunaief

Nearly 40% of United States adults are single, which is up from 29% in 1990. Now, I’ve been married, and I’ve been single. My husband died just three months before we would have marked our 25th wedding anniversary and right around when the number of singles was so much lower. Next Friday would have been our 60th anniversary, but instead, I have been single for 35 years, so I know a little about both.

I was intrigued by an article in Time magazine that spoke about being single, asserting that about one-half of all singles aren’t interested in dating or a relationship and were happily single. This is quite a change from when I was newly alone. In the early 90s, single women were at best often ignored, and at worst, stigmatized and even preyed upon. All but the closest friends disappeared, and being the odd number for a reservation in a restaurant was a decided obstacle to being included.  I don’t think single men had it all that easy, either. While single men were often invited to gatherings, as opposed to single women, there might have been some doubt about their sexuality. Heterosexuality, as evidenced by marriage then, was the norm.

Today, according to Time, the solo life is thought of as authentic, fulfilling, meaningful and psychologically rich. I have found that to be true as the years have gone by, but what a total shift in popular perspective. The marriage rate has been decreasing for decades, as has the birth rate, and the age at which marriage finally may occur, if at all, is later in life for many.

How has this happened?

For one thing, marriage is no longer considered necessary for having a family or assuring financial comfort. Someone like Alexander Hamilton, who was tortured throughout his life for being a bastard child of an unwed mother, would not recognize today’s values and would certainly have had an easier time of it. 

While people in relationships may enjoy greater satisfaction, being married doesn’t guarantee happiness, as in, “They lived happily ever after.” There are people unhappy and even lonely in marriage, although with the decline in marriage, there has also been less divorce. Research shows that people in unhappy marriages have equal or worse health compared to those who never married.

Those who are single as a result of divorce seem to have the most difficult time, according to Time. Widowhood can also be associated with poor mental health, as grief can lead to depression and loneliness. But many of us cherish our freedom, independence, even our creativity and nonconformity, again according to Time, and I wholeheartedly agree. 

There was a time when people, especially women, felt they had to have a man in order to define themselves and their position in society. A woman often was the one who sought financial security, while a man wanted a woman on his arm. Today, with the ability to earn a living, sometimes quite an excellent living, women don’t feel the same pressure to marry, nor do their mothers in urging them.

Singles have more time for themselves. They can focus on goals without having to consider the needs of someone else. There is also more time for spending on hobbies and self-care. This is especially true for younger women and for those who consider sex outside of committed relationships. That, of course, doesn’t preclude interest in a romantic relationship, which some enjoy.

As Time points out, being alone is not the same as being lonely. We singles often have strong ties to our families, to friends and to our neighborhoods. We can be actively involved in community organizations, have a sense of purpose and are generally self-sufficient.

We have to be.

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Nichie

Welcome to the 14th edition of Paw Prints, a monthly column for animal lovers dedicated to helping shelter pets find their furever home! 

Meow & Minion

Meet Meow & Minion

These two brothers were going door to door crying to get into people’s homes until a Good Samaritan brought them to the Smithtown Animal Shelter in December. Estimated to be approximately 7 months old, they are shy at first but incredibly sweet once they decide to trust you. Minion had a bad injury that led to the loss of his eye, but he is happy and healthy otherwise. These siblings are bonded and would like to be adopted together if possible. For more information or to set up a meet and greet, call 631-360-7575.

Nichie

Meet Nichie

This adorable and sweet girl is looking for love. She was brought to the Brookhaven Animal Shelter by an Animal Control Officer after being taken out of a bad situation. She arrived a bit shy and nervous, but she has so many friends now and has really come a long way with socialization. Currently she is available and actively looking for her soul-mate. Nichie is playful and energetic yet gentle and affectionate. She is a big girl, very strong, not a jumper, and loves attention and toys. 

Nichie is continuing to work on her social skills, loves her dog bed, sits on command and is very treat motivated. She will do best with kids over the age of 16 as she can be hand shy and shows mild bone guarding. No cats please and she will require a meet and greet with a dog. Nichie is 62.6 pounds, three years young, up to date on vaccinations, micro-chipped and heartworm negative. If you would like to meet her, please visit www.Brookhavenny.gov/AnimalShelter and submit a matchmaker application or call 631-451-6955. 

Paw Prints is generously sponsored by Mark T. Freeley, Esq.

Meet Bonnie

Bonnie is a 2-year-old, female pittie mix currently up for adoption at the Brookhaven Animal Shelter. This sweetheart is gentle, good with kids ages 10 and up, and prefers to be the only pet in the home. She will give you so much love that you won’t need another four-legged friend. She is a snuggle bug and loves every person she meets! If you are interested in meeting Bonnie, please visit www.Brookhavenny.gov/AnimalShelter and submit a matchmaker application or call 631-451-6955.

Check out the next Paw Prints in the issue of March 9.

Paw Prints is generously sponsored by Mark T. Freeley, Esq.

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Vitamin D supplement
Obesity can reduce the benefits of supplementation

By David Dunaief, M.D.

Dr. David Dunaief

Here in the Northeast, it’s the time of year when colder temperatures mean we’re spending lots of time indoors. When we are outside, we cover most of our skin to protect us from the cold. This means we’re not getting a lot of sun. While this will make your dermatologist happy, it also means you’re probably not converting that sun exposure to vitamin D3.

There is no question that, if you have low levels of vitamin D, replacing it is important. Previous studies have shown that it may be effective in a wide swath of chronic diseases, both in prevention and as part of a treatment regimen. However, many questions remain.

Many of us receive food-sourced vitamin D from fortified packaged foods, where vitamin D has been added. This is because sun exposure — even under the best of circumstances — will not address all of our vitamin D needs. For example, in a study of Hawaiians, a subset of the study population who had more than 20 hours of sun exposure without sunscreen per week, some participants still had low vitamin D3 values (1).

We know vitamin D’s importance for bone health, but we have mixed data for other diseases, such as cardiovascular, autoimmune and skin diseases and cancer.

There is no consensus on the ideal blood level for vitamin D. For adults, the Institute of Medicine recommends between 20 and 50 ng/ml, and The Endocrine Society recommends at least 30 ng/ml.

Are there cardiovascular benefits to vitamin D?

Several observational studies have shown benefits of vitamin D supplements with cardiovascular disease. The Framingham Offspring Study showed that those patients with deficient levels were at increased risk of cardiovascular disease (3).

However, a small randomized controlled trial (RCT) called the cardioprotective effects of vitamin D into question (4). This study of postmenopausal women, using biomarkers such as endothelial function, inflammation or vascular stiffness, showed no difference between vitamin D treatment and placebo. The authors concluded there is no reason to give vitamin D for prevention of cardiovascular disease.

The vitamin D dose given to the treatment group was 2,500 IUs. Some of the weaknesses of the study were a very short duration and small study size.

How does vitamin D affect mortality?

In a meta-analysis of a group of eight studies, vitamin D with calcium reduced the mortality rate in the elderly, whereas vitamin D alone did not (5). The difference between the groups was statistically important, but clinically small: nine percent reduction with vitamin D plus calcium and seven percent with vitamin D alone.

One of the weaknesses of this analysis was that vitamin D in two of the studies was given in large amounts of 300,000 to 500,000 IUs once a year, rather than taken daily. This has different effects.

Does obesity affect vitamin D absorption?

A recently published analysis of data from the VITAL trial, a large-scale vitamin D and Omega-3 trial, found that those with BMIs of less than 25 kg/m2 had significant health benefits from supplementation versus placebo (2). These included 24 percent lower cancer incidence, 42 percent lower cancer mortality, and 22 percent lower incidence of autoimmune disease. Those with higher BMIs showed none of these benefits.

Can vitamin D help you lose weight?

There is good news, but not great news, on the weight front. It appears that vitamin D plays a role in reducing the amount of weight gain in women 65 years and older whose blood levels are more than 30 ng/ml, compared to those below this level, in the Study of Osteoporotic Fractures (6).

This association held true at baseline and after 4.5 years of observation. If the women dropped below 30 ng/ml in this time period, they were more likely to gain more weight, and they gained less if they kept levels above the target. There were 4,659 participants in the study. Unfortunately, vitamin D did not show statistical significance with weight loss.

USPSTF recommendations and fracture risk

The U.S. Preventive Services Task Force recommends against giving “healthy” postmenopausal women vitamin D, calcium or the combination of vitamin D 400 IUs plus calcium 1,000 mg to prevent fractures, and it found inadequate evidence of fracture prevention at higher levels (7). The supplement combination does not seem to reduce fractures, but does increase the risk of kidney stones. There is also not enough data to recommend for or against vitamin D with or without calcium for cancer prevention.

When should you supplement?

It is important to supplement to optimal levels, especially since most of us living in the Northeast have insufficient to deficient levels. While vitamin D may not be a cure-all, it might play an integral role with many disorders. But it is also important not to raise the levels too high. The range that I tell my patients is between 32 and 50 ng/ml, depending on their health circumstances.

References:

(1) J Endocrinology & Metabolism. 2007 Jun;92(6):2130-2135. (2) JAMA Netw Open. 2023 Published online Jan 2023. (3) Circulation. 2008 Jan 29;117(4):503-511. (4) PLoS One. 2012;7(5):e36617. (5) J Women’s Health (Larchmt). 2012 Jun 25. (6) J Clin Endocrinol Metabol. May 17, 2012 online. (7) JAMA. 2018;319(15):1592-1599.

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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Stock photo

By Nancy Marr

At a community meeting recently I heard opposition to an IDA plan to help build a new warehouse Do we need another warehouse? Will it create jobs? And, worst of all, will there be no property tax payments, which our school district needs?

Industrial Development Agencies (IDAs) were originally authorized by New York State in 1969, governed by the provisions of 18-A of the General Municipal Law. The purpose of IDAs are to advance the job opportunities, health, general prosperity and economic welfare of the State of New York. Four to seven IDA members are appointed by the governing board of a sponsoring municipality. IDAs do not have taxing powers; they typically maintain their operations by charging fees to the businesses that participate in their projects. 

Presently there is an IDA in each NYS county, as well as a number of cities, towns, and villages. In addition to the Suffolk County IDA, there are IDAs in Babylon, Islip, Brookhaven, and Riverhead. Some of the IDAs have favored manufacturing and industrial projects, but many have supported a range of projects, including office buildings, retail establishments, education facilities, sports arenas, and projects for health and not-for-profit service organizations. 

The goal of an IDA is to help companies acquire, construct, improve, maintain or equip certain facilities. It can assist the company by bringing together resources to provide low-cost or low-interest tax exempt or taxable bonds, provide workforce training and recruitment, and help fast-track the permit process. The greater incentive offered by IDA acceptance is the ability to be exempt from local property taxes, state and local sales tax, and the mortgage recording tax. By agreement, the company transfers the title of its land and equipment to the Agency (the IDA); the Agency then agrees to lease the land and equipment to the company which completes the project. When the project is completed by the company, the title is returned to the company and it becomes the legal owner.

In order to minimize the impact of the property tax abatement, the IDA writes a contract with the company for a PILOT (payment in lieu of taxes). The amount of the PILOT is set at a rate lower than the property tax, with few or no payments due for the first five years (leaving the school district short).The amount is graduated by a set percentage over the duration of the contract (up to twenty years); at the end the tax paid by the company will be what would be the full amount if not abated. (According to a state law passed in 1993, each IDA must establish a uniform tax exemption policy with input from affected tax jurisdictions.) 

Regulations have sought to improve accountability by requiring that all IDAs file audited annual financial statements giving data about assistance given and jobs created. An IDA Reform bill became law in 2022 to counteract the “friendly” culture of everyday corruption that the legislators found. It included bills to prevent conflicts of interest, unethical profiting by government officials, failure to give public notice of the approval of  projects over $100,000, and required a “clawback;” the recapture of previously granted benefits if job creation and retention goals or other terms of the agreement were not met. 

Although there is the concern that IDA assistance may have been granted to applicants who could have completed their projects without needing help, the IDAs have helped to create a wide variety of projects, remaining in Suffolk or coming to Suffolk from other places. They have helped developers create or expand a variety of businesses, from technical and chemical innovators to health and housing facilities. Because of the requirement that the projects must create new jobs, and retain existing employees, the IDAs help with workforce training and recruitment. All new jobs must follow fair labor laws and by law must be publicized through the Department of Labor, reaching applicants who are under-employed.

Suffolk’s IDA website suffolkida.org can be helpful in familiarizing taxpayers with successful (and sometimes controversial) projects. Town websites, such as brookhavenida.org, have lists of projects  and copies of applications, agreements and resolutions. IDA public hearings are open to learn more about decisions. We can also lobby NYS elected officials to encourage and support new legislation concerning the loss of income for schools. 

Nancy Marr is 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 https//my.lwv.org/new-york/suffolk-county. 

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